Public Health Sector, Military Exercises, Impact of Arctic Sea Ice on the Indian Monsoon

(General Studies II – Health – Issues relating to the development and management of Social Sector/Services relating to Health, Education, and Human Resources)

• Public health policies are government decisions aimed at addressing the health needs of the population. These policies are based on available resources and prioritize both “felt needs” (those experienced by the people) and “projected needs” (those identified by experts).
• India’s public health policies have been criticized for not adequately addressing felt needs and prioritizing curative care over preventive care.

Public Health Needs –

Public Health Policies and Reforms –

• National Rural Health Mission (NRHM) 2005 and National Health Mission (NHM) 2013: They aimed to strengthen primary health care in the public sector. Under NHM, public sector health institutions like sub-centres, Primary Health Centers (PHCs), and Community Health Centers (CHCs) saw significant improvements.
• Ayushman Bharat and Pradhan Mantri Jan Arogya Yojana (PMJAY): Introduced in 2018, these schemes focus on providing tertiary care through public health insurance, outsourcing services to the private sector at market rates, leading to the privatization of secondary and tertiary care services.
• The Union Cabinet has approved a major expansion of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) to cover all senior citizens aged 70 years and above. This change allows anyone in this age group to be eligible for health insurance, regardless of their income level.

Challenges in the Public Health Sector –

• Underfunding of Secondary and Tertiary Care: Public secondary and tertiary health care remain weak due to inadequate infrastructure and staffing, despite improvements in primary care. E.g.  Department of Health and Family Welfare’s FY 2024-25 budget is Rs 87,656.90 crores, not at 2.5% of GDP. 
• Privatization and Insurance: The focus on Publicly Funded Health Insurance (PFHI) schemes like PMJAY benefits private hospitals more than the public health system. Only hospitalization expenses are covered under PMJAY, excluding primary and secondary care.
• Health and Wellness Centers (HWCs): HWCs aimed to provide comprehensive care but faced criticism for shifting the focus from outreach and preventive care to curative services without sufficient infrastructure.
• Overcrowded Public Facilities: The public sector’s infrastructure and staff shortages lead to overcrowding, further eroding trust.
• Renaming Health Institutions: In 2023, a directive renamed sub-centres, PHCs, and CHCs to ‘Ayushman Arogya Mandir’, several states raised concerns.

Way Forward –

• During the COVID-19 pandemic, the Public Distribution System (PDS) and National Rural Employment Guarantee Act (NREGA) worked alongside the health sector to provide essential services to the population.
• Strengthening Public Health Infrastructure: Prioritize the development of secondary and tertiary care within the public sector.
• Public-Private Collaboration: Ensure that public-private partnerships do not undermine public health care by regulating the private sector and holding it accountable for quality and affordable care.
• Increase Health Financing: The government must allocate more resources to the health sector to improve infrastructure, hire more health professionals, and reduce dependency on the private sector.

The public health sector plays a critical role in achieving several Sustainable Development Goals (SDGs), particularly SDG 3: Good Health and Well-being, and has direct and indirect connections with other SDGs such as SDG 1: No Poverty, SDG 2: Zero Hunger, and SDG 6: Clean Water and Sanitation. A balance between preventive and curative care, with increased government investment, is crucial for the sustainability of the public health system in India.

• The Union Ministry of Statistics and Programme Implementation has dissolved the Standing Committee on Statistics (SCoS).
• The National Sample Survey Office (NSSO) cited an overlap between the SCoS and the Steering Committee for National Sample Surveys (NSS)’s work, which was created based on recommendations from the National Statistical Commission (NSC).
• The SCoS, chaired by an eminent economist had raised concerns about the delay in conducting the Census. The Census remains unnotified after its postponement due to the COVID-19 pandemic.
• The Census, last conducted in 2011, has been delayed since 2021 due to the pandemic, and the Centre has yet to provide a roadmap.

Dig Deeper: Read about institutions responsible for conducting the Census.

• The north Indian Ocean plays a critical role in the summer monsoon by supplying moisture through evaporation from the Arabian Sea and the Bay of Bengal.
• Despite warm tropical seas conducive to cyclone formation, this region experiences fewer cyclones due to a mix of favourable and suppressive factors.
• The Indian Ocean’s uniqueness comes from “oceanic tunnels” connecting it to the Pacific and Southern Oceans, affecting its temperatures and cyclogenesis.

• Climate change has intensified the warming of the Indian Ocean, contributing to cyclone formation during the pre- and post-monsoon seasons.
• However, the Arabian Sea remains less prone due to weaker convective activity and strong wind shear.
• The Bay of Bengal, on the other hand, sees more cyclonic systems.
• The recent rare August cyclone, Asna, emerged from a strong land-born depression transitioning to the Arabian Sea, marking the first cyclone in the north Indian Ocean in August since 1981.
• Asna caused significant damage and casualties but dissipated due to desert air.

• The event, linked to global warming and unusual weather patterns, reflects the unpredictability of the region’s climate dynamics.

Dig Deeper: Why do tropical cyclones not form over the Equator?

• India’s military diplomacy has recently gained momentum with a series of back-to-back military exercises involving all three Services and numerous countries.
• These exercises demonstrate India’s growing international defence cooperation and strategic engagement with key global partners.

Dig Deeper: Read about India’s growing Defence trade with the US.

• India’s National Centre for Polar and Ocean Research (NCPOR), under the Ministry of Earth Sciences, and South Korea’s Korea Polar Research Institute’s study have found that seasonal changes in the Arctic Sea ice affect the Indian monsoon.

Table 1 Role of Declining Arctic Sea Ice in Monsoon Variability

• The ISMR (Indian Summar Monsoon Rain) is a complex phenomenon, climate models have shown that the surface temperatures of the Indian, Atlantic, and Pacific Oceans affect it.
• The circum-global teleconnection (CGT) seemed to significantly infl uence the monsoon as well.
• On the contrary, the scientists also found that when sea ice levels in the central Arctic increase, the heat transferred from the ocean to the atmosphere triggers a cyclonic circulation at slightly lower latitudes, like in the North Atlantic. This also bolsters Rossby waves.

• The enhanced Rossby waves result in high pressure over northwest India and low pressure over the Mediterranean region.
• As a result, an anomalous high-pressure region is created over Central Asia, disrupting atmospheric stability over the Indian landmass and bringing more rain over western and peninsular India.

Dig Deeper: Read more about Rossby waves.