Q1.Why there is a need to regulation price of patented medicines in India:-
Pharmaceutical patents grant protection to the patentee for the duration of the patent term. The patentees enjoy the liberty to determine the prices of medicines, which is time-limited to the period of monopoly, butunaffordable to the public .It puts a huge burden on the public’s purchasing power in accessing these patented medicines.
Public is put to much distress as most of these medicines generally do not find any place in the essential medicine list.The unsustainable high price of new anticancer medicines has become a major area of concern as cancer has become a money-maker for pharmaceutical companies.
Unaffordability of the medicine leaves the patient with no option but to avoid purchasing the costly medicine which would have given them an extended lease of life, rather than get caught in averitable debt trap.
Some researchers, having analysed the prices of imported patented medicines to India, have observed that,while no real technology transfer has happened, higher prices are levied on the Indian consumers .
The unaffordable prices of patented medicinescompromise equitable access to them and threaten the financial sustainability not only of patients, but even that of the public health system
Medicines that have a patent tag are those which are required by patients for specialised treatments, most often when the normal or first- and second-line treatments have failed. It, therefore, becomesimportant that new-generation medicines with better potential for treatment or cure become available at affordable prices.
Without price regulation market’s focus would only be to recover the fixed costs of the product from the sale of the products, during the validity period of the patent, so as to recoup the investment in R&D for discovery of the product.
There are no intrinsic checks and balances in the market whena patented medicine is introduced, as there is no competition from any rival pharmaceutical company for market space for the same product.
There is no express provision either in the WTO or the TRIPS agreement that explicitly prohibits price regulation of patented medicines.
In a country where very few people have health insurance, 70% of Indians pay for healthcare expenses out of their own pockets. In this scenario there is a need to regulate prices of patented medicines.
Currently, only 5% of medicines used in India are said to be patent-protected. India has over three million cancer patients, which means one in every 13 of the world’s cancer patients is Indian.
Cons of Price regulation of patented medicines in India :-
The patent regime and price protection through a legally validated high price for the medicine during the currency of the patent provide thepatentee with a legitimate mechanism to get returns on the costs incurred in innovation and research .
Patent protection, while incentivising the time and capital invested by the innovator,also serves to put in public domain the knowledge thus gained at the end of the patent period.
India is expanding this policy beyond expensive cancer drugs.
Indian Supreme Court refused to prevent an Indian generic manufacturer, Glenmark Pharmaceuticals, from manufacturing and selling Merck’s diabetes drug, Januvia, in India.
While it is an important drug, Januvia does not carry an expensive price tag.
Indian policies can signalthat intellectual property is tenuous in this country and will be granted only in those cases where it can benefit India.
Price regulation of patented medicines in some form would be a win–win solution for both, patients and the pharmaceutical industry.
Q2.What do you understand by Ensemble Production system. Discuss the advantages of its recent introduction in India.
The Ministry of Earth Science (MoES) recently launched the Ensemble Prediction System (EPS) for generating more accurate and area specific forecast of extreme weather events like rains, heat wave and cold wave.
Ensemble prediction system:-
The new Ensemble Prediction System (EPS) has been touted as best available model after such a system available in Europe.
The new EPS system has been developed by three bodies under Ministry of Earth Sciences viz. Indian Meteorological Department (IMD), National Centre for Medium Range Weather Forecasting (NCMRWF) and Indian Institute of Tropical Meteorology.
The most salient feature of new EPS is its high resolution for short-medium range weather forecasts.
In its calculations, the system will use a newly procured 8 petaflops high-power computing system. The system was recently procured for Rs. 450 crore.
These new systems, according to IMD,shall improve upon deterministic forecasts that are prone to high margins of error.
Under the new system, the area of spatial resolution (currently 23 km grid scale) will come down to 12 km. Thiswould help sending out district level warning and forecast extreme weather events as before as five days.
The EPS will not only enable the India Meteorological Department (IMD) to give forecast five days before, but would alsoadd the probability of occurrence of an extreme weather event with its level of intensity.
Thenew ensemble will tell the probability of rainfall according to its intensity and volume, this will be colour coded for ease of interpretation.
Frameworks of the new EPS are among the best weather prediction systems in the world at present and very few forecasting centres in the world use this high resolution for short-medium range probabilistic weather forecasts.
The EPS will enhance the weather informationbeing provided by the current models by quantifying the uncertainties in the weather forecast and generate probabilistic forecasts.
It will greatly help the disaster management authoritiesand other users in making better emergency response decisions by explicitly accounting for the uncertainty in weather forecasts.
Theaccurate weather forecasts would help farmers to damage crops and also support administration to take disasters prevention steps beforehand.
This system will not be very helpful when it comes to predicting thunderstorms, which India has seen across the country recently, as these are mesoscale weather phenomena (limited to a small geography) and not well captured even with 12km grid scale.
Advance prediction can help farmers and agriculture which is largely impacted due to weather changes. So the ensemble prediction system is the step in the right direction.
Q3.There is little reason to celebrate the findings of the recentreport from the World Health Organisation about the decreasing incidence of smoking in India. Critically analyze.
WHO report released recently suggests that India’s efforts to cut the prevalence of cigarette smoking are paying off. Between 2000 and 2015, this fell from 19.4% to 11.5%. By 2025, the report projected, it could drop to 8.5%, putting India well in line to meeting its 2025 target under a WHO global plan to tackle non-communicable diseases.
However the use of smokeless tobacco is still largely prevalent in India.
Positive effect of India’s achievement:-
Tobacco causes many health issues. With a favourable report people would spend less on this particular bad habit which leads to reduced out of pocket expenditure for health issues
This will also lead to reduced mortality which will ultimately help in increasing productivity etc.
However celebrating too early if of very little use :-
No global data available on smokeless tobacco:-
Smokeless tobacco is the bigger scourge in the country. The WHO report doesn’t model usage trends in this segment because of the paucity of global data. Other data, however, suggest that India is lagging on this front.
Failure of laws:-
Even though there is a 2011 government ban on the sale of food items with tobacco or nicotine in them, the consumption of gutkha, khaini and zarda continues to be rampant.
The Global Adult Tobacco Survey in 2016, for example, found that 29.6% of Indian men and 12.8% of Indian women were users. Children are victims of this lethal addiction too.
The food safety rules target pre-mixed tobacco products, such as gutkha, which contains lime, sugar and other spices.This leaves unflavoured items, such as khaini or surthi, out of regulatory purview.
Productivity of youth lost:-
Given that 66% of the world’s smokeless-tobacco users are in India, a sizeable chunk of this number would be Indian teenagers. Against this background, the drop in cigarette smoking rates gives India little cause to celebrate.
Huge health impact:-
Gutkha and other chewable tobacco items are equally harmful compared to cigarettes. Surveys show that these products are sometimes mixed with carcinogenic compounds called nitrosamines.
Meanwhile, mislabelling of smokeless tobacco is common. Even when a product contains tobacco, it is passed off as being tobacco-free.
One of the tactics of the tobacco industry is to use flavours such as cardamom and saffron to attract youngsters, triggering life-long addiction.
Large segment of population affected:-
Smokeless tobacco is cheaper source for consumers who are mostly from the low-income segment of society.
India should consider alternative regulatory measures, which will better achieve the objective of reducing tobacco consumption and be less investment-restrictive as well. One such measure is adoptingplain packaging regulation.
Another effective measure is toincrease taxes on tobacco products.
It is important to establish appropriatedata management, monitoring, and evaluation systems.
In addition, oral cancer control policies should be implemented to change the lifestyle and behavior of high-risk populations.
Q4.Declaring Indian ocean a “zone of peace “ would be in the interest of all the stakeholders, including India. Critically Comment.
Indian Ocean is important for many reasons.
It enjoys a privileged location at the crossroads of global trade, connecting the major engines of the international economy in the Northern Atlantic and Asia-Pacific.
The Indian Ocean is rich in natural resources. Forty per cent of the world’s offshore oil production takes place in the Indian Ocean basin
Historically there have been efforts to make areas in this region naval bases for instance Chagos archipelago from Mauritian territoryby Great Britain, which was handed over to the U.S. On Diego Garcia, the U.S. built a major naval base, La Reunion became the centre of French naval military operations in the Indian Ocean and now assumption island and Agalega island for India.
Zone of peace :-
The idea of Indian ocean as zone of peace (IOZOP) goes back to the days of the 1964 Cairo Conference of the Non-Aligned Movement, which had expressed concern over the efforts of the imperialists to establish bases in the Indian Ocean and declared that the Indian Ocean should not be a battleground for the big powers.
The Lusaka Declaration (1970) refined the idea further and it led to the UNGA resolution, which proposed the IOZOP strictly in the context of the raging Cold War at that time.
Why Indian ocean should be declared as a zone of peace :-
Proponents of the proposal believe that in the absence of military strength and influence to counter the growing Chinese presence in the region,India should use the multilateral route to create a consensus for preventing the military activity of external powers in the region.
There are variousHumanitarian and environmental issues associated with the militarization of small islands in the Indian Ocean
Due to increased militarization environmental threats faced by these islands like rise in sea level etc are total being sidelined .
Military influence too much:-
Increasing Chinese presence and the threat of PLA-N bases in the IOR
The growing interests of other major powers (US, UK, Russia, France and Japan) in the region, and the many Chinese infrastructure projects in the region create an imperative for India to actively limit the military maritime activity of external powers in the region.
Can balance India and China:-
With the kind of support China demonstrated in Kathmandu among the South Asian Association for Regional Cooperation (SAARC) countries, it is possible that the zone of peace idea will turn into a move to counter the U.S. as a foreign presence and to seek some balance between India and China in the Indian Ocean.
Declaring Indian ocean as Zone of peace is mired with difficulties:-
Attempting to limiting military maritime activity through the IOZOP route will ensure that while no military activity is ever practically curtailed,Indian influence and credibility in the region will stand severely eroded.
The trouble with the IOZOP proposal is itsflawed premise that by simply declaring the region a “Zone of Peace”, foreign military presence and activity can be effectively halted.
International focus on India’s naval acquisitions, present and future, may well become counterproductive.
The greatest resistance to the revival of the IOZOP will come from those who will argue that the idea itself is outdated as theCold War and great power rivalry are non-existent