CURRENT AFFAIRS DECEMBER 8, 2021

I. Health account numbers that require closer

scrutiny

1. News:
• Low public spending on health in India has meant that people depend heavily on their
own means to access health care.
• It causes rich-poor, rural-urban, gender and castebased divides in access to health care,
pushes people to poverty, and forces them to incur debt or sell assets.
• As a result, our health outcomes are worse than in many neighbouring countries.

2. Prelims Facts:

• National Health Accounts (NHA) report:

i. National Health Accounts (NHA) reported that the government has increased the
expenditure on health, making the decline of Out-Of Pocket Expenditure (OOPE) to
48.8% in 2017-18 from 64.2% in 2013-14.
ii. GDP has increased to a historic high of 1.35% of GDP, finally breaking through the
1%-1.2% mark of GDP
iii. This report was produced by the National Health Systems Resource Centre, designated
as the National Health Accounts (NHA) Technical Secretariat in 2014 by the Health
Ministry.
iv. Biggest part of NHA estimates is captured using "Household Social Consumption in
India: Health" survey of National Sample Survey Organisation of National Sample
Survey Organisation
v. Despite several pronouncements, it has continued to hover around 1%-1.2% of GDP

• Increased Government Share in the Total GDP:

i. For 2017-18, there had been an increase in the share of Government health
expenditure in the total GDP (Gross Domestic Product) of the country.
ii. It has increased from 1.15% in 2013-14 to 1.35% in 2017-18.
• Share of Primary Health Care:

i. The share of primary healthcare in current Government health expenditure has

increased from 51.1% in 2013-14 to 54.7% in 2017-18.
ii. Primary and secondary care accounts for more than 80% of the current Government
health expenditure.

• Social Security Expenditure on Health:

i. Also the share of social security expenditure on health, which includes the social
health insurance programme, Government financed health insurance schemes, and
medical reimbursements made to Government employees, has increased.

• Decline in out-of-pocket expenditure:

i. The rise in government spending on healthcare led to an increase in the share of

government expenditure in the total health expenditure to 40.8% and a decline in
out-of-pocket expenditure to 48.8% for 2017-18.
ii. The fall in OOPE is attributed to the increased utilisation of government health
facilities and reduction in the cost of services at these facilities

• Related Government Initiatives

i. Janani Shishu Suraksha Karyakram (JSSK).

ii. Rashtriya Bal Swasthya Karyakram (RBSK).
iii. Implementation of Free Drugs and Free Diagnostics Service Initiatives.
iv. PM National Dialysis Programme.
v. Ayushman Bharat.
vi. Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)

3. Mains Related Info:

• Issues with Health Sector

o Lack of Primary Healthcare Services:

i. The existing public primary health care model in the country is limited in scope.
ii. Even where there is a well-functioning public primary health centre, only services
related to pregnancy care, limited childcare and certain services related to national
health programmes are provided.
o Supply-Side Deficiencies:
i. Poor health management skills and lack of appropriate training and supportive
supervision for health workers prevent delivery of the desired quality of health
services.
ii. A report released by the Johns Hopkins Bloomberg School of Public Health in 2019
suggested that nearly one out of every 100 Indian children does not live to celebrate
their fifth birthday on account of either diarrhoea or pneumonia.

o Inadequate Funding:
i. India spent 1.8% of its GDP on health in FY 2020-21 and 1-1.5% in the previous years.
India's total out-of-pocket expenditure is around 2.3 % of GDP.
ii. As compared with the OECD countries’ average of 7.6% and other BRICS countries’
average of 3.6% on their health sector, this is considerably low

o Less than Required Doctors:

i. India currently has one doctor over the population of 1,445 against the WHO norm
of 1:1

INDIASHASTRA

GS II POLITY
II. Biden holds talks with Putin, warns against
Ukraine invasion

1. News:
• Joe Biden and Vladimir Putin held a two-hour video summit in which the U.S. president
said he would warn of painful sanctions and increased military support for Eastern
Europe if Russia invades Ukraine.

2. Russia-Ukraine Conflict

• Prime Facts:

➢ Background:
i. Ukraine and Russia share hundreds of years of cultural, linguistic and familial links
ii. As part of the Soviet Union, Ukraine was the second-most powerful Soviet republic
after Russia, and was crucial strategically, economically and culturally.

➢ Cause of Conflict:

o Balance of Power:
i. Ever since Ukraine split from the Soviet Union, both Russia and the West have vied
for greater influence in the country in order to keep the balance of power in the
region in their favour.
ii. Buffer Zone for Western Countries: For the US and the European Union, Ukraine is a
crucial buffer between Russia and the West.
iii. As tensions with Russia rise, the US and the EU are increasingly determined to keep
Ukraine away from Russian control

o Russian Interest in Black Sea:

i. The unique geography of the Black Sea region confers several geopolitical
advantages to Russia.
ii. Firstly, it is an important crossroads and strategic intersection for the entire
region.
iii. Access to the Black Sea is vital for all littoral and neighboring states, and greatly
enhances the projection of power into several adjacent regions.
iv. Secondly, the region is an important transit corridor for goods and energy.
o Separatist Movement:
i. The Donbass region (the Donetsk and Luhansk regions) of eastern Ukraine has
been facing a pro-Russian separatist movement since 2014.
ii. According to the Ukrainian government, the movement is actively supported by
the Russian government and Russian paramilitaries make up between 15% to
80% of the separatists fighting against the Ukraine government.

• Mains Related Info:

➢ Invasion of Crimea:
i. Russia seized Crimea from Ukraine in what was the first time a European country
annexed territory from another country since World War-2.
ii. The annexation of Crimea from Ukraine followed a Russian military intervention in
Crimea that took place in the aftermath of the 2014 Ukrainian revolution and was
part of wider unrest across southern and eastern Ukraine.
iii. The invasion and subsequent annexation of Crimea have given Russia a maritime
upperhand in the region.
iv. Ukrain’s NATO Membership: Ukraine has urged the North Atlantic Treaty
Organization (NATO)to speed up his country’s membership in the alliance.
v. Russia has declared such a move a “red line”, and worried about the consequences of
the US-led military alliances expanding right up to its doorstep.
vi. The Black Sea is bordered by Bulgaria, Georgia, Romania, Russia, Turkey and Ukraine.
All these countries are NATO countries

➢ Current Situation:
i. Russia is seeking assurances from the US that Ukraine will not be inducted into
NATO.However, the US is not prepared to give any such assurance.
ii. This has left the countries in a stand-off, with tens of thousands of Russian troops
ready to invade Ukraine.
iii. Russia is keeping the tensions high at the Ukraine border in order to get sanctions
relief and other concessions from the West.

➢ India’s Stand:
i. India did not join the Western powers’ condemnation of Russia’s intervention in
Crimea and kept a low profile on the issue

INDIASHASTRA

GS II INTERNATIONAL RELATIONS
 III. The Swachh Bharat Mission 2.0 guidelines have
an important dimension focused on solid waste
management

1. News:
• The recently released Swachh Bharat Mission (SBM) 2.0 guidelines continue to take
forward the aims of the SBM launched in 2014, but add an important dimension focused
on solid waste management
• Focus on processing all types of waste like plastic, construction and demolition waste, as
well as providing budgetary support for remediating old waste disposed in all dumpsites
across 4,372 cities in India before March 2023.

2. Prelims Facts:

• Swachh Bharat Mission Urban 2.0:

o The mission would be implemented over five years — from 2021 to 2026
o Focus areas of Mission:
i. Faecal sludge management and waste water treatment,
ii. Source segregation of garbage,
iii. Reduction in single-use plastic,
iv. Reduction in air pollution by effectively managing waste from construction and
demolition activities

• Funding from SBM 2.0

i. The total funding dedicated for implementation of SBM 2.0 is ₹•1.41 lakh crore of
which about ₹•39,837 crore is set aside for solid waste management
ii. This mission commits to providing financial assistance to set up fresh waste processing
facilities and bioremediation projects across all the ULBs.
iii. Financial assistance to to set up construction and demolition waste processing facilities
is limited to a chosen 154 large cities such as Bengaluru, Mysore, Davanagere, Hubli,
and Kalaburagi which have a population of over 5 lakh
iv. Commitments made by the Government of India (GoI) for solid waste management
projects are as follows: 90% for ULBs in the Northeastern and Himalayan States; 100%
 for ULBs in Union Territories without legislature; 80% for ULBs in Union Territories with
legislature; 25% for other ULBs with more than 10 lakh population; 33% for other ULBs
with more than 1 lakh but less than 10 lakh population; 50% for other ULBs with less
than 1 lakh population. The remaining project cost will be paid from the 15th Finance
Commission grants
v. About 23.3% of the project cost was funded by the State governments and the
remaining 41.6% was to be funded by the ULBs.

3. Mains Related Info:

• Swachh Bharat Mission-Urban:

i. Ministry of Housing and Urban Affairs (MoHUA) launched various initiatives to make
SBM-U a successful project. Some of them include,

• ODF, ODF+ and ODF++ Protocol:

o Norms under ODF:

i. No visible faeces shall found in the environment and every household, as well as
public/community institutions, should be using safe technology option for
disposal of faeces.

o Norms under ODF+:

i. Not a single person should be defecating and/or urinating in open.
ii. All community and public toilets should be properly maintained and cleaned.

o Norms under ODF++:

i. Proper treatment and management of faecal sludge/septage and sewage is safely
managed and treated.
ii. There should be no discharge or dumping of untreated faecal sludge/septage and
sewage in drains, water bodies or open areas.

o Water + Protocol:
 i. It is designed to ensure that no untreated wastewater is discharged into the
open environment or water bodies.

o Star rating protocol for Garbage free cities:

i. It is based on 12 parameters which follow a SMART framework – Single metric,
Measurable, Achievable, Rigorous verification mechanism and Targeted towards
outcomes.
ii. As on date, 4 cities namely, Indore (Madhya Pradesh), Ambikapur (Chattisgarh),
Navi Mumbai (Maharashtra) and Mysuru (Karnataka) have been certified as 5-
star cities.

INDIASHASTRA

GS III ENVIRONMENT