1. Come out with ‘rule curve’ for Mullaperiyar: SC
Failure to give information will attract appropriate action, it tells Tamil Nadu
The Supreme Court on Tuesday said the Tamil Nadu Chief Secretary will be “personally responsible” and “appropriate action” will be taken on failure to give information on the ‘rule curve’ for the Mullaperiyar dam to the Supreme Court-appointed Supervisory Committee.
The ‘rule curve’ in a dam decides the fluctuating storage levels in a reservoir. The gate opening schedule of a dam is based on the ‘rule curve’. It is part of the “core safety” mechanism in a dam.
After a nearly day-long hearing, a Bench led by Justice A.M. Khanwilkar directed the Supervisory Committee to issue directions or take steps to address the three core safety issues — the monitoring and performance of the instrumentation of the dam, finalising the ‘rule curve’ and fixing the gate operating schedule — and submit a compliance report in four weeks.
“We find that the three core issues are directly concerned with the safety of the dam and will have a cascading effect on persons residing in the nearby areas,” the court noted.
T.N. blames Kerala
During the high-voltage hearing, the Tamil Nadu government blamed Kerala for delaying the finalisation of the ‘rule curve’ for the 123-year-old dam.
“Right from the beginning, Kerala has adopted an obscurantist and obstructive stand… Kerala government is somehow not comfortable with Tamil Nadu operating the dam. Kerala has made consistent efforts to obstruct Tamil Nadu from operating the dam. Kerala is preventing the finalisation of the ‘rule curve’. We are not able to access data which is in their terrain. There is no road built, the power supply has not been restored, though we had paid for it… How do we function?” senior advocate Shekhar Naphade, for Tamil Nadu, said.
“First you give the information on the ‘rule curve’ to the Supervisory Committee… Trees and roads do not immediately concern the safety of the dam,” Justice Khanwilkar told the Tamil Nadu side.
The Kerala government, represented by senior advocate Jaideep Gupta, has accused Tamil Nadu of adopting an “obsolete” gate operation schedule dating back to 1939.
However, the court sharply intervened to stop Kerala from making any politically-coloured statements in court. Justice Khanwilkar said the court was not the place to make political speeches to the masses. “Local politics between States should not be played out in the Supreme Court,” Justice Khanwilkar remarked.
The court was hearing a petition filed by Dr. Joe Joseph and the office-bearers of the Kothamangalam block panchayat in Kerala, expressing their apprehensions about the lack of proper supervision of water levels in the dam located along the Periyar tiger reserve.
“Meetings are held just for attendance. The instrumentation scheme, safety mechanism, etc., have not been finalised for the past six years. The sub-committee was formed by the Supervisory Committee without informing the Supreme Court… We are seeking a continuous mandamus from the Supreme Court to control and monitor the work of the Supervisory Committee,” senior advocate Gopakumaran, representing the petitioners, said.
The court listed the case for hearing on April 22.
- The Mullaperiyar dam is located on the confluence of the Mullayar and Periyar rivers in Kerala’s Idukki district.
- It is operated and maintained by the Tamil Nadu for meeting the drinking water and irrigation requirements of five of its southern districts.
- According to a 999-year lease agreement made during the British rule the operational rights were handed over to Tamil Nadu.
- The dam intends to divert the waters of the west-flowing river Periyar eastward to the arid rain shadow regions of the Tamil Nadu.
- It is a masonry gravity dam on the Periyar River in the Indian state of Kerala.
- It is located 881 m above mean sea level, on the Cardamom Hills of the Western Ghats in Thekkady, Idukki District of Kerala.
- The Periyar River is the longest river in the state of Kerala with a length of 244 km.
- It is also known as ‘Lifeline of Kerala’ as it is one of the few perennial rivers in the state.
- A perennial river is a channel that has continuous flow in parts of its stream bed all year round.
- Periyar River originates from Sivagiri hills of Western Ghats and flows through the Periyar National Park.
- The main tributaries of Periyar are Muthirapuzha, Mullayar, Cheruthoni, Perinjankutti.
What’s the issue surrounding?
The lease agreement was renewed in the 1970s by both Tamil Nadu and Kerala giving the former rights to the land and water from the dam, besides the authority to develop hydropower projects at the site. In return, Kerala would receive rent from Tamil Nadu.
- The first cracks in this agreement surfaced in 1979 when a minor earthquake had resulted in cracks in the dam.
- The Central Water Commission, under the Government of India, conducted a study and recommended lowering the water stored in the dam’s reservoir to 136 feet from 142 feet.
- If definitive measures were implemented, only then could the Tamil Nadu administration raise water levels to the dam’s full capacity of 152 feet.
What Tamil Nadu says?
Tamil Nadu claims that although it has undertaken measures to strengthen the dam, the Kerala government has blocked any attempt to raise the reservoir water level – resulting in losses for Madurai farmers.
Kerala, however, highlights fears of devastation by residents living downstream in the earthquake-prone district of Idukki.
Scientists have argued that if there is an earthquake in the region measuring above six on the Richter scale, the lives of over three million people will come under grave danger.
Supreme Court verdict:
- In 2006, the Supreme court gave Tamil Nadu legal sanction to raise the water level to 142 feet.
- In response, Kerala amended the 2003 Kerala Irrigation and Water Conservation Act, restricting the water level to 136 feet.
- In 2012, however, an Apex court-appointed committee stated that the dam was “structurally and hydrologically safe” and that the Tamil Nadu government could raise water levels up to 142 feet.
- In 2014, the court event struck down the amendment to the 2003 Kerala Irrigation and Water Conservation Act, calling it unconstitutional.
- The Supreme Court had also directed the Centre and the governments of Kerala and Tamil Nadu to set up three panels to prepare a contingency plan in case of a disaster.
2. ‘Census interim data by 2024’
Ministry tells parliamentary panel that NPR data will also be available by LS poll
The provisional data for the latest Census and National Population Register (NPR) will be available before the Lok Sabha election in 2024, according to information provided by the Union Home Ministry to a parliamentary committee.
The Ministry informed the committee that Census and update of the NPR would be among the major thrust areas for the financial year 2021-22.
The previous Census was conducted in 2011 and the NPR, which has a database of 119 crore residents, was last updated in 2015.
The first phase of Census House-listing and Housing Census that was to be conducted along with the NPR from April 1, 2020, was indefinitely postponed due to the COVID-19 pandemic.
The Ministry shared a tentative timeline with the parliamentary panel, saying that provisional Census results will be released in the financial year 2023-24 and the primary Census abstracts (PCA) will provide village-level data on important indicators.
As reported by The Hindu, a mobile application has been developed for collecting the Census details and NPR and residents can also self-enumerate The fieldwork for the first phase of Census 2021 that will provide data on housing conditions, household amenities and assets possessed by the households is expected in 2021-22.
The fieldwork for population enumeration phase to provide data on demography, religion, SC/ST, language, literacy and education, economic activity, migration and fertility will be done in 2023-24.
The committee was informed that the mobile app through which Census will be conducted will be available in 16 languages.
The Ministry said the NPR database had been created by collecting family-wise data and it can be strengthened by linking Aadhaar to each member.
It said “consolidated details of a family” are not available through Aadhaar and based on it “a family structure” cannot be created without visiting each household and collecting information such as relationship among family members.
“Further, the Aadhaar database may not be made available to this office due to legal provisions in the Aadhaar Act, 2016. During the next update of NPR, the Aadhaar number is being collected voluntarily. The presence of the Aadhaar number in the NPR database will facilitate its integration with other databases,” the Ministry said in the report.
- A population Census is the process of collecting, compiling, analyzing and disseminating demographic, social, cultural and economic data relating to all persons in the country, at a particular time in ten years interval.
- India is recognised for its ‘Unity in diversity’ and the Census gives the citizens a chance to study this diversity and associated facets of their nation through its society, demography, economics, anthropology, sociology, statistics, etc.
- The earliest literature ‘Rig Veda’ reveals that some kind of population count was maintained during 800-600 BC.
- Kautilya’s Arthasastra (written around 321-296 BC) laid stress on Census taking as a measure of State policy for purpose of taxation.
- During the regime of Mughal king Akbar, the administrative report ‘Ain-e-Akbari’ included comprehensive data pertaining to population, industry, wealth and many other characteristics.
- The first Census was conducted in India in 1872 (although non-synchronously in different parts) during the reign of Governor-General Lord Mayo. The first complete synchronous Census was conducted in 1881.
- With a history of more than 130 years, it has proved to be a reliable exercise that is conducted every 10 years.
- Census-2021 is the 16th such exercise since inception and 8th since independence.
How is the Census Conducted?
- The primary tool of Census operations is the questionnaire that is developed over the years, taking into account the changing needs of the country.
- It is a list of questions that helps the government collect all the necessary details required about citizens. The questions enhance the credibility & quality of data if various dimensions of socio-economic issues are well incorporated in the questionnaire.
- The name of person, relationship with the head, sex, date of birth and age, current marital status, religion, mother tongue, literacy status inter alia are some of the fundamental questions which are asked by the enumerators (a person employed in taking a Census of the population).
- The Census-2021 exercise would be conducted in two rounds:
- Household Schedule: The first round will be conducted in 2020, wherein the enumerators would go on a house-to-house basis to record amenities in each household.
- The second round– ‘Headcount’ would be carried out in early 2021 approximately 6 months after the first round.
|Census Act, 1948|
Although the population Census of India is a major administrative function, the Census Organisation was set up on an ad-hoc basis for each Census till the Census of 1951.The Census Act, enacted in 1948, then provided for the permanent scheme of conducting population Census with duties and responsibilities of Census Officers.The Act makes it obligatory on the part of every citizen to answer the Census question truthfully and also penalises for giving false information.One of the most important provisions of the Census Act 1948 is that it makes provisions for the maintenance of secrecy of the information collected at the Census of each individual. All information collected under the Census is confidential and is not shared with any agency- Government or private.
The Government of India in May 1949 decided to initiate steps for developing the systematic collection of statistics on the size of the population, its growth, etc.For this purpose, it established an organisation viz. Office of the Registrar General and Census Commissioner under Ministry of Home Affairs (which is responsible for conducting the decennial Census).Later, this office was also entrusted with the responsibility of implementation of Registration of Births and Deaths Act, 1969 in the country.
Importance of Census
- Comprehensive Source of Data: Census is a data collection exercise. It gathers knowledge about the demographic dividend of the nation which is vital for many purposes.
- Various surveys like health survey, education survey, agriculture survey, etc. are based on this comprehensive data.
- Decision-making: Census is significant for any country for evidence-based decision making.
- The data collected through the Census is used for administration, governance, planning and policy-making as well as management and evaluation of various programmes run or to be introduced by the Government, NGOs, researchers, commercial and private enterprises, etc.
- Policy-making: Census is responsible for taking the collected information “from a dwelling unit to the delivery unit”. It will boost coherence policy-making and scientific planning, resulting in optimisation of resources.
- To scholars and researchers in demography, economics, anthropology, and many other disciplines, the Indian Census has been a fascinating source of data.
- The collected data from the Census is available to grassroots administrative authorities of a particular region in order to take appropriate developmental tasks.
- It helps in effective targeting and better delivery of government programmes to the most downtrodden sections of the society.
- Demarcation: Census data is also used for the demarcation of constituencies and allocation of representation to the Parliament, State Legislative Assemblies and local bodies.
- Giving Grants: Finance Commission gives grants to the states on the basis of population figures available from the Census data.
How is Census-2021 different from Earlier Ones?
- Digital Data: It is for the first time the data is collected digitally via mobile applications (installed on enumerator’s phone) with a provision of working in offline mode. This would help in reducing the delay and having the results almost immediately, unlike earlier cases where it used to take multiple years for the data to be analyzed and the reports published.
- The data collected by enumerator on his/her phone will be registered with the Census authorities. In case of lack of network availability/connectivity, he/she will also have an option to collect the same information on paper and then make data entries onto the application (in offline mode).
- No document will be required by the citizens to be shown as proof, and self-declaration will suffice the same.
- Census Monitoring & Management Portal will act as a single source for all officers/ officials involved in Census activities to provide multi-language support.
- No Caste Data: The latest Census (as per the existing plan) will not collect caste data. While the Socio-Economic Caste Census (SECC) was conducted alongside Census 2011, the outcome of the caste Census is yet to be made public.
- Transgender Head: It is for the first time that information of households headed by a person from the transgender community and members living in the family will be collected. Earlier there was a column for male and female only.
- Errors: There are two types of error during statistical exercise: Content error, and Coverage error which needs to be minimised.
- People should not be considered as a mere headcount but as citizens having certain basic rights. Therefore, accurate data collection with minimal exclusion should be focused upon.
- Furnishing of false information: Due to fear of losing intended benefits of various schemes (or fear of losing citizenship this time) and lack of education, people fabricate and tend to provide false information. For example, people had apprehensions about the data collection of children not going to school and many-a-times they did not answer the survey questions.
- In this regard, the Kerala CM urged the people to acknowledge true information and take the Census exercise seriously.
- Associated Costs: Huge expenditure (thousands of crores) is incurred by the government in conducting this exercise.
- Security: The move towards digital mode of collecting the data is a step forward to speed up the process of analysis. However, the security of the data being collected (especially on the application) and adequate backup mechanism for such data has to be looked into.
- The mistrust and fear of misuse of data need to be minimized and mitigated.
- Abuse of Data: The availability of data with regional authorities has the potential for abuse of such data, as the concerned authority has access to everything about a particular family (ownership, caste, financial aspects, occupation, lifestyle, etc.).
- Lack of community participation and inadequate training of enumerators to collect the precise and accurate data acts as a big challenge in conducting the Census exercise.
3. Energy meet calls for faster shift to renewables
Pandemic offers an opportunity: IRENA
The COVID-19 crisis offers an unexpected opportunity for countries to decouple their economies from fossil fuels and accelerate the shift to renewable energy sources, says the World Energy Transitions Outlook report, brought out by the International Renewable Energy Agency (IRENA).
Previewed at the virtual Berlin Energy Transition Dialogue, which began on Tuesday, the report proposes energy transition solutions for the narrow pathway available to contain the rise of temperature to 1.5 degree Celsius. Highlighting the need for countries to change direction with careful recalibrating of stimulus packages and recovery measures, director general of IRENA Francesco La Camera said, “The COVID-19 crisis has highlighted the cost of tying economies to the fate of fuels prone to price shocks. Amid this, renewables have shown remarkable resilience.”
IRENA observed that the emergence of a new energy system based on renewable technologies and complemented by green hydrogen and modern bioenergy. It estimated that by 2050, 90% of total electricity needs would be supplied by renewables, followed by 6% from natural gas and the remaining from nuclear. The agency has identified 30 innovations for the integration of wind and solar PV in power systems.
Ugandan climate activist Vanessa Natake, who delivered the keynote address, criticised the leaders for continuing to invest in fossil fuel commitments, saying, “We cannot eat coal and we cannot drink oil.”
It is an intergovernmental organisation mandated to facilitate cooperation, advance knowledge, and promote the adoption and sustainable use of renewable energy.
It is the first international organisation to focus exclusively on renewable energy, addressing needs in both industrialized and developing countries.
It was founded in 2009 & its statute entered into force on 8 July 2010 and is headquartered in Masdar City, Abu Dhabi.
IRENA is an official United Nations observer.
Berlin Energy Transition Dialogue
The Berlin Energy Transition Dialogue, an initiative of the German Renewable Energy Federation, the German Solar Association, the German Energy Agency and Eclareon, will be held online this year, owing to the pandemic situation all over the world.
Commenced in 2015, this dialogue has become one of the leading international forums for the energy transition community from around the world. Due to that, the team behind the idea has decided to bring the content of the conference online, this year. The reason is that energy transition initiatives in the world cannot be delayed at all and with the pandemic around, it has become all the more necessary to proceed in this regard.
A cross-media campaign has been launched already for the virtual BETD with many new formats and big plans ahead. The main motto is to reach a global green deal that will enable sustainable growth for all and also pave the way for a truly green recovery worldwide.
It has been decided by the organizers that the Green Sofa Dialogues will be arranged this year in the digital format of the dialogue. In this, celebrities from around the world are interviewed and these dialogues are quite popular now. These will be complemented by podcasts with the experts in the arena of energy transition and explanatory videos on hot energy policy topics such as green hydrogen.
4. China will allow travellers only if they take its vaccines
Little relief as such vaccines are unavailable in India
A number of China’s overseas missions, including its embassy in New Delhi, have announced they will begin “facilitating” travellers provided they have taken “Chinese-made COVID-19 vaccines”.
Indians have been barred from travelling to China since November last year, when China suspended valid visas and residents permits not just for travellers from India but for most countries citing COVID-19 concerns. The ban has been a particular concern for many Indian students enrolled in Chinese universities, who have been unable to return to China. There are at least 23,000 Indians studying in China, most in medical colleges.
The March 15 announcement will bring little relief for them as Chinese-made vaccines are not available in India. The Chinese Foreign Ministry said on Monday that China “stands ready to advance mutual recognition of vaccines with other countries”, but that process is expected to take time.
For now, the limited easing of the travel ban will only apply to travellers who have taken Chinese vaccines. A notice from the Chinese Embassy in New Delhi said, “For the purpose of resuming people-to-people exchanges in an orderly manner, starting from 15 March, 2021, the Chinese Embassies and Consulates in India will provide the persons having taken Chinese-made COVID-19 vaccine and holding the Certificates of Vaccination with the following facilitating measures”, including for those going to China for “employment contracts, work resumption and other relevant activities” and family members of Chinese nationals, provided they have taken Chinese vaccines. The announcement did not say if it would apply to students.
Asked by a reporter in January if the Chinese government would take “a sympathetic view” of the plight of some of the 23,000-plus Indian students enrolled in Chinese universities who remain in India — many of them returned to India when China was dealing with the pandemic in early 2020, but there is no official figure of how many are now awaiting to return — as many had taken on considerable financial burdens to pursue medical degrees in China, Foreign Ministry spokesperson Hua Chunying said, “I can relate to your feelings, including the confusion and plight of so many Indian students as you mentioned. I believe similar situations exist all over the world. To my knowledge, there are many Chinese students who have invested heavily in studies overseas, but due to the sudden COVID-19 outbreak, they are unable to pursue their education as planned, and a lot of them have to stay at home for online courses. Such a situation is not what we want to see.”
Ms. Hua said authorities had “required relevant departments and academic institutions to maintain close contact with overseas students, properly design and arrange online teaching, and duly handle reasonable demands and concerns.”
Indian students, who account for the fourth-largest segment of international students in China, have faced particular obstacles, the South China Morning Post reported last month, with many of the Chinese apps used for online teaching banned last year, when India restricted more than 200 Chinese apps in the wake of the June border clash in the Galwan Valley.
After WeChat was banned and students complained to their colleges, one university, the newspaper reported, began to use the Alibaba-owned DingTalk and Tencent’s Meeting for online classes. Eventually, those apps were banned as well.
The larger concern for the students, who will have to pass challenging exams in India after graduation to be able to practice, is their inability to receive laboratory training as they remain unable to return.
In a March 5 meeting with the Chinese Vice-Foreign Minister Luo Zhaohui, India’s envoy in Beijing Vikram Misri “flagged outstanding consular issues pertaining to Indian nationals” and “requested the Ministry of Foreign Affairs’ facilitation in seeking a resolution,” the Indian Embassy in Beijing said in a statement.
5. Editorial-1: Responsible AI — the need for ethical guard rails
Without adequate safeguards, AI can widen social and economic schisms, leading to discriminatory outcomes
Since Czech writer Karel Čapek first mentioned robots in a 1920s play, humans have dreamed about intelligent machines. What if robots take over policing? What if nanny-bots look after our children and elderly? What if — and this has been rich fodder for dystopian literature — they became more intelligent than us?
Surrounded as we are by the vestiges of our analogue world, to many of us, these wonderings may seem decades from fruition. But artificial intelligence (AI), the engine of the Fourth Industrial Revolution, is already very much with us.
AI’s exponential growth
It is embedded in the recommendations we get on our favourite streaming or shopping site; in GPS mapping technology; in the predictive text that completes our sentences when we try to send an email or complete a web search. It promises to be even more transformative than the harnessing of electricity. And the more we use AI, the more data we generate, the smarter it gets. In just the last decade, AI has evolved with unprecedented velocity — from beating human champions at Jeopardy! in 2011, to vanquishing the world’s number one player of Go, to decoding proteins (https://go.nature.com/30N9BQz) last year.
Automation, big data and algorithms will continue to sweep into new corners of our lives until we no longer remember how things were “before”. Just as electricity allowed us to tame time, enabling us to radically alter virtually every aspect of existence, AI can leapfrog us toward eradicating hunger, poverty and disease — opening up new and hitherto unimaginable pathways for climate change mitigation, education and scientific discovery.
For better or for worse
Already, AI has helped increase crop yields, raised business productivity, improved access to credit and made cancer detection faster and more precise. It could contribute more than $15 trillion to the world economy by 2030, adding 14% to global GDP. Google has identified over 2,600 use cases of “AI for good” worldwide. A study published in Nature reviewing the impact of AI on the Sustainable Development Goals (SDGs) finds that AI may act as an enabler on 134 — or 79% — of all SDG targets. We are on the cusp of unprecedented technological breakthroughs that promise to positively transform our world in ways deeper and more profound than anything that has come before.
Yet, the study in Nature also finds that AI can actively hinder 59 — or 35% — of SDG targets. For starters, AI requires massive computational capacity, which means more power-hungry data centres — and a big carbon footprint. Then, AI could compound digital exclusion. Robotics and AI companies are building intelligent machines that perform tasks typically carried out by low-income workers: self-service kiosks to replace cashiers, fruit-picking robots to replace field workers, etc.; but the day is not far when many desk jobs will also be edged out by AI, such as accountants, financial traders and middle managers. Without clear policies on reskilling workers, the promise of new opportunities will in fact create serious new inequalities. Investment is likely to shift to countries where AI-related work is already established, widening gaps among and within countries. Together, Big Tech’s big four — Alphabet/Google, Amazon, Apple and Facebook — are worth a staggering $5 trillion, more than the GDPs of just about every nation on earth. In 2020, when the world was reeling from the impact of the COVID-19 pandemic, they added more than $2 trillion to their value.
The fact is, just as AI has the potential to improve billions of lives, it can also replicate and exacerbate existing problems, and create new ones. Consider, for instance, the documented examples of AI facial recognition and surveillance technology discriminating against people of colour and minorities. Or how an AI-enhanced recruitment engine, based on existing workforce profiles, taught itself that male candidates were preferable to female.
AI also presents serious data privacy concerns. The algorithm’s never-ending quest for data has led to our digital footprints being harvested and sold without our knowledge or informed consent. We are constantly being profiled in service of customisation, putting us into echo chambers of like-mindedness, diminishing exposure to varied viewpoints and eroding common ground. Today, it is no exaggeration to say that with all the discrete bytes of information floating about us online, the algorithms know us better than we know ourselves. They can nudge our behaviour without our noticing. Our level of addiction to our devices, the inability to resist looking at our phones, and the chilling case of Cambridge Analytica — in which such algorithms and big data were used to alter voting decisions — should serve as a potent warning of the individual and societal concerns resulting from current AI business models.
In a world where the algorithm is king, it behoves us to remember that it is still humans — with all our biases and prejudices, conscious and unconscious — who are responsible for it. We shape the algorithms and it is our data they operate on. Remember that in 2016, it took less than a day for Microsoft’s Twitter chatbot, christened “Tay”, to start spewing egregious racist content, based on the material it encountered.
Ensuring our humane future
How then do we ensure that AI applications are as unbiased, equitable, transparent, civil and inclusive as possible? How do we ensure that potential harm is mitigated, particularly for the most vulnerable, including for children? Without ethical guard rails, AI will widen social and economic schisms, amplifying any innate biases at an irreversible scale and rate and lead to discriminatory outcomes.
It is neither enough nor is it fair to expect AI tech companies to solve all these challenges through self-regulation. First, they are not alone in developing and deploying AI; governments also do so. Second, only a “whole of society” approach to AI governance will enable us to develop broad-based ethical principles, cultures and codes of conduct, to ensure the needed harm-mitigating measures, reviews and audits during design, development and deployment phases, and to inculcate the transparency, accountability, inclusion and societal trust for AI to flourish and bring about the extraordinary breakthroughs it promises.
Given the global reach of AI, such a “whole of society” approach must rest on a “whole of world” approach. The UN Secretary-General’s Roadmap on Digital Cooperation is a good starting point: it lays out the need for multi-stakeholder efforts on global cooperation so AI is used in a manner that is “trustworthy, human rights-based, safe and sustainable, and promotes peace”. And UNESCO has developed a global, comprehensive standard-setting draft Recommendation on the Ethics of Artificial Intelligence to Member States for deliberation and adoption.
Many countries, including India, are cognisant of the opportunities and the risks, and are striving to strike the right balance between AI promotion and AI governance — both for the greater public good. NITI Aayog’s Responsible AI for All strategy, the culmination of a year-long consultative process, is a case in point. It recognises that our digital future cannot be optimised for good without multi-stakeholder governance structures that ensure the dividends are fair, inclusive, and just.
Agreeing on common guiding principles is an important first step, but it is not the most challenging part. It is in the application of the principles that the rubber hits the road. It is where principles meet reality that the ethical issues and conundrums arise in practice, and for which we must be prepared for deep, difficult, multi-stakeholder ethical reflection, analyses and resolve. Only then will AI provide humanity its full promise. Until then, AI (and the humans who created it) will embody the myth of Prometheus: the Titan who shared the fire of the gods with mortals, and the trickster whose defiance of Zeus led to Pandora opening her box.
6. Editorial-3: We need to urgently invest in public health
Only a robust public health system, and not healthcare alone, can lead to disease prevention and control
The worst pandemic in a hundred years has demonstrated the importance of healthcare and public health in times of a health crisis. The efforts of healthcare personnel, from ASHA workers with only basic training, to highly specialised intensive care physicians, have saved countless lives and made India proud.
That healthcare is science-based was convincingly demonstrated. Lab diagnosis, clinical assessments, triage and management ranging from home quarantine to intensive care, clinical trials discriminating between useful and useless therapeutic modalities all gave society a glimpse of how modern medicine works. We learned that outcomes of well-designed clinical trials with their statistically significant differences between treatment modalities are sacrosanct for evidence — not unreliable personal anecdotes.
Healthcare personnel worked tirelessly, with single-minded devotion to duty, putting the best interests of others who were in need over their own personal priorities. This made a mark in public perception. Now we realise why good grounding in theory, long years in basics and specialisation, and apprenticing to gain experience in ethical, evidence-based medical practice are essential for the making of caring medical and nursing professionals. Both the science base and the discipline belong to the allopathic system of medicine. This was brought to India just over a century ago and successfully adopted by us as our own.
Healthcare and public health
While the health-care capability in India ranks among the world’s best, it is a different story when it comes to public health. We need to distinguish between the two. Healthcare refers to the transaction between one caregiver and one sick person at a time – hence the client is the sick person and therapy is the mainstay. For public health, the client is the community at large and the goal is disease prevention and control. Disease control is the deliberate, intervention-based and quantified reduction of disease burden. It has to be data-driven. Data are required on baseline disease burden and real-time monitoring to track the control trajectory of all the highly prevalent infectious diseases. Reliable data must be collected from all sources including every healthcare provider, for monitoring disease burden by diagnosis and outcomes; for this exercise, the total population is the denominator.
Data collection for HIV control is sample-based, under the unique Indian design of sentinel surveillance, established in 1986 and still continuing. It shows only the time trend of declining infection prevalence. Counting of acute flaccid paralysis (AFP) and laboratory tests for polioviruses (including molecular methods distinguishing wild from vaccine viruses) were crucial for polio elimination in India. The commonality between HIV/AIDS and polio programmes is the availability of denominator-based data. The denominator for polio elimination is the national total under-five population. So, we knew the total disease burden. And when it reached zero, we knew polio was eliminated.
Our health management does not have a way of prospectively collecting data on all diseases and deaths by diagnosis. That is precisely the task of public health. In its absence, we have only the numerator data on various diseases, including COVID-19, but not the denominator — in short we do not have a comprehensive and quantified profile of any disease in the entire population, including those under vertical programmes — tuberculosis, malaria, leprosy, AIDS.
For COVID-19, computerised medical records informed us about how many were tested for SARS-CoV-2 infection — and among them, how many were positive, hospitalised, survived or died. All statistics are available in the public domain. Everyone knows that the numbers cover only a fraction of the total, but what proportion of the total, will remain unknown forever.
To get an insight into the totality of infections in the whole population, we rely on the shape of the COVID-19 epidemic curve that peaked in September and steadily declined to the present — with less than 20,000 daily new infections since January 7 until recently. That informs the proportion already infected — most probably 50%-60%, for 700 million to 800 million people. But the detected numbers are over 11 million. Where does the truth lie: nearer to 11 million or to 700 million? We will not know without a public health surveillance system. The sero-surveys on random samples, an attempt to derive the totality of infections, reported widely disparate figures and failed to give us a reasonably reliable picture.
For COVID-19, there are non-pharmacological preventive interventions — face masks, hand hygiene, physical distancing — and pharmacological prevention by vaccination. Where we fell short is timely and comprehensive public education with authoritative and authentic information communicated effectively to the public for self-motivated behaviour modification. In other words, a ‘social vaccine’. Social vaccination is another function of public health.
In the absence of public health infrastructure, India’s AIDS Task Force designed and successfully applied ‘social vaccine’ during the HIV/AIDS epidemic and this was continued by the National AIDS Control Organization (NACO). Sadly, there was no crosstalk between the COVID-19 programme and NACO; hence principles of social vaccine, so effectively deployed in AIDS prevention, were not adopted for COVID-19 prevention. Now, during the COVID-19 vaccine roll-out, authentic health education regarding vaccination is conspicuously lacking, leading to considerable vaccine hesitancy among even healthcare staff. Post-vaccination surveillance, vital for assessing vaccine efficacy and safety, is not being conducted, again a lacuna in public health. We sorely miss public health.
COVID-19 has strong social determinants of infection transmission — overcrowding, lack of cough/sneeze etiquette, and urban-rural divide in health awareness and education. These factors are common for influenza and TB too. Typhoid, cholera, leptospirosis, scrub typhus, malaria, rabies, etc. have environmental determinants. In countries where public health is given equal status with healthcare, public health addresses both social and environmental determinants and controls these diseases. Public health personnel have jurisdiction over people in their homes and workplaces, food and water distribution chains, and over ecosystems — ranging from densities of arthropod vectors, rodent and canine populations, to flight ranges of fruit-eating bats.
Our government errs when it thinks that healthcare for people’s felt need alone will suffice, without mitigating disease determinants through public health. India’s style of mounting ad hoc responses only when there is a pandemic is no longer tenable. Currently our healthcare institutions are cluttered with too many infectious diseases that are amenable to control if only we had public health. Imagine how much wealth is going down the drain for want of public health. Investment in public health will result in health, wealth and prosperity.