1.The next step is a constitutional right to health

Presently, any investment in health care has failed to translate into a sense of security and sanctuary for many Indians

The brevity of human memory is often a blessing and even necessary for our collective healing from suffering. But the lessons we learn from suffering are possibly even more crucial. As our people continue to face individual and collective grief as a result of the novel coronavirus pandemic, it is the moral responsibility of our leaders to look ahead and learn the necessary lessons.

A place for this ‘right’

The lesson here is the need for the constitutional ‘Right to Health for all’. The pandemic has exposed and aggravated the cracks in our health-care systems, and this is a lesson we cannot afford to ignore and not learn.

In June this year, I called on the Parliament of India to take immediate measures to make necessary amendments to the Constitution to declare health care a Fundamental Right. I was reassured with positive responses from parliamentarians across party lines who have supported this call. Now, the time has come to make this a reality for India so our people never have to undergo the suffering that they did.

Through the eyes of citizens

The primary question raised is: what will a constitutional ‘Right to Health’ mean for a citizen of India? I will try and explain this through the lens of three categories of citizens: farmers and unorganised workers, women and children.

Farmers are the primary protectors of our fundamental right to life. Yet, the majority remain at a loose end when it comes to their own rights and well-being, and that of their families. Without an anchor during times of severe illness or disease, generations of children of small and landless farmers, and unorganised, migrant and seasonal workers are thrown into bondage and debt by having to pay for medical costs from their limited earnings. Employment benefit schemes do not reach them, and the ones that do are mostly on paper. The implementation of the right to health can provide simple, transparent and quality health care to those who are most in need of such care.

Women bear a disproportionate burden of the gaps in our health-care system. The taboos and patriarchal expectations surrounding their health lead to immense avoidable suffering. In addition, social and economic challenges prevent them from freely and openly accessing the little care that is available. A ‘Right to Health’ would mean that services reach the woman where and when she needs them.

A large number of children who belong to the poorest and most marginalised communities of our country grow up working in hazardous situations be it fields, mines, brick kilns or factories. They are either not enrolled in schools or are not able to attend it due to the pressing financial needs of the family — often because of unexpected out-of-pocket medical expenses.

Making it safer for children

My organisation has rescued over 1,00,000 such children from child labour, bonded labour, and trafficking. When rescued, these children are ridden with complex health impacts of working — primarily tuberculosis, skin diseases, eyesight impairment, and malnutrition, besides the substantial mental health impact. These children have been denied a safety net of early childhood care and protection, the consequences of which are felt for a lifetime. The ‘Right to Health’ will help transition the children in exploitative conditions into a safer future.

A constitutional ‘Right to Health’ will transform not only the health and well-being of our people but will act as a leap for the economic and developmental progress of the nation. Presently, any investment in health care fails to translate into a sense of security and sanctuary for the people of India. Instead, the complex and often corrupt means of accessing even existing health care only adds to the suffering instead of alleviating it. The vision for Ayushman Bharat will be strengthened with a constitutional ‘Right to Health’. The immediate financial security that will come with the constitutional ‘Right to Health’ will be seen as a measurable impact on family savings, greater investment, and jobs creation on the one hand, and in the long-term emotional, psychological and social security of people.

As a legacy

The world is taking steps, both big and small, in recovering from the pandemic through foresight in policy and investment. India must not lag behind. The right to free and compulsory education was arguably one of the most valuable legacies of the earlier Government. The true testament of bold leadership lies in its timely, compassionate and courageous decisions for the greater good. A constitutional amendment to introduce the ‘Right to Health for India’ can be the legacy of this Government.

Kailash Satyarthi, who won the Nobel Peace Prize in 2014, is an advocate of children’s rights. He is also the founder of the Global Campaign for Education and the Laureates and Leaders for Children

Indian Public Health Standards

• IPHS are a set of uniform standards envisaged to improve the quality of health care delivery in the country.
• The IPHS documents have been revised keeping in view the changing protocols of the existing programmes and introduction of new programmes especially for Non-Communicable Diseases.
• Flexibility is allowed to suit the diverse needs of the States and regions.
• The IPHS guidelines act as the main driver for continuous improvement in quality and serve as the benchmark for assessing the functional status of health facilities.
• States and UTs adopt these IPHS guidelines for strengthening the Public Health Care Institutions.
• Right To Health: The right to health, as with other rights, includes both freedoms and entitlements:
  • Freedoms include the right to control one’s health and body (for example, sexual and reproductive rights) and to be free from interference (for example, free from torture and non-consensual medical treatment and experimentation).
  • Entitlements include the right to a system of health protection that gives everyone an equal opportunity to enjoy the highest attainable level of health.
• Provisions Related to Right to Health in India:
  • International Conventions: India is a signatory of the Article 25 of the Universal Declaration of Human Rights (1948) by the United Nations that grants the right to a standard of living adequate for the health and well-being to humans including food, clothing, housing and medical care and necessary social services.
  • Fundamental Rights: Article 21 of the Constitution of India guarantees a fundamental right to life & personal liberty. The right to health is inherent to a life with dignity.
  • Directive Principles of State Policy (DPSP): Articles 38, 39, 42, 43, & 47 put the obligation on the state in order to ensure the effective realization of right to health.
  • Judicial Pronouncements: Supreme Court in Paschim Bangal Khet Mazdoor Samity case (1996) held that in a welfare state, primary duty of the government is to secure the welfare of the people and moreover it is the obligation of the government to provide adequate medical facilities for its people.
    • Also in its landmark judgment in Parmanand Katara Vs Union Of India (1989), Supreme Court had ruled that every doctor whether at a government hospital or otherwise has the professional obligation to extend his services with due expertise for protecting life.
• Significance of Right to Health for India:
  • Right Based Healthcare Services: The people are entitled to the right to health and it puts a compulsion for the government to take steps toward this.
  • Wide Access to Health Services: Enables everyone to access the services and ensures that the quality of those services is good enough to improve the health of the people who receive them.
  • Reduce Out of Pocket Expenditure: Protects people from the financial consequences of paying for health services out of their own pockets and reduces the risk of people getting pushed into poverty.
• Challenges:
  • Lack of Primary Healthcare Services: The existing public primary health care model in the country is limited in scope.
    • Even where there is a well-functioning public primary health centre, only services related to pregnancy care, limited childcare and certain services related to national health programmes are provided.
  • Inadequate Funding: Expenditure on public health funding has been consistently low in India (approximately 1.3% of GDP).
    • As per OECD, India’s total out-of-pocket expenditure is around 2.3 % of GDP.
  • Sub-optimal Public Health System: Due to this, it is challenging to tackle Non-communicable Diseases, which is all about prevention and early detection.
    • It diminishes preparedness and effective management for new and emerging threats such as pandemic like Covid-19.

2. India’s natural laboratories

Preserving geological heritage is as important as safeguarding biodiversity and cultural heritage

Like social diversity, India’s geodiversity, or variety of the geological and physical elements of nature, is unique. India has tall mountains, deep valleys, sculpted landforms, long-winding coastlines, hot mineral springs, active volcanoes, diverse soil types, mineralised areas, and globally important fossil-bearing sites. It is long known as the world’s ‘natural laboratory’ for geo-scientific learning.

Lack of geological literacy

Broken loose from a supercontinent 150 million years ago, the Indian landmass, with all its strange-looking plants and animals, drifted northwards all by itself for 100 million years until it settled under the southern margin of the Asian continent. It got entwined with the world’s youngest plate boundary. The geological features and landscapes that evolved over billions of years through numerous cycles of tectonic and climate upheavals are recorded in India’s rock formations and terrains, and are part of the country’s heritage. For example, the Kutch region in Gujarat has dinosaur fossils and is our version of a Jurassic Park. The Tiruchirappalli region of Tamil Nadu, originally a Mesozoic Ocean, is a store house of Cretaceous (60 million years ago) marine fossils. To know how physical geography gets transformed into a cultural entity, we need to study the environmental history of the Indus River Valley, one of the cradles of human civilisation. India offers plenty of such examples.

Geo-heritage sites are educational spaces where people find themselves acquiring badly needed geological literacy, especially at a time when India’s collective regard for this legacy is abysmal. Indian classrooms view disciplines like environmental science and geology with disdain compared to how they view other ‘pure’ subjects like physics, biology, and chemistry. This lack of interest in the government and our academic circles towards geological literacy is unfortunate at a time when we face a crisis like global warming. As the climate of the future is uncertain, decision-making is difficult. Learning from the geological past, like the warmer intervals during the Miocene Epoch (23 to 5 million years ago), whose climate can be reconstructed using proxies and simulations, may serve as an analogue for future climate. The awareness accrued through educational activities in geo-heritage parks will make it easy for us to memorialise past events of climate change and appreciate the adaptive measures to be followed for survival.

The importance of the shared geological heritage of our planet was first recognised in 1991 at an UNESCO-sponsored event, ‘First International Symposium on the Conservation of our Geological Heritage’. The delegates assembled in Digne, France, and endorsed the concept of a shared legacy: “Man and the Earth share a common heritage, of which we and our governments are but the custodians.” This declaration foresaw the establishment of geo-parks as sites that commemorate unique geological features and landscapes within their assigned territories; and as spaces that educate the public on geological importance. These sites thus promote geo-tourism that generates revenue and employment.

In the late 1990s, in what may be considered as a continuation of the Digne resolution, UNESCO facilitated efforts to create a formal programme promoting a global network of geoheritage sites. These were intended to complement the World Heritage Convention and the UNESCO Man and the Biosphere programme. UNESCO provided guidelines for developing national geo-parks so that they become part of the Global Geoparks Network. Today, there are 169 Global Geoparks across 44 countries.

Countries like Vietnam and Thailand have also implemented laws to conserve their geological and natural heritage. Unfortunately, India does not have any such legislation and policy for conservation. Though the Geological Survey of India (GSI) has identified 32 sites as National Geological Monuments, there is not a single geo-park in India which is recognised by the UNESCO. This is despite the fact that India is a signatory to the establishment of UNESCO Global Geoparks. The GSI had submitted a draft legislation for geo-heritage conservation to the Ministry of Mines in 2014, but it did not make any impact.

The development juggernaut

Despite international progress in this field, the concept of geo-conservation has not found much traction in India. Many fossil-bearing sites have been destroyed in the name of development. This indifference — strange as it may seem given the current dispensation’s penchant for crying itself hoarse about India’s heritage — is going to take a toll on our heritage. The development juggernaut will soon overwhelm almost all our sites of geo-heritage. For example, the high concentration of iridium in the geological section at Anjar, Kutch district, provides evidence for a massive meteoritic impact that caused the extinction of dinosaurs about 65 million years ago. This site was destroyed due to the laying of a new rail track in the area. Similarly, a national geological monument exhibiting a unique rock called Nepheline Syenite in Ajmer district of Rajasthan was destroyed in a road-widening project. The Lonar impact crater in Buldhana district of Maharashtra is an important geo-heritage site of international significance. It is under threat of destruction, although conservation work is now in progress under the High Court’s supervision.

We are inching towards the disappearance of most of our geological heritage sites. Thanks to unplanned and booming real estate business, many such features have been destroyed. Unregulated stone mining activities have also contributed to this destruction. This situation calls for immediate implementation of sustainable conservation measures such as those formulated for protecting biodiversity. Natural assets, once destroyed, can never be recreated. And if they are uprooted, they lose much of their scientific value.

Geo-conservation legislation

The protection of geo-heritage sites requires legislation. The Biological Diversity Act was implemented in 2002 and now there are 18 notified biosphere reserves in India. Geo-conservation should be a major guiding factor in land-use planning. A progressive legal framework is needed to support such strategies. In 2009, there was a half-hearted attempt to constitute a National Commission for Heritage Sites through a bill introduced in the Rajya Sabha. Though it was eventually referred to the Standing Committee, for some unstated reasons the government backtracked and the bill was withdrawn. In 2019, a group of geologists under the auspices of the Society of Earth Scientists petitioned the Prime Minister and the Ministries concerned about the need for a national conservation policy under the direct supervision of a national body committed to the protection of geo-heritage sites. But the government’s apathy continues.

Geological Survey of India

• It was set up in 1851 primarily to find coal deposits for the Railways.
• Over the years, it has not only grown into a repository of geo-science information required in various fields in the country but has also attained the status of a geo-scientific organisation of international repute.
• The main functions of the GSI relate to creation and updation of national geo-scientific information and mineral resource assessment.
• It is headquartered in Kolkata and has six regional offices located at Lucknow, Jaipur, Nagpur, Hyderabad, Shillong and Kolkata. Every state has a state unit.
• Presently, GSI is an attached office to the Ministry of Mines.

3.U.K. asks India to update climate goals

Johnson calls Modi; they speak about vaccine certifications and Afghanistan situation

British Prime Minister Boris Johnson spoke to Prime Minister Narendra Modi on Monday, urging India to announce a “more ambitious” Nationally Determined Contribution (NDC) ahead of a United Nations climate change summit in the U.K. in a few weeks. The two leaders also spoke about the issue of vaccine certifications and the Afghanistan situation.

“Prime Minister conveyed India’s commitment to Climate Action, as seen in its ambitious target for expansion of renewable energy and the recently announced National Hydrogen Mission,” a Ministry of External Affairs (MEA) statement said.

As president of the coming climate change conference, the U.K. is asking all countries to update their NDCs to reflect climate targets for the next few decades. “Prime Minister [Johnson] underlined the importance of making concrete progress on climate change ahead of and at the upcoming COP26 Summit. He noted that India already lead(s) the world in renewable technology and expressed his hope that they will commit to a more ambitious Nationally Determined Contribution and to achieving Net Zero emissions,” said an official release from the U.K. government on the conversation.

One hundred and ninety three countries filed their first NDCs, but only 19 have so far updated them. India filed its first NDC in 2016, committing at the time to cut emissions by 33% by 2030 (from 2005 levels) and to ensure that about 40% of its installed power capacity comes from renewable energy, targets that the government says it is on track to reach. However, the U.K. and the U.S. have been asking India to do more in terms of declaring its second NDC, which includes India’s promise of installing 450 GW of renewable energy by 2030, and to declare firm deadlines for achieving Net Zero carbon emissions and ending the use of coal for generating electricity, so as to keep global warming below 1.5 degrees Celsius. Mr. Modi has been invited to the UN Climate Change Conference of the Parties (COP26) in Glasgow from October 31 to November 12, but has not confirmed his attendance yet. He had been due to attend the G7 summit as a special invitee in the U.K. in June last, but had to cancel the visit due to the second wave of the pandemic. Mr. Johnson is also expected to reschedule his proposed visits to India in January and April this year, which had to be put off due to the pandemic as well.

Foreign Secretary visit

However, high-level visits by two Ministers, including the new British Foreign Secretary Liz Truss are expected shortly, and could coincide with India-U.K. naval exercises involving the U.K. Carrier Strike Group led by HMS Queen Elizabeth. Ms. Truss spoke to External Affairs Minister S. Jaishankar over the telephone last week about the vaccine issue as well as the U.K. India “Roadmap” for ties till 2030 and an enhanced trade partnership.

According to the U.K. statement, Mr. Modi and Mr. Johnson discussed the importance of “cautiously opening up international travel”, and the issue of vaccine certification.

Covishield recognition

Last week, the U.K. agreed to recognise Indian-administered Covishield and waived the need for nationals from India and 36 other countries to undertake home quarantines as long as they are vaccinated. However, the U.K. does not yet recognise Covaxin, which is awaiting clearances from the World Health Organization. “They agreed the U.K.’s recognition of Indian vaccine certification is a welcome development to that end,” the British statement said.

The leaders also talked about Afghanistan, both sides said. “In this context, they agreed on the need to develop a common international perspective on issues regarding extremism and terrorism, as well as Human Rights and rights of women and minorities,” the MEA statement added.

Background

The UNFCCC, in its Nationally Determined Contributions (NDC) Synthesis Report, has called for more ambitious climate action plans by the countries in order to achieve the Paris Agreement target of containing global temperature rise to 2°C (ideally 1.5°C) by the end of the century.

• The report was sought ahead of the 26^th session of the Conference of the Parties (COP 26) to the UNFCCC which is scheduled to take place from 1st-12th November 2021, in Glasgow, UK.
• NDCs are at the heart of the Paris Agreement and embody efforts by each country to reduce national emissions and adapt to the impacts of climate change. Each NDC reflects the country’s ambition, taking into account its domestic circumstances and capabilities.

Key Points

• About:
  • The NDC Synthesis Report covers submissions up to 31^st December 2020 and includes new or updated NDCs by 75 Parties, which represent approximately 30% of global greenhouse gas emissions.
• Findings:
  • Good Performers:
    • The United Kingdom and the European Union are the only regions among 18 of the world’s biggest emitters that have significantly increased their greenhouse gas (GHG) reduction targets.
  • Under Performers:
    • Sixteen of the world’s biggest emitters have not increased their emission reduction targets substantially or at all.
  • Adaptation Action and Economic Diversification:
    • More countries reported on mitigation co-benefits of adaptation action and economic diversification plans.
    • Adaptation actions and economic diversification plans with mitigation co-benefits include climate-smart agriculture, adapting coastal ecosystems, increasing the share of renewable sources in energy generation, carbon dioxide capture and storage, fuel switch and fuel price reforms in the transport sector, and moving to a circular economy for better waste management.
  • Need for the Update:
    • The current levels of climate ambition are very far from putting us on a pathway that will meet our Paris Agreement goals.
    • While a majority of countries increased their individual levels of ambition to reduce emissions, their combined impact will help achieve only a 1% reduction by 2030 compared to 2010 levels.
      
      
      • Global emissions, however, need to reduce by 45% in order to meet the 1.5°C goal, according to the Intergovernmental Panel on Climate Change.

UNFCCC

• About:
  • UNFCCC stands for United Nations Framework Convention on Climate Change.
  • The UNFCCC secretariat (UN Climate Change) is the United Nations entity tasked with supporting the global response to the threat of climate change.
  • The Convention has near universal membership (197 Parties) and is the parent treaty of the 2015 Paris Agreement. The UNFCCC is also the parent treaty of the 1997 Kyoto Protocol.
• Secretariat:
  • The UNFCCC secretariat is located in Bonn, Germany.
• Objective:
  • The ultimate objective of all three agreements under the UNFCCC is to stabilize greenhouse gas concentrations in the atmosphere at a level that will prevent dangerous human interference with the climate system, in a time frame which allows ecosystems to adapt naturally and enables sustainable development.

Paris Agreement

• About:
  • Paris Agreement (also known as the Conference of Parties 21 or COP 21) is a landmark environmental accord that was adopted in 2015 to address climate change and its negative impacts.
  • It replaced the Kyoto Protocol which was an earlier agreement to deal with climate change.
• Aims: To reduce global GHG emissions in an effort to limit the global temperature increase in this century to well below 2°C above pre-industrial levels, while pursuing means to limit the increase to 1.5°C by 2100. It also includes:
  • Addressing the financial losses vulnerable countries face from climate impacts such as extreme weather.
  • Providing financial assistance to countries that are less endowed and more vulnerable enabling them to adapt to climate change and transition to clean energy.
  • Climate finance is needed for mitigation, because large-scale investments are required to significantly reduce emissions. However, this part of the deal has been made non-legally binding on developed countries.
• INDCs: Before the conference started, more than 180 countries had submitted pledges to cut their carbon emissions (Intended Nationally Determined Contributions or INDCs).
  • The INDCs were recognised under the agreement, but are not legally binding.
  • India also reaffirmed its INDCs commitments to meeting the goals under the Agreement in order to combat climate change.
• CMA:
  • The CMA oversees the implementation of the Paris Agreement and takes decisions to promote its effective implementation.
  • All States that are Parties to the Paris Agreement are represented at the Conference of the Parties serving as the meeting of the Parties to the Paris Agreement (CMA), while States that are not Parties participate as observers.

India’s INDC, to be achieved primarily, by 2030

• To reduce the emissions intensity of the GDP by about a third.
• A total of 40% of the installed capacity for electricity will be from non-fossil fuel sources.
• India also promised an additional carbon sink (a means to absorb carbon dioxide from the atmosphere) of 2.5 to 3 billion tonnes of carbon dioxide equivalent through additional forest and tree cover by the year 2030.