Headline : The WTO’s dispute settlements mechanism is all but dead
- The World Trade Organization’s (WTO’s) dispute settlement mechanism is on the brink of collapsing.
About: World Trade Organisation (WTO)
- In 1948, the General Agreement on Tariffs and Trade (GATT) came in as an ad hoc and provisional mechanism to enable international trade and to establish multilateral rules for the settlement of trade disputes.
- More than four decades after GATT, the U.S. drove the agenda to establish the World Trade Organisation (WTO) which came into existence in 1995.
- It’s an organization for liberalizing trade. It operates a system of trade rules.
- It’s a forum for governments to negotiate trade agreements.
- It’s a place for governments to settle trade disputes.
Dispute settlement at WTO:
- Resolving trade disputes is one of the core activities of the WTO.
- A dispute arises when a member government believes another member government is violating an agreement or a commitment that it has made in the WTO.
- The WTO has one of the most active international dispute settlement mechanisms in the world.
- Dispute Settlement Body:
- Settling disputes is the responsibility of the Dispute Settlement Body, which consists of all WTO members.
- The Dispute Settlement Body has the sole authority to establish “panels” of experts to consider the case.
- As the panel’s report can only be rejected by consensus in the Dispute Settlement Body, its conclusions are difficult to overturn.
- Appellate Body:
- The appeal to the DSB ruling is heard by the Appellate Body (AB) and a report is submitted to the DSB.
- The appeal is heard by three member panel of the permanent Appellate Body (consisting of a total seven-members) set up by the Dispute Settlement Body and broadly representing the range of WTO membership.
- Once the AB report is adopted by the DSB, the member concerned is obliged to implement the findings and recommendations within a reasonable period of time.
- Enforcement of dispute settlement:
- In case of reluctance or refusal to implement of the recommendations by a party, the affected member may seek enforcement by requesting the DSB to authorise retaliatory measures.
- The DSB may allow retaliation in the same sector (goods, services or intellectual property rights) or even authorise cross-retaliation, but it must be at the same level as the measure complained against.
- The process of enforcement is, thus, controlled multilaterally to ensure fairness of treatment towards all concerned.
Over the years, US has criticized the Appellate Body and called for changes:
- Over the years, the US in particular found itself on the wrong side of these developments on a few occasions.
- The US is frustrated at the AB’s rulings against its anti-dumping duties against foreign products, as well as AB’s relaxations for Chinese state-owned enterprises (SOEs).
- The US believes the WTO is biased against it, and has criticised it for being “unfair”.
- The US President Trump and others also believe the WTO has encouraged China — helping it to strengthen its economy at the cost of other nations including the US.
US caused AB membership to shrink:
- The US administration, hoping to raise attention to these issues, began blocking the he appointments of new members, and the reappointments of members who had completed their four-year tenures.
- For more than two years, the US has refused to allow vacancies at AB to be filled up.
- As a result, the strength of the AB (which can have seven members) has already been reduced to three.
AB will be rendered disfunctional:
- The AB will become dysfunctional as two more members retired on December 10, 2019. This leaves AB with only 1 member and the requirement of a quorum of three members can no longer be met.
What it means:
- AB becoming disfunctional would mean that dispute resolution would not progress beyond the panel process and there would be no final decision in disputes raised before the body.
- The importance of AB can be seen from the fact that between 1995 and 2014, around 68% of the 201 panel reports adopted were appealed.
- It could also signal the demise of the 24-year-old WTO itself, as the system for settling disputes has been the organisation’s most important function.
- Once the appellate body becomes non-functional, with no avenue for appeal, there could be the risk of arbitration proceedings against any member at the wrong end of the panel report.
- Shortage of members was already impacting AB:
- The strength of the AB has already been reduced to three in last year or two.
- The understaffed appeals body has been unable to stick to its 2-3 month deadline for appeals filed in the last few years. The backlog of cases has prevented it from initiating proceedings in appeals that have been filed in the last year.
- The three members have been proceeding on all appeals filed since October 1, 2018 (as minimum of three members must hear any appeal).
Impact on India:
- India has so far been a direct participant in 54 disputes, and has been involved in 158 as a third party.
- India has been impacted directly as a result of this situation of shortage of AB membership.
- Case of dispute with Japan:
- Earlier, the panel had found that India had acted “inconsistently” with some WTO agreements in a dispute with Japan over certain safeguard measures that India had imposed on imports of iron and steel products.
- India had then notified the Dispute Settlement Body of its decision to appeal certain issues of law and legal interpretations in December 2018.
- However, India’s appeal could not be heard due to the inability to staff the AB to hear the dispute.
- The situation could be difficult for India, which is facing a rising number of dispute cases, especially on agricultural products.
Headline : Retributive justice Editorial 6th Dec’19 TheHindu
Outcry for women’s safety after Hyderabad incident:
- The heinous rape and murder of a veterinarian in Hyderabad in late November shook the collective conscience of India.
- It resulted in an outcry for justice for the victim and outrage over the persisting lack of safety for women in public spaces.
Creates societal pressure on justice system for quick justice:
- Such societal pressure for justice invariably weighs upon legal institutions, as the police are required to find the culprits immediately and the judiciary to complete the legal process without undue delay.
But rule of law and procedure must continue to be upheld:
- But these institutions must uphold the rule of law and procedure even in such circumstances.
The ‘encounter’ of the accused was celebrated:
- The killing of the four accused of the rape and murder of the veterinary doctor by the Hyderabad police was celebrated by people in Hyderabad and across India.
Shows anger against gruesome crimes as well as justice system:
- The jubilation over the killings by the police stems from the public anger and anguish over the burgeoning crimes against women.
- There is a perception that the legal institutions are ill-equipped to deal with such crimes and to bring the perpetrators to justice.
However, the encounter raises questions:
- The police claim that they killed the accused in self-defence does not sound fully convincing, and raises disturbing questions.
The encounter must be probed:
- The National Human Rights Commission (NHRC) has deputed a fact-finding team to Hyderabad to probe the incident.
- The guidelines set by the Supreme Court to deal with such events, including the need for an independent investigation, must be strictly observed.
Some improvements in justice system from earlier times for quick justice in gruesome cases:
- There has been greater awareness and improvement in both the policing and judicial process following the ‘Nirbhaya’ case in December 2012 in New Delhi.
- The Telangana government had, in this case as well, issued orders for setting up a fast-track court to try the four accused.
- If the Hyderabad police had followed the successful prosecution similar to the Delhi case, this case could have also brought closure to the case in a time-bound manner.
Much more needs to be done:
- However, much more needs to done in terms of registration and charge-sheeting of sexual crimes by police and addressing the pendency in court of such cases.
- Existing laws on sexual crimes and punishment need better application.
But severe retribution cannot be justice:
- In any case, recourse to brutal retribution as in the case of present ‘encounter’ is no solution.
- On the contrary, the political sanction to deliver such swift retribution would only be a disincentive for the police to follow due process. It may even deter them from pursuing the course of justice.
- Far from ensuring justice to the victims, bending the law in such cases would only undermine people’s faith in the criminal justice system.
- Justice in any civilised society is not just about retribution, but also about deterrence, and in less serious crimes, rehabilitation of the offenders.
GS Paper II: Polity
Section : Editorial Analysis
Headline : Manufacturing PMI improves
- The Nikkei India Manufacturing Purchasing Managers’ Index rose in November from October, indicating an increase in manufacturing activity November.
About: Purchasing Manager Index (PMI)
- The Nikkei India Manufacturing PMI is based on data compiled from monthly survey responses by purchasing managers in more than 400 manufacturing companies, on various factors that represent demand conditions.
- PMI measures activity at the purchasing or input stage. It is very different from industrial production which is indicative of actual production. For example, the Index of Industrial Production (IIP) measures output
- The PMI is constructed separately for manufacturing and services sector, but the manufacturing sector holds more importance.
- PMI does not capture informal sector activity.
- The Index is considered as an indicator of the economic health and investor sentiment about the manufacturing sector.
- PMI is also the earliest indicator of manufacturing activity and economic health, as the manufacturing PMI report for any given month comes out without any delay – either on the last day of that month or on the first day of the next month.
How it is captured:
- The PMI is derived from survey responses from purchasing managers to a a series of qualitative questions.
- PMI is composite index based on five individual sub-indices:
- New orders
- Suppliers’ delivery times
- Stock of items purchased
Reading the PMI:
- A figure above 50 denotes expansion in business activity and anything below 50 denotes contraction.
- Higher is the difference from this mid-point, greater is the expansion or contraction.
- The rate of expansion can also be judged by comparing the PMI with that of the previous month data. If the figure is higher than the previous month’s then the economy is expanding at a faster rate. If it is lower than the previous month then it is growing at a lower rate.
- The October Nikkei India Manufacturing Purchasing Managers’ Index, at 50.6, was a two-year low.
- Now, in November, the Index rose to 51.2. In comparision, the survey average is 53.8.
- This indicates that, although business conditions in the Indian manufacturing sector improved in November, the upturn remained subdued compared to earlier in the year and the survey history.
- The rates of expansion in factory orders, production and exports remained far away from those recorded at the start of 2019. Subdued underlying demand is being seen as a major reason for this.
Performance of sub-indices:
- Good: The Index rise was driven by a modest increase in the growth of new orders and production.
- Bad: On the other hand, it was concerning that firms shed jobs (for the first time in 20 months) and continued to reduce input buying.
- The consumer goods segment growth mainly propped up the growth in the overall manufacturing sector.
- The intermediate goods segment also returned to expansion.
- However, the capital goods segment reported a deterioration in the operating conditions.
Headline : Transforming farm loans Editorial 1st Dec’19 FinancialExpress
Importance of crop loans in India:
- Crop loan is a lifeline for over 145 million farmers in India.
- Every year, millions of farmers and thousands of bank branches go through a intense process of granting crop loans delivered through Kisan Credit Cards.
- Banks disbursed Rs 12.5 lakh crore worth farm loans (majority as crop loans) during 2018-19.
Efforts to encourage crop loans:
- The Centre provides interest subvention on crop loans up to Rs 3 lakh, and with additional incentive for timely repayment, effective interest rate works out to affordable 4%.
- Banks are also mandated to secure crop insurance cover for farmers, who have to pay a minimal premium.
Still many farmers unable to access loans:
- Despite these measures to make crop loans affordable, only 61% of farmers have accessed institutional loans (NAFIS 2016-17).
- Manual crop loaning processes is a big reason for that: Due to predominantly manual crop loaning processes in banks, there are substantial direct and indirect costs inflicted on farmers, including:
- Loss of precious time and potential wage opportunities
- Expenses on visits to banks/other offices
- Legal expenses on verification of land records/documentation
- Processing fee levied by some banks
Banks still do not like these loans much:
- Yet, this massive loan segment continues to be treated as a necessary evil by banks, rather than mainstreaming as a commercial proposition like retail loans.
- Denial or delay in crop loans forces farmers to borrow from informal sources, on adverse terms.
Farm loan waivers across states:
- Undue glorification of farm loans through politically-motivated loan waivers is common.
- While the central government has resisted announcing farm loan waivers, this fiscal prudence was not replicated during the several assembly elections held since 2014.
- Political parties have been promising loan waivers as their main electoral strategy. Subsequently, the elected state governments announced farm loan waivers aggregating a whopping Rs 2.4 lakh crores.
Loan waivers cause systemic damage:
- Irrational loan waivers cause systemic damage where:
- Farmers tend to postpone repayments
- NPAs rise in banks that show reluctance in extending new loans
- State governments resort to fiscally-imprudent acts such as higher market borrowings
- Curtailing expenditure on capital investments and welfare programmes to fund waivers
- Not surprisingly, agricultural NPAs crossed Rs 1 lakh crore mark in July 2019, their proportion to total outstanding agri-loans rose from 9.6% in July 2018 to 11.0% in July 2019, and states that implemented waivers ended up in bad fiscal math.
Issues with issuing subsidised crop loans:
- Today, subsidised crop loans are a necessity for farmers.
- But there are issues relating to:
- Accurate targeting
- Skewed distribution across states
- Exclusions, adverse selection
- Actual impact in terms of incremental farm productivity/output, etc.
- Correct diagnosis and mitigation of crop loan issues can be possible only through analysis of credible micro data and trends on farm credit.
Difficulties in tracking actual progress on loans to agriculture:
- Within the priority sector norms for agriculture, banks are required to provide 8% loans to small and marginal farmers.
- The presence of women and lessee farmers, who also need credit, is steadily growing in India.
- But, with existing manual loan operations and related data, it becomes difficult to track actual progress on these parameters.
Need a paradigm shift to make crop loans work better for all stakeholders:
- This calls for a paradigm shift in approach to adopt disruptive fintech ideas for making crop loans work better for farmers, banks, governments.
Some transformative ideas towards achieving this:
- Loan process automation:
- Crop loans should continue to be delivered to farmers based on a well-evolved methodology comprising crop-wise acreage, crop seasonality, district-wise scale of finance etc.
- However, we need to make crop loan delivery simple, transparent and efficient through process automation to allow timely, hassle-free, cost-effective credit access to farmers.
- Banks must make crop loans a serious and competitive business:
- Banks must start seeing crop loans as multi-billion worth banking opportunity with 145 million aspirational rural customers, having cross-selling opportunities.
- Banks need to act proactively and disruptively to make crop loaning a serious and competitive business, like retail loans.
- National Agriculture Calamity Fund (NACF):
- To safeguard financial interests of farmers in the event of a natural calamity or market adversity, the government may create a ‘National Agriculture Calamity Fund (NACF)’ within a credible national-level agency.
- Mandatory annual contributions to NACF by the central/state governments may be facilitated by the Finance Commission in its resource-sharing formula. States granting loan waivers outside the NACF mechanism may be disincentivised in devolution of the formula.
- Seamless integration between crop loaning and insurance processes:
- There is a need to make crop insurance a preferred choice of farmers, insurance firms and banks.
- To achieve seamless integration between crop loaning and insurance processes, refinements are needed such as:
- Early remittance of premium collected by banks to insurance firms
- Timely payment of premium subsidy by state/central governments
- Use of advanced remote-sensing and digital technologies for timely and trustworthy conduct of crop cutting experiments at farmer level
- Building effective grievance mechanism, etc.
- Big data analytics:
- With numerous data points involved in crop loan operation for 145 million farmers, the segment is a mammoth big data game.
- in the absence of digitisation, banks, governments and other stakeholders are deprived of power of data analytics for making informed decisions on policies, products, processes, cross-selling opportunities, etc.
- Therefore, there is an urgent need to adopt modern financial technology in crop loaning.
- National Data Platform on Farmers (NDPF):
- Creating a robust ‘National Data Platform on Farmers (NDPF)’ to warehouse data on individual farmers, covering their demographics, land records etc. is the need of the hour.
- NDPF may be promoted as a joint venture of central/state governments, financial institutions and other stakeholders.
- Farmer-level risk assessment:
- Banks do not systematically factor structured risk assessed at farmer level in their crop loaning decisions.
- With farmer-level micro data on NDPF, it will be possible to evolve appropriate risk-assessment models and generate a ‘Farmer Rating and Credit Score (FRCS)‘.
- Crop loan eligibility for a farmer, worked out using usual standard criteria, may be further moderated, based on his/her score.
- Such a risk-based lending approach would help in promoting judicious borrowing by farmers and responsible lending by banks.
- National Crop Loaning Portal (NCLP):
- A standardised ‘National Crop Loaning Portal (NCLP)’ may be developed under the aegis of Indian Banks’ Association (IBA) as a fully digitised end-to-end solution for crop loaning.
- Farmers may be given access for making online loan application, tracking and viewing loan transaction details.
- The proposed NACF and NDPF could prove to be major steps towards promoting cooperative federalism in Indian agriculture.
- Loan process automation would enable banks to easily outsource basic loan processes to other agencies.
- Data-driven, digital and score-based approaches to crop loaning would help liberate farm loans from the crutches of political patronage.
- The adoption of a digital and score-based retailing approach to crop loans would enable banks to position this segment as their growth driver, like retail loans, and gradually make it immune to syndromes such as loan waivers.
GS Paper III: Economy
Section : Editorial Analysis
Headline : What is the project to redevelop Lutyens’ Delhi all about?
- The Central government has started its plan of redeveloping the three-km-long Central Vista and Parliament.
- The plan also includes constructing a common Central secretariat for all ministries that are currently spread over many buildings across Delhi.
- This follows calls from Members of Parliament to have their own offices at Parliament House, which only Ministers get as of now.
- In October, the Central Public Works Department (CPWD) selected a Gujarat-based architecture firm, HCP Design, Planning and Management Pvt. Ltd., to serve as its consultant for the project.
- The work on the ground in Lutyen’s Delhi is expected to start by May 2020.
Why did the government feel the need for redeveloping the area?
- The British built Parliament House and the North and South Blocks, which contain the offices of the Ministries of Finance, Home, Defence and External Affairs, between 1911 and 1931.
- Post-1947, the government of independent India added office buildings such as ShastriBhavan, KrishiBhavan and NirmanBhavan.
- According to the Ministry of Housing and Urban Affairs these buildings do not have the facilities and space required today.
- While the British-built buildings are not earthquake-proof, the buildings that came up after 1947 are prone to fires.
What is the plan?
- The huge rooms for Ministers and secretaries, with corridors lined with clerical staff would be replaced with modern workspaces.
- The new buildings that come up would have a lifespan of 150 to 200 years, would be energy-efficient and would represent a “new India”.
- While Parliament House and North and Sout Blocks will not be demolished, their usage may change, for example, they may be used as museums.
- The rest of the buildings that came up post-Independence, including ShastriBhavan, KrishiBhavan, etc, are likely to be demolished.
- Through this project the government will also save about ₹1,000 crore a year, which it spends currently on renting office premises for its ministries outside of Lutyens’ Delhi in the Capital.
What lies ahead?
- According to the government’s deadlines, the new Parliament (either as a completely new building or a renovation of the existing one) has to be ready by March 2022, the 75th year of India’s Independence.
- The revamped Central Vista, complete with public amenities and parking, has to be ready by November 2021 and the new common Central secretariat by March 2024.
- But after the government’s plan became public in September, concerns about conservation of heritage and the environment have come up.
- However, CPWD and Ministry of Housing and Urban Affairs has clarified that the green cover and the history of New Delhi will not be damaged in the process of the revamp.
Section : Polity & Governance
Headline : India can learn agri-policy lessons from China Editorial 25th Oct’19 FinancialExpress
India and China have similar challenges in agriculture:
- India and China are the most populous countries in the world, having a population size of 1.35 billion and 1.39 billion, respectively, in 2018.
- With limited arable land [about 120 million hectare (m ha) in China, and 156 m ha in India], both face the challenge of producing enough food, fodder, and fibre for their population.
Followed many similar methods to increase output:
- Both have adopted similiar methods to get more food from limited land, including:
- Modern technologies in agriculture, starting with High Yielding Variety (HYV) seeds in the mid-1960s
- Use of more chemical fertilisers
- Increased irrigation cover
- China’s irrigation cover is 41% of cultivated area, and India’s is 48%.
- As a result of this irrigation, China’s total sown area is 166 m ha compared to India’s gross cropped area of 198 m ha.
But China produces more output than India:
- Even with much lesser land under cultivation, China produces agricultural output valued at $1,367 billion—more than three times that of India’s $407 billion.
Lessons for India from China in agriculture:
- There are three important lessons for India, if it is to catch up to the levels achieved in China.
I) Increased spending on Agriculture Knowledge and Innovation Systems
- Agriculture studies have revealed that the highest impact is from investments in agriculture Research and Education (R&E).
- China spends more:
- China spends a lot more on agriculture knowledge and innovation system (AKIS), which includes agri R&D, and extension.
- China invested $7.8 billion on AKIS in 2018-19, amounting to 5.6 times the amount spent by India ($1.4 billion).
- Presently, India invests just about 0.35% of its agri-Gross Value Added (GVA) whereas China spends 0.8%.
- India needs to spend more:
- For increasing total factor productivity, India needs to increase expenditure on agri-R&Dwhile making the Indian Council for Agricultural Research (ICAR) accountable for targeted deliveries.
- Note: Better seeds that result from higher R&D expenditures generally demand more fertiliser. China’s fertiliser consumption in 2016 was 503 kg/ha of arable area compared to just 166 kg/ha for India, as per World Bank estimates. Consequently, China’s productivity in most crops is 50 to 100% higher than India’s.
II) Better incentive structure to farmers through agri-marketing reforms
- The incentive structure, as measured by Producer Support Estimates (PSEs), is much better for Chinese farmers than Indian ones.
- The PSE concept measures the output prices that farmers get in relation to free trade scenario, as well as input subsidies received by them.
- The PSE concept is adopted by 52 countries that produce more than three-fourths of global agri-output.
- China’s PSE much higher to India:
- For Chinese farmers, PSE was 15.3% of gross farm receipts during the triennium average ending (TE) 2018-19.
- For the same period, Indian farmers had a PSE of -5.7%.
- In a way, this reflects that Indian farmers had been net taxed, not subsidised, despite high amounts of input subsidies.
- Due to restrictive trade and marketing practices in India:
- This negative PSE (support) comes due to restrictive marketing, and trade policies that do not allow Indian farmers to get free trade prices for their outputs.
- This negative market price support is so strong that it exceeds even the positive input subsidy support the government gives to farmers through low prices of fertilisers, power, irrigation, agri-credit, crop insurance, etc.
- China’s experience that high MSPs do not work:
- India can take a leaf out of Chinese bad experience from high MSPs.
- China, in fact, used to give procurement prices to farmers that were much higher than even international prices.
- The result was massive accumulation of stocks of wheat, rice, and corn that touched almost 300 million metric tonnes (MMT) in 2016-17 (see graphic).
- As a result, they had to incur large expenditure for withholding these stocks without much purpose.
- Having learnt lesson, China dropped the price support scheme for corn, and in fact, have been gradually reducing support prices of wheat, and rice.
- India should learn from China and move away from high MSPs:
- Indian government has been trying to jack up minimum support prices (MSPs) for 23 crops.
- As a result, India’s stock situation in July 2019 was 81 MMT as against a buffer stock norm of 41 MMT.
- India needs to reduce the gamut of commodities under the MSP system, and keep MSPs below international prices.
- Else, India will also suffer from the same problems of overflowing granaries as China did.
- Marketing reforms are necessary in India:
- To improve this situation, large-scale agri-marketing reforms (APMC and Essential Commodities Act) need to be carried out.
III) Implementation of single direct income support scheme:
Single input subsidy scheme in China:
- China has combined its major input subsidies in a single scheme that allows direct payment to farmers on a per hectare basis, and has spent $20.7 billion in 2018-19.
- This gives farmers freedom to produce anything, rather than incentivising them to produce specific crops.
- Inputs are priced at market prices, encouraging farmers to use resources optimally.
India offers heavy input subsidies apart from direct benefits:
- India spent only $3 billion under its direct income scheme, PM-KISAN, in 2018-19.
- On the other hand, it spent $27 billion on heavily subsidising fertilisers, power, irrigation, insurance, and credit.
- This leads to large inefficiencies in their use, and has also created environmental problems.
India needs to consolidate subsidies into a single scheme:
- It may be better for India to also consolidate all its input subsidies and give them directly to farmers on a per hectare basis, and free up their prices from all controls.
- This would go a long way to spur efficiency, and productivity in Indian agriculture.
- If India needs to learn these three lessons from China, i.e., to invest more in agri-R&D and innovations, improve incentives for farmers by carrying out agri-marketing reforms, and collapse input subsidies into direct income support on a per hectare basis.
- Through this, India can benefit its farmers and put agriculture on a high growth trajectory.
GS Paper III: Indian Economy
Section : Editorial Analysis
Headline : Is seawater the ultimate answer?
Context of the topic:
- As per National Health Profile (NHP), India’s public health spend as a percentage of GDP has increased by 0.16 percentage points from 1.12% to 1.28% of GDP, between 2009-10 and 2018-19.
- India’s target is 5% GDP on health spend.
- The NHP is an annual stocktaking exercise on the health of the health sector.
The key findings of NHP 2019 are as below:
- Increase in cost of treatmentleading to inequity in access to health care services.
- Increase in per capita public expenditure on health in nominal terms from Rs 621 in 2009-10 to Rs 1,657 in 2017-18.
- There has been an improvement in sex ratio and a decline in birth and death rates
Health expenditure as percentage of GDP
- Spending by states showed deviation with the highest average per capita public expenditure on health by Northeastern states and the lowest by Empowered Action Group (EAG) states plus Assam.
- EAG states are the eight socio-economically backward states of Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Odisha, Rajasthan, Uttarakhand and Uttar Pradesh.
- Among the NE states, highest GSDP spend was by Mizoram (4.20%) and Arunachal Pradesh (3.29%).
- Tamil Nadu and Kerala though having better performers on health parameters, performed poorly on the health finance index with low GSDP spend (Tamil Nadu – 0.74% and Kerala – 0.93%).
- Globally, India’s per capita health expenditure was only $16 in 2016. A comparison has provided against other countries that are on the UHC path.
Other Findings of NHP 2019
- As per NHP 2019, there has been a change in disease profile of the country with a shift from communicable onestowards the non-communicable diseases (NCDs)such as cardiovascular disease, chronic obstructive pulmonary disease, cancer, mental health disorder and injuries.
- This was also documented by the State Level Disease Burden Study 2017. It highlighted an increase in disease burden from NCDs from 30 to 55% between 1990 and 2016.
- Several initiatives have been taken in this regard. These include:
- National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) launched in 100 districts across 21 states with the aim to prevent and control thesediseases thorough awareness generation, behavior and lifestyle changes.
- Free door-to-door screening programme for early detection of cancer, heart disorders and diabetes.
- As per the NHP, sex ratio in the country has improved from 933 in 2001 to 943 in 2011.
- The sex ratio in rural areas has increased from 946 to 949, and in urban areas from 900 to 929.
- Kerala has recorded the highest sex ratio (1,084), and Chandigarh has recorded the lowest sex ratio (690).
- Also, the estimated birth rate, death rate and natural growth rate are declining. During 2000 to 2016, the figures were as below:
- The estimated birth rate reduced from 25.8 to 20.4.
- The death rate declined from 8.5 to 6.4 per 1,000 population.
- The natural growth rate declined from 17.3 to 14.
- The total fertility rate in 12 States has fallen below 2 children per woman and nine States have reached replacement levels of 2.1 and above.
- Delhi, Tamil Nadu and West Bengal have the lowest fertility rate among other States.
- There has been growth in medical education infrastructure.
- The country has 529 medical colleges, 313 Dental Colleges for BDS & 253 Dental Colleges for MDS.
About: National Health Profile (NHP)
- The NHP covers demographic, socio-economic, health status and health finance indicators, human resources in the health sector and health infrastructure.
- It is an important source of information on various communicable and non-communicable diseases that are not covered under any other major programmes.
- This information is essential for health system policy development, governance, health research, human resource development, health education and training.
Universal Health Coverage
- In 2011, the High Level Expert Group of the erstwhile Planning Commission submitted its report on the rollout of Universal Health Coverage (UHC) in India.
- It recommended that the government (central government and states combined) should increase public expenditures on health from the current level of 1.2% of GDP to at least 2.5% by the end of the 12th plan and to at least 3% of GDP by 2022.
- The benefit of increasing health expenditure would result in:
- A five-fold increase in real per capita health expenditures by the government (from around Rs 650-700 in 2011-12 to Rs 3,400-3,500 by 2021- 22).
- A corresponding decline in real private out-of-pocket expenditures(from around Rs 1,800-1,850 in 2011-12 to Rs 1,700-1,750 by 2021-22).
- According to the WHO, Universal Health Coveragemeans “all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.
- The three objectives of UHC are:
- Equity in access to health services;
- Quality of health services should be good enough to improve the health of those receiving them;
- People should be protected against financial-risk, ensuring that the cost of using services does not put people at risk of financial harm.
About: Central Bureau of Health Intelligence
- Central Bureau of Health Intelligence (CBHI) was established in 1961 by the Act of Parliament on the recommendation of Mudaliar committee.
- It is the Health Intelligence Wing under Directorate General of Health Services (Dte.GHS), Ministry of Health & Family Welfare (MoHFW).
- Vision–To havea strong Health Management Information System (HMIS) in entire country.
- Mission –To strengthen Health Information System (HIS) in each of the district in the country up to the facility level for evidence based decision-making in the Health Sector.
- Sex Ratio – The number of females per 1,000 males
- Total fertility rate – The average number of children that will be born to a woman during her lifetime
- Disability-adjusted life years (DALYs) measures how much of a normal life span of an individual is taken away by a disease related morbidity of mortality.
- It is an international standard of disease burden.