Precision Medicine in India 

Syllabus: GS 2 / Health 

In News

• Precision medicine is bringing in a new era of personalized healthcare. 

About Precision medicine

• Precision medicine, sometimes known as “personalized medicine” is an innovative approach to tailoring disease prevention and treatment that takes into account differences in people’s genes, environments, and lifestyles.
• The goal of precision medicine is to target the right treatments to the right patients at the right time.

Major Contributors 

• Emerging technologies such as gene-editing and mRNA therapeutics also contribute to precision medicine.
  • In a recent success story, researchers were able to restore vision in people who had lost it due to a genetic mutation using gene therapy.
  • During the COVID-19 pandemic, researchers were able to use the mRNA platform to develop new vaccines in record time, winning the technology a Nobel Prize last year.
• Organ-on-chips is another area that promises precision medical solutions.
  • These small microfluidic devices containing human cells can replicate the microenvironment of a tumour or an organ in a laboratory setting.
  • They are expected to allow researchers to test drugs in settings more similar to the drugs’ eventual user.
• Biobanks’ Role: Biobanks store biological samples and genetic data, crucial for precision medicine. Large, diverse biobanks are essential for broad societal benefits.

Precision medicine in India

• Precision medicine has gained momentum since the completion of the Human Genome Project.
• Since then, genomics has played a major role in the diagnosis and treatment of various cancers, chronic diseases, and immunological, cardiovascular, and liver diseases.
• The Indian precision medicine market is estimated to be growing at a CAGR of 16% and is expected to be worth more than $5 billion by 2030, according to industry estimates. 
• Currently, it contributes 36% of the national bioeconomy, alongside cancer immunotherapy, gene editing, biologics, etc. 

Developments 

• The development of precision therapeutics is also part of the new ‘BioE3’ policy.
• In October 2023, the Central Drugs Standard Control Organization approved NexCAR19, India’s domestically developed CAR-T cell therapy, and earlier this year the government opened a dedicated centre for it. 
• India has 19 registered biobanks and the ‘Genome India‘ programme finished sequencing 10,000 genomes from 99 ethnic groups, to identify treatments for rare genetic diseases, among others
  • The Paediatric Rare Genetic Disorders (PRaGeD) mission could help identify new genes or variants to develop targeted therapies for genetic diseases that affect children.
• Recently, the Apollo Cancer Centre and a collaboration between Siemens Healthineers and the Indian Institute of Science, Bengaluru, opened new facilities to deploy artificial intelligence for precision medicine.

Issues and Concerns 

• At present, India’s regulation of biobanks is inconsistent, with gaps that could undermine public trust and limit the potential of precision medicine. In particular, there is no law to protect the rights of individuals
• India’s regulatory gaps could prevent it from maximizing precision medicine’s potential.
• In the absence of an overarching law, Indians could be deprived of the ownership of biological samples and/or the data thereof, and the profits from the resulting research findings.
• In the absence of a single authority to regulate biobanks and no penalty for misconduct, the risk of inconsistencies arising from sample mishandling and ethical violations like data or sample sharing for non-consenting purposes is nontrivial.

Global Comparisons

• The U.K., the U.S., Japan, China, and many European countries have laws or comprehensive regulations that address several biobanking issues, including informed consent, withdrawal rights, privacy, and data protection.

Suggestions 

• India is a part of international groups like the Quad and BRICS, and an important plank of its soft diplomatic efforts has been pharmaceuticals.
  • It is a major supplier of generic drugs and is a hub of vaccine manufacturing, and it has plans to expand leadership to include next-generation therapeutics. 
• Stronger data protections and oversight would boost public confidence in biobanks, align India with global standards, and position it for leadership in next-generation therapeutics.
• For precision medicine to succeed, biobanks need to be large and diverse. Otherwise only a small section of society will benefit from the findings of precision medicine.

Global Hunger Index 2024

Syllabus: GS2/Health, GS3/ Economy, Inclusive Growth

Context

• India has been ranked 105th out of 127 countries in the Global Hunger Index (GHI) 2024, placing it in the “serious” category for hunger levels. 

What is the Global Hunger Index (GHI)?

• GHI is a tool for comprehensively measuring and tracking hunger at global, regional, and national levels. 
• The index is published by Concern Worldwide, an Irish humanitarian organisation, and Welthungerhilfe, a German aid agency.

Findings of the GHI 2024

• The 2024 Global Hunger Index score for the world is 18.3, considered moderate, down only slightly from the 2016 score of 18.8.
  • Little progress has been made on reducing hunger since 2016, and the prospects for achieving Zero Hunger by the target date of 2030 are grim, with 42 countries still experiencing alarming or serious hunger.
• The wars in Gaza and Sudan have led to exceptional food crises. 
• Somalia, Yemen, Chad, and Madagascar are the countries with the highest 2024 GHI scores; Burundi and South Sudan are also provisionally designated as alarming.
• Progress has been notable for example in Bangladesh, Mozambique, Nepal, Somalia, and Togo, although challenges remain.
• India’s performance remains concerning, in comparison to the South Asian neighbours such as Bangladesh, Nepal, and Sri Lanka, which fall into the “moderate” category. 
  • India is listed alongside countries like Pakistan and Afghanistan, which also face severe hunger challenges.
• The report reveals alarming statistics: 13.7 percent of India’s population is undernourished, 35.5 percent of children under five are stunted, 18.7 percent suffer from wasting, and 2.9 percent of children die before their fifth birthday. 

Policy Recommendations

• Strengthen accountability to international law and enforce the right to food.
• Promote gender-transformative approaches in food and climate policies.
• Invest in gender, climate, and food justice, ensuring public resources address inequalities.

Initiatives by Government of India to address Hunger – Mid Day Meal Programme: It is a flagship programme of the Government of India aiming at enhancing enrolment, retention and attendance and simultaneously improving nutritional levels among children studying in Government, Local Body and Government-aided primary and upper primary school areas across the country. – The National Food Security Act, 2013: The Act provides for coverage of upto 75% of the rural population and upto 50% of the urban population for receiving subsidized foodgrains under Targeted Public Distribution System (TPDS), thus covering about two-thirds of the population.  1. The Act also has a special focus on the nutritional support to women and children. – Poshan Tracker: The Ministry of Women and Child Development developed and deployed the ‘Poshan Tracker’ ICT Application as an important governance tool.  1. The Poshan Tracker has incorporated WHO’s expanded tables, which provide day-based z-scores, to dynamically determine stunting, wasting, underweight, and obesity status based on a child’s height, weight, gender, and age. – The Central Government launched Pradhan Mantri Garib Kalyan Anna Yojana (PMGKAY) with the specific purpose of ameliorating the hardships faced by the poor and needy due to economic disruptions caused by the COVID-19 outbreak in the country.  1. The allocation of free food grains under PMGKAY was in addition to normal allocation done under the National Food Security Act (NFSA), 2013.  – SakshamAnganwadi and Poshan 2.0 (Mission Poshan 2.0) includes key schemes such as the POSHAN Abhiyaan, Anganwadi Services and Scheme for Adolescent Girls as direct targeted interventions to address the problem of malnutrition in the country.  1. The beneficiaries under the Anganwadi Services scheme are children in the age group of 0-6 years, pregnant women and lactating mothers.  2. Supplementary nutrition is provided to beneficiaries in the form of Hot Cooked Meals at Anganwadi Centres and Take Home Ration (not raw ration).

Rupee Hits an All-Time Low of 84 Against the US Dollar

Syllabus: GS3/Economy

Context

• The Indian rupee has recently crossed the 84 mark against the US dollar, marking an all-time low.

About

• Currency depreciation refers to the decline in the value of one country’s currency relative to another currency. 
• The Indian rupee has seen a periodic depreciation against major currencies, particularly the US dollar. 

Reasons for depreciation of rupee

• Rising Crude Oil Prices: The surge in global crude oil prices has led to increased import bills for India, thereby exerting downward pressure on the rupee.
• Outflows to China: Foreign portfolio investors (FPIs) have shifted their investments from India to China, driven by the latter’s recent monetary and fiscal measures aimed at stimulating its economy.
  • This trend reflects a ‘Sell India, Buy China’ strategy, causing a reduction in demand for the Indian rupee.
• Increased Demand for US Dollars: There has been a heightened demand for the US dollar from foreign banks, exacerbating the rupee’s depreciation.
• Weak Domestic Markets: The overall weakness in domestic equity and bond markets has further contributed to the rupee’s decline, making it less attractive to foreign investors.

Impact of Rupee depreciation

• Exports and Imports: While a weaker rupee can boost exports by making Indian goods cheaper for foreign buyers, it also raises the cost of imports, particularly essential commodities like oil and machinery. 
• Foreign Debt Servicing: For companies and the government with significant foreign currency debt, a depreciating rupee increases the cost of servicing the debt, straining their financial positions.
• Inflation: The increase in import costs lead to higher consumer prices, impacting purchasing power and potentially leading to overall inflation in the economy.
• Investor Sentiment: A declining currency affects investor confidence, resulting in reduced foreign direct investment (FDI) and further capital outflows.

How does the RBI maintain the rupee value?

• Intervention in Forex Markets: The RBI intervenes in the foreign exchange market by buying or selling dollars to stabilize the rupee’s value. This helps mitigate excessive volatility.
• Monetary Policy adjustments: By adjusting interest rates, the RBI influences capital flows. Higher interest rates can attract foreign investment, supporting the rupee’s value.
• Forex  reserve management: The RBI maintains a buffer of foreign exchange reserves that can be utilized during times of currency volatility. 

Way Ahead

• Long-term investment: A stable rupee requires steady capital inflows. India should focus on attracting long-term foreign direct investment (FDI) rather than volatile foreign portfolio investments (FPI).
• Maximizing Remittances: India is one of the largest recipients of remittances globally. Policies that make it easier for Non-Resident Indians (NRIs) to remit money home, can increase foreign currency inflows, stabilizing the rupee.
• Export Competitiveness: The focus should be on enhancing the competitiveness of Indian exports by investing in sectors like technology, pharmaceuticals, textiles, and manufacturing.

Nuclear Disarmament

Syllabus: GS3/Internal Security, Defence

Context

• Japanese atom bomb survivors’ organisation Nihon Hidankyo has won the Nobel Peace Prize for its “efforts to achieve a world free of nuclear weapons”.
  • The argument for nuclear disarmament is rooted in the terrible effects and aftereffects of nuclear weapons, which were seen first hand in Hiroshima and Nagasaki. 

About

• From the immediate thermal and shock effects to long term environmental damage, a nuclear detonation exacts terrible human costs.
• Weapons available today are many times more devastating than the ones detonated in Japan in 1945. 

• Concerns: Over the first 9 weeks of a nuclear explosion, it is estimated that roughly 10% of deaths will be due to the effects of radiation, with 90% deaths being due to thermal injuries or blast effects.
  • However, the effects of radiation will manifest themselves in the form of various cancers and genetic damage over the coming years and generations.

Nuclear Disarmament

• Disarmament refers to the act of eliminating or abolishing weapons (particularly offensive arms) either unilaterally or reciprocally. 
• It may refer either to reducing the number of arms, or to eliminating entire categories of weapons.

Nuclear Powers in the World

• There are nine countries recognized as possessing nuclear weapons. 
• These countries are often referred to as “nuclear-armed states” or “nuclear powers.” 
• United States, Russia, China, United Kingdom, France, India, Pakistan, North Korea and Israel.

Treaties Related to Nuclear Disarmament

• Treaty on the Non-Proliferation of Nuclear Weapons (NPT): Signed in 1968 and entered into force in 1970, the NPT aims to prevent the spread of nuclear weapons and promote disarmament.
  • It divides the world into nuclear-weapon states (NWS), recognized as possessing nuclear weapons at the time of the treaty’s signing, and non-nuclear-weapon states (NNWS), which agree not to develop or acquire nuclear weapons. 
  • The treaty also requires NWS to pursue disarmament negotiations in good faith.
• Treaty on the Prohibition of Nuclear Weapons (TPNW): Adopted by the United Nations in 2017 and opened for signature in 2018, the TPNW aims to prohibit the development, testing, production, stockpiling, stationing, transfer, use, and threat of use of nuclear weapons.
  • It represents a significant step towards nuclear disarmament, although it has not been signed by nuclear-armed states.
• Comprehensive Nuclear-Test-Ban Treaty (CTBT): Opened for signature in 1996, the CTBT aims to ban all nuclear explosions for both civilian and military purposes.
  • While the treaty has been signed by 185 countries and ratified by 170, it has not entered into force as nuclear-armed states must ratify it to become operational.
• Outer Space Treaty: This multilateral agreement entered into force in 1967 and bans the siting of weapons of mass destruction in space.
  • All nine states believed to have nuclear weapons are parties to this treaty.

Arguments in Favour of Nuclear Disarmament

• Humanitarian Concerns: Nuclear weapons possess unparalleled destructive power, capable of causing immense loss of life, widespread devastation, and long-term environmental damage.
• Global Security: The proliferation of nuclear weapons increases the likelihood of their use, whether intentionally or accidentally, leading to catastrophic consequences for humanity. 
• Economic Benefits: Maintaining and modernizing nuclear arsenals incurs substantial financial costs for countries whereas funds can be redirected from nuclear weapons towards more constructive purposes to improve overall well-being.
• Non-proliferation and Arms Control: By demonstrating commitment to disarmament, nuclear-armed states can encourage non-nuclear-weapon states to adhere to non-proliferation agreements and refrain from developing their own nuclear capabilities.
• Ethical and Moral Imperatives: Eliminating nuclear weapons is viewed as a moral imperative and a step towards building a more peaceful and just world.
• Environment Pollution: Nuclear weapons testing and potential use have devastating environmental consequences, including radioactive contamination of land, air, and water. 

Arguments Against Nuclear Disarmament

• Deterrence: Proponents of nuclear deterrence argue that possessing nuclear weapons serves as a powerful deterrent against potential adversaries, preventing conflicts and maintaining strategic stability. 
• National Security: Possessing nuclear arsenals provides a form of insurance against potential threats and enhances the ability to protect the interests and sovereignty of a country in an uncertain international environment.
  • For these countries, relinquishing nuclear weapons could be perceived as weakening their security posture and leaving them vulnerable to external threats.
• Strategic Stability: Nuclear weapons are often seen as instruments for maintaining strategic stability between rival nuclear-armed states. 
• Geopolitical Tensions: Tensions between nuclear powers such as India and Pakistan, USA and Russia, and North Korea and the USA make disarmament difficult. In regions of high conflict, nuclear weapons are seen as necessary for survival or maintaining a balance of power.
• Verification and Compliance: Critics argue that without robust verification mechanisms and effective enforcement measures, countries may exploit disarmament agreements for strategic advantage. 
• Geopolitical Realities: Deep-rooted mistrust, unresolved conflicts, and strategic competition among states make it difficult to envision a scenario in which all countries would willingly and simultaneously relinquish their nuclear weapons. 

Way Ahead

• Nuclear disarmament is seen as a crucial step towards reducing the risks and promoting international peace and stability.
• While achieving complete nuclear disarmament may be a long-term objective, incremental progress can still be made through concerted international efforts and cooperation. 
• It requires sustained commitment from all nations to work towards a world free of nuclear weapons, ensuring the security and well-being of future generations.

India’s Nuclear Weapon Program – Smiling Buddha: In 1974, India conducted its first nuclear test code-named “Smiling Buddha, and since then, it has developed a nuclear triad consisting of land-based, sea-based, and air based delivery systems.  – Operation Shakti: In 1998, India conducted a series of nuclear tests at Pokhran, codenamed “Operation Shakti.”  1. These tests included both fission and fusion devices and marked India’s formal entry into the nuclear weapons club. – International Criticism: The international community has criticised India’s nuclear weapons programme, particularly the United States and its allies.  – No First Use: India has a “no first use” policy, meaning it pledges not to use nuclear weapons first in a conflict but reserves the right to retaliate if attacked with nuclear weapons.  India’s stance on nuclear disarmament?  – India has argued that any country’s possession of nuclear weapons poses a threat to global security, and that the only way to ensure peace and stability is for all nuclear weapons to be destroyed.  – India is not a signatory to the Non-Proliferation Treaty (NPT), and stated that the NPT is discriminatory and perpetuates a two-tiered system of nuclear haves and have-nots by unfairly restricting access to peaceful nuclear technology for non-nuclear weapon states. – National Security: India’s nuclear weapons programme is a legitimate expression of its national sovereignty, and that India has the right to defend itself against potential threats.  1. India’s nuclear disarmament and nonproliferation policy is complex and nuanced, reflecting the country’s desire for security and recognition, as well as its commitment to global disarmament and non-proliferation.

Nobel Prize in Medicine 2024: Discovery of microRNA

Syllabus:GS3/Science and Technology

Context

• The Nobel Prize for Medicine 2024, has been awarded to scientists Victor Ambros and Gary Ruvkun for their discovery of microRNA.

What is MicroRNA?

• MicroRNA are molecules that help cells control their protein production.
  • Different cells in the body create different proteins, depending on their specific functions. 
• The differentiation among cells is governed by gene regulation, which effectively turns on or off specific genes in a cell in order to allow it to carry its specific task. 

Proteins formation 

• The body makes proteins in a complex process with two broad steps. 

• In the transcription step, a cell copies a DNA sequence into messenger RNA (mRNA) in the nucleus. The mRNA moves from the nucleus, through the cell fluid, and attaches itself to the ribosome. 
• In the translation step, another type of RNA called transfer RNA (tRNA) brings specific amino acids to the ribosome, where they are linked together in the order specified by the mRNA to make the protein.
• Micro RNA, or miRNA, regulates the production of proteins by bonding with and subsequently silencing the mRNA at an appropriate juncture. The process is called post-transcriptional gene regulation.

Significance of the study

• The discovery revealed a new dimension to gene regulation where MicroRNAs are fundamentally important for how organisms develop and function.
• A single microRNA can regulate the expression of many different genes and similarly a single gene can be regulated by multiple microRNAs.
  • Hence microRNA coordinating and fine-tuning entire networks of genes. 
• The cells and tissues do not develop normally without microRNAs. Abnormal regulation by microRNA can contribute to cancer. 
• Mutations in genes coding for microRNAs have been found in humans, causing conditions such as congenital hearing loss, eye and skeletal disorders.