0 I O N 2 Health
Check TB
The world has come a long way since Charles Dickens wrote of tuberculosis in 1838 as “a dread disease” which “medicine never cured,” and which “wealth never warded off”. Once referred colloquially as ‘consumption’, it was a sure cause of death. Not anymore. But it still requires sustained treatment to be cured.
Approximately 1.5 million people died of tuberculosis in the world in 2018, an 11 per cent dip from the number who lost their lives to TB in 2015. While that is progress, it falls far short of the global target for TB control for 2020 – a 35% reduction in the number of deaths from 2015 and a 20 per cent dip in number of TB incidence over the same period.
India aims to eradicate TB by 2025. In 2018, there were 199 reported case of TB (per 100,000 population). Inconsistency in treatment is a challenge. And so we have superstar Amitabh Bachchan encouraging people to get examined in case of a persistent cough and to continue with the treatment till cured.
Mission malaria
“This is Ann... she drinks blood”, wrote authorillustrator Dr Seuss, sometime during World War II. And he wasn’t referring to a vampire. Rather, he was warning the troops against malaria-causing mosquito bites.
In recent years, locally, our chief fear of mosquitoes stems from a possibility of contracting dengue. But the malaria scare is far from over. Incidence went down from 71.73 (per 1000 population at risk) in 2010 to 59.12 in 2017. The global target aims for a 40% decline in incidence and death rates and the elimination of the disease in at least 10 countries. India aims to be free of the disease by 2027. “In 15 states and union territories, the target is no local case of malaria by 2020,” says Kaushik Sarkar, India technical lead of the NGO, Malaria No More. “It is doable. Compared to 2014, the number of cases in the country has shown a cumulative decline of 60%.”
Stop AIDS
In 1983, Eddie Murphy reportedly stated during his stand-up acts that girls could be hanging out with their gay friends, give them a kiss and “go home with AIDS on their lips”. (The actor in later years has apologised for such jokes.) Tom Hanks won his first Oscar award for the 1993 film Philadelphia, playing a lawyer who is fired from his legal firm after his colleagues found out that he is gay, and suffering from AIDS. More than 25 years later, not much has changed.
There is ignorance, there is stigma and there are lives being lost, often without treatment. Which is why the global target of 90-90-90 for AIDS for 2020 makes complete sense: “90% of all people living with HIV will know their status, 90% all people with diagnosed HIV infection will receive sustained antiretroviral therapy and 90% of all people receiving antiretroviral therapy will have viral suppression”.
“Currently this status is 79-62-53 globally,” says an expert on AIDS in India. “In India, the percentage is 79-56-59.” The 2020 target is achievable, he feels, but the first 90 needs to be reached to achieve the other two. “Many people who are at high risk of infection – sex workers, homosexuals and intravenous drug users – are reluctant to go to testing sites because they fear discrimination or stigma. Self-testing or community-driven (a group of positive people or organisations working with positive people) testing can help with early detection and intervention,” he says.
Global non-communicable diseases (NCD) action plan 2013-2020
More than 36 million lives are lost to NCDs annually. This is 63% of all global deaths. NCDs include cardiovascular diseases, cancers, diabetes, chronic respiratory diseases etc.
Most premature deaths are caused by tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol. The global action plan aims to cut down on these risks to control the number of lives lost to NCDs. Adhering to the plan is expected to bring down premature deaths from NCDs by 25 per cent by 2025.
Education
Not just numbers
India’s higher education system is the third largest in the world, next only to United States and China. But can we say the same about its quality? There are also issues like exam-oriented learning, pressure to perform etc. (Many stories have been written, many films made on this already).
But this year, the University Grants Commission (UGC) chairman, DP Singh, was quoted in the media as saying that the Commission had drawn up a set of objectives to improve the quality of learning in institutions higher education institutions. The government has also fixed a target of 30% gross enrolment ratio (GER) in higher education by 2020-21. The GER went up from 24.5% in 2015-16 to 25.8% in 2017-18.
Climate & emissions
More e-vehicles, please
In November this year, Delhi woke up – again – to a thick smog covering the city. No one was surprised. It wasn’t the first time it had happened. And so chief minister Arvind Kejriwal again announced the odd-even programme to curb the number of cars on the roads and thus reduce pollution.
What might help in the long run – not just in Delhi but across the country – is the target, set in 2013, to achieve a year-on-year sale of 6-7 million hybrid and electric vehicles from 2020 onwards or a cumulative sales of 15-16 million by 2020. (Road transport and highways minister Nitin Gadkari was quoted in the media in 2017 as saying that India will have 100% e-vehicles by 2030, which was later revised, to set a target of having only electric three-wheelers in the country by 2023, followed by electric-only two-wheelers by 2025. 30% of all vehicles are targeted to be e-vehicles by 2030.)
But as Anumita Roychowdhury, executive director (research and advocacy), Centre for Science and Environment, says, targets work only when they are backed by mandates. “In India, the government gives some incentives for the use of e-vehicles, but there has to be a mandate to push sales, there has to be an ecosystem to make it user-friendly, there have to be charging slots available, for example.” In the absence of all that, figures released this year showed that till May, the country had only about 0.28 million e-vehicles.
EU to go green
In December 1952, a lethal smog caused by a combination of industrial pollution and high-pressure weather conditions, covered London for five days. The British capital was no stranger to smogs. In 1915, TS Eliot, in The Love Song of J Alfred Prufrock, talks of the “yellow fog” , the “yellow smoke that rubs its muzzle on the window-panes”. But if the severity of the problem then pushed the UK to pass the Clean Air Act of 1956, in 2007 the fear of pollution, climate change and loss of resources made the EU as a whole adopt the Climate and Energy Package 2020.
Targets include a 20% reduction in emission of greenhouse gases from the 1990 levels, drawing 20% of energy needs from renewable resources and achieving a 20% improvement in energy efficiency. A news report published in March this year suggests that Europe is well on its way to achieving the first target, with “EU GHG emissions, including emissions from international aviation and indirect CO2 emissions” already “down by 22.4 percent compared with 1990 levels.”
Biodiversity
Saving the species
The Vanishing – a documentary film by Martin Buzora revolves around the idea of the earth’s sixth era of extinction, caused not by natural disaster, but by humans. If the above scenario is scary, there is hope in the 2020 biodiversity targets, both the global goals known as the Aichi targets and India’s National Biodiversity Targets 2012-2020.
Making people aware of the value of biodiversity and steps they can take to conserve and use it sustainably, and making issues of biodiversity a part of implemented policies across sectors, are the first targets – both globally and back home. The Aichi goals also include checking loss of all natural habitats, maintaining genetic diversity of cultivated plants and livestock, etc.
But “these targets have to be understood as guiding instruments for governance. Governments have to turn them into specific action plans and implement them with intent,” says Kanchi Kohli, senior researcher, Centre For Policy Research.
Kohli suggests that governments should open themselves to a public audit, “to review both the targets and the country’s performance to achieve the same. This is not with the intent to undermine what has been done, but to ensure that there is wider understanding of these targets that are otherwise very limited to the implementing ministry and departments”. Vision 2020
Future forward
In June 2000, the Planning Commission of India constituted a committee under the chairmanship of SP Gupta (a member of the Planning Commission and with 30 experts from different fields on board) to draw up a vision statement for the future. Titled Vision 2020, the report clarifies that it “is neither a prediction of what will actually occur, nor simply a wish list of desirable but unattainable ends. Rather, it is a statement of what we believe is possible for our nation to achieve”.
Some of the possibilities envisioned in the report include 100% literacy, a targeted annual GDP growth rate of 8.5 to 9%, and universal access to healthcare.
The Planning Commission was dissolved in 2014 and the Niti Aayog that has taken its place has its own targets for the country. But a recent article in Mint, looking back at Vision 2020, used data to show the gap between that vision and reality – while the 2004-09 period did see an economic growth of 8-9 per cent per year, it has been dipping since and is currently at its lowest; extreme poverty has come down but more than 60 per cent of the population earns less than
$3 a day.