1. Centre picks 75 tribal districts for TB intervention project
Move comes after door-to-door screening of over 68,000 villages in tribal districts
After having run an active case-finding campaign to detect instances of Tuberculosis (TB) among tribal populations over the past six months, the Ministry of Tribal Affairs and the Central TB Division of the Ministry of Health and Family Welfare have now zeroed in on 75 tribal districts, where focused interventions will be run over the next few months with the aim to make them TB-free.
The campaign to detect TB cases across 174 tribal districts in the States of Jharkhand, Odisha, Chhatisgarh, Assam, Gujarat, Telangana and others started this January under the Aashwasan Campaign, under which door-to-door screening was done in over 68,000 villages. Official data showed that 3,82,811 people were identified for presumptive TB after a verbal screening of over 1.03 crore people in these villages.
Of these, over 2.79 lakh people’s samples were tested for TB, among which, 9,971 people tested positive and were placed under treatment.
At a conclave held to discuss the findings from the campaign, Tribal Affairs Ministry Joint Secretary Naval Jit Kapoor said the data clearly indicated that tribal populations are more vulnerable to TB and other respiratory diseases compared to other population groups.
Discussing the way forward, both the Health and Tribal Affairs ministries have decided on a three-pronged strategy to address the high incidence of TB in the selected 75 tribal districts, keeping with the government’s mission to make India TB-free by 2025, a government statement said.
This includes generating demand for TB services by engaging with community influencers like tribal leaders, tribal healers, Panchayati Raj Institution members, Self-Help Groups and youth in the tribal areas, who are expected to help increase awareness on TB.
To guide the implementation of these measures, the government plans to deploy two officials each at the district level and three officials in each of the state TB cells.
- Aashwasan campaign Launched in 2021 by the Ministry of Tribal Affairs, Ministry of Health and Family Welfare, United States Agency for International Development (USAID) and Anamaya, Tribal Health Collaborative (an initiative of Piramal Foundation, The Bill and Melinda Gates Foundation and USAID)
- The Tribal TB Initiative aims to improve care and support among tribal populations in India.
- The campaign fosters community engagement, forging partnerships with community-based organisations and community-influencers to influence behaviour change to reduce the burden of TB. It also works with the public health system to enhance screening and diagnosis, increase notification and complement government efforts.
- Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis.
- TB commonly affects the lungs (pulmonary TB) but can also affect other parts (extrapulmonary TB)
- Tuberculosis spreads from person to person through the air, when people who are infected with TB infection cough, sneeze or otherwise transmit respiratory fluids through the air.
- The most common risk factor associated with TB is HIV & other conditions that impair the immune system.
- Common symptoms of tuberculosis are Chronic cough with blood-tinged sputum, Loss of weight, Loss of appetite, Fever and night sweats, Fatigue, etc.
- TB Treatment: consists of four drugs:
- Isoniazid (INH),
- Pyrazinamide &
Multidrug-Resistant TB (MDR-TB)
- In MDR-TB, the bacteria that cause TB develop resistance to antimicrobial drugs used to cure the disease.
- MDR-TB does not respond to at least isoniazid and rifampicin, the 2 most powerful anti-TB drugs.
- Treatment options for MDR-TB are limited and expensive. CBNAAT (Cartridges Based Nucleic Acid Amplification Test) is used for early diagnosis of MDR-TB.
Extensively Drug-Resistant TB (XDR-TB)
- XDR-TB is a form of multidrug-resistant TB with additional resistance to more anti-TB drugs.
- People who are resistant to isoniazid and rifampicin, plus any fluoroquinolone and at least one of three injectable second-line drugs (amikacin, kanamycin, capreomycin) are said to have XDR-TB.
To achieve goal: To end TB by 2025
- India’s Initiative
- National Strategic Plan (NSP) for Tuberculosis Elimination (2017-2025)
- The Nikshay Ecosystem (National TB information system)
- Nikshay Poshan Yojana (NPY- financial support)
- TB Harega Desh Jeetega Campaign.
- Global Initiative:
- The WHO (World Health Organisation) has launched a joint initiative “Find. Treat. All. #EndTB” with the Global Fund and Stop TB Partnership.
- WHO also releases the Global Tuberculosis Report
2. Editorial-1: A draconian law that needs to disappear
The north-east needs to be freed from the net of AFSPA, as it has subsumed constitutional rights with impunity
The statement made by the Prime Minister, Narendra Modi, in April this year, to the people of the North-east to the effect that the Government intends withdrawing the much-dreaded Armed Forces (Special Powers) Act 1958, or AFSPA, completely from the region — this follows its partial withdrawal from parts of Assam, Nagaland, Arunachal Pradesh and Manipur in March this year — could spell tidings for the denizens of these States. The Prime Minister was addressing a ‘Peace, Unity and Development’ rally in Diphu in Assam’s Karbi Anglong district. In the north-east, Nagaland has largely borne the brunt of this draconian law after it was imposed in the late 1950s when insurgency raised its head in the State.
Roots in the Raj
The genesis of the law can be traced to the Armed Forces (Special Powers) Ordinance 1942 which was enacted by the British to subjugate the rebels in the country during the Quit India movement, particularly in Assam and Bengal in October 1942. The law continues to be enforced in its new format as the Armed Forces (Special Powers) Act 1958.
Indubitably, the need for the law was required in the 1950s when Naga insurgents resorted to large-scale violence. Hundreds of Indian Army soldiers, central and State paramilitary personnel were either killed or injured in ambushes that had been meticulously planned and launched by the insurgents. Informers of the security forces were eliminated or disabled.
Nagaland, other aberrations
While there was some semblance of peace having been restored after the Shillong Peace Accord with the Naga insurgents in 1975, the situation took an ugly turn after the breakaway group led by Isak Chishi Swu and Thuingaleng Muivah formed the Nationalist Socialist Council of Nagalim (Isak-Muivah), better known as the NSCN(I-M), in January 1980, and resorted to large-scale violence across the States of Nagaland and Manipur. Thuingaleng Muivah is a Tangkhul Naga from Ukhrul district of Manipur while Isak Chishi Swu was a Sumi Naga from Zunehboto in Nagaland. Isak Chishi Swu died in June 2016 after the Naga Framework Agreement had been signed between the Government and the NSCN (I-M) in August 2015. It is believed that the agreement was rushed through given Isak Swu’s health condition. The agreement has been hanging fire since then as the Government has not agreed to permit a separate flag and constitution for Nagaland which the NSCN (I-M) is determined to have.
A generation has lived with AFSPA in Manipur and Nagaland. Residents in these States have been victims of the aberrations committed by security forces for decades. While AFSPA gives sweeping powers to the security forces to shoot and kill anyone on suspicion and even search or arrest any person without warrant, no prosecution against them is possible for any wrongdoing without the previous sanction of the Central government. While the Armed Forces (Special Powers) Ordinance 1942, authorised “Any officer not below the rank of Captain in (the Indian) Military forces… to use such force as may be necessary, even to the causing death against any person…”, AFSPA 1958 empowers even a non-commissioned officer (may be a Lance Naik, a Naik or Havildar) to “fire upon or otherwise use force; even to the causing of death”; no prosecution against them is possible without the consent of the Central Government.
It is the consent from the Central government that is delaying any further action being taken against the commandos of the Army’s 21 Para (Special Forces) who killed six locals initially in a case of mistaken identity in Mon district of Nagaland on December 4, 2021. The incident led to a riotous situation in which more persons, including an Assam Rifles jawan, were killed. Unconfirmed reports put the civilian death toll at 17.
Meanwhile, the Supreme Court of India passed an interim order recently “staying further proceedings pursuant to FIR No.27 of 2021/Final Report of the Special Investigation Team [SIT]/Chargesheet,” on a petition filed by the wives of the commandos found guilty by the SIT.
Armed with unbridled power, aberrations by security forces operating in the States are bound to take place. When the Extrajudicial Execution Victim Families’ Association Manipur (EEVFAM) approached the top court in 2012 to have 1,528 cases of alleged fake encounters investigated through the Central Bureau of Investigation (Extra Judicial Execution Victim Families Association (EEVFAM) vs Union of India & Anr.), it was found that the first six cases investigated were indeed fake encounters. This prompted the Court to conclude that the veracity of the allegations made by the Association was beyond suspicion. Having come under the scanner, the AFSPA drew critical comments from the Supreme Court.
Despised by every citizen of the States where it has been in force, AFSPA was not withdrawn despite their demands. The very basic tenets of democracy which espouse the principles “of the people, by the people and for the people” have stood negated. No section of society would ever allow itself to be subjected to a law that is as draconian as AFSPA, which in effect curbs the liberty and the rights of the people as enshrined in the Constitution — a Constitution that is held sacrosanct by the nation.
Resistance to a rescinding
Efforts made in the past to rescind the law have met with failure. The iron lady of Manipur, Irom Chanu Sharmila, went on a 16-year long hunger strike starting from November 2000. Hailed as a heroine for nearly two decades, she fell from glory when people were disapproving of her breaking the fast. On being asked to comment on the withdrawal of AFSPA in several parts of Manipur, Assam and Nagaland, she was of the opinion that this was a new beginning and a result of decades-long fight.
The Justice B.P. Jeevan Reddy Commission that was tasked with reviewing the provisions of AFSPA submitted its report on June 6, 2005 with the recommendation that AFSPA be withdrawn. Surprisingly, it had suggested making amendments to the Unlawful Activities (Prevention) Act, 1967 (UAPA) to achieve the purpose of AFSPA. The report was subsequently shelved.
Former Union Home Minister P. Chidambaram was of the firm opinion that AFSPA should be withdrawn. But stiff resistance from the Defence Ministry which was headed by A.K. Antony scuttled the proposal. The Indian Army offered stiff opposition to any proposal to do away with the much-detested law.
There needs to be a review
The present dispensation at the Centre has been hailed for its bold decision to rescind the law as the Army would have still offered resistance to its withdrawal. It must be noted that at a function in Guwahati on April 23, Union Defence Minister Rajnath Singh said that all three wings of the defence forces were in favour of the removal of AFSPA from the Northeast and Jammu and Kashmir, but the act remained in place “due to the situation”. In Nagaland, AFSPA has been removed from the jurisdiction of 15 police stations in seven districts, while in Assam, it has been removed completely from 23 districts; one district will be covered partially under the Act. In Manipur, 15 police station areas of six districts will be excluded. However, there needs to be a comprehensive and serious periodical review undertaken by the Centre till the entire North-east is freed from the tentacles of AFSPA.
Investigations into the 1,528 alleged fake encounters also need to be fast tracked and taken to their logical conclusion. If necessary, there needs to be incarceration of the guilty, thereby sending out a clear message that those who murder under the cloak of the uniform of the security forces cannot expect to go scot free if there are violations.
3. Editorial-2: Puttaswamy and the fading promise of a right
Five years after the crucial judgment on the right to privacy, the ground reality is an eye-opener
August 24 has passed, marking five years since a nine-judge Bench of the Supreme Court of India delivered a crucial judgment in the case of Justice K.S. Puttaswamy (retd.) vs Union of India (2017). The judgment delivered on that date formally recognised the right to privacy as being a fundamental right stemming from the right to life and personal liberty, guaranteed under Article 21 of the Indian Constitution. The Bench also held that while the right to privacy is intrinsic to an individual’s ability to exercise bodily autonomy, it is still not an “absolute right” in and of itself, placing limitations in a manner similar to those placed on the right to free speech and expression.
Five years later, however, the once eventual-beneficiaries of the agency that the recognition of the fundamental right had promised may realise that the order delivered as part of the judgment has not been upheld in letter or in practice. For example, one can consider the nature of the relationship that is currently shared among consumers and companies. If one looks at how the negotiation of privacy is placed now, they would realise that not much changed following the formal recognition of the right to privacy. The Personal Data Protection Bill, 2021, which had been in the offing for quite some time now (despite how flawed it may have been) was withdrawn earlier this month after an unnecessarily long period of stagnation.
Personal data for a price
Meanwhile, the ground reality for the citizenry has not changed much either. Data security breaches which result in the loss and theft of personal, sensitive data have not reduced in terms of measurable frequency or their impact. Even worse, as of today, any person or business within and outside India is still in a position where, for a slight bargain, they can procure the personal information for a vast majority of the people, categorised and labelled neatly wherever possible, for use and consumption.
Data concerning the scale and nature described here is used most often by some legitimate advertising agencies, unscrupulous telemarketing firms, and cyber criminals. Brokers of such data have in fact become so brazen where they have taken to listing their goods for sale on mainstream e-commerce platforms. This may be done in a bid to reach more customers who can discover and subsequently purchase the data they provide, but perhaps also in an attempt to lend some kind of legitimacy to the unethical and possibly illegal nature of their trade. This status quo leaves the general populace open to a range of harm in the form of elaborate phishing attacks and financial scams aided by the attacker’s access to personal information, as well as other harmful activities which rely on the attacker possessing key bits of information about an individual.
‘Spying’ from above
While the threat model for a general user of the Internet in India may only comprise non-state actors (such as cyber criminals and unscrupulous businesses), individuals with certain political and intellectual affinities however have found themselves worrying about the capabilities of the Government in this regard; and rightly so, as far as the security and integrity of their electronic devices are concerned.
An investigation in January 2022 by The New York Times offered some credence to the debate and outcry that had existed around the alleged use of the Pegasus spyware in India. The investigation revealed that the Indian government had purchased access to the Pegasus spyware suite in 2017 as part of a roughly $2 billion acquisition deal for weapons and miscellaneous surveillance gear from Israel. The alarming revelations and the planting incriminating evidence in at least one case, targeting Indian nationals (alleged to have been carried out by the Government of India) reveals a blatant disregard for any jurisprudential significance the Puttaswamy judgment might have been thought to carry.
The recent interventions by the Government which aim to restrict Indian nationals from subscribing to and accessing VPN services shows a similar disregard, too. Summarily, the Government has demanded that VPN service providers — most of which operate in jurisdictions outside of India — start collecting and maintaining KYC records on Indian nationals who seek to avail their services.
The kind of information requested to be collected and stored includes general identifiers such as full name, phone number, home address, and more (information which generally is not sought by VPN service providers, and which may only be validated by a potential customer having to furnish valid identity documents to a given service provider), along with a small box asking for the “reason” for which an individual sought access to the VPN service. The justification provided by the Government for the request to collect and furnish data predictably begins and ends with a mention of the words “national security”.
While it need not even be said that VPN services in and of themselves do not enable or significantly further criminal activity in a way where such a response would be warranted, the Government’s position demonstrates that it is not above placing hindrances in an individual’s effort to exercise their fundamental right to privacy, of which informational privacy is a part. However, this should not be surprising given other privacy-infringing transgressions, and considering that the initial position, argued by the then Attorney General was that “the right of privacy may at best be a common law right, but not a fundamental right guaranteed by the Constitution”.
In light of all of this, five years later, it can be said confidently that the Puttaswamy judgment has missed the mark quite spectacularly for the objective that was sought, and that it represents a foregone opportunity to protect the rights of Indian citizens while ensuring all of the checks and balances necessary to prevent Government overreach and abuse of power.
4. Editorial-3: Murder in the sewer
Deaths during manual cleaning of sewage are unacceptable
All human lives are precious, but, in practice, some are seen as less precious than others. Despite the efforts of courts and governments, law and enforcement have been unable to keep a certain category of workers out of harm’s way: those who are engaged in sewage cleaning. While the job itself is dangerous, as several other human pursuits are, sewage cleaning involves working with human excreta, and cannot be seen without invoking the concept of dignity of labour. To allot the task of removing excreta and cleaning sewers to humans when machines are able to do the work is a gross violation of rights. It is in this context that Tamil Nadu’s recent move to notify the rules of the Prohibition of Employment as Manual Scavengers and their Rehabilitation Act, 2013, though belated, must be seen. While manual ‘scavenging’ is completely prohibited, the rules allow manual cleaning, in specific conditions where mechanical equipment cannot be deployed to fix the problem, or when it is absolutely necessary to have human intervention, after stating the valid reasons for allowing such a process to take place. But, more importantly, it specifies a long list of protective devices and gear that any person engaged to clean a sewer or a septic tank must be provided, including air line breathing apparatus, air line respirator, air purifier gas mask, a device for artificial respiration, mask and breathing apparatus. Besides this, chlorine masks, emergency medical oxygen resuscitator kit, gas monitor for gases, hydraulic devices, and first aid will have to be provided by the employer. The list is not limited to those devices mentioned. Regular maintenance of the equipment and devices has also been mandated by the rules. Naturally, all workers must be fitted out in the safety gear before they enter the sewer line.
The practice of manual cleaning of septic tanks and sewers has been, and will always be, as long as it exists, a serious concern in any country sworn to humane treatment of all citizens. While quibbling has dominated discussions about the actual number of deaths due to manual scavenging, government-acknowledged deaths from manual cleaning of sewers and septic tanks are shocking enough. A total of 971 people lost their lives while cleaning sewers or septic tanks since 1993, the year the law prohibiting employment of manual scavengers was enacted, according to the Social Justice and Empowerment Ministry. Tamil Nadu is among the top States in the list. Since the causes of deaths while cleaning sewers and septic tanks are predictable — noxious gases — not taking measures to prevent those deaths would be criminal. Proper implementation of the rules, and adequate monitoring are absolutely essential. Simultaneously, all efforts must be taken, within existing schemes, to provide compensation to the family members of those who have died, and to provide them a way out of the profession, if they so wish.