17 August 2023

MAINS DAILY QUESTIONS & MODEL ANSWERS

Q1. Examine the causes of India’s high tuberculosis prevalence. Mention some actions that can be taken to prevent and manage TB.

GS II – Health related issues

• Mycobacterium tuberculosis, an infectious bacterial illness that most frequently affects the lungs, is the cause of tuberculosis (TB). Around 27% of TB cases worldwide are located in India. This has the highest TB burden of any nation in the world. India’s TB incidence for the year 2021 was 210 per 100,000 people, according to WHO’s Global TB Report 2022. As a result, TB continues to be one of India’s most urgent and difficult challenges.

The following factors contribute to India’s high tuberculosis prevalence:

• The most pervasive risk factor for TB in India is undernutrition, which accounts for the “highest population attributable risk for TB.” In India, undernutrition causes over 40% of newly discovered TB cases each year. It is also to blame for worsening TB disease, higher mortality, and unsuccessful treatment outcomes. Undernutrition reduces the body’s ability to fight infections and raises the risk of drug toxicity and TB relapse, according to the theory.
• Poverty is a significant risk factor for developing TB. Poor general health literacy and a lack of motivation to act on that literacy are also linked to poverty, which increases the chance of exposure to several other tuberculosis risk factors.
• Lack of access to diagnosis and treatment: Due to insufficient access to healthcare facilities and available treatments, the burden of tuberculosis is increased in rural areas.
• Low immunity: One of the most frequent causes of TB infection developing into TB disease is low immunity. A greater risk of contracting the disease exists in those with HIV, stress, diabetes, damaged lungs, alcoholism, and smoking, as well as those with poor general health.
• Socio-economic deprivation: Socio-economic deprivation is the absence of basic economic and social needs. This is a complicated idea that encompasses a number of elements, including, among others, illiteracy, poverty, overcrowding, and unemployment. A significant portion of health disparities and the higher risk of tuberculosis can be attributed to structural determinants and the environments in which people live.
• Drug resistance is rising: The germs that cause tuberculosis (TB) might become resistant to the antibiotics used to treat the condition. When TB does not react to at least isoniazid and rifampicin, the two most potent anti-TB medications, it is referred to as multidrug-resistant TB (MDR-TB). The improper management of TB treatment contributes to the emergence and development of multidrug resistance.

The following actions can be taken to prevent and manage tuberculosis:

• Early detection: The best strategy to stop the spread of tuberculosis is by early detection and treatment. The World Health Organisation (WHO) has published a Standard on Universal Access to Rapid TB Diagnostics, which suggests using molecular diagnostics as the first test. These lessen treatment-related delays, are cost-effective, detect medication resistance, and are extremely accurate.
• Environment control: Since TB is an airborne infection, when a person who has infectious TB coughs or sneezes, TB bacteria are released into the air. Therefore, preventing the spread of bacteria requires sufficient ventilation, natural light, and basic cleanliness.
• Supportive nutrition: According to recent articles in The Lancet and The Lancet Global Health, nutritional support has assisted in a trial in Jharkhand in reducing mortality among TB patients as well as tuberculosis among household contacts. Therefore, tackling the issue of undernutrition is crucial for eradicating TB in India.
• An urgent need exists to promote educational efforts and understanding of the causes, transmission, and preventive strategies for dealing with tuberculosis among patients and the more vulnerable population.
• Treatment for drug-resistant tuberculosis (DR-TB) should be decentralised and made available. For the treatment of DRTB, it is important to guarantee that medications like bedaquiline and delamanid are made even more accessible.

Additional measures:

• Expand social safety and pursue comprehensive solutions for reducing poverty.
• Enhance the living and working conditions for those who are housed in jails and other communal areas.
• Encourage people to lead healthy lifestyles and diets, and to cut back on dangerous alcohol and drug usage as well as smoking.
• By 2025, India hopes to have eradicated TB. The National TB Elimination Programme (NTEP), the Nikshay Poshan Yojna, the Ni-kshay Mitras, and other programmes have been implemented by the government to achieve this. The Health in All Policies (HiAP) strategy, which considers the health implications of actions, seeks synergies, and avoids detrimental health impacts, would also greatly aid in the treatment, prevention, and control of tuberculosis.

Q2. Do you believe it is wise to gauge legislative productivity by the volume of bills the legislature passes? Examine critically.

GS II – Parliament related issues

Introduction:

• The percentage of laws passed by legislators as compared to the total number of laws presented is known as legislative productivity. Recently, it was reported that the Rajya Sabha managed to reach 82.7% productivity with only 33 sittings.

It is true that the quantity of laws passed does indicate productivity:

• Since enacting laws is the primary purpose of the legislature, productivity is increased when more bills are passed.
• Draught legislation that has been developed after extensive debate with numerous parties is more significant.
• As a house of mediocres, parliament is not thought to add many significant points. Therefore, shorter chats at home are preferable. Due to the attitude of the legislative members, over time, the value of laws has diminished in the eyes of the public.
• It is true that keeping order in a big house can be challenging.
• Furthermore, in the confusion that legislatures create, not every party or viewpoint is adequately represented.
• The amount of laws enacted, however, does not imply that the Parliament or the state legislature has performed its obligations in full.

Limitations of this method of calculating legislative productivity include:

• Risk of passing measures without debate: It lessens discussion on crucial issues of public concern, which reduces government accountability.
• As Parliament, and specifically Rajya Sabha, is given a responsibility to serve the interests of the state, it has an impact on the federal system. The conversation with the representatives of the states is weakened.
• Loss of accountability and transparency: Citizens are unable to learn about government activities.
• Loss of public confidence in the legislature as a means of effective voice-expression.
• Misuse of Power: The practise of passing laws through ordinances or other means without consultation with select or joint committees.
• The legislature is the last resort for any flawed legislation: If the administration has not fully consulted the stakeholder group about a proposed law, the legislature is the last resort.

Conclusion:

• Since legislatures are the foundation of every democracy, they must have sufficient opportunities for discussion. If they are, however, being ineffective, the solution is to make them productive by using better discussion techniques and effectively using committee tools, rather than by removing those opportunities from them.