Mains – 27th 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 SwasthyaKaryakram (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.

 

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The SCO

Why in News?

• Recently, India successfully hosted the 23rd Meeting of the Council of Heads of State of the Shanghai Cooperation Organization (SCO).
• Though the world witnessed another “SCO moment,” challenges from Indian perspective remain and the organisation can get better.

About the Shanghai Cooperation Organisation (SCO)

• SCO is a permanent intergovernmental political, economic, international security and defence organisation, created in June 2001 (HQ – Beijing, China).
• The founding members of SCO – Kazakhstan, China, Kyrgyzstan, Russia, Tajikistan – had come together (as the Shanghai Five) to work on regional security, reduction of border troops, and terrorism in the post-Soviet era in 1996.
• In 2001, the Shanghai Five inducted Uzbekistan into the group and named it the SCO outlining its principles in a charter that promoted what was called the Shanghai spirit of cooperation.
• India and Pakistan became full members at the Heads of State Council meet in Astana in 2017.
• Iran is inducted as the newest member (9^th) of the SCO in 2023 under the chairmanship of India.
• It is the world’s largest regional organization in terms of geographic scope and population, covering approximately 60% of the area of Eurasia, 40% of the world population.
• As of 2021, its combined GDP was around 20% of global GDP.

Highlights of the Recently Held SCO Summit

• Leaders of the SCO member-states signed the New Delhi Declaration, and issued the statements on countering radicalisation and exploring cooperation in digital transformation.
• The summit granted Iran full SCO membership, signed the memorandum of obligations of Belarus to join the SCO as a member-state, and adopted the SCO’s economic development strategy for the period until 2030.
• India refused to join other members on paragraphs relating to China’s Belt and Road Initiative (BRI) in the joint statement, and stayed out of a joint statement on SCO Economic Development Strategy 2030, indicating a lack of consensus in the grouping.
• The Indian PM also took sharp aim at Pakistan for cross-border terrorism, and at China for connectivity projects that do not respect sovereign boundaries.
• SCO members also agreed to explore the use of “national currencies” for payments within the grouping, which would circumvent international dollar-based payments.

The Role of SCO in a Changing World and Geo Politics

• Over the years, the SCO has been committed to becoming a community with a shared future for mankind, firmly supporting each other in upholding their core interests, and synergising their national development strategies and regional cooperation initiatives.
• Member-states have carried forward the spirit of good neighbourliness and friendship, and built partnerships featuring dialogue instead of confrontation, and cooperation instead of alliance.
• The SCO has been a guardian of and contributor to regional peace, stability, and prosperity.
• These achievements manifest the common aspirations of all countries so that there is peace, development and win-win cooperation.
• The SCO’s leading and exemplary role can help strengthen unity and cooperation, seize development opportunities, and address risks and challenges.

The Significance of SCO for India

• India’s security, geopolitical, strategic, and economic interests are closely intertwined with developments in the region.
• The Central Asian region is richly endowed with natural resources and vital minerals and SCO provides a platform for India’s efforts to connect with Central Asia.
• The Regional Anti-Terrorism Structure (RATS) of SCO specifically deals with issues relating to security and defence.
• SCO is a platform which can play an important role in Afghanistan and stable Afghanistan is in India’s interest.

Challenges faced by India as a SCO Member

• SCO as a platform is seen by the West as an organization to forward Chinese interests.
• Growing convergence with China and Russia will be another challenge for India.
• Differences between India and Pakistan might hamper the functioning of the SCO.
• All members of SCO have supported One Belt One Road (OBOR) except India. It might lead to isolation of India on this platform.
• It would be difficult for India to overcome the burden of geography and make tangible gains in terms of trans-regional connectivity.
• Biggest challenge of India is State-sponsored terrorism and to sensitise the influential members of SCO on Pakistan’s state-sponsored terrorism.

Suggestions to Make SCO a Better Organisation

• Need to Strengthen Strategic Communication: The SCO member-states should strengthen strategic communication, deepen practical cooperation, and support each other’s development and rejuvenation.
• Enhance Solidarity and Mutual Trust for Common Security
  • Emerging developments like a new cold war and bloc confrontation must be addressed with high vigilance and firm rejection.
  • SCO member-states need to upgrade security cooperation, and crackdown in a decisive manner on terrorism, separatism and extremism, and transnational organised crimes.
• Enhanced Cooperation in Digital, Space and Technology: The SCO member states should pursue cooperation in digital, biological, and outer space security, and facilitate political settlement when it comes to international and regional hot-spot issues.
• Embrace Win-win Cooperation
  • Protectionism, unilateral sanctions, and decoupling undermine people’s well-being all over the world.
  • It is imperative for the SCO to generate stronger momentum for collaboration in trade, investment, technology, climate actions, infrastructure, and people-to-people engagement.
  • To contribute to high-quality and resilient economic growth of the region, there need to be collective efforts.
  • This will help in scaling up local currency settlement between members, expand cooperation on sovereign digital currency, and promote the establishment of an SCO development bank.
• Advocate Multilateralism
  • Multilateralism is imperative to shape the common destiny.
  • The SCO needs more engagements with its observer states, dialogue partners and other regional and international organisations such as the UN, to uphold the UN-centered international system and the international order based on international law.
• China Should Work on its Commitments
  • China has made several commitments with respect to the Global Security Initiative, Global Development Initiative and Global Civilization Initiative, to contribute to world peace, security, and prosperity.
  • But China’s Debt trap model is not hidden anymore. Moreover, China continues its military aggression on LAC and in South China Sea.
  • To pursue common, comprehensive, cooperative, and sustainable security China must respect each country’s independent choice of the path to development and social system, and abide by the purpose and principles of the UN Charter.
  • China must deescalate on every front where it is engaged in border skirmishes.
  • The reasonable security interests of all countries deserve consideration and China must uphold this principle.

Conclusion

• The SCO’s success story is part of the broader global partnership of emerging economies and developing countries.
• However, challenges remain and only after overcoming these challenges the SCO will lead by example in safeguarding the development rights and legitimate interests of the developing world.