Nushaiba Iqbal | SabrangIndia https://sabrangindia.in/content-author/content-author-23567/ News Related to Human Rights Wed, 30 Oct 2019 06:27:48 +0000 en-US hourly 1 https://wordpress.org/?v=6.2.2 https://sabrangindia.in/wp-content/uploads/2023/06/Favicon_0.png Nushaiba Iqbal | SabrangIndia https://sabrangindia.in/content-author/content-author-23567/ 32 32 38% Of Indian Children Under 4–Poor And Rich Alike–Are Stunted: Study https://sabrangindia.in/38-indian-children-under-4-poor-and-rich-alike-are-stunted-study/ Wed, 30 Oct 2019 06:27:48 +0000 http://localhost/sabrangv4/2019/10/30/38-indian-children-under-4-poor-and-rich-alike-are-stunted-study/ Mumbai: Over one-fifth (22%) of children belonging to India’s richest households are short for their age (or stunted as per the World Health Organization), according to the State of the World’s Children (SOWC) report released by UNICEF on October 15, 2019. Children from poorer households are worse off: Over half (51%) are stunted. Overall, 38% […]

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Mumbai: Over one-fifth (22%) of children belonging to India’s richest households are short for their age (or stunted as per the World Health Organization), according to the State of the World’s Children (SOWC) report released by UNICEF on October 15, 2019. Children from poorer households are worse off: Over half (51%) are stunted. Overall, 38% of the children below four years of age are stunted.

Stunting is caused by malnutrition and both rich and poor children in India are eating badly for different reasons, said experts. “Awareness about healthy diets is low in India, even among the economically well-off segment,” said Shweta Khandelwal, additional professor and head of nutrition research at the Public Health Foundation of India.

India also has the world’s third worst (after Djibouti and South Sudan) wasting rate: 21% of its children are underweight for their height, according to the SOWC report.

Low weight and height in early childhood are a consequence of undernutrition, and their effects may be irreversible: Children who eat insufficient food lacking in the required nutrients fall sick more often and earn less as adults, effectively keeping them trapped in poverty.

India was ranked 102 on the Global Hunger Index 2019 (GHI), below Pakistan (94), Bangladesh (88) and Nepal (73). The index is a weighted average of stunting and wasting rate, and the GHI estimates that the percentage of wasted children in India increased from 16.5% to 20.8% between 2008-12 and 2014-18.

Inadequate food intake in first 1,000 days of life
Poor nutrition in early life leads to stunting and loss of IQ, which has consequences for the economy, said Mumbai-based pediatrician Rupal Dalal, adjunct professor at the Centre for Technology Alternatives for Rural Areas at Indian Institute of Technology, Bombay, and director of health at the Shrimati Malati Dahanukar Trust.

Stunting and impaired brain development are common among those who received inadequate food in the first 1,000 days of their life, said Khandelwal. “The adverse effects are difficult to reverse,” she added.

Early childhood malnutrition increases the risk of developing non-communicable diseases such as hypertension, diabetes and heart disease in adult life, the experts concurred. In addition, stunted mothers face complications during pregnancy and this affects their children as well.

Children who were stunted in the first two years of their life go on to spend less time in school and earn up to $1,440 (equivalent to Rs 1 lakh) less over their life than their peers of average height, said the SOWC report.

Poor children do not get enough protein: Study
The role of income is most apparent in the consumption of protein-rich foods such as milk products and eggs, according to the Comprehensive National Nutrition Survey (CNNS). While 82.7% of children from the richest households aged 2-4 years consume dairy products, half that number (41.3%) from poorest households do. Similarly, 8.2% of children from the poorest households ate eggs compared to 20% from the richest households.

Overall, few children aged 2-4 years consumed protein-rich foods, said the CNNS study: 62% consumed dairy products, 15.6% ate eggs and 31.6% ate pulses and nuts, indicating few children get the required amount of proteins regardless of household income.

Children under the age of two, breastfed or not, also do not get required nourishment irrespective of household income. Only 6.4% of children in this age group had enough intake of essential nutrients, found the CNNS.

Consumption of proteins was low among children from the poorer states in the eastern and central parts of India, the study found.


Source: Comprehensive National Nutrition Survey

“Poor diets like one having inadequate quantity and quality of carbohydrates and proteins are adversely associated with child’s growth and development and may result in stunting and/or wasting,” said Khandelwal. “Failure to provide key nutrients during the first 1,000 days, a critical period of brain development, may result in lifelong irreversible deficits in brain function.”

Growing children require nutrient-dense foods, especially proteins from eggs, milk, beans, nuts and seeds, fish and meat, and good fats, Dalal said. “Lack of protein, good fats and micronutrient-dense foods which are replaced by empty calories will cause growth failure, frequent infections, lack of concentration in school, tiredness and so on,” she said.

Rice and wheat dominate, fruits and vegetable rare
Around 55% of children aged 6-23 months who were surveyed consumed no fruit or vegetable, according to the SOWC report. But almost all children, across age groups, consumed cereals and (starch-rich) tubers such as potatoes, according to the CNNS.

Traditionally, Indian diets were rich in nutrient-rich foods such as millets and pulses. However, in a bid to ensure food security, the Indian government enacted policies that led to farmers favouring rice and wheat over fruits, vegetables and livestock products, according to Transforming Food Systems for a Rising India, a 2019 book by Cornell University researcher Prabhu Pingali.

The result is that fruits and vegetables are too expensive for many families: Only 25.4% of the poorest children aged 2-4 years ate fruits and 54% vegetables, according to the CNNS.

Children from the relatively richer households did slightly better–56.7% of the richest children ate fruits and 61% vegetables. But the low numbers indicate that nutritious food is not consumed even by children whose parents can afford it.

“Most studies say that children may be considered to have adequately diversified dietary intake if they had food items from at least four of the seven food groups,” said Khandelwal. The seven food groups, as per the WHO’s infant and young child feeding practices guidelines, are grains, roots, and tubers, legumes and nuts, dairy products, flesh foods, eggs, vitamin A rich fruits and vegetables and “other fruits and vegetables”.


Source: Comprehensive National Nutrition Survey

“Lack of (food) diversity is a serious threat gradually pushing us towards hidden hunger,” said Khandelwal. “Several micronutrients, vitamins and minerals have vanished from our diets because we have substantially cut down variety in our daily meals. Most households, due to time and resource (money, education, access, availability) paucity, are moving away from traditional local recipes, vegetables and fruits to a quicker, more accessible market version of takeaway or home-delivered meals.”

It is important to emphasise balanced healthy diets with micro- and macronutrients as a public health policy, she added.

Anaemia, obesity and stunting/wasting
As many as 38% of Indian children below four years of age, as we said, are stunted–including those belonging to the richest households. Obesity is less prevalent–2% of all children of that age are overweight or obese, according to the SOWC report. Over 40% of children aged 1-4 years are anaemic, as per the CNNS.

In addition to being stunted, children from the richest households–who can afford iron-rich vegetables, fruits and meat–also reported being anaemic. Over one-third (34.2%) of such children and just under half (46%) of the poorest children reported some form of anaemia.

This simultaneous existence of anaemia, obesity and stunting/wasting is what nutrition experts call the “triple burden of malnutrition”.

Inadequate protein and good fats in mother’s diet is also a reason for stunting, according to Dalal. A significant reason for faltering growth in the first few months of a child’s life is the lack of awareness about right breastfeeding techniques, said Dalal. Ignorance about how an infant should latch on correctly to the lower areola exists not just among mothers but also doctors, nurses and healthcare workers.

Breastfed children’s diets do not contain enough proteins and other growth micronutrients. “It is also important to include vegetables and fruits and (a) variety of whole grains like bajra, sorghum, millets and so on,” said Dalal. “They (the children) should not be exposed to junk foods like biscuits, wafers, street foods like batata-vada, bhajiya, (nutritional supplements like) Pediasure, Horlicks, high sugar/jaggery foods, sugary drinks and cakes and pastries.”

The WHO recommends that the child be introduced to solid and semi-solid foods–called complementary foods–at six months, as breast milk is no longer sufficient to meet the needs of the growing body, the CNNS report noted. However, the complementary foods fed to most children lack proteins and other micronutrients, said Dalal. “They are monotonous and watery and do not contain seeds, nuts, legumes and animal proteins,” she said.

Multi-disciplinary approach
Nutrition cannot be improved by standalone programmes and India’s attempts at tackling multiple forms of malnutrition are diluted, said Khandelwal. “Health fads, yo-yo diets, poor environmental factors, exposure to domestic violence, smoke or alcohol during the first 1,000 days also impact stunting,” said Khandelwal.

“Many issues around income, education, gender, women empowerment, poverty, social inclusion/welfare schemes, sanitation etc are related and known to have an impact on nutritional status of the masses,” she added. “All these have to be addressed under a smooth harmonised multi-sectoral strategy guided by effective leadership to have a sustained impact.”

Khandelwal emphasised the need for multidisciplinary strategies. “Right now, most programmes and policies are a bunch of single-focus top-down initiatives with no conversations between the multiple sectors who should be talking and assuming collective responsibility to advance science and translate those into public health policy/action,” she said.

A plan for improving diagnostic and tertiary care, providing trained staff and enhancing the capacity to deal with issues related to malnutrition are necessary, Khandelwal pointed out. “Let us not associate nutrition with merely how much and what to eat but all other related behaviours to have a meaningful impact on public health and nutrition,” she added

This story was first published here on Healthcheck.

(Iqbal is an intern with IndiaSpend.)

Courtesy: India Spend

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Medical Termination of Pregnancy Act Failing Women Who Need It The Most https://sabrangindia.in/medical-termination-pregnancy-act-failing-women-who-need-it-most/ Tue, 22 Oct 2019 07:02:07 +0000 http://localhost/sabrangv4/2019/10/22/medical-termination-pregnancy-act-failing-women-who-need-it-most/ Mumbai: A minor rape victim was forced to give birth to the child of her rapist after the Madras High Court denied her request for abortion under the Medical Termination of Pregnancy (MTP) Act of 1971. The victim was first examined by a doctor at 19 weeks, who declined to perform an abortion, even though […]

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Mumbai: A minor rape victim was forced to give birth to the child of her rapist after the Madras High Court denied her request for abortion under the Medical Termination of Pregnancy (MTP) Act of 1971. The victim was first examined by a doctor at 19 weeks, who declined to perform an abortion, even though it was permitted under the law. By the time her petition was heard, her pregnancy had crossed the 20-week limit beyond which abortion is prohibited under the MTP Act.

This case featured in a September 28, 2019, report authored by lawyers Anubha Rastogi and Raunaq Chandrashekhar of New Delhi-based Pratigya, an NGO that works to advance women’s rights to safe abortion in India.

Courts refused to allow minor rape victims an abortion in 17% of 82 cases between April 2016 and July 2019, the report said. Even though the MTP Act allows abortion until 20 weeks, 40 petitions seeking to terminate pregnancies under 20 weeks had to be filed in courts around the country between April 2016 and July 2019 because doctors refused to perform them. As many as 33 of these cases were filed by rape victims.

“By not allowing women access to safe abortion, you are leaving women with two choices: death (due to unsafe and illegal abortions) or the psychological and emotional consequences of a pregnancy they were not prepared for,” said Anand Pawar, executive director of Samyak, a Pune-based advocacy group that works for sexual and reproductive health rights of women in Maharashtra and Rajasthan.

The lack of clarity in the outdated MTP Act, along with lack of awareness of the law among women and doctors, limits women’s access to safe abortions, the report found. Further, doctors refuse abortions citing the law preventing sex-selective abortion, and legal processes in the case of child sexual abuse, even though neither of these laws restrict abortion. Delays in court decisions on abortions and the stigma around abortion also endanger women’s health, the report said.

As a result, 56% of abortions performed in India are unsafe, with 10 women dying of unsafe abortions each day, as IndiaSpend reported in November 2017.

Globally, around 47,000 women die annually as a result of unsafe abortions, according to the United Nations.

MTP Act vague, outdated

Under the MTP Act, a pregnancy can be terminated until 20 weeks after conception if it will harm the mother, if the pregnancy was the result of rape, if the child will be born with serious physical or mental defects, or in case of contraceptive failure.

For minors, written consent from parents is required, and unmarried women cannot cite contraceptive failure as a reason for getting an abortion.

The 20-week limit on abortion is based on outdated concepts from 1971 when abortion was viewed as a surgery performed by allopathic doctors, the Pratigya report said. Developments in medicine such as medical abortion pills and vacuum aspiration–a technique that uses suction to remove the foetus–allow for relatively safer abortions in advanced stages of pregnancy.

“Since the foetus is at its largest size at nine months when it gets delivered, the risk to the pregnant woman is bound to be less when the size is less,” said Suchitra Dalvie, a practising gynaecologist and co-founder of the Asia Safe Abortion Partnership. “Therefore, there is no risk to the life of the woman at any time during an abortion, assuming it is being done by a trained and qualified person in the safe way (at least not a greater risk than there is during delivery!).”

A pregnancy can be terminated even after 20 weeks if it is “immediately necessary to save the life of the pregnant woman”, the Act says, leaving it to the doctor to decide what constitutes an immediate threat. This makes doctors wary of performing an abortion after the 20-week period has passed, the report said.

“The MTP Act needs to be updated and revised as it is not in line with current technological advances,” said Rastogi, a co-author of the report. “A number of foetal abnormalities are detected after 20 weeks, which may turn a wanted pregnancy into an unwanted one. As long as the woman’s health is not at risk, she should be able to get an abortion on demand, at any stage.”

Unsafe abortions can result in serious infection, future infertility, sepsis, bowel injury, internal injuries, and even death, Dalvie said.

Abdominal massages, drinking herbal concoctions and inserting sticks in the vagina are common methods to terminate unwanted pregnancies, according to this January 2018 article in The Lancet, a medical journal.

As many as 194 women filed writ petitions in the Supreme Court seeking permission for abortion between June 1, 2016, and April 30, 2019.
As many as 97 of these cases involved rape victims, 82 of whom were less than 18 years old. Foetal abnormality was cited as the reason for seeking abortion in 88 of the cases.

Thirteen of the 82 pregnant minor rape victims were denied the procedure because the pregnancy had advanced beyond 20 weeks, as we said earlier.

The MTP Act should be amended to make abortion available to all women regardless of marital status and age, up until 12 weeks after conception, said Rastogi. The limit of legal abortion should be extended to 24 weeks, since abortions until that stage are safe, and the limit should not apply in cases of rape and foetal anomalies, Rastogi said, adding that an amendment to the law should be passed immediately.

A 2014 draft bill, not yet approved by parliament, proposes to allow abortion for up to 24 weeks’ gestation in rape cases, and to remove the limit altogether in case of specified abnormalities in the foetus, as IndiaSpend reported in November 2017.  

Effects of early childbirth ignored

While the physical health of the pregnant woman is considered valid grounds for abortion under the Act, mental health, and the socio-economic implications of an unwanted pregnancy–particularly to survivors of rape–are not considered, the report said. The United Nations has declared that denying abortion to victims of sexual violence constitutes a human rights violation.

In India, court verdicts do not take into account the detrimental effect of childbirth on the health of a young girl. Complications from childbirth are the leading cause of death for 15- to 19-year-old girls globally, according to a February 2018 World Health Organization report.

“Risks from pregnancy to younger girls are much higher since the body is very small. Normal delivery is not possible,” Dalvie said. “Abortion is definitely better than delivery. Also, pregnancy at that age, due to rape, leads to mental health issues as well.”

Very few people know about abortion being legal, said Pawar of Samyak. For instance, less than half the women from Bihar and Jharkhand knew that abortion is legal, according to a 2012 BioMed Central study.

Too few gynaecologists

An abortion can be performed only by a registered gynaecologist and obstetrician who has completed one year of practice or assisted another with at least 25 abortions, according to 2003 guidelines from the health ministry. After meeting these requirements, a gynaecologist can perform abortion only in the first trimester (up to 12 weeks after conception), the guidelines say.

For abortion between 12 and 20 weeks, two registered medical practitioners must establish that the abortion is permissible under law.
Rural India has a 75% shortage of gynaecologists and obstetricians, with 85% specialist positions (4,757 of 5,624) vacant in community health centres, according to a 2019-20 report on the National Health Mission from Accountability Initiative, a research organisation.

To increase the number of qualified professionals providing abortion, Pawar recommends allowing doctors in sub-district hospitals to perform abortion. In addition, Ayurvedic, Unani, Naturopathy, Siddha and Homoeopathic doctors can be allowed to perform abortion as long as they are within reach of sub-district hospitals so that any complications that arise can be attended to promptly, Pawar said. These practitioners would require to be trained.

Doctors unaware

Section 19 of the Protection of Children from Sexual Offences (POCSO) Act of 2012 requires any person aware that a minor is pregnant to report her to the police, regardless of the girl’s consent. However, to avoid getting involved in legal proceedings, doctors refuse to treat and perform abortions on minors, the authors of the Pratigya report found.

As the POCSO Act does not distinguish between consensual sex and rape, every underage pregnancy is treated the same way.

“Fearing persecution under the POCSO Act, doctors subject women to extra-legal procedures–such as filing affidavits, etc., which have no basis in the Act itself–before they perform the abortion,” said Pawar. Because of this, victims of sexual violence, who are already involved in criminal proceedings, are reluctant to report their pregnancy, the report said.

Doctors also cite the Preconception and Prenatal Diagnostic Technique Act (PCPNDT) of 1994 to refuse abortion. Originally enacted to crack down on sex-selective abortions that were thought to be the cause of the declining sex ratio in the country, PCPNDT Act requires radiologists to not declare the sex of the foetus to the mother.

No provision in the PCPNDT Act prohibits abortion, yet doctors refuse, particularly after the second trimester, fearing prosecution under the PCPNDT Act, according to this September 2019 report by Crea, a feminist human rights organisation based in New Delhi.

Court delays 

Similarly, approval by a medical board is not required to perform an abortion if it is legal under the MTP Act. But courts often ignore the medical advice of the woman’s own gynaecologist, and wait for the approval of a medical board, consisting of court-appointed gynaecologists. The boards do not consider the long-term effects of carrying a pregnancy to term and only allow abortions if there is an immediate risk to the life of the woman, according to the Pratigya report.

This “risk” is not defined in the Act itself, and its definition can be highly subjective, and could be influenced by personal beliefs, the report explained. The time spent in setting up a board and waiting for the board’s decision could push the pregnancy beyond the 20-week period, as happened in the case of the minor rape victim we referred to earlier.

In another instance, an HIV-positive rape victim from Bihar, who was denied abortion by Patna Medical College when she was 18 weeks pregnant, was forced to give birth as a result of delay by the Patna High Court in 2017, according to an August 2017 report in the Hindustan Times.

Rights of the foetus vs rights of the mother

The perception of abortion as a means of ending an unwanted pregnancy rather than a medical procedure for the well-being of a woman pits the woman against the foetus, the Pratigya report said. “However, the rights of the foetus do not find a basis in science or law.”

“As per (the) human rights statement, all humans are born free and equal and that is interpreted to mean that we are human only after being born,” Dalvie said. “As long as the foetus is inside someone’s body, that person is a priority over the potential to-be-born foetus. However, many countries set a limit on what is called viability–the stage after which the foetus can survive independently outside the woman’s body. This is usually considered 28 weeks, but as technology advances it can be earlier in some places. However a foetus is never considered a person while it is inside the woman’s body.”

But not everyone agrees. Some doctors have moral qualms in aborting a foetus after 20 weeks, as we reported in November 2017.

Women do not have the absolute right to abort, said the Ministry of Health and Family Welfare in an affidavit submitted before the Supreme Court, according to this report published in the Hindustan Times in September 2019. The government wanted to remove Section 5 of the MTP Act that says abortions can be performed even after the 20-week period if the mother’s life is in danger.

Bhama Narayanan–undersecretary (reproductive and child health) at the Ministry of Health and Family Welfare–and the ministry spokesperson did not respond to our numerous calls and emails on the issue of amendments in the MTP Act. This story will be updated when they respond.

This story was first published here on Healthcheck.

(Iqbal is an intern at IndiaSpend.)

Courtesy: India Spend

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Flu-Like Epidemic Could Kill 80 Mn Globally, Wipe Out 5% Global GDP: New Report https://sabrangindia.in/flu-epidemic-could-kill-80-mn-globally-wipe-out-5-global-gdp-new-report/ Fri, 20 Sep 2019 05:55:20 +0000 http://localhost/sabrangv4/2019/09/20/flu-epidemic-could-kill-80-mn-globally-wipe-out-5-global-gdp-new-report/ Mumbai: With increased mobility, unprepared health facilities and the possibility of weaponising disease, a viral respiratory disease can travel through the world quickly, turning into an outbreak capable of killing up to 80 million people and wiping out 5% of the world’s economy, a new report has warned. Source: A World At Risk, released by […]

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Mumbai: With increased mobility, unprepared health facilities and the possibility of weaponising disease, a viral respiratory disease can travel through the world quickly, turning into an outbreak capable of killing up to 80 million people and wiping out 5% of the world’s economy, a new report has warned.


Source: A World At Risk, released by Global Preparedness Monitoring Board, convened by World Health Organization & World Bank

In such an epidemic, India will lose 2% of its gross domestic product (GDP)–that is, Rs 3.8 lakh crore ($53.5 billion) or roughly twice the Centre’s agriculture budget in 2019-20.

This is unless world leaders increase funding for disease control and coordinate their efforts to develop strategies to contain the disease, the Global Preparedness Monitoring Board (GPMB), convened by the World Health Organization (WHO) and the World Bank, said. 

Drawing on the recommendations made by experts after the 2009 H1N1 influenza pandemic and 2014-16 Ebola outbreak along with other reports and data, the 15-member panel of experts, politicians and heads of agencies assessed the preparedness of countries in dealing with pandemics. The panel includes former WHO director-general Gro Harlem Brundtland and International Federation of Red Cross and Red Crescent Societies secretary-general Elhadj As Sy.

An outbreak of a viral disease such as Ebola, severe acute respiratory syndrome (SARS) and influenza will be more difficult to manage at a time when travel times are shorter than ever before, the report, released on September 18, 2019, said. Management is even more difficult in underdeveloped countries with large populations lacking access to healthcare.

Countries and donor agencies need to increase expenditure on building systems that detect health emergencies to ensure timely and adequate response and share data and resources like vaccines to minimise the spread of the pandemic, the board recommended.

Lives and livelihoods at risk from disease

Since the 1918 flu epidemic that killed 50 million people (2.8% of the population) worldwide, the population has increased over four times. In addition, a person carrying a deadly virus can travel to any part of the world in less than 36 hours, increasing the likelihood of turning a localised outbreak into a catastrophe that has the potential to destabilise the global economy. 

The WHO tracked 1,483 epidemics between 2011 and 2018 in 172 countries, including SARS, Ebola, zika and the nipah virus. It detected man-made and previously unknown viruses in the last 50 years and mapped them. 

Healthcare facilities are already inadequate in poor countries, making it more difficult to contain the spread of infectious diseases. A lack of trust in government agencies, such as that witnessed in Pakistan, reduces the efficacy of preventive measures. The cost of treating those affected and implementing preventive measures puts an additional strain on the economy.

The combined cost of the Ebola epidemic of 2014-16 to Sierra Leone, Guinea and Liberia–the three countries in which 99.8% of all cases–was $2.8 billion. Economic activity was adversely affected: every second Liberian worker lost their job nine months into the epidemic; tourist visits to Sierra Leone, which lost 20% of its GDP, were down by half; and government revenues from taxes fell by 4.9-9.4% in the three countries, according to the report. 

In such an epidemic, as we said, India stands to lose about 2% of its GDP in a year, according to GDP forecast models used in the report.

Estimated Loss From A Viral Respiratory Disease

Prepare for the worst

Donors and multilateral institutions must ensure adequate investment in the development of vaccines and other treatments, increasing manufacturing capacity for vaccines at short notice during a pandemic and implementing appropriate public safety protocols, the report said.
Existing systems for responding to outbreaks are not sufficient and funds earmarked for epidemic control would fall short in the case of an actual epidemic, the report noted, adding that new vaccines, medication and diagnostic techniques need to be developed, which require research and development (R&D).

To limit the damage caused by infections, the GPMB recommended that countries, aid agencies and multilateral institutions like the WHO increase funding for R&D. In addition, developing countries’ capacities for dealing with epidemics need to be increased.

The WHO has assisted countries financially and technically to improve their health capacity. Funding for research on neglected diseases has increased 7% to reach a 10-year high between 2016 and 2017, the GPMB noted.

The world is currently in possession of a stockpile of 400 million doses of pandemic influenza vaccines with the capacity to manufacture 6.4 billion doses, which can be used to vaccinate 43% of the world’s population with two doses in the event of a pandemic. However, the ultimate aim is to develop a universal influenza vaccine, and the GPMB wants world leaders to commit to a timeline and allocate funds for developing such a vaccine by September 2020.

Diagnostic technology–which helps identify affected persons in time and test the efficacy of vaccines–is a critical investment that pays off during epidemics. The Global Influenza Surveillance and Response System has 151 laboratories in 115 countries that allows timely identification and effective monitoring of respiratory pathogens, including SARS and the Middle East Respiratory Syndrome (MERS) viruses, according to the GPMB. 

Countries with high maternal & child mortalities cannot contain pandemics: report

Provision of basic healthcare is crucial for a country to be able to deal with health crises: Unless the most basic healthcare facilities, such as those for maternal and child health, are in place, a country cannot prepare for a pandemic, the GPMB said.

The Board called for improving health coverage and involving religious leaders, local governments and civil society to devise community-specific plans that are tested adequately before an emergency actually occurs.

Accessible and efficient care provided locally will build the people’s trust in government agencies, according to the GPMB. In addition, existing facilities and resources can be mobilised in times of emergencies, such as in Nigeria, where polio care facilities were used during the Ebola outbreak.

Investment in disease-containing capabilities pays off, as illustrated by the successful implementation of strategies that helped limit the damage caused by the Nipah virus in Kerala in India and the MERS virus in the Republic of Korea, both in 2018. In the same year, Uganda and countries bordering the Democratic Republic of Congo managed to detect and treat cases of Ebola in time, reflecting better preparedness.

National-level bodies, commissions or agencies with political authority and accountability should be set up in every country to lead efforts during health crises, the GPMB recommended. This will help avoid delays in decision making, such as those witnessed in the Ebola and Zika response.

The way forward: Clear leadership, more money & resource-sharing agreements

Investing $3.4 billion in health systems will provide a benefit of $30 billion, reducing both economic and human loss, making health a worthwhile investment. Yet, the GPMB observed, governments continue to neglect health.

Poor countries are unable to deal with healthcare emergencies by themselves, putting the world at risk of a pandemic. The WHO’s contingency fund for emergencies (CFE) has been depleted after the Ebola outbreak in DRC in 2018. Member states should increase their contributions to the WHO’s CFE and also assist developing countries to develop the infrastructure required to deal with pandemics, the Board recommended.
National leaders should lead efforts, not only during epidemics but also in ensuring preparedness for health crises, the report said. In times of epidemics, the UN and WHO need to unanimously declare a leader to oversee disease control efforts.

New approaches are required to deal with health emergencies in conflict zones like the Eastern DRC and Yemen. Poverty and unstable governance can amplify a disease outbreak, making it difficult for government agencies to control it.

(Iqbal, an economics graduate, is an intern with IndiaSpend.)

Courtesy: India Spend

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How Government Action Can Drive Or Divert Online Attention https://sabrangindia.in/how-government-action-can-drive-or-divert-online-attention/ Wed, 21 Aug 2019 06:22:32 +0000 http://localhost/sabrangv4/2019/08/21/how-government-action-can-drive-or-divert-online-attention/ Mumbai: “Article 370” superseded the popularity of online-search words such as “jobs” and “taxes” in India after August 5, 2019, the day the government announced the abrogation of special status for Jammu and Kashmir. The most-searched term the day before that was “India vs West Indies” and a week before “Bear Gryllis”, according to an […]

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Mumbai: “Article 370” superseded the popularity of online-search words such as “jobs” and “taxes” in India after August 5, 2019, the day the government announced the abrogation of special status for Jammu and Kashmir.

The most-searched term the day before that was “India vs West Indies” and a week before “Bear Gryllis”, according to an IndiaSpend analysis of Google trends data.

These replaced the usually most-searched terms by Indians such as ”exam results”, “news” and “Whatsapp status”.

The analysis confirms academic studies (here, here and here) that indicate how the media set the agenda for online searches. Since these are often determined by government actions, this implies that government moves can drive or divert national attention online.

On August 5, five of the top 10 or half of the most searched terms were related to Kashmir, according to the data, which means the abrogation of special status for Kashmir diverted attention from other issues. The passage of 10 other bills by the Lok Sabha, parliament’s lower house, over the week following August 5 received no attention in the search trends.

If a topic receives more media attention, there are likely to be more searches related to it, predicted a 2010 paper by University of Minnesota researchers Brian Weeks and Brian Southwell.

Some events may not be driven by government action but by others’, but result in diversion of online attention. For instance, in February 2019, after more than 40 paramilitary troopers died in a car-bomb attack on a Kashmir highway, the word “Pulwama” replaced “Rafale”, which referred to a controversial Indian government arms deal.


Source: Google trends

The rupee also fell to its lowest value (Rs 71.2218) against the dollar this year in February 2019, a 3.6% fall compared to its value in July 2018, but this development was overshadowed by the interest in Pulwama.

Interest in Kashmir increased 257% between February 10 and February 17, 2019.

Our analysis also indicates that search interest can change almost immediately after a news break and flip back again when interest dies down.
From “Article 370”, back to “India vs West Indies”

“India vs West Indies”, a reference to the cricket match between India and the West Indies, was the most searched term between August 1 and August 4, 2019, after which it was replaced by “Article 370” on August 5.


Source: Google trends

The trend was reversed a day later, when senior Bharatiya Janata Party (BJP) leader and former minister for external affairs Sushma Swaraj died on the night of August 5. “India vs West Indies” was back at the top spot by August 7, with more than a million searches.

In the first week of August 2019, as India’s jobs crisis grew and the economy slowed down, Indians online searched for exam results, cricket and entertainment, our analysis showed.

This is because many results were declared for exams in universities in north India, entrance tests to Andhra Pradesh’s engineering and medical colleges, the Railway Recruitment Board and the Jaipur Vidyut Vitran Nigam Limited, a state electricity company.

The Reserve Bank of India (RBI) reduced the repo rate, the rate at which the Central Bank lends to commercial banks, by 35 basis points on August 7, its fourth successive rate cut, and lowered its GDP growth prediction, according to this RBI press release. The rupee depreciated, inflation fell, but except for “repo rate”, no search string related to the economy featured in the trends list, which continued to be dominated by results of sporting events and entertainment.

Kuldeep Sengar, a suspended BJP state legislator facing rape charges, did not make it to the trends list that week, nor did Unnao, the Uttar Pradesh city that is home to him and the victim.

Google trends indicate where public attention lies

Academic research backs the trajectory of online search trends.

Google trends provide a score measuring the popularity of a search term and its movement over time. This score is calculated by dividing the number of queries related to a search term by the number of queries received from a region during a time frame, explained University of California-Berkeley economist Hal Varian in a December 2011 paper.

The more attention the media provide to a topic, the more the audience is likely to consider it important, researchers Maxwell McCombs and Donald Shaw wrote in a 1972 paper on the media’s agenda-setting role.

When news consumers need to know more about a topic, they try to get more information on it, from Google search and other sources, according to Weeks and Southwell.

(Iqbal, an MA in economics from the Madras School of Economics, is an IndiaSpend intern.)

Courtesy: India Spend

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