“TB-Mission 2020”

Dr Harsh Vardhan announces India’s “TB-Mission 2020” At Barcelona meet: “I am in a hurry, want intensity with accountability”

Dr Harsh Vardhan, Union Health Minister, today outlined the broad contours of India’s new thrust against tuberculosis (TB), and stressed that he is determined to take the country substantially down the road to elimination of the disease by 2020. Delivering the keynote address at the World Health Organisation’s Global TB Symposium –titled “Moving out of the box to end global TB epidemic: with post-2015 strategy” – the Minister said, “I am a man in a hurry. While I am all for having a long-term perspective, I am not interested in something that may or may not be achieved in 2035 or 2050.” Dr Harsh Vardhan announced that under the evolving “TB-Mission 2020” he had instructed India’s anti-TB mission officials to work hard to achieve considerable success over the next five years. In his view, a distant target date would not demand of his team the kind of accountability that would be naturally ensured if the objective is brought forward. Already, the government has put TB control measures in top gear. From the traditionally passive approach, India has gone into “intensive mission mode” which is playing out at the most micro levels with the involvement of local self-government bodies and voluntary sector activists. The “Standards for TB Care in India” which have been developed are not minimum standards but a composite of the best possible diagnosis strategies using high-sensitive tools, universal drug susceptibility testing, quality-assured drugs and improved regimens. Dr Harsh Vardhan said that India is also in the process of ensuring free diagnosis and treatment to all TB patients irrespective of the provider –government or private hospital. Steps are underway to ensure that patients are provided with nutrition support and relevant financial enablers. “Drastic reduction demands we take bold steps –catching the bull by the horn. We have already taken regulatory steps like banning commercial serology for TB diagnosis, bringing anti-TB drugs under a separate schedule of the national law on drugs to prevent misuse and mandatory notification whenever a new TB case is detected,” Dr Harsh Vardhan said. Dr Mario Raviglione, Director of WHO’s Global TB Programme, and Dr Jose Louise Castro, Director of the International Union against TB and Lung Diseases, shared the podium with Dr Harsh Vardhan. He made a ringing appeal to the world body to recognise TB as not just a medical but development issue. “TB is the by-product of poverty,” Dr Harsh Vardhan pointed out. “I strongly believe TB control should be taken up by all as a development issue. The responsibility of TB control needs to move from doctors to medical administrators and politicians. That I wear all these hats is pure coincidence and, indeed, an opportunity to lessen the suffering of mankind.” Later, Dr Harsh Vardhan was joined by the Health Minister of South Africa, Mr Aaron Motsoaledi, in addressing delegates to the 45th Union World Conference on Lung Health. Mr Motsoaledi holds the chair of the “Stop TB Initiative”. The Ministers also had a one-on-one meeting on the sidelines of the conference. Addressing the experts, he said that solutions to lung health challenges faced by countries should be found by involving all stakeholders –from health care professionals and policy makers to the people and communities they serve. “That is why we are intent on developing a large social movement over health”, Dr Harsh Vardhan said. The Indian and South African Ministers also jointly chaired a meeting of technical experts from BRICS countries. It was decided that TB control would dominate the agenda of the upcoming meeting of BRICS Health Ministers in December 2014.

First Indegenously Developed Diagnostic Test Kit for Intestinal Disorder “Celiac Disease”

As a part of the recent initiative to expand the activities of Department of Science & Technology into the health sector, Union Minister of State (Independent Charge) of Science & Technology and Earth Sciences, MoS PMO, Personnel, Public Grievances & Pensions, Atomic Energy and Space, Dr. Jitendra Singh yesterday launched an indigenously developed, cost-effective diagnostic test kit, the first of its kind in India, for the autoimmune “Celiac disease”, which is a lifelong intestinal disorder manifesting as intolerance to certain foods such as wheat, barley, etc. with symptoms like recurring abdominal pain, diarrhoea and weight loss. This launch comes close on the heels of the Department of Science & Technology launching a cost-effective injectable Polio vaccine and ROTA virus vaccine about two months ago. The diagnostic kit has been developed by Department of Biotechnology in the Union Ministry of Science & Technology through a project sponsored by it with the involvement of All India Institute of Medical Sciences (AIIMS), New Delhi, International Centre for Genetic Engineering and Biotechnology (ICGEB) and an industrial partner, M/s. J. Mitra & Co. The diagnostic assay test, through this method, will be affordable, rapid, sensitive and more specific, allowing prompt therapeutic interventions. While congratulating his department for adding a new milestone within a short period of five months, Dr Jitendra Singh said, at the time of taking over as Minister for Science & Technology, he had professed to make science a medium of social transformation in India through cost-effective means and today`s launch was a step forward in that direction. Dr Jitendra Singh said, the Indian profile of most of the diseases is different from the rest of the world and requires exclusively different management, partly because of the different Indian phenotype or genetic makeup and partly because of the tropical dimensions of the disease. This, he said, applies to a variety of diseases including autoimmune disorders like Celiac disease, Type 1 Diabetes Mellitus, Osteoporosis and host of other associated disorders. Moreover, in the backdrop of India`s socio-economic conditions, Dr Jitendra Singh said, expensive treatment of longstanding diseases poses a huge financial burden and especially autoimmune disorders occurring at young age also take a toll of the vital productive years, thus depriving the nation of its immense youth power, particularly at a time when more than 65% of India’s population is below the age of 35 years.

India favours ban on e-cigarettes

Dr Harsh Vardhan outlines proactive measures against tobacco use

Dr Harsh Vardhan, Union Health Minister, is in favour of a complete ban on e-cigarettes and all products described as “Electronic Nicotine Delivery Systems (ENDS)”. In his clearest message yet on the controversy over the safety of ENDS, Dr Harsh Vardhan ruled out their acceptability in the light of research findings by experts which have held that they are no less unsafe than the “real thing”. The Minister, who was addressing global tobacco control experts at the 45th Union World Conference on Lung Health in Barcelona, Spain, yesterday, said that e-cigarettes and similar products push children towards the tobacco habit eventually via nicotine dependence. “In our national consultation it has been shown that children and other non-smokers tend to develop nicotine addiction at a rate greater than situations where ENDS did not exist. And after that the slide to tobacco is practically inevitable,” he said. Dr Harsh Vardhan, who is credited with writing the first ever anti-smoking consumption law in the country –The Delhi Prohibition of Smoking and Non-Smokers’ Health Protection Act, 1996 – received a rousing reception at the meeting. The Union is a 94-year-old forum dealing with lung diseases, TB and tobacco issues. He however pointed out that banning ENDS should not be an end in itself. “The success of a ban strategy will depend on how we agree to control illicit trade and cross border sales of such products. The use of the Internet for this trade should also be curbed.” India is home to 275 million tobacco users. The use of smokeless tobacco has become a major public health menace, which, if not checked in time with strong measures, could become a national threat. The aggressive marketing strategies marked by attractive packaging, flavouring and price-cuts represent a major challenge for the government. Dr Harsh Vardhan said, “I am sure all experts present here are aware of the power of the tobacco industry. India is committed to taking proactive measures to counter the challenges they throw up.” In this context, he mentioned India’s recent climbing to the first position among countries notifying mandatory printing of warnings on the largest surface area of packages containing cigarettes and other forms of tobacco. The new rules demand pictorial health warnings on 85 percent on both sides of tobacco packs. The government’s clamping of the highest ever rates of taxes and reduction of duty free allowance on all tobacco products has in fact become a test case of State intervention. Delegates here greeted Dr Harsh Vardhan’s advocacy behind this Union Budget announcement and sought his advice on similar proposals considered in other countries. Dr Harsh Vardhan said that he had a definite road map for the future. This includes institutionalising a 24-hour telephone helpline (to be called “Quitline”) to counsel tobacco users who are fighting the habit. Also on the anvil are five tobacco testing laboratories at the national and regional levels, setting up 27 new state tobacco control cells during the present financial year and Amendments to the Cigarettes and Other Tobacco Products Act, 2003 to ensure better implementation and enforcement.

Acquisition of a Polar Research Vessel

The Cabinet Committee on Economic Affairs, chaired by the Prime Minister Shri Narendra Modi, has approved the acquisition of Polar Research Vessel (Ice-breaker, Research cum Supply Vessel) by the Ministry of Earth Sciences at a total cost of Rs. 1051.13 crore within a period of 34 months. The Ministry of Earth Sciences felt necessary to have the country`s own polar research vessel considering the need to sustain two Indian research bases in Antarctica (Maitri and Bharti); dovetailing research initiatives in the Southern Ocean domain with those in the proximal regions of the Antarctic continent; widen the thrust on Arctic research disciplines undertaken through Indian Station Himadri, and to provide a suitable research platform for other tropical sea programmes. Such a vessel, it is envisaged, can not only perform dual functions, research and logistics, in the polar region but can also serve as a research platform for scientists to undertake scientific research in the ocean realm including the Southern Ocean. In the context of India having expanded its scientific presence to the Arctic as well and the country`s growing strategic interests in the polar and ocean domain, a polar research vessel would certainly serve as the perfect vehicle for building up on India’s sustained presence and increased visibility in the ocean sector. Background: Indian Antarctic expeditions have been undertaken every year onboard ice-class vessels/ice-breakers chartered from the international market. These vessels have largely been cargo ships capable of transporting men and material and unable to serve as a research platform. With increased demand for cargo vessels and their dwindling availability, the charter charges of these vessels have been escalating over the years. The First Indian Scientific Expedition to Antarctica was launched in 1981. From 2004, India embarked on its scientific endeavors in the Southern Ocean realm. In addition, since 2007, Indian scientists have had a sustained presence in the Arctic. With India`s entry into the Arctic Council as an Observer along with China, Singapore, Japan and South Korea, it has become strategically important to have increased visibility in the Arctic too. This will facilitate India to assume a lead role among Asian nations active in the polar regions.

Govt chalks out plans for massive solar power push Targets 100,000 Mw in 5 years; Modi wants action plan prepared by November first week

India is about to witness a massive scaling up of solar powercapacity to 100,000 Mw, with Prime Minister Narendra Modiasking the ministry of new and renewable energy (MNRE) to prepare an action plan by November first week.

Aiming to reach this target in five years, before the next general elections, the government is expediting the work by directing states to identify suitable locations across terrains - deserts, wastelands, national highways, river banks and even over canals (as was done in Gujarat).

With Modi at the helm, as the chief minister of Gujarat, the state had become one of the largest contributors in the cumulative renewable energy mix of the country. At 900 Mw, Gujarat is still the largest contributor to the country's total installed solar power capacity of 2,600 Mw.

The Bharatiya Janata Party's election manifesto has also promised a considerable push to clean energy.

The target is five times the target designated under the Jawaharlal Nehru National Solar Mission (JNNSM), one of the key programmes of the earlier United Progressive Alliance government. Large solar projects similar to coal-based ultra mega power projects, solar parks, micro grids and solar rooftops - all would be a part of the project.

MNRE recently announced a draft proposal on bidding for solar projects worth 3,000 Mw - double the original target in JNNSM.

Officials said the total projected amount for this mega plan is Rs 1,00,000 crore for five years, with the per year amount falling to Rs 20,000 crore in two-three years when the price of solar power inches towards grid parity.

"The cost of gas-based power plants has gone up and with coal looking at fresh auctions; thermal power prices would also go up. The current price of solar power production is Rs 6.5 crore per Mw. So, with a viability gap funding (VGF) support of Rs 1 crore per Mw, solar is looking at parity with coal very soon," said a senior government official.

The government, though, would look at all possible models - VGF, power bundling, state support - according to size and type of project.

The average cost of setting up a coal-based power plant is about Rs 3.5-4 crore per Mw and a gas-based plant Rs 5.5 crore per Mw.

MNRE is also setting up a single-window clearance agency to promote investment in solar power. "We have written to major banks in the country to increase their credit limit for the solar power sector. Also, multilateral agencies are also on board to design an investment road map for the 100,000 Mw target," said a senior MNRE official.

MNRE has joined hands with PwC to prepare a report on the execution of the programme, which is likely to be presented to the clean energy enthusiast prime minister by November 4 or 5.

Government officials said agencies such as ADB, KfW, World Bank and US Exim Bank are already a part of the action plan.

Following the directions from the Minister of State for Coal, Power and Renewable Energy Piyush Goyal, the ministry of new and renewable energy is also approaching top 500 private companies and 50 public sector companies, to sign commitment for developing solar power and set a trend for the sector.

PM'S SOLAR PLAN

Ministry of new and renewable energy ready to present action plan to PM in November   Target is five times the target designated under the United Progressive Alliance's flagship Jawaharlal Nehru National Solar Mission   Top 500 private companies and 50 PSUs to sign green commitment   Bank, financial institutions, multilateral agencies also on board   States to identify suitable land and project   Centre to assist with finance, clearance

Clearing the air on clearances

Are environmental clearances holding up industrial and infrastructure investment in India? India's manufacturing sector has struggled to increase its contribution to gross domestic product and infrastructure investments have not kept pace with the need. This economic stagnation is often blamed on, among other factors, hurdles in securing environmental clearances. How true are these perceptions? Which aspects need attention? How could these be addressed?

Clearances are sought under various regulatory provisions: environmental clearance for new activities or expansion of existing projects; forest clearance for any project involving diversion of forest land; wildlife clearance for projects falling within 10-kilometre radii of a "core zone" boundary.

While many argue that projects are being delayed, there is no clear definition of "delays". In the environmental-clearance process, the grant of terms of reference (TORs) from the date of submission of the project proposal is meant to take 60 days. Next, the environmental impact assessment (EIA) and other scoping studies are to be undertaken, while the TOR remains valid - for two years. This is followed by public consultations, for which 45 days are allocated. The recommendation from the expert appraisal committee (EAC) is meant to take up to 60 days with final clearance from the regulatory authority within another 45 days. If all stages took the maximum time allocated, securing an environment clearance could take 940 days.

In reality, however, clearances are often granted much sooner. The Council on Energy, Environment and Water analysed 11,174 proposals from 2003 until September 2014. Of these, 72 per cent had received environmental clearance. Of the remaining 3,119 pending applications, 89 per cent had been granted TORs. Further, among those granted environmental clearance, 90 per cent of projects in construction, hydropower and industry received clearance within a year of application.

If most projects get cleared and soon enough, why are there delays in other cases? The collection of baseline data, conduct of the EIAs and public hearings, and submission of relevant documents requires the most time and are the reasons for most delays across sectors. A review of the minutes of the EAC meetings during 2013-14 shows that a quarter of the projects applied for an extension of TOR validity, as they were unable to comply with the TOR conditions, or were found to have submitted incomplete or incorrect information.

We estimate that 40 to 60 per cent of projects in thermal power, hydropower, coal mining and nuclear power sectors are likely to face delays during the post-TOR stage of the clearance process. Land acquisitions were found to cause delays particularly in river valley, hydropower and infrastructure projects. Also, during 2003-14, while 53 per cent of applications (out of 10,403) had received forest clearances, within industry (which includes, among others, steel, cement, chemicals, paper and pulp), 90 per cent of projects were pending forest clearance.

Overall, three problems afflict the process of environmental clearances: (a) post-TOR delays in collecting data, conducting the EIAs and public hearings and submission of required documents; (b) poorly designed public hearings; and (c) poor information management.

What can be done? First, the quality of the EIAs has to significantly improve. An environment clearance service cell (ECSC) should act as a single window, to provide project proponents assistance to obtain necessary approvals and seek project-related information. By coordinating with the Quality Council of India, the ECSC can develop a cadre of accredited EIA consultants, reviewed by an international agency such as the International Association of Impact Assessment. Accredited consultants would be randomly allotted to appraise projects, to reduce the conflict of interest in promoters choosing their own consultants. Streamlining the process is not a guarantee of clearance. But a more credible and time-bound process can increase confidence on all sides.

Secondly, public hearings have to be revamped. They are held too late in the decision-making process to be meaningful. The EIA consultant should be required to prepare a ToR for the EIA and should get the same vetted by the public at the start of the scoping phase. Once the report is prepared, a second public hearing should be organised once the community has had a chance to deliberate for a month. If more than 50 per cent of the affected community votes against the sanctity of the EIA report, then it would have to be redone. However, public consultations are not decision-making forums; that authority rests with the ministry of environment, forests and climate change.

Thirdly, better information management is needed to establish baselines. An environmental clearance information system (ECIS), within the ECSC, could conduct a countrywide baseline mapping of environmental quality parameters (air, water, land use, meteorology, soil, biodiversity, social factors). Real-time information could flow from quality-monitoring stations (say, via the National Air Quality Monitoring Programme and National Water Quality Monitoring Programme). More granular data would eventually become available with monitoring agencies at regional levels. Finally, an "EIA follow-up" is a globally recognised practice and includes monitoring actual impacts, adaptive management and regular communication with communities. Over time, this should be integrated to strengthen the ECIS, provide updated data and adjust baselines.

The "Make in India" campaign aspires for "zero defect and zero effect". Raising the bar for quality products is imperative. Equally, lowering the resource footprint of India's growth recognises the benefits that the natural environment and calls for accounting for the impact of anthropogenic activities. Rather than viewing environmental clearances as a zero-sum game, they could be streamlined, made more credible, more informative, more inclusive and yet time-bound. It would reinforce the symbiotic relationship between the environment and human activities, which India's new manufacturing vision seeks to preserve.

Mr Jaitley's best decision The defence minister gives us hope that he might be more energetic than his predecessor in filling a yawning gap in our maritime power

On Saturday, Defence Minister Arun Jaitley took his best procurement decision so far, relating to building six state-of-the-art submarines for the navy under Project 75I. He ruled that a ministry committee would identify Indian shipyards that had the capability and capacity to build submarines, and the chosen ones would bid, in partnership with a foreign vendor, on a winner-take-all basis. Over the last decade, three committees have been set up for precisely this purpose, but the United Progressive Alliance (UPA) government’s antipathy for tough choices stymied any decision. Now, by giving the committee just six-eight weeks to submit its findings, Mr Jaitley gives us hope that he might be more energetic than his predecessor in filling a yawning gap in our maritime power.

That weakness is the dire shortfall of state-of-the-art submarines. Our powerful surface fleet of some 130 vessels grows stronger every year as Indian shipyards build bristling, multi-role destroyers, frigates and corvettes — albeit slowly. The Russian-built aircraft carrier, INS Vikramaditya, commissioned last November, flies the MiG-29K, one of the most capable carrier-borne fighters outside the United States Navy. In 2018, Cochin Shipyard will hand over INS Vikrant; and then start building a larger, even more capable, indigenous carrier. These three carriers and their battleship escorts will project power far out at sea. Thanks to India’s peninsular geography and to forward air bases in the Andaman and Nicobar Islands, the Indian Air Force can support a fleet a long distance away. In short, the surface navy is well poised to exercise “sea control” over chosen parts of the northern Indian Ocean.

Yet we lack “sea denial” capability, or the ability to deny enemy warships, submarines and merchantmen the use of waters that we do not control. Submarines are sea denial instruments, lurking underwater to detect and destroy enemy vessels that happen along. In a war with China, for example, the surface fleet – operating as aircraft carrier battle groups – might blockade Chinese oil supplies and trade; while submarines patrol the Indonesian archipelago, denying Chinese warships entry into the Indian Ocean. Other submarines might lurk outside Pakistani harbours, bottling up warships inside.

To build this crucial capability, the government signed off in 1999 on a plan to build 24 conventional submarines over the next 30 years. Although half that period elapsed this year, not a single submarine has joined the fleet. Six Scorpene submarines, built in Mumbai by Mazagon Dock Ltd (MDL), will start being commissioned only in 2016. Even so, they will be without air independent propulsion, or AIP, and land attack missiles until those capabilities are retrofitted. Meanwhile, the navy makes do with nine ageing, Russian, Kilo-class; and four German HDW submarines.

The UPA’s procrastination with Project 75I did not stem from a profusion of choices. There is agreement that just two Indian shipyards can build modern submarines: the public sector MDL, because of the experience of building the Scorpene; and private sector engineering giant, Larsen & Toubro (L&T), which has worked on India’s nuclear ballistic missile submarine (SSBN) programme for two decades. With MDL busy with the Scorpenes, the navy had been urging the ministry to let L&T bid for Project 75I, in partnership with a foreign vendor that met the technical and financial requirements. Yet the ministry’s department of defence production (the DDP directly oversees MDL, a major conflict of interest) assiduously undermined L&T’s chances. The DDP illogically insisted that L&T’s Hazira shipyard, which had built large sections of the bigger and far more technologically challenging SSBN, INS Arihant, was inadequate for building a smaller conventional submarine. Until Mr Jaitley intervened, Project 75I was going to be built as follows: two submarines abroad and four by MDL.

Meanwhile, L&T has built a Rs 4,500-crore shipyard-cum-port at Katupalli, near Ennore in Tamil Nadu, with sufficient draught and capacity to build any size of submarine. It has also established a submarine design centre in Chennai and a virtual reality centre in Mumbai. For good measure, it created a Rs 500-crore fabrication unit at Talegaon, near Pune; and a Rs 350-crore unit at Coimbatore for engineering missile parts. Locating Katupalli shipyard on the east coast was a smart move by L&T, since that distributes the risk of disruption to production.

With the defence ministry looking to identify an Indian shipyard, it must also think hard about the foreign technology partner. Traditionally, the choice has been between “eastern bloc” and “western bloc” weaponry, that is, Russian or European. Today, however, other potential choices present themselves — notably the Japanese Soryu-class submarines that many experts consider the world’s finest conventional submarine. There remain questions about its high cost; and Tokyo’s willingness to transfer Soryu-class production and technology to India. Even so, New Delhi must consider the Soryu’s technological edge, the growing strategic embrace with Tokyo, and the likelihood that prices could be lowered if Japan’s own production (five planned) were boosted by simultaneous orders from India (six or more) and Australia’s planned purchase of up to 12.

Finally, if Mr Jaitley does take the strategic decision to establish one private sector submarine line on the east coast (L&T), in addition to a public-sector line on the west coast (MDL), it must keep the Scorpene submarine line rolling even after MDL delivers the sixth and final vessel in 2019-20. More Scorpenes are only to be welcomed; and New Delhi could negotiate tough with DCNS, insisting on enhanced technology transfer and a greater share of production as a precondition for ordering four to six more.

Additionally, in developing two submarines lines, the defence ministry must keep the future in mind. The 30-year submarine plan stipulates that the manufacture of 12 submarines (Project 75 and 75I) must lead on to indigenous production, with 12 vessels to follow that have been designed and built in India.