Editorials/Opinions Analysis For UPSC 24 March 2023
- The Path to Tuberculosis Elimination
- Grid Managers Prepare for ‘Alert Days’: Power shortage
The Path to Tuberculosis Elimination
- TB was deemed a global health emergency by the World Health Organization in 1993.
- Among all developmental interventions, adult TB treatment was deemed by the 1993 World Development Report to be the best investment.
- In the thirty years that have passed, the response has been long on procedures and short on urgency.
GS Paper-2: Issues Relating to Development and Management of Social Sector/Services relating to Health; Government Policies and Interventions for Development in various sectors and Issues arising out of their Design and Implementation
Talk about the areas in India that are underserved in terms of TB treatment. Also, make some recommendations for these areas. (250 Words)
The current target is to eradicate tuberculosis (TB) by 2030, but definitions of “end” and methods of verification are not yet fully established.
TB: the disease
- A bacterium known as Mycobacterium tuberculosis is the cause of tuberculosis (TB).
- It can affect other organs in addition to the lungs (pulmonary TB). (extra-pulmonary TB).
- BCG vaccines are used to prevent it because it is a contagious, treatable, and curable disease.
- Drug Resistant TB (DR-TB) is a type of TB that cannot be treated with commonly prescribed TB medications.
- MDR-TB is caused by tuberculosis bacteria that are resistant to at least one of the two most effective TB medications, isoniazid or rifampin.
- The bacteria that cause extensively drug-resistant tuberculosis (XDR-TB) are resistant to the second-line drugs “isoniazid,” “rifampin,” any fluoroquinolone, and at least one of three injectable second-line drugs. (i.e., amikacin, kanamycin, or capreomycin).
The stats related to TB
- According to TB statistics, India is responsible for the highest percentage of the global TB burden at 27%.
- India’s TB incidence decreased from 256 per 1 lakh people in 2015 to 210 per 1 lakh people in 2021.
- Eight nations—Bangladesh, China, India, Indonesia, Nigeria, Pakistan, the Philippines, and South Africa—are home to about half of the world’s TB patients.
Three Unserved Regions
- The TB vaccine
- The current TB vaccine is 100 years old. It is given at birth and is especially helpful for children.
- The COVID-19 vaccine development process experience has helped us to better understand what is possible when there is a common goal and effort.
- It is also not surprising that the list of vaccines that are in development prominently features Indian efforts.
- Newer Therapeutic agents for TB: This field, which is capable of progressing much more quickly than the vaccine, focuses on finding newer therapeutic agents for TB.
- If only costs and production limitations weren’t an issue, a few new anti-TB drugs are now widely accessible after a nearly five-decade development drought.
- Switching to an all-oral, injection-free regimen for treating tuberculosis (the current standard is for at least six months) will increase patient compliance and lessen fatigue.
- The development of a variety of newer drugs needs to be accelerated so that we will have newer therapies available when drug resistance to the most recently introduced drugs manifests, which it will given that the TB bacilli are in a battle for survival and have a track record of doing so for millennia.
- Current estimates of drug-resistant TB are, at best, depressing and, at worst, alarming.
- Diagnostics: Utilizing AI-assisted handheld radiology with 90-second reporting and 95%+ accuracy for diagnosing tuberculosis is a promising development.
- This is an advanced piece of technology that needs to be made available to everyone right away.
- Another ground-breaking area is the interpretation of cough sounds for TB, sentinel surveillance, and passive surveillance.
- This enables unobtrusive home-level screening and monitoring and offers encouragement to get help.
- This technology is prepared for wider application and may alter how public spaces and other air quality indicators are tracked.
- Nucleic acid amplification-based confirmation diagnosis is vulnerable to disruption. o India brought together the InDx diagnostics coalition in Bengaluru for COVID-19.
- This biotech startup and others should be encouraged to develop low-cost, high-quality innovations that can overcome the difficulties associated with molecular testing and price barriers.
- New developments in this field should allow for the purchase of twice as many TB diagnostics with the funds currently available.
2022 World Tuberculosis Report
- Information: o The World Health Organization (WHO) published the World Tuberculosis Report 2022, which details how COVID-19 has affected TB diagnosis and treatment in 215 different nations and regions.
- Primary Findings:
- 10.6 million people had TB diagnoses worldwide in 2021, a 4.5% increase from 2020.
- Of the 1.6 million people who died from tuberculosis, 187,000 were found to have HIV.
- The regions of Africa and South-East Asia accounted for about 82% of all non-HIV TB deaths worldwide.
- Of the world’s total TB patients, about 68.3% come from India (28% of cases), along with 7 other nations.
- 36% of all TB-related deaths worldwide among non-HIV patients occurred in India.
Yozana Nikshaya Poshan
- As part of the National Health Mission (NHM), a centrally funded program, each patient with notified TB is given a financial incentive of Rs. 500 per month for nutritional support for as long as the patient is receiving anti-TB treatment.
- Beneficiaries’ bank accounts receive incentives through the Direct Benefit Transfer (DBT) programme.
The Varanasi Stop
- TB board meeting this week, the United Nations High-Level Meeting on TB in September of this year, and India’s G20 presidency this year provide the ideal platforms for India’s actions to speak loudly and will help the world end TB sooner.
- The G20 presidency of India and its emphasis on health could be transformative, much like how the G7 presidency of Japan in 2001 led to the founding of the Global Fund.
- Maintaining historical symmetry, Japan will be the G7’s leader in 2023, enabling leaders of both countries and groupings to work together to end TB.
- The government should encourage professional accountability in the healthcare industry and guarantee adequate, long-term funding for access to both prevention and treatment.
- Every hospital should set up an aftercare system that ensures that every TB case is followed up on periodically.
- In order for people with TB to understand their rights and be able to speak out when those rights are violated, we must both treat them and educate them about the law.
It’s critical to address the social issues and variables that influence tuberculosis risk and increase vulnerability to it.
Grid Managers Prepare for ‘Alert Days’: Power shortage
- The Indian electricity grid is preparing for a difficult summer because it expects peak demand to increase by over 8% this year, reaching 230 GW (gigawatts).
- According to the National Load Despatch Centre’s forecast, system operators are preparing for approximately 18 “alert days” in April when a significant power shortage may be possible. (NLDC).
GS Paper-3: Infrastructure: Energy, Ports, Roads, Airports, Railways etc
What are the main difficulties the Indian power sector is currently facing, and what actions can the government take to resolve them? (150 words)
- Due to an increase in demand this summer, India’s power grid system is expected to experience more difficulties than in previous years.
- The nation’s power supply has historically relied on outdated, inflexible coal-fired plants for base load capacity, but a lack of both coal and gas, which fuel thermal capacity, has presented several challenges.
- In addition, relying on renewable energy sources to meet capacity addition targets over the past decade or so has further complicated matters, as renewable energy is not always available during peak demand hours.
Actions Started To Balance The Surge
- The government has taken a number of actions to combat the summer’s spike in demand.
- Postponement of preventive maintenance: The conventional thermal plants’ April–June preventive maintenance schedule has been postponed for three months.
- This action is anticipated to guarantee that the plants run at full capacity during this time.
- Orders under Section 11 of the Electricity Act: Developers of imported coal-fired plants have been instructed to run their units at maximum capacity from March 16 to June 30.
- State distribution firms with PPAs (power purchase agreements) with these plants have been given first dibs on the electricity produced.
- Gas-based generation operationalization: Orders have been issued to put approximately 5,000 MW of NTPC Ltd., a state-owned company, into operation.
- The electricity produced by these stations will be sold to the PPA holders, and the nation’s largest power producer will offload the remaining generation into the electricity market.
- Water-saving measures: Reservoir levels in the southern region are lower than usual, and hydropower generation is probably not going to be at expected levels.
- In April, utilities in the south have been urged to conserve water and use it to generate electricity at night.
- Coal blending advisories: A recommendation has been made to ensure a 6% blending of imported coal in conventional thermal plants to cover any potential domestic supply shortages.
Despite Steps, Challenges Still Exist
- Obsolete Coal-Based Plants: India’s extensive fleet of 200 MW coal-fired thermal power plants is over 25 years old, employs antiquated technology, and does not guarantee high reliability.
- As a first step towards complete transition, it is imperative to replace outdated coal-based plants with supercritical coal-based plants that provide operational flexibility.
- In light of the impending climate crisis, the international community might not find this acceptable.
- Renewable Energy Targets: Due to the relative slow growth of solar projects, renewable energy targets are currently stagnating. The fleet of coal-fired power plants, which are 30- to 35-years-old, is extremely important to the grid.
- In the absence of energy storage devices, the addition of RE power is making it more difficult to ensure grid operation. Without storage, RE is not a dependable source of energy.
- The nation’s outdated thermal plants lack the reserve shaft power or spinning reserves necessary for automatic frequency response, which is now proving to be absolutely necessary.
- Lithium shortage: This year’s Budget includes a viability grant for 4,000 MW of lithium-ion battery storage.
- There are currently no practical substitutes for lithium for large-scale storage, which makes the lack of lithium a major barrier.
- Off-stream pumped storage is the only practical option for energy storage, but choosing a project site and conducting due diligence on it take time.
- Lack of Demand Projection: The main underlying cause of India’s power shortage is the absence of a precise demand forecast.
- Despite the fact that the country’s load demand is far from being met, various supply chain industry participants have called attention to this deficiency.
- As a result, despite the nation’s installed capacity of 410 GW, power demand cannot be satisfied.
- The lack of electricity during the summer months has caused a serious crisis in the Indian power sector. The actions taken by the government may temporarily avert the crisis.
- It’s past time to deal with the bigger issue of decommissioned coal-fired power plants and the requirement to switch to renewable energy sources. Also required is a strong demand forecast that accounts for the nation’s expanding needs.
- The government must hasten the transition to a sustainable energy model, which can be accomplished by promoting increased investment in renewable energy and introducing newer technologies.