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Editorial Notes

Editorial Notes 2nd December 2016

What is HIV self-testing? Importance of self-testing; Challenges & Status of awareness in India; Demonetisation and its effects on logistics industry.
By IT's Editorial Notes Team
December 02, 2016

 

GS (M) Paper-2: “Government policies and interventions for development in various sectors and issues arising out of their design and implementation.”

 

Demonetisation has hit logistics industry

Introduction:

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  • The demonetisation drive and resultant disruption due to the liquidity crunch has triggered shockwaves across the economy, as we are a cash-driven economy and 45 per cent of the gross domestic product comes from the informal sector.
  • Among all the sectors, logistics is one of the worst hit, at least in the short-term.

Current scenario:

  • Early estimates suggest that cash shortage has led to four lakh trucks being stranded in the very first week itself.
  • The business volume has come down by up to 40 per cent across the country.
  • The capacity utilisation of the fleet has come down by 60 per cent.
  • A truck takes 7-8 days on a single trip on an average and at least 10 per cent of the expenses throughout the route are borne by the drivers and the support crew, for whom hard cash is the most convenient and practical option.
  • While 55-66 per cent of the total trip costs are on account of fuel, another 25-40 per cent account for heads such as tolls, octroi (on goods entering particular areas), speedy clearance at check posts, and so on.
  • The country has 177 inter-State check posts and 268 toll barriers on National Highways alone.
  • This gives an idea about the amount of hard cash required and the concerns due to restrictions on cash withdrawal.

Fall in demand:

  • There is a stronger ripple effect on the sector in the medium term when the total demand comes down across the sectors such as construction, consumer durables, steel and cement.
  • Demand for goods and services across all sectors have gone down, and logistics industry being solely dependent upon these goods for business, has borne the brunt.
  • The excess supply in the market and contraction in demand keep the logistics players off the roads.
  • Tier-II and Tier-III cities have borne the brunt more in the last couple of weeks.

Some positives for the logistics industry:

  • The e-commerce sector which is bound to pick up once people get more adjusted to plastic money and mobile wallets.
  • With the shift to online payments and fuel cards, the working capital requirement at least in the case of established logistics players can come down.
  • There has also been a drastic drop in costs, such as tolls and other miscellaneous expenses borne by drivers en route their journey.
  • Unorganised players account for 80 per cent in the sector and they predominantly deal in liquid cash. The demonetisation will drive them to move to the organised sector and which in turn can help the Indian logistics industry evolve.
  • The move also comes as stimulus for the players to adopt technology more than ever before. GST coupled with the demonetisation can give a positive guidance for the industry.

The logistics industry needs time to evolve on its own, given its complexity and traditional baggage. The industry may be inured to speed barriers and headwinds, but such ill-timed and ill-planned roadblocks can stymie the growth of the sector at least in the short-term.

[Ref: Business Line]

 

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

 

HIV: The self-test option

Introduction:

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In advance of World AIDS Day, WHO has released new guidelines on HIV self-testing to improve access to and uptake of HIV diagnosis.

What is HIV self-testing?

  • HIV self-testing means people can use oral fluid or blood- finger-pricks to discover their status in a private and convenient setting.
  • Results are ready within 20 minutes or less.
  • Those with positive results are advised to seek confirmatory tests at health clinics.
  • The WHO-approved OraQuick HIV self-testing is based on HIV antibodies present in oral and blood samples.
  • The test can detect antibodies developed within three months of getting infected. It is a screening test, and a positive result should be reconfirmed though a blood-based test.

Who misses out on HIV testing?

  • HIV testing coverage remains low among various population groups. e.g Global coverage rates for all HIV testing, prevention, and treatment are lower among men than women. Men account for only 30% of people who have tested for HIV.
  • But some women miss out too. Adolescent girls and young women in East and Southern Africa experience infection rates up to eight times higher than among their male peers. Fewer than one in every five girls (15–19 years of age) are aware of their HIV status.
  • Testing also remains low among “key populations” and their partners – particularly men who have sex with men (MSM), sex workers, transgender people, people who inject drugs, and people in prisons – who comprise approximately 44% of the 1.9 million new adult HIV infections that occur each year.
  • Up to 70 % of partners of people with HIV are also HIV positive. Many of those partners are not currently getting tested. The new WHO guidelines recommend ways to help HIV positive people notify their partners about their status, and also encourage them to get tested.

Importance of self-testing:

  • These major obstacles for diagnosis are now being cleared by self-diagnosis.
  • Across the world, nearly 40% of people with HIV are unaware of their infection and run the risk of unknowingly transmitting it.
  • The OraQuick self-testing makes diagnosis easier and faster.
  • HIV self-testing is a way to reach more people with undiagnosed HIV and represents a step forward to empower individuals, diagnose people earlier before they become sick, bring services closer to where people live, and create demand for HIV testing.
  • Despite greater awareness, people with HIV still face stigma and discrimination. As a result, getting everyone at risk of HIV infection tested has been a challenge. Self-diagnosis ensures privacy and confidentiality, thus encouraging more people to get tested.
  • This is particularly important for those people facing barriers to accessing existing services.
  • Besides going a long way in preventing new infections, early diagnosis will help in a prompt start to treatment and enable the infected to live longer and healthier.
  • Self-testing has been shown to nearly double the frequency of HIV testing among men who have sex with men, and recent studies in Kenya found that male partners of pregnant women had twice the uptake of HIV testing when offered self-testing compared with standard testing.

Challenges:

  • But there are challenges in terms of counselling and sensitivity, with the accuracy of the tests pegged at around 93%.
  • Counselling has to be done through innovative ways, such as over the telephone, as in the case of the U.S.
  • Unlike the conventional method of getting tested at ICTCs, people self-testing should be more aware about the possibility of false negatives.
  • But the risk of not getting tested far outweighs the limitations posed by self-testing.

Status of awareness in India:

  • Though much progress has been achieved in India in making HIV testing accessible and free of cost, many infected persons remain unaware of their status.
  • Though there has been a 66% drop in incidence in 2015 in India compared with 2000, the number of new HIV infections last year was 86,000; children below 15 years of age alone account for 12% of this number.
  • In 2015, the total number of people with HIV in India was estimated to be 2.1 million.
  • Of this, 1.5 million were detected and tested at integrated counselling and testing centres (ICTC) and about a million people are on treatment.
  • This leaves about half a million who are unaware of their HIV status.
  • The government has approved in principle the proposal to take HIV testing closer to those in need by starting community-based testing.
  • This will soon become operational and will be in addition to institutional testing. India is also weighing the option of self-testing.
  • Twenty-three countries have in place policies that support HIV self-testing. It is time India adopted it quickly to enable more people to test themselves and help break the transmission cycle.
[Ref: The Hindu]

 

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