Surgery and Ayurveda

Why in News

Recently, a government notification listed out specific surgical procedures that a postgraduate medical student of Ayurveda must be practically trained to acquaint with, as well as to independently perform.

• The notification has been criticised by the Indian Medical Association (IMA).
• IMA is a national voluntary organisation of Doctors of Modern Scientific System of Medicine, which looks after the interest of doctors as well as the well being of the community at large.

Key Points

• History of Surgery in Ayurveda:
  
  • The Rigveda is the earliest account of ancient Indian civilization which mentions that Ashwini Kumaras known as Dev Vaidya were the chief surgeons of Vedic periods, who had performed rare legendary surgical operations.
  • There are many Granthas and Samhitas dealing with Ayurveda; among them, Charak Samhita, Sushrutaa Samhita, and Ashtanga Sangraha are the three main pillars of Ayurveda.
    
    • Charak Samhita and Ashtanga Samhita mainly deal with medicine knowledge while Sushrutaa Samhita deals mainly with surgical knowledge.
    • Sushruta is the father of surgery, his works are compiled as Sushrutaa Samhita. He described 60 types of upakarma for treatment of wounds, 120 surgical instruments and 300 surgical procedures.
    • Sushruta considered surgery the first and foremost branch of medicine and stated that surgery has the superior advantage of producing instantaneous effects by means of surgical instruments and appliances and hence is the highest in value of all the medical tantras.
• The Current Debate: It revolves around allowing postgraduate students in Ayurveda undergoing ‘Shalya’ (general surgery) and ‘Shalakya’ (dealing with eye, ear, nose, throat, head and neck, oro-dentistry) to perform 58 specified surgical procedures.
• Arguments in Favour:
  
  • There are two branches of surgery in Ayurveda, Shalya Tantra and Shalakya Tantra. All postgraduate students of Ayurveda have to study these courses, and some go on to specialise in these, and become Ayurveda surgeons.
  • Postgraduate education in Ayurveda is guided by the Indian Medical Central Council (Post Graduate Education) Regulations.
    
    • The 2016 regulations allow postgraduate students to specialise in Shalya Tantra, Shalakya Tantra, and Prasuti evam Stree Roga (Obstetrics and Gynecology).
    • Students of these three disciplines are granted MS (Master in Surgery in Ayurveda) degrees.
  • The process of education, internship and learning for Ayurveda students is similar to that of Modern Medicine students.
    
    • Medico-legal issues, surgical ethics and informed consent is also part of the course apart from teaching Sushruta’s surgical principles and practices.
  • For several surgeries, Ayurvedic procedures almost exactly match those of modern medicine, however there is significant divergence in post-operative care.
  • National Institute of Ayurveda in Jaipur, claims that at least 1,000 major surgeries are performed every year at the hospital.
  • As per the Ayurveda practitioners, the latest notification just brings clarity to the skills that an Ayurveda practitioner possesses.
    
    • A patient is usually not clear whether an Ayurvedic practitioner has the necessary skill to perform one of these operations, after the notification, they know exactly what an Ayurveda doctor is capable of.
• Objections:
  
  • IMA doctors claim that the new notification gives the impression that the skills or training of the Ayurveda doctor in performing modern surgeries are the same as those practising modern medicine which is misleading and an encroachment into the jurisdiction and competencies of modern medicine.
  • Just because Ayurveda institutions prescribe textbooks from modern medicine, or that they carry out surgeries with the help of practitioners of modern medicine, is not reason enough to allow this encroachment.
  • IMA doctors have asked the Central Council of Indian Medicine (CCIM- functions under the Ministry of Ayush) to explain, with proof, how each of the procedures mentioned in Ayurveda literature is equivalent to the modern surgical procedures.
  • Surgery involves technical expertise developed through many workshops to standardise training and impart it. The infrastructure of training, research and exchange of knowledge in modern medicine is much better evolved than in Ayurveda.
    
    • Government-funded Ayurvedic colleges are not equipped with the necessary infrastructure, skilled manpower and supporting staff to impart quality training.
• Gaps in Healthcare Infrastructure:
  
  • According to research earlier this year by Brookings Institute, a US-based policy organization, the country has only 0.55 beds per 1,000 people.
  • According to a government statement in Parliament in 2019, there is only one modern medicine doctor for every 1,445 Indians.
    
    • The World Health Organisation’s norm is one doctor per 1,000 people.
    • The shortage of allopathic doctors, including surgeons is compounded by the concentration of medical colleges in Southern States, as well as the unwillingness of doctors to serve in rural areas despite measures such as compulsory rural internships.
• Government initiative to resolve the problem :
  
  • AYUSH Health and Wellness Centres (AYUSH HWCs) is a component of the Ayushman Bharat.

Way Forward

• The government has to take steps to improve healthcare service however it should make sure that safety standards should not be compromised while inducting Ayurveda practitioners to perform surgery.
• Government should rethink and introduce bridge courses as mentioned in the National Medical Commission (NMC) Bill 2017 which should be aimed to serve an important part of a broader effort to empower and better utilise the capabilities of Ayush practitioners for healthcare delivery.
• Government needs to explore creative ways of addressing this gap by evidence-based approaches, such as task-sharing, supported by efficient and quality referral mechanisms.
• India should achieve Medical pluralism which is already a reality in several countries like China, Japan, etc.
• The need of the hour is an adequate investment, for creating a health system that can withstand any kind of public health emergencies, deliver universal health coverage and meet the targets of the Sustainable Development Goals.

Source:IE

Monetary Policy: RBI

Why in News

Recently, the Monetary Policy Committee (MPC) of the Reserve Bank of India (RBI) has left the repo rate unchanged and maintained an accommodative policy stance as it prioritised support for the economy's recovery over inflation amid the Covid-19 pandemic.

• It has also announced various other liquidity management measures and steps to improve regulatory oversight of the financial system.
• The MPC is a statutory and institutionalized framework under the RBI Act 1934, for maintaining price stability, while keeping in mind the objective of growth. It determines the policy interest rate (repo rate) required to achieve the inflation target (4%).

Key Points

• Repo Rate:
  
  • The MPC has kept the RBI’s key lending rate, the repo rate, steady at 4% and reverse repo rate at 3.35%.
    
    • The repo rate, also known as the policy rate, is the interest rate at which the RBI provides loans to banks.
    • The reverse repo is the rate at which commercial banks park their money with the central bank.
  • It has left key policy rates unchanged for the third time in a row in the wake of persistently high retail inflation, even as it pointed to the economy, which contracted in the last two quarters, showing signs of early recovery.
  • The central bank has slashed the repo rate by 115 basis points (bps) since late March to cushion the economy from the fallout of the Covid-19 and the resultant lockdowns.
    
    • Generally, a low repo rate translates into low cost loans for the general masses.
• GDP Projections:
  
  • The real Gross Domestic Product (GDP) for FY 2020-21 has been projected at -7.5%.
    
    • Real GDP is an inflation-adjusted measure that reflects the value of all goods and services produced by an economy in a given year.
  • However, with the country gradually opening up after the lockdown and the improvement in activity in the second quarter, GDP is expected to expand by 0.1% in the December quarter and 0.7% in the March quarter.
    
    • GDP growth contracted by 23.9% in the Q1 of 2020 compared to the same period (April-June) in 2019.
• Inflation:
  
  • Inflation still remains a concern for policymakers as the supply-side bottlenecks had fuelled inflation and large margins were being charged to the consumer.
  • Cost push pressure or cost push inflation continue to impinge on core inflation, which has not changed much and could firm up as economic activity normalises and demand picks up.
    
    • Cost-push Inflation: Spurt in production prices of certain commodities also causes inflation as the price of the final product increases.
    • Core Inflation: It excludes volatile goods from the basket of commodities tracking Headline Inflation. These volatile commodities mainly comprise food and beverages (including vegetables) and fuel and light (crude oil).
  • RBI projected retail inflation to average 6.8% in Q3, before moderating to 5.8% in Q4 and 5.2% to 4.6% in the first half of the fiscal year 2021-22, with risks broadly balanced.
  • This constrains monetary policy at the current juncture from using the space available to act in support of growth. At the same time, the signs of recovery are far from being broad-based and are dependent on sustained policy support.
  • Consumer Price Inflation (CPI) at a six-year high of 7.6% in October, which is well above its medium target level of 4% within a band of plus/minus 2%.
• Accommodative Stance:
  
  • The MPC had decided to continue with the accommodative stance as long as necessary, at least during the current financial year and into the next financial year, to revive growth on a durable basis and mitigate the impact of Covid-19 on the economy.
• Risk-based Internal Audit Norms:
  
  • RBI has announced the introduction of risk-based internal audit norms for large Urban Cooperative Banks (UCBs) and Non-Banking Financial Companies (NBFCs), as part of measures aimed at improving governance and assurance functions at supervised entities.
  • The RBI also moved to harmonise the guidelines on the appointment of statutory auditors for commercial banks, UCBs and NBFCs in order to improve the quality of financial reporting.
  • It had been decided to put in place transparent criteria for the declaration of dividends by different categories of NBFCs.
  • With a view to deepening financial markets, regional rural banks would be allowed to access the Liquidity Adjustment Facility (LAF) and Marginal Standing Facility (MSF) of the RBI, as also the call/notice money market.
    
    • LAF is a tool used in monetary policy by the RBI, that allows banks to borrow money through repurchase agreements (repos) or for banks to make loans to the RBI through reverse repo agreements.
    • MSF is a window for scheduled banks to borrow overnight from the RBI in an emergency situation when interbank liquidity dries up completely. Under interbank lending, banks lend funds to one another for a specified term.
• Digital Payment Security Controls Directions:
  
  • To significantly improve the ecosystem of digital payment channels with robust security and convenience for users, the RBI has proposed to issue Digital Payment Security Controls directions for the regulated entities.
  • These directions will contain requirements for robust governance, implementation and monitoring of certain minimum standards on common security controls for channels like Internet and mobile banking and card payments.
• Targeted Long-Term Repo Operations:
  
  • RBI has decided to bring the 26 stressed sectors identified by the Kamath Committee within the ambit of sectors eligible under on tap Targeted Long-Term Repo Operations (TLTRO), providing more liquidity to the slowdown-hit economy.
    
    • The RBI had announced the TLTRO on Tap scheme in October 2020, which will be available up to 31^st March 2021.
    • Accordingly, it was decided to conduct on tap TLTRO with tenors of up to three years for a total amount of up to Rs. 1 lakh crore at a floating rate linked to the policy repo rate with flexibility to enhance the amount and period after a review of the response to the scheme.
  • Under TLTRO, banks can invest in specific sectors through debt instruments like corporate bonds, commercial papers and non-convertible debentures (NCDs) to push the credit flow in the economy.
  • As part of the Aatmanirbhar Bharat Package 3.0, the Centre launched the Emergency Credit Line Guarantee Scheme 2.0 (ECLGS 2.0).
    
    • Under it, the corpus of Rs. 3 lakh crore of existing ECLGS 1.0 was extended to provide 100% guaranteed collateral-free additional credit to entities in 26 stressed sectors identified by the Kamath panel.
  • According to the RBI, banks are encouraged to synergise the two schemes by availing funds from RBI under on tap TLTRO and seek guarantee under ECLGS 2.0 to provide credit support to stressed sectors.

Source: TH

CCTV in Police Stations: SC

Why in News

Recently, the Supreme Court (SC) has asked the States and Union Territories Governments to ensure that CCTV (closed-circuit television) cameras are installed in each and every Police Station.

Key Points

• Background:
  
  • 2015: In the case of D K Basu vs State of West Bengal, the SC directed that CCTVs should be installed in every police station and prison to check human rights abuses.
  • 2018: The SC asked the Ministry of Home Affairs to set up a Central Oversight Body (COB) to implement the plan of action with respect to videography in the crime scene during investigation.
  • Recently, the SC has found that the majority of the states and UTs lack the details of installing CCTVs in police stations.
• Latest Directions:
  
  • States and UTs should ensure that CCTV cameras are installed at each and every police station, at all entry and exit points, main gate, lock-ups, corridors, lobby and reception as also areas outside the lock-up rooms so that no part is left uncovered.
  • CCTV systems must be equipped with night vision and have audio as well as video footage and it shall be mandatory for the Centre, states and UTs to purchase such systems which allow storage of data for maximum period possible, at least one year.
  • The Centre should install CCTV cameras and recording equipment at the offices of investigating agencies, including the Central Bureau of Investigations (CBI), the Enforcement Directorate (ED) and National Investigation Agency (NIA), which conduct interrogations and have the power of arrest.
    
    • Oversight Bodies should be extended to state and district level.
• Constitutional Dimension: The current directions by the SC are furtherance of the fundamental right enshrined in Article 21 (Protection of life and personal liberty) of the Indian Constitution.
  
  • Article 21: States that no person shall be deprived of his life or personal liberty except according to the procedure established by law.
  • The expanded scope of Article 21 has been explained by the SC in the case of Unni Krishnan vs. State of Andhra Pradesh (1993) and the SC has itself provided the list of some of the rights covered under Article 21 on the basis of earlier pronouncements and some of them are listed below:
    
    • The right to go abroad, The right to privacy, The right to shelter, The right to social justice and economic empowerment, The right against solitary confinement, The right against handcuffing, The right against delayed execution, The right against custodial death, The right against public hanging, Doctors’ assistance, Protection of cultural heritage, Right of every child to a full development, Right to pollution free water and air.
• Data Related to Violence in Custody:
  
  • According to National Crime Records Bureau (NCRB) data, between 2001 and 2018, only 26 policemen were convicted of custodial violence despite 1,727 such deaths being recorded in India.
    
    • Only 4.3% of the 70 deaths in 2018 were attributed to injuries during custody due to physical assault by police.
  • Apart from custodial deaths, more than 2,000 human rights violation cases were also recorded against the police between 2000 and 2018. And only 344 policemen were convicted in those cases.
• India is not a signatory of United Nations Convention Against Torture which requires states to take effective measures to prevent torture in any territory under their jurisdiction and forbids states to transport people to any country where there is a reason to believe they will be tortured.
• CCTV:
  
  • It is a Television system in which signals are not publicly distributed but are monitored, primarily for surveillance and security purposes.
  • Components: It consists of basic components that do not vary much from system-to-system. At a high level, these include a camera (with a lens), cabling, a digital video recorder (DVR) or network video recorder (NVR), and a video monitor.
  • Security Uses:
    
    • It is one of the most important physical security controls to address terrorism and other security threats.
    • CCTV has incomparable value as a forensic tool as well as in deterring all types of physical and electronic threats.

Source:IE

Lottery, Gambling, Betting Taxable under GST Act: SC

Why in News

Recently, the Supreme Court (SC) has held that lottery, gambling and betting are taxable under the Goods and Services Tax (GST) Act, 2017.

Key Points

• Background:
  
  • The SC passed the order in a batch of pleas filed by various lottery dealers who argued that the Central government had wrongfully classified lottery as goods.
  • Challenging Section 2 (52) of the 2017 Act and notifications levying tax on lottery, petitioners contended that the law was violative of the fundamental rights and contrary to the SC judgment (Sunrise Associates Vs. Government of NCT of Delhi 2006) that held that lotteries were merely actionable claims and cannot be defined as ‘goods’.
• Judgement:
  
  • Lottery, betting and gambling are actionable claims and come within the definition of goods under Section 2 (52) of the Central Goods and Services Tax Act, 2017.
  • The levy of GST on lotteries does not amount to hostile discrimination.
    
    • As per Schedule III of CGST Act 2017, actionable claims other than lottery, betting and gambling are neither treated as supply of goods nor a supply of services.
  • The Parliament has an absolute power to go for an inclusive definition of the term ‘goods’ to include actionable claims like lottery, gambling and betting.
    
    • Article 246A of the Constitution fully empowers the Parliament to make laws with respect to goods and services tax and expansive definition of goods given in Section 2 (52) cannot be said to be not in accord with the constitutional provisions.

Central Laws Related to Lottery, Gambling and Betting

• The Lotteries Regulation Act, 1998:
  
  • Lottery is considered as legal in India. Lottery should be organized by the state government and the place of Draw should be in that particular state.
• Indian Penal Code, 1860:
  
  • The code has provisions for punishing anyone who to the annoyance of others does any obscene act in a public place or sings, recites or utters any obscene song, ballad or words, in or near any public place.
  • These provisions of the IPC may be attracted if any obscene matter is used for the purpose of advertising betting and gambling activities.
• Prize Competitions Act, 1955:
  
  • It defines Prize in Competitions.
• Foreign Exchange Management Act, 1999:
  
  • Remittance of the income generated from lottery winning, racing/riding is prohibited under this Act.
• Information Technology Rules, 2011:
  
  • Under these rules, any internet service provider, network service provider or any search engine will not host any such content which directly or indirectly support Gambling.
• Income Tax Act, 1961:
  
  • Under this Act, current taxation policy in India covers all types of Gambling industry directly and indirectly. Thus, it can be said that all regulated and legalized Gambling is supported in the Gross Domestic Product (GDP) of India.

Source:TH

Deteriorating Great Barrier Reef

Why in News

Recently, the International Union for Conservation of Nature (IUCN) has highlighted that Australia’s Great Barrier Reef is in a critical state and deteriorating as climate change warms up the waters in which it lies.

Key Points

• Great Barrier Reef:
  
  • It is the world’s most extensive and spectacular coral reef ecosystem composed of over 2,900 individual reefs and 900 islands.
  • The reef is located in the Coral Sea (North-East Coast), off the coast of Queensland, Australia.
  • It can be seen from outer space and is the world’s biggest single structure made by living organisms.
  • This reef structure is composed of and built by billions of tiny organisms, known as coral polyps.
    
    • They are made up of genetically identical organisms called polyps, which are tiny, soft-bodied organisms. At their base is a hard, protective limestone skeleton called a calicle, which forms the structure of coral reefs.
    • These polyps have microscopic algae called zooxanthellae living within their tissues. The corals and algae have a mutualistic (symbiotic) relationship.
  • It was selected as a World Heritage Site in 1981.
• Concern:
  
  • Coral along large swathes of the 2,300-kilometre reef have been killed by rising sea temperatures linked to climate change, leaving behind skeletal remains in a process known as coral bleaching.
    
    • When corals face stress by changes in conditions such as temperature, light, or nutrients, they expel the symbiotic algae zooxanthellae living in their tissues, causing them to turn completely white. This phenomenon is called coral bleaching.
    • Corals can recover if the stress-caused bleaching is not severe.
    • Coral bleaching has occurred in the Caribbean, Indian, and Pacific oceans on a regular basis.
• In August 2019, Australia downgraded its long-term outlook to "Very Poor" for the first time and there are high chances that it will be considered for the List of World Heritage in Danger.
  
  • The List is designed to inform the international community of conditions which threaten the very characteristics for which a property was inscribed on the World Heritage List.
  • It also encourages corrective action.

The Cancer Genome Atlas 2020 Conference

Why in News

The Minister of Science and Technology has virtually inaugurated the 2^nd TCGA (The Cancer Genome Atlas) 2020 Conference in New Delhi.

• The Conference brings together scientists and clinicians from across the globe to build Indian Cancer Genome Atlas (ICGA).

Key Points

• Indian Cancer Genome Atlas (ICGA):
  
  • It aims to create indigenous, open-source and comprehensive database of molecular profiles of all cancers prevalent in Indian population.
  • Diverse molecular mechanisms including genetic and lifestyle factors contribute to cancer, posing significant challenges to treatment.
  • Therefore, it is necessary to better understand the underlying factors patient by patient.
• About TCGA:
  
  • It is a landmark cancer genomics program that molecularly characterized over 20,000 primary cancer and matched normal samples spanning 33 cancer types.
    
    • Genomics aims to sequence, assemble, and analyse the structure and function of genomes.
    • Genome is all genetic material of an organism. It consists of DNA (or RNA in RNA viruses).
  • TCGA is a joint effort of the National Cancer Institute (NCI) and the National Human Genome Research Institute (NHGRI), which are both part of the National Institutes of Health, U.S. Department of Health and Human Services. It was started in 2006.
  • TCGA generated a huge amount of genomic, epigenomic, transcriptomic, and proteomic data.
    
    • Transcriptomics technologies are the techniques used to study an organism's transcriptome, the sum of all of its RNA transcripts.
    • A Proteome is a set of proteins produced in an organism.
  • This data has led to improvements in the ability to diagnose, treat, and prevent cancer.
  • On similar lines, the establishment of an ‘Indian Cancer Genomics Atlas (ICGA)’ has been initiated by a consortium of key stakeholders in India led by Council Of Scientific And Industrial Research, Government of India in which several government agencies, cancer hospitals, academic institutions and private sector are partners.
• Other Similar Missions:
  
  • Genome India:
    
    • Its aim is to ultimately build a grid of the Indian “reference genome”, to fully understand the type and nature of diseases and traits that comprise the diverse Indian population.
    • The mega project hopes to form a grid after collecting 10,000 samples in the first phase from across India, to arrive at a representative Indian genome.
  • IndiGen Genome Project:
    
    • The initiative was implemented by the CSIR-Institute of Genomics and Integrative Biology (IGIB), Delhi and CSIR-Centre for Cellular and Molecular Biology (CCMB), Hyderabad.
    • The IndiGen programme aims to undertake whole genome sequencing of thousands of individuals representing diverse ethnic groups from India.

Source:PIB

Global Teacher Prize 2020

Why in News

Ranjitsinh Disale, a primary teacher from Maharashtra's Solapur, has won the Global Teacher Prize 2020.

Key Points

• Global Teacher Prize:
  
  • It is a 1 million dollar award presented annually to an exceptional teacher who has made an outstanding contribution to their profession.
  • Founder: Varkey Foundation, which is a global charitable foundation focused on improving the standards of education. The award is organised in partnership with UNESCO.
  • Objective:
    
    • It serves to underline the importance of educators and the fact that, throughout the world, their efforts deserve to be recognised and celebrated.
    • It seeks to acknowledge the impacts of the very best teachers not only on their students but on the communities around them.
      
      • An inadequate education is a major factor behind the social, political, economic and health issues faced by the world today. Education has the power to reduce poverty, prejudice and conflict.
• Ranjitsinh Disale’s Contribution:
  
  • He changed a dilapidated school to a school which went on to become the first in Maharashtra to introduce Quick Response (QR) Codes.
    
    • A QR code is a type of barcode that contains a matrix of dots. It can be scanned using a QR scanner or a smartphone with a built-in camera.
  • He not only translated the class textbooks into his pupils' mother tongue, but also embedded them with unique QR codes to give students access to audio poems, video lectures, stories and assignments.
  • He is also passionate about building peace between young people across conflict zones. His ‘Let’s Cross the Borders’ project connects young people from India and Pakistan, Palestine and Israel, Iraq and Iran and the USA and North Korea.
• Impact of Disale’s Efforts:
  
  • There are now no reported teenage marriages in the village and 100% attendance of girls at the school.
  • The state government announced in 2017 that they would introduce QR coded textbooks across the state for all grades.
    
    • In 2018, it was announced that all NCERT textbooks would have embedded QR Codes.

Source:IE