Editorials/Opinions Analysis For UPSC 22 March 2023

Editorials/Opinions Analysis For UPSC 22 March 2023

Contents

1. Slow Steps to India-China Border Tranquility
2. Developing a Newer Concept for Universal Health Care

Slow Steps to India-China Border Tranquility

Context

Keeping peace and tranquility along their disputed 4,000-kilometer border appears to be India and China’s new modus vivendi.

Relevance

GS Paper-2: Bilateral, regional and global groupings and agreements involving India and/or affecting India’s interests, India and its neighborhood- relations.

Mains Question

Describe the significance of the Line of Actual Control (LAC) and how the ambiguity of the LAC has resulted in border disputes between China and India. Also, talk about the steps that can be taken to end the regional conflicts that are still raging. (250 words).

Key Points

• In 2020, the older agreements in Ladakh, which were shaped by the agreements of 1993, 1996, 2005, and 2013, disintegrated.
• Twenty Indian and four Chinese soldiers were killed in a clash in Galwan in June 2020, the first such casualties on the Line of Actual Control (LAC) since 1975. o It occurred when the Chinese massed forces in Tibet and erected blockades at six locations along the LAC to prevent Indian troops from patrolling the border.
• The Sino-Indian conflict in December 2022 at Yangtse, northeast of Tawang, raises the possibility that additional measures, not just in Ladakh, may be needed for the LAC as a whole.

Initiatives to De-escalate the Border Situation

• During the 26th Meeting of the Working Mechanism for Consultation and Coordination (WMCC) on China-India Border Affairs in Beijing, representatives from both countries had crucial discussions.
  • Following the 2020 events, the WMCC held its first in-person meeting after holding its first 11 rounds via video conference.
• According to a press release from India, discussions about proposals for disengagement in “remaining areas” were “open and constructive,” and that they may result in the reestablishment of normal bilateral relations.
• The Chinese statement referred to “achievements made in the disengagement of border troops of the two countries at four locations, including Galwan Valley,” and stated that the two sides would cooperate along “established lines” to settle the western boundary disputes.
• While patient diplomacy over the past three years has resulted in the disengagement of forces at four of the six locations, the Depsang Bulge and the Charding Ninglung Junction in the Demchok region, the two crucial locations, remain.

Measures to Restore Normality include:

• Establishing similar no-patrol zones in other parts of the LAC, which could result in a package settlement in the remaining areas of Depsang and Charding Nala.
• The discussions have also reportedly focused on improving border management by substituting the WMCC with a system that includes both military and civilian officers.
• The 1993 and 1996 agreements stressed the importance of identifying and resolving these differences. o Confidence-building measures since 1993 were based on the assumption that both sides accepted the LAC’s general layout, despite differences regarding around 18-20 points.
  • The Galwan Valley incident happened as a result of the Chinese giving up on the task of defining a distinct LAC without providing any clear justifications.

Regarding no-patrol zones:

• It’s possible that they won’t be used in any areas where the two sides have conflicting territorial claims.
• Patrols from each side operated up to the limits of their respective claims prior to 2020, and in the event that they came into contact, they would halt and display banners to warn the other side to retreat to their own area.
• Meetings were then held at one of the five predetermined border meeting points to settle disagreements.
• In some areas lacking obvious geomorphological features or population, a Chinese journalist-scholar proposed that the idea of the “zone of actual control” could take the place of the “line of actual control.”
• Other regions could also be categorized as a “border belt” if population adjustments weren’t necessary.However, the goals of both parties are crucial to the idea’s success. The proposal won’t make much of a difference if the Chinese intend to keep India off balance by exploiting the LAC’s imprecision.This proposal is similar to one made by Chinese Premier Zhou Enlai to Indian Prime Minister Jawaharlal Nehru in November 1959 after the Kongka La incident, in which ten Indian police officers were killed and twelve were taken hostage.
• Zhou suggested that both sides withdraw 20 kilometers from the “so-called” McMahon Line, as well as the “line up to which each side exercises control in the west” to quell the uproar.

Conclusion

• Since no detailed maps have been made available to address the issue, it has remained unclear how much of the west is under Chinese control.
  • This has made it possible for the Chinese to reposition themselves along the border with Ladakh as they see fit, escalating tensions between India and China.
  • Officials and ministers from both countries have been meeting regularly despite these tensions.The trust established over the previous 27 years, from 1993 to 2020, has been shattered by the events. The bar for restoring normal relations between China and India has consequently been significantly raised.

Developing a Newer Concept for Universal Health Care

Context

The right to life guaranteed by the Indian Constitution includes the fundamental human right to health.But achieving health in its broader sense necessitates addressing health determinants outside of the realm of medicine and health departments.

Relevance

GS Paper-2: Issues Relating to the Development and Management of Social Sector/Services relating to Health, Education, Human Resources

Mains Question

What is Comprehensive Universal Health Care, how has the Indian government’s approach to healthcare changed over time, and what obstacles still stand in the way?

The Definition of health

• According to the World Health Organization (WHO), health is a complete state of physical, mental, and social well-being and does not merely refer to the absence of disease or infirmity.This means that without addressing health determinants, we cannot achieve health in its broader definition.
• Beyond medical and health departments, such as those responsible for women’s and children’s development, food and nutrition, agriculture and animal husbandry, civil supplies, rural water supply and sanitation, social welfare, tribal welfare, education, and forestry, are required as a result of this.

Evolution of universal health care

• The World Health Assembly approved the phrase “Health for All by 2000,” which implied universalization, in 1977.
• The Evolution of Universal Health Care.India committed to this goal through its National Health Policy in 1983.
• As a result, nobody is denied this and everyone is eligible without being subjected to discrimination on the basis of socioeconomic status, gender, race, place of residence, ability to pay, or any other factors.

Putting primary care first

• Eight elements of a minimum standard of care for all citizens were listed by the International Conference on Primary Health Care in Alma Ata in 1978.
• It required that all health promotion initiatives, disease prevention measures, such as vaccinations, and the treatment of minor illnesses and accidents be provided free of charge to everyone using public funds, with a focus on the underprivileged.
• Investigations into and treatment for virtually all non-communicable diseases, chronic illnesses, including mental illnesses, were not included in primary healthcare.
• It was up to the individual to either seek secondary and tertiary care from one of the few public hospitals available or the private sector by paying out of pocket.
• There weren’t enough government-run facilities for the underprivileged. (who cannot afford exploitative and expensive private care).
• The state’s abdication of its duty to provide secondary or tertiary care ensured the well-being and prosperity of both the dominant, unregulated, for-profit private sector and the health insurance industry.
• This led to a division between secondary and tertiary level peripheral primary care and institutionally referred specialist care.

Looking forward

• Comprehensive PHC: o A Primary Health Care (PHC) Version 2 or Comprehensive PHC was defined in response to the realization that even the poor develop chronic illnesses and non-communicable diseases like cardiac, neural, mental, and metabolic disorders, which also require investigations and management at peripheral primary health institutions.
  • In 2013, the National Rural Health Mission (NRHM) in India put it into operation.
  • The Health and Wellness Center was put into operation in the second half of the previous decade as a model for implementing Comprehensive Primary Health Care.
• The necessity of comprehensive universal healthcare: Every person has a right to recovery from illness without complications, impairment, or death.
  • Individualism in public health, which ensures that no one goes unaccounted for or uncared for, is the new global approach to UHC.
  • The more recent idea of UHC must include affordable primary, secondary, and tertiary care for everyone who requires it.

Problems with the concept of universal health coverage include:

• A misleading slogan;
• A lack of true universality or comprehensiveness in the services it covers;
• A lack of accessibility and affordability because funding is frequently contingent on insurance premiums.
• Pro-Market Driven Reforms: The World Health Organization’s decision to accede to pro-market-driven reform guidelines between 2004 and 2010 weakened the UHC concept by reducing state regulation and restricting coverage of uneconomical services.
• Out-of-Pocket Expenses: o The World Health Assembly’s resolution from 2011 calls on nations to lower out-of-pocket costs and catastrophic health expenditures, but it does not address the problems of unemployment and poverty.

Astana Declaration of 2018

• Despite the detrimental effects of industries like alcohol, tobacco, ultra-processed foods, and pollution from commercial private sectors, the Astana Declaration of 2018 calls for partnership with the private sector.
  • Private Sector Regulation:
    • The Astana Declaration’s call for partnership with the private sector is impractical because poorer countries frequently struggle with or refuse to regulate the private sector.
  • Ignorance of Broader Universal Health Care: Although the Astana Declaration highlights high-quality Primary Health Care as the foundation for Universal Health Coverage, it neglects to address broader Universal Health Care issues like unemployment, poverty, and subpar living conditions.

Multi-nodal system

Since the Beijing Health Systems Research Conference in 2012, the idea of a multi-nodal system—a collection of various sectors, professional streams, and specialties—with a variety of staff to deliver Comprehensive Universal Health Care—has gained widespread acceptance.

Conclusion

The Mahatma Gandhi National Rural Employment Guarantee Act, water sanitation, Sarva Shiksha Abhiyan, etc., along with concurrent intersectoral thrusts on Poshan Abhiyan, National Food Security, and Universal Health Care are better examples of fully tax-funded Universal Health Care. As a result, a newer concept of Universal Health Care is required to encompass primary, secondary, and tertiary care for all who need it at an affordable cost.