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Wednesday, July 24, 2019


National Medical Commission (NMC) Bill
National Medical Commission Bill:
  1. The bill provides for the constitution of four autonomous boards entrusted with conducting undergraduate and postgraduate education, assessment and accreditation of medical institutions and registration of practitioners under the National Medical Commission.
  2. Composition of National Medical Commission: It will have government nominated chairman and members, and the board members will be selected by a search committee under the Cabinet Secretary. There will be five elected and 12 ex-officio members in the commission.
  3. As per the Bill, the government, under the National Medical Commission (NMC), can dictate guidelines for fees up to 40% of seats in private medical colleges. The bill also has a provision for a common entrance exam and licentiate (exit) exam that medical graduates have to pass before practising or pursuing PG courses. For MBBS, students have to clear NEET, and before they step into practice, they must pass the exit exam.
  4. Recognised medical institutions don’t need the regulator’s permission to add more seats or start PG course. This mechanism is to reduce the discretionary powers of the regulator.
  5. Earlier, medical colleges required the MCI’s approval for establishment, recognition, renewal of the yearly permission or recognition of degrees, and even increase the number of students they admitted. Under the new bill, the powers of the regulator are reduced to establishment and recognition. This means less red tape, but also less scrutiny of medical colleges.

Significance and the need:
  • The Bill seeks to regulate medical education and practice in India. 
  • The Bill attempts to tackle two main things on quality and quantity: Corruption in medical education and shortage of medical professionals.
  • The Bill aims to overhaul the corrupt and inefficient Medical Council of India, which regulates medical education and practice and replace with National medical commission.

Why is Medical Council of India being replaced?
  1. The Medical Council of India has repeatedly been found short of fulfilling its mandated responsibilities.
  2. Quality of medical education is at its lowest ebb; the current model of medical education is not producing the right type of health professionals that meet the basic health needs of the country because medical education and curricula are not integrated with the needs of our health system.
  3. Medical graduates lack competence in performing basic health care tasks like conducting normal deliveries; instances of unethical practice continue to grow due to which respect for the profession has dwindled.
  4. Compromised individuals have been able to make it to the MCI, but the Ministry is not empowered to remove or sanction a Member of the Council even if he has been proved corrupt.

Concerns:
  1. A bridge course allowing alternative-medicine practitioners to prescribe modern drugs is mentioned in the bill. Unscientific mixing of systems and empowering of other practitioners through bridge courses will only pave the way for substandard doctors and substandard medical practice. This will seriously impact patient care and patient safety
  2. Indian Medical Association (IMA) opposed the bill that it will cripple the functioning of medical professionals by making them completely answerable to the bureaucracy and non-medical administrators. NMC will become subservient to the health ministry, given that the representation of the medical profession in the new regulatory framework is minimal.
  3. The bill takes away the voting right of every doctor in Indiato elect their medical council.
  4. The bill allows private medical colleges to charge at will, nullifying whatever solace the NEET brought. The proposed NMC Bill discreetly intends to equate the post-graduate degrees given by MCI or proposed NMC and the National Board of Examination (NBE), which is unjustified too.
  5. Standards have been laid down for MCI courses, but not for NBE courses which are often run in private hospitals and nursing homes.
  6. It would replace an elected body (Medical Council of India, MCI) with one where representatives are “nominated.

Background:
The Medical Council of India was first established in 1934 under the Indian Medical Council Act, 1933. This Act was repealed and replaced with a new Act in 1956. Under the 1956 Act, the objectives of MCI include:
  • Maintenance of standards in medical education through curriculum guidelines, inspections and permissions to start colleges, courses or increasing number of seats.
  • Recognition of medical qualifications.
  • Registration of doctors and maintenance of the All India Medical Register.
  • Regulation of the medical profession by prescribing a code of conduct and taking action against erring doctors.

Sources: the hindu.

What to study?
For Prelims and Mains: e-cigarettes- concerns, effects on health, need for regulation, challenges associated and measures needed.

Context: Government’s proposal to ban e-cigarettes and other electronic nicotine delivery systems (ENDS) needs to be welcomed as such a move will ensure that Indians, especially, children, are kept away from these pernicious products.

Background:
The Indian Council of Medical Research (ICMR) has recommended ‘complete’ ban on Electronic Nicotine Delivery Systems (ENDS), including e-cigarettes. The recommendation is based on currently available scientific evidence.

Why ICMR has recommended a complete ban?
Addictive in nature: e-cigarettes and other such devices contained not only nicotine solution, that was highly addictive, but also harmful ingredients like flavoring agents and vaporisers. Availability of flavour variants and attractive designs are adding to allure of devices, and globally there was an increasing trend of e-cigarettes consumption among youth and adolescents.
Use of ENDS or e-cigarettes can open a gateway for new tobacco addiction among the masses as on the balance, these have a negative impact on public health.
Prolonged use of ENDS or e-cigarettes has documented adverse impact on humans which includes DNA damage, respiratory/cardiovascular/ neurological Disorders, carcinogenic/cellular/molecular/immunological Toxicity and even have adverse effects on fetal development and pregnancy.
Research has found that youths using e-cigarettes (or other such devices) are more likely to use regular cigarettes in later period. The exposure to ENDS increases the likelihood to experiment with regular products and increase intention to indulge in cigarette smoking.

What are e-cigarettes? 
An electronic cigarette (or e-cig) is a battery-powered vaporizer that mimics tobacco smoking. It works by heating up a nicotine liquid, called “juice.”
Nicotine juice (or e-juice) comes in various flavors and nicotine levels. e-liquid is composed of five ingredients:vegetable glycerin (a material used in all types of food and personal care products, like toothpaste) and propylene glycol (a solvent most commonly used in fog machines.) propylene glycol is the ingredient that produces thicker clouds of vapor.
Proponents of e-cigs argue that the practice is healthier than traditional cigarettes because users are only inhaling water vapor and nicotine.

Why its hard to regulate them? 
As e-cigarettes contain nicotine and not tobacco, they do not fall within the ambit of the Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003 (COTPA), which mandates stringent health warnings on the packaging and advertisements of tobacco products.

Need for regulation: The current unregulated sale of e-cigarettes is dangerous for a country like India where the number of smokers is on the decline (WHO Global Report, 2015) as it increases the possibility of e-cigarettes becoming a gateway for smoking by inducing nicotine addiction and perpetuating smoking by making it more attractive, thereby encouraging persons to become users of tobacco as well as e-cigarettes.

WHO report on e- cigarettes and effects:
  • As per the report, Electronic Nicotine Delivery Systems (ENDS) (also known as e-cigarettes) emits nicotine, the addictive component of tobacco products. In addition to dependence, nicotine can have adverse effects on the development of the foetus during pregnancy and may contribute to cardiovascular disease.
  • The WHO report further says that although nicotine itself is not a carcinogen, it may function as a “tumour promoter” and seems to be involved in the biology of malignant disease, as well as of neurodegeneration.
  • Foetal and adolescent nicotine exposure may have long-term consequences for brain development, potentially leading to learning and anxiety disorders.
  • The evidence is sufficient to warn children and adolescents, pregnant women, and women of reproductive age against ENDS use and nicotine.

Sources: the Hindu.

Prime Minister’s Research Fellows (PMRF) Scheme

In order to attract meritorious students into research, Government of India, in 2018 launched Prime Minister’s Research Fellows (PMRF) Scheme, which offers direct admission to such students in the Ph.D programmes in IITs, IISERs and IISc.
§  The scheme is aimed at attracting the talent pool of the country to doctoral (Ph.D.) programmes for carrying out research in cutting edge science and technology domains, with focus on national priorities.
§  Under the scheme, students who have completed, or are pursuing, the final year of four year undergraduate or five year integrated M.Tech or five year integrated M.Sc. or five year undergraduate-postgraduate dual degree programmes or two year M.Sc. programmes in Science and Technology streams from IIEST/IISc/IITs/NITs/IISERs and centrally funded IIITs or any other Institute / University recognized in India, are eligible for admission to full time Ph.D. programme in the IISc, IISERs and IITs.
§  A fellowship of Rs.70,000/- per month for the first two years, Rs.75,000/- per month for the 3rd year, and Rs.80,000/- per month in the 4th and 5th year provided under the scheme.
§  Apart from this, a research grant of Rs.2.00 lakh per year will be provided to each of the Fellows for a period of 5 years to cover their academic contingency expenses and for foreign/national travel expenses.
§  With further modification, the scheme has been opened for eligible students from all recognized institutions/universities in the country.
§  There will be a rigorous review of the performance of Prime Minister’s Research Fellowship holders and continuation of the next year fellowship shall be contingent upon successful review.
§  For attracting highly skilled researchers and scientists to pursue their R&D interests in Indian Institutions, several initiatives have been launched such as: 

o    CV Raman Post-Doctoral Fellowship Scheme by University Grants Commission (UGC),
o    Ramanujan Fellowship,
o    JC Bose Fellowship,
o    Young Scientist Project Award,
o    Women Scientist Scheme by Department of Science & Technology (DST), and
o    Global Initiative for Academic Network (GIAN) launched by MHRD, seeks to tap the talent pool of scientists and entrepreneurs from abroad, including those of Indian origin to augment the country’s existing academic resources.

South Asians at Higher Health Risks

According to a study published in Nature Scientific Reports,South Asians, even those who move to other countries, are at a higher risk of diabetes than people of most other ethnicities, the reason for this is their relatively low lean mass.

Findings

§  Mesolithic hunter-gatherer ancestors of South Asians were much taller, but low lean mass has characterised South Asians for at least 11,000 years, putting them at higher risk of type-2 diabetes and other non-communicable diseases (NCDs) such as heart disease, according to the study which analysed 197 archaeological and recent South Asian adult skeletons.
§  Height decreased by 8.5cm in men and 7.7cm in women when South Asians transitioned from hunting and gathering to farming around 9,000 years ago, but their lean mass (organ and muscle mass) has remained unchanged over the past 11,000 years, the study said.
§  The study suggests that while height is determined by nutritional factors, physique (bone breadth and lean mass) reflects ecological pressures.
§  The ancient origins of low lean mass in South Asians would be most consistent with long-term adaptation to ecological pressures, rather than more recent dietary change or the impact of 19th-20th century famines exacerbated by British colonial policy.
§  Low lean mass is present at birth in South Asian babies compared with European babies. Even after South Asian families migrate to other parts of the world, such as the UK, their children, after several generations still have low lean mass compared with children of European ancestry.
§  People of South Asian ancestry are at a higher risk of diabetes, compared to their European counterparts, even after considering the risks like unhealthy diet, sedentary lifestyles and obesity.

Projection

§  Since changes in lean mass are unlikely over the next four to five generations, making lifestyle interventions are crucial to containing NCDs, which account for 60% of all deaths in India.

Suggestions

§  The implications of the study are that low lean mass is a very ancient characteristic, so it is unlikely to change much in the coming generations.
§  This means that other interventions, especially the promotion of healthy lifestyles, are particularly critical to manage the growing health and economic burden of chronic diseases.
§  Building muscle mass and high fitness levels have the potential for averting diabetes, and even heart disease.
§  South Asians need to build lean muscle mass from an early age, so sports should be an integral part of school curriculum, along with muscle-building exercises and enhanced protein intake.
Diabetes is defined as a condition that occurs when the body cannot efficiently make use of glucose that serves as a source of energy for body cells. A hormone called Insulin controls blood sugar levels.
§  Diabetes is either caused by insufficient production of insulin by the pancreas or if the body cells not effectively responds to the insulin produced.
Diabetes Mellitus
§  It is the inability of the body to effectively use or respond to the insulin produced by the body, and as a result, blood sugar levels cannot be regulated effectively. It is further classified into two types,
§  Type 1 Diabetes: It occurs when the pancreas fails to produce sufficient insulin.
§  Type 2 Diabetes: Type 2 diabetes is the most common type of diabetes. In this condition body does not use insulin properly. This is called insulin resistance.The main reason for the occurrence of type 2 diabetes is due to obesity and lack of exercise.

 Context: Ministry of Tourism under the Swadesh Darshan Scheme has identified Tirthankar Circuit as one of the fifteen thematic circuits for development in the country. All the sites associated with Jainism are covered under this circuit.
Ministry has sanctioned the project “Development of Tirthankar Circuit: Vaishali-Arrah-Masad-Patna-Rajgir-Pawapuri-Champapuri in Bihar”.

About Swadesh Darshan Scheme:
Tourism Ministry launched the scheme.
Objective: to develop theme-based tourist circuits in the country. These tourist circuits will be developed on the principles of high tourist value, competitiveness and sustainability in an integrated manner.

Features of Swadesh Darshan Scheme:
  1. 100% centrally fundedfor the project components undertaken for public funding.
  2. To leverage the voluntary funding available for Corporate Social Responsibility (CSR)initiatives of Central Public Sector Undertakings and corporate sector.
  3. Funding of individual project will vary from state to state and will be finalised on the basis of detailed project reports prepared by PMC (Programme Management Consultant).
  4. PMC will be a national level consultant to be appointed by the Mission Directorate.
  5. National Steering Committee (NSC)will be constituted with Minister in charge of M/O Tourism as Chairman, to steer the mission objectives and vision of the scheme.
  6. Mission Directorateheaded by the Member Secretary, NSC as a nodal officer will help in identification of projects in consultation with the States/ UTs governments and other stake holders.



Background:
The National Policy on Biofuels-2018 approved by the Government envisages an indicative target of 20% blending of ethanol in petrol and 5% blending of bio-diesel in diesel by 2030.

National Policy on biofuels- salient features:
  1. Categorization: The Policy categorises biofuels as “Basic Biofuels” viz. First Generation (1G) bioethanol & biodiesel and “Advanced Biofuels” – Second Generation (2G) ethanol, Municipal Solid Waste (MSW) to drop-in fuels, Third Generation (3G) biofuels, bio-CNG etc. to enable extension of appropriate financial and fiscal incentives under each category.
  2. Scope of raw materials:The Policy expands the scope of raw material for ethanol production by allowing use of Sugarcane Juice, Sugar containing materials like Sugar Beet, Sweet Sorghum, Starch containing materials like Corn, Cassava, Damaged food grains like wheat, broken rice, Rotten Potatoes, unfit for human consumption for ethanol production.
  3. Protection to farmers:Farmers are at a risk of not getting appropriate price for their produce during the surplus production phase. Taking this into account, the Policy allows use of surplus food grains for production of ethanol for blending with petrol with the approval of National Biofuel Coordination Committee.
  4. Viability gap funding: With a thrust on Advanced Biofuels, the Policy indicates a viability gap funding scheme for 2G ethanol Bio refineries of Rs.5000 crore in 6 years in addition to additional tax incentives, higher purchase price as compared to 1G biofuels.
  5. Boost to biodiesel production:The Policy encourages setting up of supply chain mechanisms for biodiesel production from non-edible oilseeds, Used Cooking Oil, short gestation crops.

Expected benefits:
Import dependency: The policy aims at reducing import dependency.
Cleaner environment: By reducing crop burning & conversion of agricultural residues/wastes to biofuels there will be further reduction in Green House Gas emissions.
Health benefits: Prolonged reuse of Cooking Oil for preparing food, particularly in deep-frying is a potential health hazard and can lead to many diseases. Used Cooking Oil is a potential feedstock for biodiesel and its use for making biodiesel will prevent diversion of used cooking oil in the food industry.
Employment Generation: One 100klpd 2G bio refinery can contribute 1200 jobs in Plant Operations, Village Level Entrepreneurs and Supply Chain Management.
Additional Income to Farmers: By adopting 2G technologies, agricultural residues/waste which otherwise are burnt by the farmers can be converted to ethanol and can fetch a price for these waste if a market is developed for the same.

Significance of Biofuels:
Globally, biofuels have caught the attention in last decade and it is imperative to keep up with the pace of developments in the field of biofuels. Biofuels in India are of strategic importance as it augers well with the ongoing initiatives of the Government such as Make in India, Swachh Bharat Abhiyan, Skill Development and offers great opportunity to integrate with the ambitious targets of doubling of Farmers Income, Import Reduction, Employment Generation, Waste to Wealth Creation.

Classification of Biofuels:
1st generation biofuels are also called conventional biofuels. They are made from things like sugar, starch, or vegetable oil. Note that these are all food products. Any biofuel made from a feedstock that can also be consumed as a human food is considered a first-generation biofuel.
2nd generation biofuels are produced from sustainable feedstock. The sustainability of a feedstock is defined by its availability, its impact on greenhouse gas emissions, its impact on land use, and by its potential to threaten the food supply. No second generation biofuel is also a food crop, though certain food products can become second generation fuels when they are no longer useful for consumption. Second generation biofuels are often called “advanced biofuels.”
3rd generation biofuels are biofuel derived from algae. These biofuels are given their own separate class because of their unique production mechanism and their potential to mitigate most of the drawbacks of 1st and 2nd generation biofuels.

Mains Question: Discuss the importance of biofuels for India? Critically examine whether the national policy on biofuels will help India unlock it’s biofuel potential?
Context: In 2016, a 17-year-old was booked for the murder of his three-year-old neighbour in Mumbai. The Mumbai city Juvenile Justice Board as well as a children’s court directed that he be tried as an adult under the Juvenile Justice (Care and Protection) Act, 2015. Last week, the Bombay High Court set aside these orders and directed that the accused be tried as a minor, saying the Act is reformative and not retributive.

When is a child tried as an adult?
The Juvenile Justice Act of 2000 was amended in 2015 with a provision allowing for Children in Conflict with Law (CCL) to be tried as adults under certain circumstances.
The Act defines a child as someone who is under age 18. For a CCL, age on the date of the offence is the basis for determining whether he or she was a child or an adult.
The amended Act distinguishes children in the age group 16-18 as a category which can be tried as adults if they are alleged to have committed a heinous offence — one that attracts a minimum punishment of seven yearsThe Act does not, however, make it mandatory for all children in this age group to be tried as adults.

Why was this distinction made?
The amendment was proposed by the Ministry of Women and Child Development in 2014. This was in the backdrop of the gang-rape of a woman inside a bus in Delhi in 2012, leading to her death. One of the offenders was a 17-year-old, which led to the Ministry proposing the amendment (although it could not have retrospectively applied to him).
The then Minister, Maneka Gandhi, cited an increase in cases of offenders in that age group; child rights activists objected to the amendment.
The J S Verma Committee constituted to recommend amendments also stated that it was not inclined to reduce the age of a juvenile from 18 to 16. The amendment was made in 2015.

When can a child be tried as an adult?
As per Section 15 of the JJ Act, there are three criteria that the Juvenile Justice Board in the concerned district should consider while conducting a preliminary assessment to determine whether the child should be tried as an adult or under the juvenile justice system, which prescribes a maximum term of three years in a special home. The criteria are:
  1. Whether the child has the mental and physical capacity to commit such an offence.
  2. Whether the child has the ability to understand its consequences.
  3. The circumstances in which the offence was committed.
If the Board finds that the child can be tried as an adult, the case is transferred to a designated children’s court, which again decides whether the Board’s decision is correct.
Sources: Indian Express.


Context: The Right to Information (Amendment) Bill, 2019 that amends the Right to Information Act, 2005 has been introduced in Lok Sabha.
However, former information commissioners and RTI activists have come out strongly against the move by the central government to amend the RTI Act, 2005.

Amendments include:
  1. The Centre shall have the powers to set the salaries and service conditions of Information Commissioners at central as well as state levels.
  2. Term of the central Chief Information Commissioner and Information Commissioners: appointment will be “for such term as may be prescribed by the Central Government”.
  3. While the original Act prescribes salaries, allowances and other terms of service of the state Chief Information Commissioner as “the same as that of an Election Commissioner”, and the salaries and other terms of service of the State Information Commissioners as “the same as that of the Chief Secretary to the State Government”, the amendment proposes that these “shall be such as may be prescribed by the Central Government”.

Why is it being opposed?
  1. The original Act had quantified the tenures, and defined the salaries in terms of existing benchmarks. The amendments are being viewed as implying that, in effect, the terms of appointment, salaries and tenures of the Chief Information Commissioners and Information Commissioners can be decided on a case-to-case basis by the government. This will take away the independence of the RTI authorities.
  2. Therefore, the Bill is being seen as a “threat to the independence” of the Central Information Commissioner.
  3. By diminishing the status of the CIC, IC and State CIC from that of a Supreme Court judgewould reduce their ability to issue directives to senior government functionaries.
  4. The amendments would empower the Centre to make rules to decide the tenure, salary, allowances and other terms of service of information commissioners of the Central and also State Information Commissions. This will fundamentally weaken the institution of the information commissions as it will adversely impact the ability of commissioners to function in an independent manner.
  5. The government has brought about the Bill in complete secrecy and there have been no public consultations on the Bill, which will impact the fundamental right to information of the citizens of the country.

What are the government’s stated grounds for bringing the amendments?
The statement of objects says “the mandate of Election Commission of India and Central and State Information Commissions are different. Hence, their status and service conditions need to be rationalised accordingly”.
CIC has been given the status of a Supreme Court Judge, but his judgments can be challenged in the High Courts.
Therefore, the amendments Have been brought to correct certain anomalies in the RTI Act. It does not dilute the Act in anyway and it was passed in a hurry in 2005. RTI Amendments would strengthen the overall RTI structure.

Over the last 14 years, how far has the RTI Act served the purposes for which it was introduced?
The RTI Act is regarded as one of the most successful laws of independent India. It has given ordinary citizens the confidence and the right to ask questions of government authorities. According to estimates, nearly 60 lakh applications are being filed every year. It is used by citizens as well as the media. The law is seen as having acted as a deterrent for government servants against taking arbitrary decisions.
Sources: the Hindu.

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