Monthly Current Affairs June 2020

Easy to PICK587 – “UPSC Monthly Magazine\" June - 2020 # The Act was not enforced for a long time even menace by extending relief under the by the United Progressive Alliance/Congress NDRF as also the SDRF. government which enacted it. # So, according to the government, the threat of # The Supreme Court of India intervened at the locusts is more severe than the novel coronavirus. instance of Swaraj Abhiyan (Swaraj Abhiyan vs Clearly, the government of the day has not only Union Of India And Ors) and Prashant ignored the binding law but also circumvented it. Bhushan. Justices Madan Lokur and N.V. Ramanna directed, in 2016, that the Act be # The government has decided to fight the crisis in implemented, and in particular the preparation an ad hoc and arbitrary manner instead of of a National Plan, a National Disaster the organised steps as mandated by the Act. Response Fund, or NDRF, and a National Disaster Mitigation Fund, or NDMF. # Unilateral decisions without the advice of others only cause problems, two classic examples # So, for the first time, the government came being demonetisation that was forced on the nation out with a National Disaster Management Plan in November 2016, and the national lockdown of (NDMP), 2016, which dealt with various kinds of March 25 that was thrust upon a one billion-plus disasters; it was amended in 2019. people at four hours notice. # So why is this National Plan not even in place? # With Parliament not in session and Without it, the fight against COVID-19 is ad hoc, and has resulted in thousands of government the judiciary virtually silent, despite its suo motu orders, confusing those who are to enforce them intervention in the migrants’ crisis, no one is even as well as the public. demanding the implementation of an immediate National Plan for COVID-19. Obtuse steps # The media and civil society have to step in to # Worse still, the NDRF is inactive. On April 3, guard the nation as they are the last bastions of a 2020, the government of India agreed to contribute vibrant democracy. One can only think of the its share to the NDRF. poem by Josiah Gilbert Holland, with the line, “...A time like this demands, Strong minds, # But curiously, “keeping in mind the need for great hearts, true faith and ready hands.” a dedicated national fund with the primary objective of dealing with any kind of emergency # As Albert Einstein once said, “The strength of or distress situation, like [that] posed by COVID- the Constitution lies entirely in the 19”, a public charitable trust under the name determination of each Citizen to defend it.” of Prime Minister’s Citizen Assistance and Relief in Emergency Situations Fund (PM CARES Fund) was set up to receive grants made by persons and institutions out of the NDRF, in violation of Section 46 of the Act. # The crores being sent to this fund are not even audited by the Comptroller and Auditor General (CAG) of India. # It is a totally opaque exercise. Curiously on May 22, the government of India issued a notification to fight the locust

Easy to PICK588 – “UPSC Monthly Magazine\" June - 2020 Signalling intent: On Government e-Marketplace New guidelines for GeM platform # The weaponisation of trade ties, especially one # The Centre’s decision to make it mandatory where India’s reliance on imports from for vendors on the Government e- China now extend?s beyond smartphones and Marketplace (GeM) procurement platform low-cost electronics to heavy to specify the country of origin of new products machinery and active pharmaceutical listed by them is on the face of it unexceptionable, ingredients, is a double-edged sword and fraught aimed as it is at promoting India-made goods. with risks for the Indian economy as well. # Apart from the place of manufacture, the # India’s drug makers, who are seeking to platform’s administrators have also sought details entrench themselves as a pharmacy to the on the extent of local content and set guidelines world amid the pandemic and accompanying rush on the percentage of localisation for enabling for affordable generic treatments, depend on the procurement in the case of bids of a specified northern neighbour for about 70% of their value. requirements of bulk drugs and intermediates. # However, the timing and thrust of the Way ahead announcement — set in the backdrop of the # For India to wean itself off these dependencies government’s new-found push for self-reliance in will take time. the wake of the COVID-19 pandemic and its devastating impact on the global economy, # The fact is that enhancing manufacturing coupled with the recent heightened border capacities with improved efficiency and reduced tensions with China — raises several questions. cost would require an overhaul of bureaucratic processes. # The government’s attempts to raise the share of manufacturing in the economy through # Attaining genuine self-reliance is a long and the ‘Make in India’ programme have so far failed capital intensive process that would require far to significantly boost investment in new, greater investment in education, skill-building cutting-edge technology-driven or export- and infrastructure. oriented industries and instead only taken the country back to import substitution plants # The GeM move on country of origin is at best making goods predominantly for domestic symbolic. For now, policymakers ought to tone consumption. down any trade-linked rhetoric and give diplomats and military negotiators the room to smoothe ties. Demerits of this policy # To that extent, the drive for self-reliance and greater localisation risks once again eroding Indian industry’s global competitiveness by placing a premium on ‘Indianness’ over quality or cost. # The Centre’s move with its GeM portal has also predictably kindled and amplified a gathering clamour for the identification and subsequent boycott of Chinese products including on private e-commerce platforms.

Easy to PICK589 – “UPSC Monthly Magazine\" June - 2020 The many questions about Favipiravir (Analysis of Favipiravir Drug) S.P. Kalantri is Professor of Medicine at the Questions that arise Mahatma Gandhi Institute of Medical Sciences # On what basis did the DCGI grant approval? and Medical Superintendent of Kasturba Hospital, Will the underlying data be made publicly Sevagram, Maharashtra; Dinesh Thakur is a available to the medical community? public health activist # While the New Drugs and Clinical Trial Rules, Context 2019 allow the DCGI to grant approvals for the # The pandemic has not only exposed the dire use of certain drugs based on approvals granted situation of the public health infrastructure, but overseas, they do not absolve it from making their also the opacity with which drug/medical device rationale for such decisions public. approvals are granted in India. Is there a scientific basis for the approval of # We have had many controversies over the last Favipiravir? few months: the use of hydroxychloroquine for # There is no information on the DCGI’s treating COVID-19 patients, grant of website explaining the scientific basis of its licences for diagnostic kits for COVID-19, and approval of Favipiravir for COVID-19. the specificity of serological tests for detecting antibodies against the virus. # Evidence-based medicine requires the testing of pharmaceutical drugs through randomised # Another controversy is brewing due to clinical trials (RCT) wherein one set of the opacity surrounding the regulatory patients get a placebo (or an alternate therapy) approval granted to Favipiravir for the treatment and the other set of patients gets of COVID-19 patients with mild or moderate the investigational drug. symptoms. # Neither the doctors nor the patients know No scientific consensus who gets what drug. # The Drugs Controller General of India (DCGI) has approved Glenmark # If the set of patients that gets the investigational Pharmaceuticals, an Indian pharmaceutical drug shows a better outcome, it can be presumed company, to sell generic versions of that the drug has a demonstrable therapeutic Favipiravir for the treatment of COVID-19. effect on the disease in comparison to the comparator. # This drug, originally invented by a Japanese company, was meant to treat influenza. # Randomised Control Trial is the gold standard for demonstrating the efficacy of a # After the outbreak of COVID-19, doctors drug in treating a particular disease. in China and Russia started using it to treat COVID-19 patients although there is no scientific # The data collected from such clinical trials are consensus on the efficacy of the drug. usually published in a peer-reviewed journal where they are subject to scientific # As per Glenmark’s filing with the Bombay scrutiny. Stock Exchange, the company has received “accelerated approval” from the DCGI for # This system has worked during this pandemic to “restricted emergency use in India”. disprove claims that hydroxychloroquine was useful in treating COVID-19.

Easy to PICK590 – “UPSC Monthly Magazine\" June - 2020 # With regard to Favipiravir, we know opinion. that Glenmark was conducting a clinical trial for this drug in India. # We tried to retrieve the scientific studies that have tested the effectiveness and safety of this Flaws in the Clinical trials for Favipiravir drug among mildly ill COVID-19 patients. # According to the Clinical Trials Registry of India (CTRI), Glenmark’s study was meant to be # PubMed, a database that contains more than 30 carried out on 150 patients at 12 different hospitals million citations and abstracts of biomedical in Chhattisgarh, Gujarat, Maharashtra and Delhi literature, lists a single study published in with the aim of comparing Favipiravir with a journal called Engineering. “standard care” provided to patients with mild or moderate COVID-19. # It shows that a group of Chinese investigators did an observational study on 80 # The decision to enrol patients with “mild” patients and concluded that those who got the COVID-19 is baffling given that virtually all these drug tended to have faster disappearance of “mild” cases often resolve themselves without virus and quicker improvement of shadows in any intervention. their chest x-rays. # Further, the CTRI does not explain the nature # The study was not a randomised controlled of the “standard care” being provided to the trial and therefore, small size apart, had patients. It is important to disclose this two serious flaws — bias (the sample studied is information from a scientific and ethical not representative of the population it was drawn viewpoint. If we do not know the treatment with from or the population at large) which Favipiravir is being compared, how do we and confounders (unable to control for all other know if it is any better than perhaps a placebo? factors that might differ between the two groups). Dangers of Favipiravir drug # The only way to eliminate these is to design # The Japanese regulator, which approved this a prospective randomised controlled study. drug for influenza, mandated a warning to be printed on the packaging of this drug for early Subject Expert Committee (SEC) embryo toxicity and teratogenicity, specifically # Subsequent to a scandal in 2012, the DCGI cautioning its use in women in the early stages of instituted a system of review by a Subject pregnancy. Expert Committee (SEC) to decide whether a new drug should be approved for the Indian # The exclusion criteria listed on the CTRI list market. pregnant and lactating women, which is not necessarily the same thing. # The SEC was meant to have external experts who were specialists in the field of # The protocol on CTRI also specifies that the 150 therapy being considered. patients enrolled in the study will be randomised 1:1. This patient cohort is not adequate to # After a SEC approval, the DCGI is required to substantiate statistically either the primary or the take the final call on whether to approve a drug. secondary endpoint of the study. Thereafter the information on which such decisions were made was required to be disclosed Flaws in observational studies because the Right to Information Act requires # Glenmark claims in a letter to the Bombay such a disclosure. Stock Exchange that it was granted approval based on evaluation of data and expert # However, in this case, the minutes of the

Easy to PICK591 – “UPSC Monthly Magazine\" June - 2020 meetings, the composition of the SEC and the clinical trial results submitted to the SEC/DCGI are not available on the DCGI’s website. # A representative of Glenmark disclosed on a channel that the approval for restricted use was based on an “early readout” from the study; the study is expected to be completed in the coming weeks and months. So, on what basis did the DCGI approve restricted use of this drug? # A culture of secrecy around drug approvals serves no purpose except to benefit pharmaceutical companies. # At ?103 a tablet, the manufacturer stands to make a fortune once there are bulk orders for this drug. # However, if the drug does not work as advertised, the DCGI could end up promoting widespread misuse of this drug and a false sense of security amongst the population. # The regulator would be responsible for promoting irrational medicine as it has been on previous occasions.

Easy to PICK592 – “UPSC Monthly Magazine\" June - 2020 Drug abuse amidst pandemic By, Ghada Waly is the Executive Director of the (UNODC). Some 35.6 million people United Nations Office on Drugs and Crime suffer from drug use disorders globally. Introduction The affected segments # More people are using drugs, and more illicit # One out of three drug users is a woman but drugs are available than ever. women represent only one out of five people in treatment. # The economic downturn caused by the global pandemic may drive more people to substance # People in prison settings, minorities, abuse or leave them vulnerable to involvement in immigrants and displaced people also face drug trafficking and related crime. barriers to treatment due to discrimination and stigma. # In the global recession that followed the 2008 financial crisis, drug users sought out cheaper # Around 269 million people used drugs in 2018, synthetic substances and patterns of use up 30% from 2009, with adolescents and young shifted towards injecting drugs, adults accounting for the largest share of users. while governments reduced budgets to deal with drug-related problems. # While the increase reflects population growth and other factors, the data nevertheless # Vulnerable and marginalised groups, youth, indicate that illicit drugs are more diverse, more women and the poor have been harmed the most. potent and more available. # Now facing the gravest socio-economic crisis in # At the same time, more than 80% of the generations, governments cannot afford to ignore world’s population, mostly living in low- and the dangers illicit drugs pose to public health and middle-income countries, are deprived of access safety. to controlled drugs for pain relief and other essential medical uses. # All over the world, the risks and consequences of drug use are worsened by poverty, limited # Governments have repeatedly pledged to work opportunities for education and jobs, stigma and together to address the challenges posed by the social exclusion, which in turn helps to deepen world drug problem, in the SDGs, and most inequalities, moving us further away from recently in the 2019 Ministerial Declaration achieving the Sustainable Development Goals adopted by the Commission on Narcotic Drugs. (SDGs). # But data indicate that support has actually # While more people use drugs in developed fallen over time, imperilling government countries than in developing countries, commitment as well as regional and global and wealthier segments of society have a higher coordination. prevalence of drug use, people who are socially and economically disadvantaged are more likely # Development assistance dedicated to drug to develop drug use disorders. control fell by some 90% between 2000-2017. # Only one out of eight people who need drug- Solutions related treatment receive it, according to # Funding to address drugs may be provided under the World Drug Report 2020 other budget lines, but there is little evidence of

Easy to PICK593 – “UPSC Monthly Magazine\" June - 2020 international donor attention to this priority. # Assistance for alternative development — creating viable, licit forms of income to enable poor farmers to stop growing illicit opium poppy or coca — also remains very low. # Leaving no one behind requires greater investment in evidence-based prevention, as well as treatment and other services for drug use disorders, HIV, hepatitis C and other infections. # We need international cooperation to increase access to controlled drugs for medical purposes, while preventing diversion and abuse, and to strengthen law enforcement action to dismantle the transnational organised crime networks. # Health-centred, rights-based and gender- responsive approaches to drug use and related diseases deliver better public health outcomes. # We need drug strategies addressing the country-level, as well as regional challenges.

Easy to PICK594 – “UPSC Monthly Magazine\" June - 2020 Getting out of the ‘guns, germs and steel’ crisis By, Praveen Chakravarty is a political economist # A portion of India’s land in Ladakh has and a senior office-bearer of the Congress party been grabbed by China. Context # Surely, India is bound to assert its rights, which # India faces a “guns, germs and steel” crisis. will necessitate higher expenditure. There are Chinese “guns” on the borders. There are coronavirus “germs” in our bodies. There are # India’s defence budget has been whittled down “steel” makers and other businesses on the verge to just 2% of GDP for the financial year 2021. of bankruptcy. # China’s defence budget is nearly four times larger. In all likelihood, the Chinese conflict will # Arguably, this is the gravest confluence of stretch central government finances by an military, health and economic crises threatening additional one to two percentage points of GDP, our nation in more than a generation. as India staves off the current threat and shores up its defence preparedness. # The Chinese military threat calls for immediate and strategic action by our Health care and economy defence and foreign affairs establishments. # The health pandemic has exposed India’s The COVID-19 health epidemic is here to stay woefully inadequate health infrastructure. and needs constant monitoring by the Health The combined public health expenditure of Ministry and local administration. The economic States and the central government in India is a collapse is an enormous challenge that needs to be mere 1.5% of GDP, compared to China’s at 3% overcome with prudent policy. and America’s at 9%. Standoff and Kargil parallel # The COVID-19 epidemic is expected to linger # The common thread across these is that its on for another two years until a suitable vaccine resolution requires significant financial is available at large. resources. Standing up to a military threat by a superpower neighbour will pose an inevitable # Many public health experts are of the opinion drain on the finances of the government. that the central government will need additional funds of the equivalent of at # India’s war against Pakistan in Kargil in May least one percentage point of GDP to continue 1999 provides hints of the financial burden of a the fight against COVID-19.(i.e.2.3% of GDP) military threat. # It is no secret that the extreme national # India’s defence expenditure in the war lockdown has thrown India’s economy into utter year shot up by nearly 20% from the previous disarray. year. It also forced the then government to increase India’s defence budget for the next # India’s economy has four major drivers — financial year to 2.7% of nominal GDP, people’s spending on consumption, government the highest in decades. spending, investment and external trade. # China is a far mightier power than Pakistan. # Spending by people is the largest contributor to In this face-off, 20 Indian soldiers have been India’s economic growth every year. brutally killed and many more injured by the Chinese Army. # For every ?100 in incremental GDP, ?60 to ?70

Easy to PICK595 – “UPSC Monthly Magazine\" June - 2020 comes from people’s consumption spending. (60- elucidate, it only means that his total sales is a tad 70 % is our consumption expenditure) higher than two years ago. # The lockdown shut off people from spending for # Central government revenues for this year were two full months, which will contract India’s budgeted at 10% of GDP which will not be economy for the first time in nearly five achieved. Revenues will likely fall short by two decades, regardless of a strong agriculture percentage points of GDP. performance. # In sum, the government needs to spend # Even prior to COVID-19 when the global an additional eight percentage points of economy was robust, India’s trade levels had GDP while revenues will be lower by two fallen from 55% of nominal GDP in 2014 to 40% percentage points of GDP, a combined gap of 10% in 2020. of GDP. # Now, with the global economy in tatters, trade # Potential new sources of revenue such as is not a viable alternative to offset the loss from a wealth tax or a large capital gains tax are ideas consumption. Investment is also not a viable worth exploring for the medium term but will not option at this stage since the demand for goods be of much immediate help. and services has fallen dramatically. The ‘junk rating’ risk Incremental funds needed # The only option for the government to finance # The only options then are to either put money in its needs is to borrow copiously, which will the hands of the needy to stimulate immediate obviously push up debt to ominous levels. consumption or for the government to embark on a massive spending spree, akin to the “New # When government debt rises dramatically, there Deal” which was a series of programmes and will be a fourth dimension to the “guns, germs and projects instituted by U.S. President Franklin D. steel crisis”; a “junk” crisis. Roosevelt during the Great Depression of the 1930s. # With rising debt levels, international ratings agencies will likely downgrade # Based on estimates of loss of consumption, India’s investment rating to “junk”, which will incomes and its multiplier impact, my estimate then trigger panic among foreign investors. is that the government will need to inject incremental funds of five percentage points of # Some economists argue that there is a magical GDP to absorb the economic shock and kick start third choice – to simply print how much ever the spending cycle again. money the government needs to overcome these crises. # The government had expected a nominal GDP growth of 10% this year. It is clear now that GDP # Economic theory states that if money is printed will not grow but shrink. at will, it can lead to a massive spike in prices and inflation. # There is much hullabaloo about a ‘V’ shaped economic recovery, which is a mere illusion. # This theory has fallen flat in the past decade in developed nations such as America where # A 5% fall now and a 10% growth next year will the creation of phantom money has not led to be hailed as a sharp ‘V’ shaped recovery by inflation. economists and the International Monetary Fund. But as your local grocery store-keeper will # Hence, the Reserve Bank of India can

Easy to PICK596 – “UPSC Monthly Magazine\" June - 2020 just create money at will and transfer them to government coffers electronically, is the argument. # There are multiple problems with this argument but the most important one is that regardless of whether money is printed or borrowed from others, it will still be counted as government debt and not escape a potential downgrade to a “junk” rating. # The U.S dollar, by virtue of being the world’s reserve currency, has an in-built protection against a currency crisis that can be triggered by at-will printing of money, that other developing nations such as India do not possess. # If there were indeed no costs to printing money whenever governments need, then why tax citizens at all? Countries could just print money for all their expenses every year. The magical third choice is not a magic wand that can give the Indian government the money it needs and, also prevent a ratings downgrade.

Easy to PICK597 – “UPSC Monthly Magazine\" June - 2020 Science vs nonsense: On Patanjali’s COVID-19 claim # Patanjali Ayurved’s recent claim of having review. discovered a “cure” and the publicity that this garnered, bypassing every regulatory # Therefore, the company’s claim of a cure by all requirement without any serious consequence so accounts was a clear subversion of the scientific far, shows that India’s regulatory checks and process. balances are wanting. # When hydroxychloroquine was being touted as # The company said in Haridwar that its product, ‘Coronil’, had cured everyone in a a potential wonder drug for COVID-19, some of clinical trial. India’s scientists were quick to join a global # While quackery and the potency of ‘magic opprobrium that raised methodological issues with drugs’ are a part of life in India, its declarations a study in The Lancet, that claimed no effect — could not be ignored because of the tremendous and even harm — from HCQ. The study was influence its products wield and its claim to have proved the product through a clinical trial, which retracted as it relied on a spurious database. makes it open to evaluation by the standards of modern medicine. # But its overall finding that HCQ does not work has been borne out by other validated studies. Issues in the clinical trials # As it now emerges, the company has probably # Thus, more than the outcome, it is the method misrepresented the drug’s efficacy. deployed that ought to be scrutinised by scientists to reinforce public trust in scientific # The clinical trial tested the drug on 45 and assessment. another 50 were administered a placebo. # All of the participants had tested positive for the # There has always been a tension between virus. On the third day, 31 who were given the drug recovered and 25 of those on the placebo traditional Indian systems of recovered. medicine and pharmaceutical drugs but there is # That is not a measurable improvement now consensus in India’s regulatory system that considering the small number enrolled in the trial. Moreover, they were mildly symptomatic. claims by both systems of developing safe # Ramdev claimed that by the seventh day, all efficacious drugs must pass clinical trials. had recovered. # It is well within the domain of institutions of # If this also included all those on the placebo, then the ICMR or the CSIR or national science it further weakens the claim that it was the drug academies to call out a breach of due process in alone that worked. the appraisal of any drug, whether allopathic, ayurvedic or homeopathic. # To not do so would amount to criminal negligence. # The doctors in the trial have spelt out on the clinical trials registry the process they would employ to test the drug but said they had neither published their results nor submitted it for peer-

Easy to PICK598 – “UPSC Monthly Magazine\" June - 2020 Why is there a stress on randomised controlled trials? Context positive were given the medicine (five dropped # On June 23, the claim by Patanjali out midway). Ayurved [Haridwar (Uttrakhand)] that its preparations, ‘Coronil’ and ‘Swasari’, would # The clinical trial tested the drug on 45 people cure COVID-19 in only seven days, was met with and another 50 were given a placebo. The claim robust disbelief in some quarters, even as it was that 69% (31 persons) of those on the drug hogged media space soon after the announcement. tested negative on the third day, and 25 of those on the placebo arm of the trial had also tested # Ramdev, the yoga guru, and who is associated negative.0 with the company, claimed that a randomised controlled trial (RCT) among COVID- What is the place of RCTs place in clinical 19 positive patients had proved favourable results. trials? # As per definition, a randomised controlled trial, # The government, through the Ministry of or RCT, is a study in which people are allocated at random, entirely by chance, to receive one of AYUSH (ayurveda, Yoga & Naturopathy, Unani, several clinical interventions. Siddha and Homoeopathy) responding a short # One of these interventions is the standard of comparison or control. while later, told the company to stop advertising # The control may be standard the drug as a cure for COVID-19, pointing out practice/treatment options, a placebo (a drug without an active substance, or a ‘sugar pill’), that it would attract provisions of Drugs and or no intervention at all. The idea is to measure and compare the outcomes against the Magic Remedies (Objectionable control after the participants receive the treatment. Advertisements) Act, 1954 # RCTs are based on multiple factors, What has the government said? including type of interventions being evaluated, # The Ministry, in a statement, said the details of and number of participants. the study were not known to it and it has asked Patanjali Ayurved “to provide at the earliest # In single-blind trials, the participants, or the details of the name and composition of the investigators do not know who is assigned what; medicines being claimed for COVID treatment; in double-blind trials, both participants and site(s)/hospital(s), where the research study was investigators do not know; and triple and conducted for COVID-19; protocol, sample size, quadruple-blind trials, where three or four of Institutional Ethics Committee clearance, CTRI the relevant groups are not aware of the registration and results data of the study (ies) and treatment assignment. stop advertising/publicizing such claims till the issue is duly examined”. Is an RCT a good tool to employ during the throes of an epidemic? Why do we need RCTs? # The Ministry has also “requested the State # Nancy Cartwright, writing in one of the Springer journals, in October 2009, argues that RCTs are Licensing Authority of the Uttarakhand widely taken as the gold standard for establishing government to provide copies of the licence and product approval details of the Ayurvedic medicines being claimed for the treatment of COVID-19”. # It is learnt from media reports on the yet-to- be published RCT conducted on behalf of the company, that 100 patients who had tested

Easy to PICK599 – “UPSC Monthly Magazine\" June - 2020 causal conclusions. RCTs done with multiple partners at many locations, bang in the middle of an epidemic. # S.P. Kalantri, professor of medicine, Mahatma Gandhi Institute of Medical Sciences, Sevagram, # They have already been instrumental in setting Maharashtra, answers this question with a the standard of care — for instance, resounding yes. He says, “We need studies that get hydroxychloroquine was hyped up as a drug but data that we can trust.” This means, clear and studies conclusively proved no ameliorative effect robust evidence about benefits and risks. in using it. The Remdesivir study, on the other hand, showed some improvement in reducing # A good RCT (for COVID-19) should enrol intensive care unit stay, while there was no great enough numbers, define clinical endpoints, impact on mortality, says Dr. Kalantri. including mortality and morbidity, also whether intubation was needed and days of stay in hospital. What is the future? # Strident science should be the basis of any # In well-designed RCTs, researchers, after interventions in therapeutics or vaccinology, random assignment of participants, assess experts emphasise. The over 200 projects in the whether randomisation was done sufficiently pipeline, listed in the Clinical Trials Registry of to eliminate the influence of confounding factors, India (CTRI), might produce results over time, and avoid selection bias. but as in the case of Patanjali Ayurved, the regulator’s immediate and scientific response to # Researchers follow the groups over days, unpublished claims will be essential, they urge. weeks, years and observe major clinical end points. # In the end, all other things being equal, it will be possible to measure what benefit a particular group X got, in comparison to Y group. # It is possible to estimate if there were any differences between the two groups, say, in mortality, and if this was because of strategic effect of the cause, or due to pure chance. RCTs remove the impact of chance in cause and effect relationships, says Dr. Kalantri. # But ethically, an RCT can only be employed when researchers think/hope that the interventions will offer benefits. # Participants can be enrolled in a randomised controlled trial that is expected to leave them better off. The dexamethasone study where mortality was reduced by a third, is a classic example here. # The Solidarity and RECOVERY (or Randomised Evaluation of COVid-19 thERapY) trials are examples of large-scale

Easy to PICK600 – “UPSC Monthly Magazine\" June - 2020 Cyber Security Framework Recently, the cyber security attack on Australia’s comprises 14-15% of India’s total communication system has brought the economy, and is targeted to reach 20% by governance to a standstill. In India, too, cyber 2024. attacks have been occurring with increasing  Added Complexity: With more inclusion frequency. For example, leak of personal of artificial intelligence (AI), machine information of 3.2 million debit cards in 2016 learning (ML), data analytics, cloud and the Data Theft At Zomato (2017), computing and Internet of Things (IoT), Wannacry Ransomware (2017), PETYA cyberspace will become a complex Ransomware (2017) etc. domain, giving rise to issues of a techno- Further, Cyber security has become an integral legal nature. aspect of national security. Moreover, its area of  Securing Data: Data is referred to as the influence extends far beyond military domains to currency of the 21st century and due to its cover all aspects of a nation’s governance, bulk creation owing to India’s population, economy and welfare. several international companies (Google, Although India was one of the few countries Amazon etc.) are trying to have access to to launch a cybersecurity policy in 2013, not it. Given this there are issues related to data much has transpired in terms of a coordinated sovereignty, data localisation, internet cyber approach. Thus, there is a need for a governance, etc. Thus, there is a need to comprehensive cyber security policy in India. build strong cyber security architecture. Challenges Need For Cyber Security Framework  Lack of Cybersecurity WorkForce: The  National Security Imperative: The Indian military, central police change in military doctrines favouring the organizations, law enforcement agencies need to raise cyber commands reflects a and others are deficient in manpower, for shift in strategies, which include building software and hardware aspects integral to deterrence in cyberspace. The need for a this field. Moreover, there is a growing competent cyber security infrastructure as demand for professionals in Artificial part of national security was first Intelligence (AI), BlockChain emphasized by the Kargil Review Technology (BCT), Internet of Things Committee 1999. (IoT) and Machine Learning (ML).  Increasing Importance of Digital According to several estimates there is a Economy: The digital economy today need for at least three million cybersecurity professionals today.  Lack of Active Cyber Defence: India doesn’t have the ‘active cyber defence’ like the EU's General Data Protection Regulation (GDPR) or US’ Clarifying Lawful Overseas Use of Data (CLOUD) Act. Note:  Active Cyber Defence: It is far more than just the enhancement of defensive cybersecurity capabilities for the Government and the Intelligence Community. Active Cyber Defence-

Easy to PICK601 – “UPSC Monthly Magazine\" June - 2020 defined capabilities and processes are  Bringing Cyber Security in employed to support federal, state, and Education: Educational institutions local government agencies and including central universities, private organizations, critical infrastructure universities, industry associations, segments, and industry. Industrial Training Institutes (ITIs) must  Overlapping Regulatory Bodies: Unlike incorporate courses on cybersecurity. the US, Singapore, and the UK where there is a single umbrella organisation dealing in  Integrated Approach: Given increasing cybersecurity, India has several central dominance of mobile and bodies that deal with cyber issues, and telecommunication, both National cyber each has a different reporting structure. security policy and National Telecom Further, each state government has its Policy will have to effectively coalesce to own Cyber emergency Response Team make a comprehensive policy for 2030. (CERT).  Dependency on Foreign Players For Conclusion Cyber Security Tools: India lacks Promoting Indigenisation: There is a need to indigenisation in hardware as well as create opportunities for developing software to software cybersecurity tools. This makes safeguard cyber security and digital India’s cyberspace vulnerable to communications. The Government of India may cyberattacks motivated by state and non- consider including cybersecurity architecture in state actors. its Make In India programme. Also, there is a need to create suitable hardware on a unique  External Challenges: Challenges such as Indian pattern that can serve localised needs. growing Chinese influence in Indian Given the future of technology under Industrial telecom space, social media is becoming a Revolution 4.0, India requires a strong powerful tool for dissemination of cybersecurity framework based on the 4D “information” making it difficult to principles i.e. Deter, Detect, Destroy and differentiate fact from fake news. Document so that it can subverse all attempts towards any cyber challenges. Way Forward  Creating Awareness: With countries resorting to digital warfare and hackers targeting business organisations and government processes, India has to create awareness that not a single person or institution is immune to it. While the government and the corporate world are better placed perhaps to create their own programs, it is the civil society who needs to bring into this ambit.  Strengthening of Existing Cyber Security Framework: National cybersecurity projects such as the National Cyber Coordination Centre (NCCC), National Critical Information Infrastructure Protection Centre (NCIIPC) and the Computer Emergency Response Team (CERT) need to be strengthened manifold and reviewed.

Easy to PICK602 – “UPSC Monthly Magazine\" June - 2020 Grain aplenty and the crisis of hunger By, Dipa Sinha teaches at Ambedkar University expanded across the country, which is supposed to Delhi be achieved by March 2021. Context # Under ONOC, a beneficiary can receive # With the economic crisis continuing on the one ration entitlements as under the NFSA from any hand and the health system crumbling under the fair price shop in the country using burden of rising COVID-19 cases on the other, her/his Aadhaar number and biometric unemployment is high and it will take a while for authentication. lost livelihoods to be rebuilt, especially given the # This will apparently be possible once the fact that India was already facing an economic Aadhaar numbers of all members enlisted in slowdown along with high levels of inequality. ration cards are seeded, which will enable # It is absolutely essential that food support in the transactions under the Public Distribution form of free/subsidised grains is made available System across the country to be brought on to one to all without any disruptions. digital platform. # It has been announced that ONOC is An inadequate response operational in 20 States. # As a measure to address hunger, the central government announced as part of the ?1.70-lakh Biometric authentication crore relief package under the Pradhan Mantri # Portability across States is an important and Garib Kalyan Yojana (PMGKY) in the last valid concern that needs to be ensured so week of March that it would provide 5kg of that migrant workers can access their foodgrains and 1 kg of pulses for free to all those entitlements. who are beneficiaries under the National Food # ONOC, however, has a number of problems in Security Act (NFSA) for three months. the way it has been conceived, being Aadhaar- # As it became obvious that many were not part based. of the NFSA, the government, in May, almost # The experience of biometric two months after the lockdown was initiated, authentication using electronic point of sale announced its expansion to cover an additional (ePoS) machines so far suggests that it results eight crore individuals for two months to ensure in exclusion of some of the most that migrants are included under marginalised because of multiple reasons the Atmanirbhar Bharat Abhiyan package. including network issues, authentication # This basically meant each State being given failure and so on. foodgrain to the tune of 10% more than what # Keeping these concerns aside for now, it must be they normally get under the NFSA. noted that ONOC is definitely not a solution to the immediate crisis of hunger that continues in the What needs to be done aftermath of the lockdown. # What is required is a universal Public # The integrated management of PDS (IM-PDS) Distribution System (PDS) to ensure that nobody portal, which gives real time is excluded. data on transactions under ONOC, shows that # What is also an urgent need now is for the food for the month of May, there were a total of 378 support announced as part of the PMGKAY and transactions (3,077 beneficiaries) under ONOC Atmanirbhar package to be extended for a and 479 transactions (3,856 beneficiaries) in June longer period, as both end in June. (as on June 29, 2020). # Rather, the government seems to be indicating that all problems of exclusion will be resolved Overflowing granaries once the One Nation One Ration Card scheme is # The real issue is of burgeoning food stocks along

Easy to PICK603 – “UPSC Monthly Magazine\" June - 2020 with widespread hunger. # If we include unmilled paddy, foodgrain stock in the Food Corporation of India has now risen to almost 100 million MTs while the buffer stock norms is 41 million MTs. # This will increase even more as there is another week of procurement open in the rabi marketing season; there will be another round of procurement of kharif crop in a few months (49.9 million MTs of rice was the procurement during the kharif marketing season in 2019-20). # A universalised PDS giving 10kg of foodgrains per person per month for another four months requires about 47 million tonnes in total, assuming that nearly 85% of the population actually lifts their rations. # It can be safely assumed that the rich will automatically self-select themselves out of the system. This is indicative and the actual requirements would most likely be lower. # It is unfathomable why the PDS is not being universalised immediately especially when food stocks are at such a historic high. # The government seems to be hoping to get rid of grain through the Open Market Sale Scheme (OMSS) where it sells the grains at prices lower than the procurement cost but much higher than the issue prices under PDS, so that the fiscal consequences can be contained. # Earlier experiences with the OMSS do not spell much hope that this plan of the government will be successful. # In the period 2017-18 to 2020-21 (up to first week of June), only 16.6 million tonnes of rice and wheat have been sold under the OMSS. # The quantity sold each year was less than the quantity offered. # Moreover, one-third of all sales was to State governments (almost all the rice) thereby shifting the subsidy burden to State governments. # If not OMSS to private buyers, the only other options left are to either export them or let the grain go waste. Needless to say, choosing any of these options while people go hungry is nothing less than criminal.

Easy to PICK604 – “UPSC Monthly Magazine\" June - 2020 Legitimate concern: on law and order in Nagaland Context dismantle its parallel administrative and # By writing a strong letter to Nagaland Chief paramilitary structure. Minister Neiphiu Rio, alleging that “law and # The distrust it invokes among other Naga order has collapsed” in the State and that armed organisations besides other north-eastern gangs “who question the sovereignty and governments because of its core ideology of integrity of the nation” had challenged its a “greater Nagalim”, and the inherent authority by engaging in blatant “extortion” and difficulties in getting other insurgent actors on siphoning off funds meant for development board have made this a conflict that persists work, Governor R.N. Ravi has thrown down the despite the ceasefire and a problem that does not gauntlet to the ruling Nationalist Democratic lend itself to a quick solution. Progressive Party-led government, in which the # Yet, without an agreement to rein in all the BJP is a coalition partner. insurgent groups, the State government will have little leeway in imposing its will and prevent Slide in Law and Order the blatant extortion that is hampering # The Governor went on to write that functions development and law and order. such as “transfer and posting of officials” who are in charge of law and order above the district Way ahead level will be done with his approval, as proposed # The ball is therefore in the Centre’s court, and under Article 371A(1)(b) of the Constitution. by extension its interlocutor, Mr. Ravi’s, in # In a way, he was only voicing the concerns of finding a way to address this knotty issue. sections of civil society over the slide in law and # This the Governor must do, not by usurping the order; illegal collections by armed groups have authority of the State government in governance been an issue for several years. matters, but by patiently refocusing on the peace # In its response to the letter, the process. insurgent National Socialist Council of Nagalim-Isak Muivah (NSCN-IM), which has been observing a ceasefire with the government for the last 23 years, has said the group was only engaged in collecting “taxes”. # The much touted peace accord with the insurgent groups involved in the long- standing Naga conflict is yet to be achieved, despite the Centre’s push to conclude it last year. # Mr. Ravi has remained the Centre’s interlocutor, a position he took up in 2015, even after becoming the State Governor in August 2019. # Despite the Centre’s heady statements heralding a Naga peace accord since 2015, it is nowhere close to finalising it with the groups. # In some ways, this is due to the NSCN-IM’s obstinacy such as its insistence on retaining a separate flag and a Constitution for the State of Nagaland and its unwillingness to

Easy to PICK605 – “UPSC Monthly Magazine\" June - 2020 GS-IV

Easy to PICK606 – “UPSC Monthly Magazine\" June - 2020 \"My Life My Yoga\" video contest Introduction will be selected from winners from  Shri Narendra Modi, Prime Minister of different countries. India today called upon one and all to  Entries can be submitted by participate in the “My Life – My participants under three categories Yoga”(also called “Jeevan Yoga”) Video covering youth (aged under 18), adults (above 18 years) and yoga professionals, Blogging Contest, a joint effort and further, separately for male and by the Ministry of AYUSH and the female contestants. This makes it a total Indian Council for Cultural Relations of six categories in all. For the India contestants, prizes worth Rs. 1 lakh, (ICCR), during the course of his 50K and 25K for 1st, 2nd and monthly Mann Ki Baat address to the 3rd ranking within each of the nation. categories have been announced within the first leg. About My Life – My Yoga  Details of the global prizes will be announced shortly on the Yoga Portal of  The contest focuses on Ministry of AYUSH.  This contest is open to all participants the transformative impact of Yoga on across the world. the lives of individuals, and comes as one of the activities related to the observation of the sixth International Day of Yoga (IDY) coming up on 21st June 2020.  The contest has gone live on the social media handles of the Ministry of AYUSH today, 31 May 2020.  This year the Ministry is encouraging the people to practice Yoga at their homes due to the impact of COVID-19, with participation from the entire family.  Through the My Life – My Yoga video blogging competition, the Ministry of AYUSH and ICCR seek to raise awareness about Yoga and to inspire people to prepare for and become active participants in the observation of IDY 2020.  The contest will support participation via the social media platforms of Facebook, Twitter and Instagram. Video contest will be open to participants from all countries.  The contest will run in two legs. First leg consisting of an international video blogging contest, wherein the winners will be picked within a country. This will be followed by global prize winners who

Easy to PICK607 – “UPSC Monthly Magazine\" June - 2020 Profit, not profiteering States have done well to step in to regulate Way Forward charges for COVID-19 care in private hospitals  The state’s intervention could not have The role of the state as a big brother is been delayed any further. In fact, in problematic, and yet only a vigilant, just state retrospect, the strategy employed by the can temper the avaricious excesses in the Central government to cap the price of society it governs. The move by certain States tests for COVID-19 at ?4,500 in private to regulate hospital fees charged in the private labs could have been used to regulate sector for COVID-19 care falls square in this private hospitals’ charges too. category. Bombarded with reports about  Hospitals have been graded into exorbitant bills being raised in the private categories, depending on facilities sector for hospital care of persons who tested provided, with reasonable rates fixed positive for COVID-19, a few States decided to per day for each category. ICU rates are get involved, rightly so, and set a cap on the naturally higher, and States have tariff that can be charged by private hospitals. specified that private hospitals should follow the tariff for beds or they could  In some instances, the Indian Medical be charged for violations. Association also prayed for intervention  Making it a participatory process, the by the government to regulate this. private sector was also co-opted into discussions on tariff. Tamil Nadu  Maharashtra was the first to fix a tariff, has also fixed a separate tariff for followed by Gujarat and Tamil Nadu, beneficiaries under the Chief Minister’s three of the States seeing a high number Comprehensive Health Insurance of COVID-19 infections. Scheme (now subsumed under the Central Insurance scheme) making it  For the initial part of the epidemic, it easy for patients from lower income was the State that was the primary groups to access private care treatments testing agent and care giver, for all for COVID-19. COVID-19 cases.  It has also re-fixed the rate for testing in a private lab at ?3,000 per test. Further  At that stage, few private hospitals, if watchfulness should continue on the any, were in the front line of the battle. part of the State, but shorn of high- All tests were initially done by the handedness. government, and anyone who tested  Staying alive to the hardships of its positive was shifted to a government people, it must ensure ?that the harsh hospital for isolation and treatment. times are not further exacerbated by profiteering.  However, as the number of cases increased, naturally calling all hands to the deck meant the significant involvement of the private sector. Complaints of overcharging followed.  Media reports revealed differential rates across the country, but costs were upwards of ?7 lakh for a minimum 14- day period of hospitalisation, even for mildly symptomatic or asymptomatic patients. If intensive care unit care is warranted, then the rates would be much higher.

Easy to PICK608 – “UPSC Monthly Magazine\" June - 2020 International Day of Yoga 2020 with the “Yoga at Home, Yoga with Family” campaign Context buster.  In context of the current COVID-19  The 45-minute Common Yoga Protocol pandemic situation, slowdown in daily activities and restrictions on the (CYP) is one of the most popular Yoga movement of people, this year’s programmes across the world and has observance of International Day of been at the heart of the IDY since the Yoga will aim to highlight the health- beginning. building and stress-relieving aspects of  It was developed by a team of leading Yoga. Yoga gurus and experts, and includes  To facilitate this, the Ministry of safe practices to improve physical, AYUSH is organising a trainer-led mental, emotional and spiritual health session which will be telecasted on of the population, which can be Doordarshan on 21st June at practiced at home on a daily basis. 6:30AM for people to follow and  It is designed to be easily adoptable by practice in solidarity. the majority of the people irrespective of their age and gender and can be learnt Yoga at home through simple training sessions and online classes.  In the new scenario, the trend that has Common Yoga Protocol emerged for observation of IDY is to  The Ministry of AYUSH is encouraging the people to learn the Common Yoga focus on its health- rewards and to do Protocol using the resources made publicly available by the Ministry on Yoga at home on Yoga Day. The the Yoga Portal, its social media handles and the television. Ministry of AYUSH is supporting this  Prasar Bharati has initiated the daily trend by promoting the theme “Yoga at telecast of the Common Yoga Home, Yoga with Family” in its IDY Protocol on DD Bharati from 08:00 a.m. to 08:30 a.m., from the 11th of June activities. 2020.  The International Naturopathy  Every year, the 21st of June is Organisation (INO), an NGO that works for promotion of Naturopathy celebrated worldwide as and Yoga, has set a programme in motion to encourage its 25 lakh the International Day of Yoga (IDY). members to perform Yoga harmoniously based on CYP, from their  The public has embraced this event in houses. the previous years, adopting it as a celebration of India’s culture and tradition.  Today the whole world is worried and gloomy about the Covid- 19 pandemic. Yoga is especially relevant now, since its practice leads to both physical and mental wellbeing.  Of particular importance in these difficult times are the following two proven benefits which the public can gain from Yoga: 1. Positive impact on general health and immunity enhancement, and 2. Its globally accepted role as a stress

Easy to PICK609 – “UPSC Monthly Magazine\" June - 2020 NITI Aayog: Navigating the New Normal The National Institution for Transforming economics to several issues, including gender equality, a India (NITI) Aayog, in partnership with healthy and beautiful India, savings, tax compliance and several other stakeholders has launched credit quality. a behaviour change Behavioural Science campaign called ‘Navigating the New  Behavioural science is a method of Normal’, and its website. analysis that applies psychological insights into human behaviour to The campaign has two parts: explain their decision-making  In reality, decisions made by people  often deviate from the classical principles. Drawing on the psychology o Covid-safe behavioural of human behaviour, science provides insights to ‘nudge’ people towards norms: The first is a web portal, desirable behaviour. containing resources informed Nudge Theory  According to Nudge theory, people, by behavioural science and the rather than being forced, can be encouraged and influenced to pursue use of nudge and social norms or desist from certain actions through nudges. theory, related to Covid-safe  It does not talk about penalizing people if they do not behave in a particular behavioural norms during the manner, rather it encourages them to make desirable decisions. ongoing Unlock phase, and  It believes that Humans are not-so- rational and often need encouragement o Wearing of Masks: The second is or intervention — a nudge — to get going and do what’s best for the country a media campaign focused on or society at large.  American economist Richard Thaler the wearing of masks. has won the 2017 Nobel Prize in economics for his contributions to The portal focuses on easy implementation behavioural economics. of four key behaviours in the unlock phase: mask-wearing (essential focus), social distancing, Hand hygiene, and not spitting in public.  Citizens Role: It aims at desired social behaviour in which the enforcement burden shifts from the Government to the citizens.  Sector Specific: The website will have sector-specific collaterals and guidelines for health, nutrition, and public transport (in metro cities).  International Examples: Japan and South Korea have made ‘mask-wearing’ a socially accepted norm.  Recent Examples/Initiatives in India: o Recently, Meghalaya has issued a new health protocol which also lays emphasis on the Behaviour Change Model for living with Covid-19. o The Economic Survey 2019 too lays out an ambitious agenda for behavioural change by applying the principles of behavioural

Easy to PICK610 – “UPSC Monthly Magazine\" June - 2020 activities to enable consistent compliance to the COVID-19 protective behaviours. Limitations of Behavioural Science  Continuous Efforts vs One-time Action - Give It Up campaign for LPG subsidy was a comparatively easy policy as it requires only a one-time action of affluent households, whereas task is very difficult in case of living with Covid-19, Beti Bachao, Beti Padao and SBM, as it requires continuous effort to dislodge mind-sets that prevailed for decades.  Specific Targeting is Required: In order to make this campaign a success, focus must be on special areas of concern such as small factories and poor labourers, who comprise a large part of the vulnerable population. Example: Advertising campaigns such as the Beti Bachao Beti Padhao scheme did not target specific states where child sex ratios were already skewed (although it was effective in Haryana, which also has a very poor sex ratio).  Case of Confirmation Bias: The applications of behavioural insights appeared to be a result of confirmation bias (to the extent that past policies were viewed with a behavioural lens). Way Forward  As the lockdown is lifted, people will resume their normal activities. This raises a challenge of minimising the spread of Covid-19 without impacting the movement of people. This signals a need for change and creation of a “New Normal” – where we adapt our routine

Easy to PICK611 – “UPSC Monthly Magazine\" June - 2020