Mains – 19th Oct 23

National Sickle Cell Anaemia Eradication Mission (NSCAEM)

Why in news?

• PM launched National Sickle Cell Anaemia Eradication Mission (NSCAEM) 2047 by unveiling a portal in Shahdol, Madhya Pradesh.

 

What is Sickle Cell Anaemia?

• First discovered by a physician named James Herrick, Sickle cell disease is a genetic blood disease which affects the whole life of affected patient. It not only causes anemia but also reduced growth, and affects many organs like lungs, heart, kidney, eyes, bones and the brain.
• World Sickle Cell Day is observed every year on June 19.

 

What happens in Sickle Cell Anaemia?

• It affects the shape of red blood cells, which carry oxygen to all parts of the body. Red blood cells contain hemoglobin, a protein that carries oxygen.
• Healthy red blood cells are round, and they move through small blood vessels to carry oxygen to all parts of the body, but sickle red blood cells end up slowing and even blocking, the blood flow.
• Moreover, sickle cells die early, resulting in a shortage of red blood cells that deprive the body of oxygen. These obstructions and shortages may cause chronic anaemia, pain, fatigue, acute chest syndrome, stroke, and a host of other serious health complications.
• In someone who has SCD, the hemoglobin is abnormal, which causes the red blood cells to become hard and sticky and look like a C-shaped farm tool called a sickle.

 

Is it possible to treat Sickle Cell Anaemia?

• Sickle cell anaemia is a genetic disorder, the only cure comes in the form of gene therapy and stem cell transplants — both costly and still in developmental stages.
• In gene therapy, the DNA inside the haemoglobin gene is edited to stop the disease.
• In stem cell transplants, the bone marrow affected by sickle cell anaemia is replaced with healthy bone marrow from a donor.
• Blood transfusion, wherein red blood cells are removed from donated blood and given to a patient, is also a trusted treatment in the absence of permanent cures. But challenges include a scarcity of donors, fears around safe supply of blood, risk of infection etc.

 

National Sickle Cell Anaemia Elimination Mission:

The programme was first announced in the Union Budget 2023.

• To improve care of all Sickle Cell Disease patients for their better future and to lower the prevalence of the disease through multi-faced coordinated approach towards screening and awareness strategies
• Eliminate sickle cell disease as a public health problem in India before 2047.
• The overall aim is to enable access to affordable and quality health care to all SCD patients, and to lower the prevalence through awareness, change of practices and screening interventions.
• Beneficiaries: The program will cover the entire population from zero to 18 years of age and shall incrementally include the entire population up to 40 years. Over a period of three years, spanning from the fiscal year 2023-24 to 2025-26, the program targets screening approximately 7.0 crore people.
• The strategy emphasizes on THREE pillars:

1. Health promotion– Awareness generation & pre-marital genetic counselling
2. Prevention: Universal screening and early detection

• Holistic Management & continuum of care–
• Management of persons with sickle cell disease at primary, secondary and tertiary health care levels; treatment facilities at tertiary health care facilities
• Patient support system
• Community adoption

Implementation: The programme will be executed as part of the National Health Mission (NHM) and in integration with existing mechanism under NHM such as Rashtriya Bal Swasthya Karyakram (RBSK) and Pradhan Mantri SurakshitMatritva Abhiyan (PMSMA).

 

Status of Sickle Cell Anaemia in In India:

• India is the second-worst affected country in terms of predicted births with SCA — i.e., chances of being born with the condition.
  • In India, around 18 million people have sickle cell traits and 1.4 million patients have sickle cell disease.
  • In India, it is more common in the tribal population where about 1 in 86 births among STs have SCD, but occurs in non-tribals too.
  • India has the largest density of tribal population, globally. As per Census 2011, India has an 8.6% tribal population which is 67.8 million across the Indian states.
• A few states in India have a significantly higher SCD prevalence. These include: Chhattisgarh, West Bengal, Uttar Pradesh, Maharashtra, Madhya Pradesh, Jharkhand, Gujarat, Odisha, Kerala and Rajasthan. Collectively, these states are referred to as the sickle cell belt.

 

Steps taken by India:

• Ministry of health under NHM initiated the work on hemoglobinopathies (Thalassemia & Sickle Cell Disease) in 2016 wherein comprehensive guidelines on prevention and management of heamoglobinopathies were released and provision of funds towards screening and management of Sickle cell disease were made.
• The Ministry of Tribal Affairs (MoTA) has launched the Sickle Cell Disease Support Corner to bridge the gap between patients and health care services in tribal areas.
• The National Council on Sickle Cell Disease has also been constituted for timely and effective action.
• In the Budget 2023-24, the government announced its plans to distribute “special cards” across tribal areas to people below the age of 40. The cards will be divided into different categories based on the screening results. The mission will receive funding under the National Health Mission.

 

What should be the way forward?

• Increasing the awareness about the disease in the community.
• Implementation of mass screening activities for early identification.
• Building a strong network of diagnosis and linkages.
• Implementing robust monitoring system.
• Strengthening the existing primary health care mechanism to incorporate SCD related strategies.
• Capacity building of primary, secondary and tertiary health care teams.
• Building cost-effective intensive interventions at higher care facilities.

 

Criminalization of Politics

Why in news?

• Recently, the Association for Democratic Reforms (ADR), wrote to the Election Commission seeking action against parties that fail to publish details of criminal antecedents of candidates as per orders of the Supreme Court and the poll panel.

 

Rule pertaining to declaration of criminal antecedent

A political party that runs candidates with criminal antecedents must publish information about their criminal background. This will be both on its website and in newspapers and TV channels on three occasions prominently.

 

What is Meant by Criminalization of Politics?

• The criminalization of politics refers to the infiltration of criminals, lawbreakers, and corrupt individuals into the political system, who then use their power and influence to further their own interests at the cost of the country and its citizens.
• Over the years, this trend has only worsened. Today, many politicians with criminal backgrounds have managed to secure top positions in political parties, and in some cases, even become ministers in state and central governments.

Some Statistics on Criminalization of Politics in India:

• According to a report by the ADR in the 2019 Lok Sabha elections, 43% of the winners had declared criminal cases against themselves, and 29% had declared serious criminal cases, such as murder, attempt to murder, kidnapping, and crimes against women.
• ADR’s analysis of candidates in the 2014 Lok Sabha elections found that 34% of the candidates had criminal cases against them, and 17% had serious criminal cases.
• ADR’s analysis of the 2020 Bihar assembly elections found that 328 out of 1,463 candidates had declared criminal cases against themselves, and 245 had declared serious criminal cases.
• A report by the National Crime Records Bureau (NCRB) found that between 2014 and 2018, there was a 44% increase in the number of cases of elected representatives booked under various sections of the Indian Penal Code (IPC).

 

Reasons for the criminalization of politics:

• Due to the government’s inability to adequately respond to the socio-economic and political issues of the populace, individuals are drawn to people with a criminal reputation. These influential individuals, endowed with both power and riches, are anticipated to meet the people’s requirements.
• Since, in India electoral politics is more about caste, ethnicity, religion and several other factors, money and muscle power of criminals help political parties gain votes.
• Electoral politics is largely dependent on the funding that it receives. Since candidates with criminal records often possess greater wealth, they ensure greater inflow of funds, labour and other advantages that may help a party in successful campaign, and also possess greater ‘winnability’.
• Lack of Intra-party democracy: Political parties in India largely lack intra-party democracy and the decisions on candidature are largely taken by the elite leadership of the party. Consequently, politicians with criminal histories often evade scrutiny from local party workers and organizations.
• Due to the low levels of convictions of MPs and MLAs, and delays in trials, political parties are not deterred from giving tickets to criminals.
• Moreover, the slow judicial process and the inadequate enforcement of election laws also provide opportunities for politicians with criminal records to thrive.

 

Implications of Criminalisation of Politics:

• Threat to Democracy: Criminalization of politics poses a serious threat to democracy as it undermines the rule of law and democratic institutions. When politicians with criminal backgrounds hold public office, they can use their power to subvert the justice system and create a culture of impunity.
• Governance Issues: When politicians with criminal backgrounds hold public office, they are likely to be more interested in serving their own interests rather than those of the people. This can lead to a lack of good governance, and a failure to address important issues facing the country.
• Corruption: Criminalization of politics often goes hand in hand with corruption. Politicians with criminal backgrounds are more likely to use their power for personal gain, which can lead to widespread corruption.

• According to the NCRB’s “Crime in India” report for 2019, there were 9,427 cases of crimes committed by politicians, of which 4,029 cases were related to corruption.

• Criminalization of Political Parties: Criminalization of politics can lead to criminalization of political parties, with criminal elements gaining control of political parties and using them for their own benefit. This can further weaken democratic institutions and undermine the rule of law.
• Public Perception: When politicians with criminal backgrounds hold public office, it can erode public trust in the political system. This can lead to apathy and disillusionment among the public, with people losing faith in democratic institutions and the rule of law.

 

Some recent guidelines of the Supreme Court:

• In 2002, in the case of Association for Democratic Reforms v. Union of India, the Supreme Court observed that criminalization of politics is a serious threat to democracy and directed the Election Commission of India to issue guidelines to ensure that candidates with criminal records were not given tickets to contest elections by political parties. The court also ordered that candidates must disclose their criminal records in their nomination papers.
• In 2013, in the case of Lily Thomas v. Union of India, the Supreme Court observed that allowing convicted criminals to hold public office is against the principles of democracy and held that any member of parliament or state legislative assembly who is convicted of a crime and sentenced to a prison term of two years or more would be disqualified from holding office. The court also declared that a convicted lawmaker could not contest an election or continue as a member of the legislature while the appeal was pending.
• In 2018, in the case of Public Interest Foundation v. Union of India, the Supreme Court observed that criminalization of politics is a “cancer” that is eating away at the vitals of democracy and directed political parties to publish the criminal records of their candidates on their websites, social media handles, and newspapers. The court also directed the Election Commission of India to create a framework to ensure that the information on candidates’ criminal records was disseminated effectively.
• In 2019, in the case of Mahipal Singh Rana v. State of Uttar Pradesh, the Supreme Court observed that the criminalization of politics was a matter of great concern and called for urgent action to tackle the problem. The court also directed the central government to set up special courts to hear cases against politicians.

 

Vohra Committee on CoP, 1993

• It was constituted with an objective to identify the extent of the political-criminal nexus and to recommend ways in which the criminalisation of politics can be effectively dealt with.
• The committee had concluded that agencies, including the CBI, IB, RAW, had unanimously expressed their opinion that the criminal network was virtually running a parallel government.

 

The Law Commission of India

• In its 244th report, LCI said that instead of politicians having suspected links to criminal networks, as was the case earlier, it was persons with extensive criminal backgrounds who began entering politics.
• The Law Commission said that in the 10 years since 2004, 18% of the candidates contesting either national or State elections had criminal cases against them.

 

 

Solutions to curb Criminalization of Politics:

• Political parties should voluntarily abstain from offering electoral nominations to candidates with blemished records.
• Amendments to the RPA Act should be enacted to disqualify individuals with pending cases of serious offenses from participating in elections.
• The Election Commission of India (ECI) should have the power to audit the financial accounts of political parties, or political parties’ finances should be brought under the right to information (RTI) law.
• There is a need to create awareness among the public about the negative consequences of criminalization of politics. Awareness can help to create pressure on politicians to clean up their act and work for the benefit of the people.
• Broader governance will have to improve for voters to reduce the reliance on criminal politicians.

Conclusion:

In a 2018 report, the Election Commission of India noted that criminalization of politics was a growing threat to the country’s democracy, and called for urgent action to address the issue. The solutions to curb criminalization of politics are multi-faceted and require a concerted effort from all stakeholders.