Editorial Notes

Editorial Notes 19th July 2016

Inter-State Council (ISC); TB Diagnostic; FDI in Food; Floods in an Urban Setting
By By IT's Editorial Notes Team
July 19, 2016


Polity & Governance

  • Indian federalism needs the Inter-State Council
  • How a diagnosis is delayed


  • From plate to plough: A thought for food

Environment & Ecology

  • Lessons from flood


Polity & Governance

GS (M) Paper-2 Topics: 
“Functions and responsibilities of the Union and the States, issues and challenges pertaining to the federal structure, devolution of powers and finances up to local levels and challenges therein.”
“Statutory, regulatory and various quasi-judicial bodies”


Indian federalism needs the Inter-State Council

The Inter-State Council (ISC) meet convened last week after a decade’s gap. And the discontent there—chief ministers have voiced their concerns on issues ranging from adventurism by governors to shifting of subjects from the state list to the concurrent list—makes that gap particularly puzzling.

The Prime Minister, Shri Narendra Modi delivering his inaugural address at the eleventh Inter-State Council Meeting, in New Delhi on July 16, 2016.
The Prime Minister, Shri Narendra Modi delivering his inaugural address at the eleventh Inter-State Council Meeting, in New Delhi on July 16, 2016.

About the ISC:

The Inter-State Council (ISC) was constituted under Article 263 of the Constitution in 1990 following the Sarkaria Commission’s recommendations.

Its duties include:

  • Inquire into and advise upon disputes which may have arisen between States;
  • Investigate and discuss subjects in which some or all of the States, or the Union and one or more of the States, have a common interest; or
  • Make recommendations upon any such subject and in particular, recommendations for the better co-ordination of policy and action with respect to that subject.

ISC- how effective in improving centre-state relations?

  • The Inter-State Council (ISC) proved to be crucial in the implementation of many of the Sarkaria Commission’s 247 other recommendations, such as altering the states’ share of central taxes.
  • The council helped bridge the trust deficit between the centre and the states. If not always a problem solver, it at least acted as a safety valve.
  • Tax devolution is another crucial issue. For example, the acceptance of the 14th Finance Commission’s recommendation to change the quantum of the funds allocated to the states from 32% to 42% of the tax pool was well received at recently held council meet.
  • Currently there is an impasse over the passing of the GST bill. This deadlock mandates periodic consultation and assessment of the kind which the ISC can provide.

ISC vs. other bodies:

  • There are other bodies such as the NITI Aayog’s Governing Council—it has a similar composition, including the prime minister, chosen cabinet ministers and chief ministers—that could address centre-state issues. But the ISC has constitutional backing, as against the NITI Aayog which only has an executive mandate. This puts the states on more solid footing—an essential ingredient in building the atmosphere of cooperation needed for calibrating centre-state relations.


  • The challenges of maintaining a federation are many, but the solution is no mystery: healthy debate and discussion. This is easier said than done, of course.
  • But Modi, to his credit, has a very different federalist vision—one with an emphasis on decentralizing decision making and encouraging state competition. If that vision is to succeed, the ISC must be a core component of the new cooperative federalism.
[Ref: LiveMint]


GS (M) Paper-2 Topic: “Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.”


How a diagnosis is delayed


  • Tuberculosis (TB) patients in India face huge challenges ranging from diagnosing to treating.
  • Following conclusions are made with the help of some studies primarily concerned with the challenges faced by TB patients in India.

Key concerns:   

  • Tuberculosis (TB) patients in India who seek care in the private sector face a delay of as long as two months before they are diagnosed correctly. This is alarming, as TB patients begin their pathway to care in the private sector before they get treated in the public sector.
  • While allopathic medicines, including antibiotics, were prescribed for acute conditions, the physicians generally prescribed their system of medicine for chronic conditions.
  • The patient had to visit a doctor several times before he or she was suspected of having TB.
  • The patients were treated with broad-spectrum antibiotics and other symptomatic drugs during the first few visits. Different antibiotics were prescribed during each visit. This process of experimentation using antibiotics usually lasted 10-14 days.
  • Though fever is common and not very specific to TB, and more than two weeks of cough is one of the main symptoms of TB, no physician ever asked for lab investigation on the first visit. Instead the focus was in managing symptoms using non-specific therapies.
  • Though an X-ray should be used as a screening tool and sputum smear or GeneXpert as confirmatory tests, only few practitioners asked for sputum smear and only after conducting blood tests and a chest X-ray.
  • Not treating TB patients could be due to a number of factors including uncertainty about treatment protocol, fear of MDR-TB, stronger messaging by RNTCP, fear of being exposed to TB themselves, and a desire to protect other patients in the waiting room from TB exposure.
  • Private doctors using fever as a diagnostic criterion for TB due to “ubiquity of cough and paucity of sputum production by patients.
  • Doctors from all systems of medicine treating patients symptomatically based on patient history and clinical observation without asking for diagnostic tests.
  • Patients were asked for a chest X-ray and other lab tests when some doctors suspected TB, but “often after months of fever”. Even when patients had a history of cough, none of the practitioners of alternative medicine suspected TB on the first visit.
  • This empirical approach not only leads to delay in diagnosis and increase in the spread of TB but also exposes the patients to a broad-spectrum of needless antibiotics.
  • Using drugs, particularly quinolones and amoxicillin-clavulanate, as diagnostic tools adds to the delay in diagnosing TB as they tend to temporarily mask symptoms such as cough, fever, or sputum production. As the patients are poor and need immediate relief, the only way to reduce experimentation with antibiotics is to work to reduce the cost of TB diagnostic tests.
  • The uptake of sputum smear testing is low in the private sector because it only confirms what the X-ray already suggests. Moreover, an X-ray presents a broader set of information about what is happening in the patients’ lungs.

Why doctors choose the ‘treat with antibiotics and wait’ approach while dealing with TB patients?

  • First, there is a compulsion to provide rapid symptom relief; there is a risk of losing patients, especially when diagnostic tests are asked for during the first visit; there is the factor of financial capability of patients; and there is an easy availability of antibiotics.
  • Second, there is a lack of clear and unique TB symptoms besides TB’s slow onset and progression.
  • Finally, doctors perceive that many TB patients come without a cough or do not produce sputum.


  • These studies suggest the urgent need for the Indian TB programme to engage with private providers (allopathic and AYUSH) and change their traditional, empirical approach to dealing with TB.
  • Ordering a chest X-ray early, a greater use of sputum TB tests (especially GeneXpert), and greater linkages and referrals to the public sector would be key issues for behaviour change management.
[Ref: Hindu]



GS (M) Paper-3 Topics: 
“Indian Economy and issues relating to planning, mobilization of resources, growth, development and employment.”
“Food processing and related industries in India- scope and significance, location, upstream and downstream requirements, supply chain management”


From plate to plough: A thought for food

Recently, the government opened several key sectors such as defence, pharmaceuticals, civil aviation and food products to 100 per cent foreign direct investment (FDI).

The objective behind this FDI policy is to attract higher investments, better technologies in manufacturing, commerce, and the agri-food space to promote growth, jobs, and incomes of people.

However, there are many hurdles in fulfilling the above objectives. Here the authors take a note of these hurdles and also suggest few steps to overcome with.


  • It is somewhat puzzling that under the new FDI policy while large domestic retailers (like Big Bazaar) can sell imported food, foreign retailers won’t be permitted to do so.
  • Two major roadblocks are the Agricultural Produce Market Committee (APMC) Act and the Essential Commodities Act, which do not allow procuring directly from farmers in most states or holding large stocks by big corporations. This hampers their efficiency and dissuades them from large investments, defeating the very purpose of the FDI policy.
  • In case of high-value perishable food, particularly, fruits and vegetables, milk, meat, fish, etc. demand is growing fast, and good infrastructure is lacking, which leads to large wastages. The economic worth of food so lost is estimated to be around Rs 92,651 crore. Investing in this is not in favour of big players’ Business models.
  • The challenge is to bring in foreign investment in ways that help compress the value chain by taking on board small players both at the back-end and front-end.

Case of value chain in Dairy:

  • Dairy is leading by example where domestic cooperatives like AMUL and multinationals like Nestle have incorporated even small-holders into their model for procuring milk and local kirana stores for their distribution network.

Case of China’s e-commerce:

  • In China, e-commerce is growing fast and food is a major part of the business — about 45 million people are regularly buying foods online. Big e-commerce companies like Alibaba and JD Online are dedicated to rural expansion. Apart from the push of cost and convenience factors, direct procurement from producers and availability of sophisticated supply chains have enabled online sale of standardised and fresh food in China.


  • The new FDI policy in trade for food can attract big players like Walmart, Tesco, Amazon, Alibaba, etc. They can help build more competitive and inclusive value chains by investing in procurement, storage and distribution networks. For this, the government must change the rules of the game and clear up the policy environment holistically to attract FDI in much needed infrastructure.
  • If India wants its FDI in food to deliver, it must clear up the institutional mess that regulations such as the APMC and ECA have created.
  • Value chain in Dairy can be used for fruit, vegetables and meat that are registering much higher growth in demand than dairy. However, it needs a non-restrictive environment for foreign firms to function and scale up their operations many fold.
  • Imports need to be governed by trade policy and not by retail policy.
  • To this effect, permitting FDI through the automatic route (rather than through approval) will be a much desired and well-awaited annexure to the new policy prescription.
  • Efficient, integrated, well-developed and reliable value chains for high value perishable agri-commodities will reduce food losses and improve the stakes of small players in the value chain.
  • It is high time India worked towards becoming not just an open economy but also a competitive and inclusive one.
[Ref: Indian Express]


Environment & Ecology

GS (M) Paper-3 Topic: “Disaster and disaster management”


Lessons from flood

Guwahati became the first city in the country to undergo a major drill to tackle floods in an urban setting. The drill was part of the Narendra Modi government’s National Disaster Management Plan.

The author suggests better urban planning keeping in view of the floods.


  • Floods have rarely been taken up at the level of urban planning and the government has scarcely tried to understand them as the fallout of changes to a city’s topography and drainage system.
  • The recent cases of urban floods — especially in Chennai and Srinagar — show that there has been little attempt to deal with floods beyond providing relief.
  • A fundamental principle of hydrology says that during heavy rains, natural waterbodies and interlinked drainage systems hold back some water, use that to replenish groundwater and release excess water into larger waterbodies — oceans and big rivers. Most urban planners in the country have ignored this axiom.
  • In most cases, the waterbodies have been victims of real estate development. Such disregard for hydrology seems unfortunate when the government has been talking of urban renewal, especially through its smart cities programme.

Case of Guwahati:

  • In Guwahati, natural and artificial drains are choked with garbage; they get clogged during heavy rains and water spills on to the roads.
  • The Bharalu, the only river which flows through Guwahati and carries rainwater to the Brahmaputra, is a terrible garbage dump today.
  • The river is critical to the city’s hydrology because the level of the Brahmaputra is about 6 meters below Guwahati; the city requires the Bharalu to carry the run-off to the mighty river. Wetlands that could have soaked up the rainwater have also become garbage dumps.

In these respects, Guwahati’s story is strikingly similar to Srinagar and Chennai — and Mumbai a little more than a decade earlier. The Dal Lake in Srinagar is today a third of what it was about a hundred years ago.

[Ref: Indian Express]


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