Nov 11th 2024 Current Affairs

Index:

1. An ambitious goal of "eliminating" TB by 2025

CONTEXT: In March 2018, Prime Minister Narendra Modi set an ambitious goal of “eliminating” TB by 2025, five years ahead of the United Nations Sustainable Development Goals (SDG) deadline set for 2030. Mr. Modi reiterated the government’s goal of “eliminating” TB by 2025 even in March 2023 while inaugurating the One World TB Summit 2023 in Varanasi.

The SDG targets for 2030 is 90% reduction in TB deaths compared with 2015 and 80% reduction in TB incidence compared with 2015.
As per WHO’s post-2015 End TB Strategy, compared with 2015, countries are required to meet the2025 milestones of reducing TB deaths by 75%, and reducing TB incidence rate by 50%
But as per the WHO Global TB Report 2024 and the India TB Report 2024 released a few days ago, India will not be able to even meet the 2025 milestones set by the WHO End TB Strategy, let alone achieving the ambitious goal of “eliminating” TB by 2025.

Fact

According to the India TB Report 2024, the TB incidence rate in India in 2015 was 237 per 1,00,000 population and the mortality rate was 28 per 1,00,000 population in 2015.
According to the WHO global TB report 2024, the TB incidence rate for India in 2023 was 195 per 1,00,000 population. It was 199 per 1,00,000 in 2022.
In the case of TB mortality, the rate was 22 per 1,00,000 population in 2023, down from 23 per one lakh in 2022.
As per the WHO report, the TB incidence rate in india had reduced by 18% between 2015 and 2023, while the reduction in the total number of TB deaths between 2015 and 2023 was only 24%
Since the End TB Strategy 2025 milestone requires 75% reduction in the total number of TB deaths and 50% reduction in TB incidence, India has to reduce the TB death rate from 28 per 1,00,000 in 2015 to seven per 1,00,000 by 2025 and the TB incidence rate from 237 per 1,00,000 in 2015 to 118.5 per 1,00,000 by 2025.
With only 24% reduction in the total number of TB deaths and 18% reduction in TB incidence between 2015 and 2023, India has not even met the 2020 milestones for TB deaths and TB incidence even three years after the 2020 target date.

India did not meet the ‘elimination’ targets set for 2023 by the India’s National Strategic Plan for TB elimination: 2017-2025 report published in 2017- reducing the estimated TB incidence rate per lakh population to 77, and reducing the estimated TB deaths per 1,00,000 population to six.

About – Tuberculosis is a serious infectious and contagious disease that generally affects lungs.

Cause: TB is caused by a bacterium known as Mycobacterium tuberculosis. Transmission – TB bacteria spread through the air from one person to another

Treatment-Drugs include Isoniazid (INH), Rifampicin, Pyrazinamide and Ethambutol (RZE) in daily doses

The National Tuberculosis Elimination Programme NTEP)-Aims to strategically reduce TB burden in India by 2025.

It was previously by known as Revised National Tuberculosis Control Programme (RNTCP). The government reached over a billion people in 632 districts/reporting units.
The National Strategic Plan for TB Elimination-It was launched to achieve the target of ending TB by 2025 in a mission mode.
It is a multi-pronged approach which aims to detect all TB patients with an emphasis on reaching TB patients seeking care from private providers and undiagnosed TB in high-risk populations
Ni-kshay Poshan Yojana(NPY)(Nutritional Support to TB) It helps to meet the nutritional requirements of TB patients, especially the underserved
From 2018 till present, around Rs. 1,707 crore has been disbursed to more than 65 lakh people on TB treatment across the country

What are the global measures to eradicate TB?

End TB Strategy-by World Health Organization (WHO) It serves as a blueprint for countries to reduce TB incidence by 80%, TB deaths by 90%, and to eliminate catastrophic costs for TB-affected households by 2030.
World Development Report (1993)-Published by the World Health Organization (WHO). The 1993 World Development Report labelled TB treatment for adults as the best buy among all developmental interventions.
The Global Fund – A worldwide movement to defeat HIV, TB and malaria and ensure a healthier, safer, more equitable future for all.
The Stop TB Partnership – Brings together expertise from a broad spectrum of country, regional, and global partners in our shared mission to revolutionize the TB space and and TB by 2030

Sustainable Development Goal 3- To and TB epidemic by 2030

2. Pinaka Multi-Barrel Rocket Launcher (MBRL) System

Overview:
- Pinaka is an indigenously developed multi-barrel rocket launcher (MBRL) designed by the Armament Research and Development Establishment (ARDE), a part of India’s Defence Research and Development Organisation (DRDO).
- First deployed during the 1999 Kargil War, the system played a crucial role in neutralizing enemy positions on mountain tops.
- Its primary function is to deliver lethal, responsive fire over a large area, targeting enemy troops, vehicles, communication centers, and ammunition dumps.

Key Features:
- Components:
  - A multi-tube launcher vehicle.
  - A replenishment-cum-loader vehicle.
  - A replenishment vehicle.
  - A command post vehicle.

Capacity: The launcher has two pods, each containing six rockets, capable of neutralizing an area of 700 x 500 square meters within 48 seconds.
Mobility:
- Mounted on a Tatra truck for rapid movement and mobility.
- Supported by four hydraulically actuated outriggers for stabilization during firing.
Range: Rockets have a range of 60 to 75 kilometers.
Origin: Developed in the late 1980s as an alternative to the Russian-made BM-21 ‘Grad’ rocket system, which remains in use by some Indian Army regiments.

Operational History:
- Kargil War: Played a key role by targeting Pakistani military positions during the conflict.
- Post-1999: Following successful battlefield use, multiple Pinaka regiments have been inducted into the Indian Army over the years.

Current Status:
- The Indian Army has four regiments of the Pinaka system, with six additional regiments on order.
- Pinaka Mark-1 was the first version, and advanced versions with extended range and capabilities have been developed.

International Interest:
- Armenia: Armenia became the first export customer of the Pinaka system.
- France: France is considering the Pinaka MBRL system to replace its aging M270 Lance-Roquettes Unitaire (LRU) rocket systems. The French Army is planning to conduct a detailed evaluation of the Pinaka system.

Strategic Importance:
- The system enhances India’s artillery capabilities and serves as a significant force multiplier in warfare.

Several countries have shown interest in the Pinaka system, underscoring its growing global reputation as a reliable and effective artillery system.

3. Trends in Government Health Spending in LICs and LMICs (2019-2023)

Overview: A recent World Bank study has revealed concerning trends in health spending across low-income countries (LICs) and lower-middle-income countries (LMICs), particularly as the world approaches the deadline for the Sustainable Development Goals (SDGs).
- The analysis covers government health expenditure in 63 LICs and LMICs from 2019 to 2023, comparing it with pre-pandemic spending patterns from 2015 to 2019.

Key Findings:
- Initial Spike in Health Spending: During the COVID-19 pandemic, there was an increase in health spending across LICs and LMICs as governments responded to the crisis.
- Post-Pandemic Decline:
  - Following the pandemic, there was a steady decline in health spending, with reductions becoming more permanent than initially expected.
  - Health expenditure per capita in many LICs and LMICs has been shrinking, raising concerns about meeting SDG targets related to healthcare access and quality.

Health Spending Trends (2019-2023):
- Slow Growth in Per Capita Spending: Between 2019 and 2023, per capita government health spending increased only modestly. This was mainly because general government spending grew faster than health spending, reducing the share of health in national budgets.
- Pre-Pandemic vs. Post-Pandemic: Prior to the pandemic, health spending was gaining prominence in national budgets. However, post-2020, this trend has reversed, especially in LICs where health funding has remained minimal and heavily reliant on external aid.
- Decline in Budget Share: The share of health spending in government budgets has decreased in many countries, particularly affecting low-income nations.

Risks for LICs and LMICs:
- Impact on 35 Nations (Including India): The study highlights risks for 35 nations, including India, where government health spending per capita and its share in the national budget have both fallen.
- IMF Projections (2023-2029): In 23 of these nations, the International Monetary Fund (IMF) projects a likely contraction in government budgets between 2023 and 2029, which may force policymakers to make difficult trade-offs to sustain health spending.

Challenges for SDG Targets: The ongoing decline in health spending poses a major challenge to achieving health-related SDGs, as sustained investment in healthcare is crucial to improving outcomes like universal health coverage, reducing maternal and child mortality, and combating diseases like malaria and HIV/AIDS.