Malnutrition and Disease Burden

A study led by the Indian Council of Medical Research (ICMR), has given comprehensive estimates of disease burden due to child and maternal malnutrition and the trends of its indicators in every state of India from 1990 to 2017.

• The estimates were produced as part of the Global Burden of Diseases Study (GBD) 2017.
• The Global Burden of Disease Study is a comprehensive regional and global assessment of mortality and disability from major diseases, injuries, and risk factors.
  
  • The study was initiated in the 1990s as a collaborative effort of hundreds of experts worldwide, including researchers at the World Health Organization (WHO), and the World Bank.

Key Findings

• Child and maternal malnutrition is still a leading cause of:
  
  • Death Rate: Although, the death rate attributable to malnutrition in under-5 children, has dropped by two-thirds from 1990 to 2017. Malnutrition is, however, still the underlying risk factor for 68% of the deaths, ranging between a high of 72.7% in Bihar and a low of 50.8% in Kerala.
  • Disability-Adjusted Life Years (DALY): DALY rate attributable to malnutrition in children varies 7-fold among the states — a gap between a high of 74,782 in Uttar Pradesh and a low of 11,002 in Kerala.
  • Anaemia: The prevalence of anaemia in women was at 54% in 2017.

• Low Birthweight: It is the largest contributor to child deaths among all malnutrition indications, followed by child growth failure which includes stunting, underweight, and wasting. Also, its rate of decline is among the lowest.
• Overweight: It is becoming a significant public health problem as it is increasing rapidly across all States.
• Implication: The country may miss global targets with respect to malnutrition and others for the year 2030, set by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) and those included in the Sustainable Development Goals (SDGs).
• Suggestions:
  
  • Improving the overall nutritional status of girls and women during the preconception and pregnancy period and providing quality antenatal care can positively influence low birth weight indicators.
  • Focus is needed on major determinants like provision of clean drinking water, reducing rates of open defecation, improving women’s educational status, and food and nutrition security for the most vulnerable families.
  • It is important to plan the reduction in malnutrition in a manner that is suitable for the trends and context of each State.

Note

Disability-Adjusted Life Years (DALYs) is the sum of the number of years of life lost due to premature death and a weighted measure of the years lived with disability due to a disease or injury. The use of DALYs to track disease burden is recommended by India’s National Health Policy of 2017.

Anaemia

• It is a condition in which the number of red blood cells or their oxygen-carrying capacity is insufficient to meet physiologic needs, which vary by age, sex, altitude, smoking, and pregnancy status.
• Iron deficiency is the most common cause of anaemia, although other conditions, such as folate, vitamin B12 and vitamin A deficiencies, chronic inflammation, parasitic infections, and inherited disorders can all cause anaemia.
• In its severe form, it is associated with fatigue, weakness, dizziness and drowsiness. Pregnant women and children are particularly vulnerable.

Malnutrition

• Malnutrition refers to deficiencies, excesses or imbalances in a person’s intake of energy and/or nutrients.
• The term malnutrition covers two broad groups of conditions.
  
  • One is ‘undernutrition’—which includes stunting (low height for age), wasting (low weight for height), underweight (low weight for age) and micronutrient deficiencies or insufficiencies (a lack of important vitamins and minerals).
  • The other is overweight, obesity and diet-related noncommunicable diseases (such as heart disease, stroke, diabetes and cancer).

Steps Taken by India

• Mid-day Meal (MDM) scheme aims to improve nutritional levels among school children which also has a direct and positive impact on enrolment, retention and attendance in schools.
• Under the Pradhan Mantri Matru Vandana Yojana (PMMVY), Rs.6,000 is transferred directly to the bank accounts of pregnant women for availing better facilities for their delivery.
• POSHAN Abhiyaan, launched in 2017-18, aims to reduce stunting, under-nutrition, anaemia and low birth weight babies through synergy and convergence among different programmes, better monitoring and improved community mobilisation.
• The National Food Security Act (NFSA), 2013, aims to ensure food and nutrition security for the most vulnerable through its associated schemes and programmes, making access to food a legal right.

Source: IE

Promulgation of the Prohibition of Electronic Cigarettes Ordinance

Recently, the Union Cabinet has approved the Promulgation of the Prohibition of Electronic Cigarettes (production, manufacture, import, export, transport, sale, distribution, storage and advertisement) Ordinance, 2019.

• The prohibition of e-cigarettes includes all forms of Electronic Nicotine Delivery Systems [ENDS), Heat Not Burn Products, e-Hookah, and the like devices.
• Any production, manufacturing, import, export, transport, sale (including online sale), distribution or advertisement (including online advertisement) of e-cigarettes shall be a cognizable offence.
• The above-mentioned activities are punishable with an imprisonment of up to one year or fine up to Rs. 1 lakh or both for the first offence; and imprisonment of up to three years and fine up to Rs. 5 lakh for a subsequent offence.
• Storage of electronic-cigarettes shall also be punishable with imprisonment up to 6 months or fine up to Rs 50,000 or both.
• The owners of existing stocks of e-cigarettes on the date of commencement of the Ordinance will have to suo moto declare and deposit these stocks with the nearest police station.
• The Sub-Inspector of Police has been designated as the Authorized Officer to take action under the Ordinance.
• The Central or State Governments may also designate any other equivalent officer(s) as Authorized Officer for enforcement of the provisions of the Ordinance.
• It enforces Article 47 of the Indian Constitution which mentions about State’s responsibility to promote Public Health.
• It also enforces Sustainable Development Goals, National Monitoring Framework for Prevention and Control of Non-communicable Diseases and National Health Policy, 2017.

Background

• The Government had issued an advisory in 2018 to all States to consider banning e-cigarettes.
• Punjab, Karnataka, Kerala, Bihar, Uttar Pradesh, Himachal Pradesh, Tamil Nadu, Maharashtra, Jharkhand, Rajasthan, and Mizoram have already banned e-cigarettes in their jurisdictions.
• The World Health Organisation (WHO) has urged member countries to take appropriate steps including prohibiting e-cigarettes and related products.
• The Indian Council of Medical Research (ICMR) has also recommended a complete ban on e-cigarettes as it adversely affects almost all the human body systems with impact across the life course.
• These products are usually marketed as being safer alternatives for conventional cigarettes but these products may act as gateway products to induce non-smokers, especially youth and adolescents, to nicotine-use, leading to addiction and subsequent use of conventional tobacco products.
• E-cigarettes are usually promoted by the industry as smoking cessation aids but their efficacy and safety as a quitting aid have not yet been established.
• Apart from nicotine, e-cigarettes may also be used for the delivery of other psychoactive substances.

Electronic Nicotine Delivery Systems (ENDS)

• ENDS heat a solution (e-liquid) to create an aerosol which frequently contains flavourings, usually dissolved into Propylene Glycol or/and Glycerin.
• Electronic cigarettes, the most common prototype, are devices that do not burn or use tobacco leaves but instead vaporize a solution so that a user can inhale.
• The main constituents of the solution, in addition to nicotine, are propylene glycol, with or without glycerol and flavouring agents.
• ENDS solutions and emissions also contain some other toxicant chemicals.

Concerns related to ENDS

• These products are not registered as nicotine replacement therapy products in India.
• E-cigarettes usually contain nicotine which makes product addictive.
• E-cigarettes cause health hazards for youth, young adults, and pregnant women.
• A number of metals, including lead, chromium, and nickel, and chemicals like formaldehyde have been found in aerosols of some ENDS, with concentrations equal to or greater than traditional cigarettes.
• Lack of knowledge about negative effects of nicotine and the easy accessibility of these products make the youth prone to addiction.

Impact of Prohibition of E-Cigarettes

• The decision to prohibit e-cigarettes will help protect the population, especially the youth and children, from the risk of addiction through E-cigarettes.
• Enforcement of the Ordinance will complement the government's efforts for tobacco control and will help in the reduction of tobacco use and reduction in associated economic and disease burden.

National Health Policy, 2017

• It aims to achieve universal access to good quality health care services without anyone having to face financial hardship as a consequence.
• It intends to gradually increase public health expenditure to 2.5% of the GDP.
• It proposes free drugs, free diagnostics, and free emergency and essential healthcare services in public hospitals.
• The policy advocates allocating two-thirds of resources to primary care.

Source:PIB

India- The Top Source Of Immigrants

According to the International Migrant Stock 2019 report, released by the United Nations Department of Economic and Social Affairs (UN DESA), India has emerged as the leading country of origin for immigrants across the world.

Highlights of the Report

• The report provides the latest estimates of the number of international migrants as per their age, sex, and origin, for all countries and areas of the world.
• India remained the top source of international migrants constituting 6.4% of the total world’s migrant population.
  
  • The most preferred destination of the Indian migrants was the UAE followed by the US, and then Saudi Arabia.
  • In India, the highest number of international migrants came from Bangladesh, Pakistan, and Nepal.
• The percentage of international migrants of the total global population has increased to 3.5% from 2.8% in 2000.
• Source of Migrants: Around two-fifths of all international migrants had gone from one developing country to another.
  
  • The one-third of all international migrants originated from mostly 10 countries.
  • India (17.5 million international migrants) is followed by Mexico (12 million migrants), China (11 million), Russia (10 million) and Syria (8 million).
• Destination of Migrants:
  
  • The European region hosted the highest number of immigrants (82 million), followed by North America (59 million) and Northern Africa and Western Asia (49 million).
  • Among countries, the U.S. hosted the highest number of international migrants that constitute about 19% of the global population.
• Also, the forced displacements across international borders continue to rise.
• The share of women and girls in the global number of international migrants fell slightly from 49% in 2000 to 48% in 2019.
• In terms of age, one out of every seven international migrants is below the age of 20 years.

• Facilitating orderly, safe, regular and responsible migration and mobility of people will contribute much to achieving Sustainable Development Goals.

United Nations Department of Economic and Social Affairs (UNDESA)

• It was formed in the year 1948.
• It is the development pillar of the United Nations.
• UN DESA is a pioneer of the Sustainable Development Goals (SDGs).
• It brings the global community together to work towards common solutions to the world’s most pressing problems.
• It helps countries translate their global commitments into national action in the economic, social and environmental spheres.

Source: TH

Initiatives of AICTE

Recently, the Union Human Resource Development Minister has launched several initiatives of the All India Council for Technical Education (AICTE) in order to improve the technical education in India.

Initiatives Undertaken

• Facilitation through Margadarshan and Margadarshak
  
  • Margadarshan: Under this scheme,
    
    • Institutions having good accreditation records or the top-performing institutions are selected to mentor relatively newer 10 to 12 potential institutions.
    • Best teaching and learning practices followed in the mentor institute will be simulated in the identified mentee institutions.
    • The mentee institutions will also be provided with funding up to Rs. 50 lakhs (per institution) over a period of three years (in instalments), for carrying out various activities like training, workshops, conferences, etc.
  • Margdarshak: Under this scheme,
    
    • The mentor teachers or the Margdarshaks, who are either serving or are superannuated, with good knowledge of accreditation and are willing and motivated to devote adequate time to the mentee Institutions are identified.
    • These Margdarshaks will regularly visit the identified mentee institutions, stay on their campus and guide them for the improvement in their quality so that institutions are able to get accreditation by the National Board of Accreditation.
• Waste Management Accelerators for Aspire Women Entrepreneurs (Wawe) Summit 2019
  
  • The Wawe Summit will be the largest gathering of young women students, that will promote entrepreneurship in waste management and provide alternatives to single-use plastic carry bags.
  • The Summit will be jointly organized by All India Council for Technical Education (AICTE) and Institute of Waste Management (IIWM) at Jaipur.
  • IIWM & AICTE will be registering the interested participants and will guide them to connect from Start-Up India to Stand Up India.
  • The theme of the summit is: “Make your own bag – empowering women to take up income generation activity and entrepreneurship in waste management, through making a business out of this record-creating concept.”
• Several other initiatives were taken by the ministry of HRD for improving the higher education quality by proposing changes in:
  
  • The model curriculum for diploma courses- to start new courses that can prepare students in today’s competitive age, and
  • 360-degree faculty feedback- to improve the quality of education in India.

All India Council for Technical Education (AICTE)

• It was set up in November 1945 as a national-level apex advisory body.
• Its purpose was to conduct a survey on the facilities available for technical education and to promote development in the country in a coordinated and integrated manner.
• According to the National Policy of Education (1986), AICTE is vested with:
  
  • Statutory authority for planning, formulation, and maintenance of norms & standards,
  • Quality assurance through accreditation,
  • Funding in priority areas, monitoring, and evaluation,
  • Maintaining parity of certification & awards,
  • The management of technical education in the country.

Source: PIB

Report on Pandemic Threat

According to a report released by the Global Preparedness Monitoring Board (GPMB), the chances of a global pandemic are growing and the world is not prepared for the same.

• The report titled ‘A World At Risk’ has been authored by 15 global scientists and public health leaders, including India’s principal scientific advisor, Dr K Vijay Raghavan.
• It is co-convened by the World Bank and the World Health Organization (WHO).
• WHO tracked 1,483 epidemics in 172 countries between 2011 and 2018.

Key Findings

• Epidemic-prone diseases, such as influenza, Ebola, Zika, plague, yellow fever and others, are harbingers of a new era of high-impact, potentially fast-spreading outbreaks that are more frequently detected and increasingly difficult to manage.
• Reasons Behind frequency: Population growth, urbanisation, globally integrated economy, widespread and faster travel, conflict, migration and climate change.
• Possible Impact: A pandemic equivalent to the 1918 Spanish Flu could kill 80 million and wipe out nearly 5% of the global economy, devastating health systems and hitting low-resourced communities the hardest.
• Indian Context: India has handled the threats of Nipah and zoonotic influenza viruses quite well. However, the threat of a devastating pandemic looms large on the world and India remains highly vulnerable.
• Suggestions:
  
  • Intergovernmental organisations, donors and multilateral institutions need to come together to strengthen funding mechanisms, information sharing and continuous monitoring.
  • Multilateral financing organisations like the International Monetary Fund and World Bank need to integrate preparedness into replenishments, national and international financial risk assessments, incentive systems and funding mechanisms.
  • Increasing country preparedness by
    
    • raising funding,
    • doing more research into new technologies, vaccines and medicines,
    • establishing rapid communication systems,
    • launching a coordinated government, industry and community response;
    • and following through on international commitments.
  • Investing in building a competent health system:
    
    • Building high health system capability for prevention, effective surveillance, early detection and containment and appropriate management of any cases.
    • This requires a sufficiently large and well-skilled health workforce with public health expertise and well-resourced health care infrastructure apart from robust health information systems that can provide early alerts.

Global Preparedness Monitoring Board

• Created in response to recommendations by the UN Secretary General’s Global Health Crises Task Force in 2017, the GPMB was co-convened by the World Health Organization and the World Bank Group and formally launched in May 2018.
• It is an independent monitoring and accountability body to ensure preparedness for global health crises.
• Its secretariat is located in Geneva, Switzerland.

Source: HT

Genetically modified Aedes aegypti

Recently, genes from genetically-modified Aedes aegypti mosquito were found to have been transferred to naturally-occurring Aedes aegypti mosquito population in Brazil where transgenic mosquitoes were released.

• It is unclear if the presence of transgenic mosquito genes in the natural population will affect the disease transmission capacity or make mosquito control efforts more difficult.
• A.aegypti mosquitoes are responsible for transmitting dengue, chikungunya and Zika virus.
• The employed genetic strategy RIDL (Release of Insects Carrying Dominant Lethal Genes) was supposed to only reduce the population of the naturally occurring A. aegypti mosquitoes and not affect or alter their genetics.
• But the study has found transgenic genes in 10-60% of naturally-occurring mosquitoes.
• Also, the naturally occurring A. aegypti mosquitoes carrying some genes of the transgenic mosquitoes are able to reproduce in nature.

Zika Virus

• Zika virus is a mosquito-borne flavivirus that was first identified in Uganda in 1947 in monkeys.
• It was later identified in humans in 1952 in Uganda and the United Republic of Tanzania. Outbreaks of Zika virus disease have been recorded in Africa, the Americas, Asia, and the Pacific.
• Zika virus disease is caused by a virus transmitted primarily by Aedes mosquitoes and can be passed from a pregnant woman to her foetus.
• Sexual transmission of Zika virus is also possible.
• There is no vaccine or medicine for Zika. Instead, the focus is on relieving symptoms and includes rest, rehydration and acetaminophen for fever and pain.

Dengue

• Dengue is transmitted by several species of mosquito within the genus Aedes.
• Symptoms include fever, headache, muscle, and joint pains, and a characteristic skin rash that is similar to measles.
• Dengvaxia is the first dengue vaccine but the Indian drug controller has yet to grant approval to it.
• India has reported 6,210 cases and six deaths from dengue until June 9, 2019.

Chikungunya

• Chikungunya is caused by a mosquito-borne virus.
• It is transmitted by Aedes aegypti and Aedes albopictus mosquitoes.
• Its symptoms are characterized by abrupt fever and severe joint pain, often in hands and feet, and may include headache, muscle pain, joint swelling or rash.
• There is no specific antiviral drug treatment for chikungunya.
• There is no commercial chikungunya vaccine.

Source:TH

India’s Eastern-most Village

Recently, The Indian Air Force has inaugurated resurfaced runway at India’s Easternmost Village-Vijaynagar in Arunachal Pradesh.

• Vijaynagar in Changlang district of Arunachal Pradesh is the eastern-most inhabited locality of the country.
• It is not connected by road. Thus, the main mode of transport to Vijaynagar has been helicopters.
• Vijaynagar is surrounded by Myanmar on three sides and the fourth side comprises stretches of Namdapha National Park.
• Nearby cities to Vijaynagar are Miao (157 km, 7 days walk), Hayuliang and Tezu in India. Putao (40 km) is the nearest city in Myanmar.
• In the 1960s, over 200 Gorkha families of retired Assam Rifles personnel were settled in the area by the Union government.

Namdapha National Park

• It lies at the international border between India and Myanmar within Changlang District in the state of Arunachal Pradesh.
• It is only parked in the World to have the four Feline species of big cat namely the Tiger (Panthera Tigris), Leopard (Panthera Pardus), Snow Leopard (Panthera Uncia) and Clouded Leopard (Neofelis Nebulosa).
• Hoolock Gibbons, the only ‘ape’ species found in India is found in this National Park.

Source:IE

Bio-fences to Curb Man-Animal Conflict

Recently, the Uttarakhand government has decided to carry out bio-fencing by growing various species of plants in the areas.

• The purpose is to,
  
  • Reduce the man-animal conflict,
  • Prevent wild animals from entering residential areas, and
  • Protect agricultural crops and livestock in areas adjoining the forests.
• According to officials, lemongrass, agave, rambans, and certain species of chilly and some other plant species have been identified to be grown in areas where wild animals enter residential areas and near forests.
• So far, the state Forest Department had been using traditional methods like solar-powered wire fencings, walls and pits in the woods to prevent the entry of elephants, wild boars, tigers, leopards and others in residential areas.
• Bio-fencing will be economical and environment-friendly as compared to the other methods.
  
  • It is an innovative measure for curbing the man-animal conflict.
  • The farmers can also earn by growing lemongrass- which is a good source of oil.
  • Bio-fencing will help in saving the money that the government spends on building walls, digging pits and solar-powered wire fencing.

Source: IE