Swachh Sarvekshan rankings should force cities to get cleaner in the aggregate and not hide inequity

GS 2: Government policies

Context: Swachh Sarvekshan rankings were released recently.

The Swachh Sarvekshan rankings:

  • It was launched as part of the Swachh Bharat Abhiyan, which aimed to make India clean and free of open defecation by 2nd October 2019.
  • It is an annual survey of cleanliness, hygiene and sanitation in cities and towns across India. The first survey was undertaken in 2016 and covered 73 cities; by 2021 the survey had grown to cover 4320 cities and was said to be the largest cleanliness survey in the world.
  • Ministry of Housing and Urban Affairs (MoHUA) has now conducted the 6th edition of the survey to rank all cities under Swachh Bharat Mission-Urban (SBM-U) with Quality Council of India (QCI) as its implementation partner, to improve its coverage.
  • Objective of the Survey: to encourage large scale citizen participation, ensure sustainability of initiatives taken towards garbage free and open defecation free cities, provide credible outcomes which would be validated by third party certification, institutionalize existing systems through online processes and create awareness amongst all sections of society.

2021 Rankings:

  • Indore was ranked the cleanest city for the fifth year, followed by Surat and Vijayawada.
  • Chhattisgarh was the cleanest State, for the third time, in the category of ‘States with more than 100 urban local bodies’.
  • Prime Minister Narendra Modi’s constituency, Varanasi, won for the cleanest ‘Ganga city’.
  • This year there was a novel ‘Prerak Daaur Samman’ that saw Indore, Surat, Navi Mumbai, New Delhi Municipal Council and Tirupati categorised as ‘divya’ (platinum). They were assessed for solid waste management. 

About the Survey for the Rankings

  • The organiser, the Ministry of Housing and Urban Affairs, surveyed 4,320 cities for nearly a month and solicited feedback from 4.2 crore people.
  • The Categories for evaluation include: garbage disposal, open defecation-free ratings, functionality and maintenance of community toilets and safe management of faecal sludge.
  • Procedure followed:

Part 1 – Service Level Progress (SLP): Data provided by ULBs

Part 2 – Certification: Based on GFC Star rating, ODF+/ODF++/Water+

Part 3 – Based on GFC Star rating, ODF+/ODF++/Water+: 5 components – Feedback, engagement, experience, Swachhta app, Innovation

Final Score: Cities are ranked based on marks obtained from Part 1, Part 2 and Part 3

  • Prerak Dauur Samman awards: It gives rank according to the state rankings, on the basis of ODF, ODF + and ODF ++ status. It includes categories of divya (platinum), anupam (gold), ujjwal (silver), udit (bronze), and aarohi (copper / aspiring).

Criticism of the Ranking procedure:

  • It is based on feedback. Every State has at least a few participants who will top one category or the other, thus making the process a giant appeasement scheme.
  • Problem with State ranking – No categorization by size: Along with a category such as ‘States with over 100 urban local bodies (ULB),’ where Maharashtra and MP were ranked second and third, respectively, there was also a top ranker for ‘State with less than 100 ULBs’ where Jharkhand was judged the cleanest.
  • Then there was a category for a ‘Ganga’ city and separate population-wise categories. Unsurprisingly, these were entities that had already topped ranks in other categories.
  • Though the number of cities surveyed has increased since the first edition of the survey in 2016, it appears that the same cities — Indore, Surat, for instance — keep topping the list.
  • No clarity on what it intends to achieve: is it motivating cities to significantly allocate resources towards improving sanitation? Are cleaner cities cleaner because they are better positioned to access State funds and thus able to pull further away from other cities? Do States focus their energies and funds in keeping some cities clean to avail of a rank in any of the wide number of categories?

Way Forward: Rankings serve two broad purposes: A publicity boost and recognition for the other winners but also motivation to climb higher on the totem pole. However, reducing a metric as complex as sanitation and cleanliness to blunt rankings can often induce a false sense of progress. Both at the regional level and at the Centre there should be more qualitative analysis of whether India’s cities are getting cleaner in the aggregate or if numbers are hiding inequity.

2.The only way to do this is to present evidence before the scientific community that Ayurveda works

GS 2: Health, GS 3: Traditional knowledge

Context: Ayurveda has gained popularity in recent years, but a lot is still to be done to ensure that it stands the scrutiny of science. The author Kishor Patwardhan(Faculty of Ayurveda, Banaras Hindu University) shares his views as a teacher of Ayurveda with 20 years of experience.

Rampant misinformation during COVID:

  • Selfmedication: Advocation of self-medication during COVID waves diluted the message that unscrupulous, excessive and prolonged use of any medicine could be harmful.
  • Lost a chance on correct usage of herbs: We did not educate the public on the identification of the correct herbs, though we encouraged their consumption. For example, Giloy (Tinospora cordifolia) and Dalchini (Cinnamomum zeylanicum) are two plants where correct identification matters. Sometimes, Tinospora crispa and Cassia cinnamon are mistakenly identified as Giloy and Dalichini, which could be harmful.
  • Lack of Scientific evidence: Almost every Ayurveda physician came up with his/her own formulations as a purported cure for COVID-19. Many lab reports suggesting clinical improvements with Ayurveda interventions were shared on different social media platforms. However, most of them could not make it to peer-reviewed journals.
  • Miss opportunity: Thousands of COVID-19 cases treated by Ayurveda physicians could have provided good data that could have been further analysed. Even though the Ministry of Ayush came up with an online case registry, our fraternity could not make any meaningful use of it.
  • Lack of coordination between agencies: The protocols of ICMR and Ayush were disconnected .

Challenges in research in Ayurveda:

  • Lack of protocols for research: For example, in most of the COVID trials, the Ayurveda interventions were either in addition to Indian Council of Medical Research (ICMR) protocols or, when used as independent interventions, they were administered in mild to moderate cases only.
  • Too Subjective – Variety of interpretations: Absence of uniform protocols either for diagnosis or for interventions make Ayurveda too subjective and diverse.
  • Vague terminology: Scientifically speaking, ‘immune boosting’ is a vague and potentially misleading term(used during COVID).
  • Lack of Regulations in Ayurvedic medicine: During the pandemic, every other Ayurveda pharmacy came up with its own patent and proprietary formulation that supposedly boosted immunity. The common public was made to believe that Ayush interventions were safe, of preventive value, and effective in treating the disease. But most of these claims lacked credible evidence.
  • Commercial take-over of Ayurveda: Formally, we never teach our graduates patent and proprietary formulations. However, as these graduates set up their clinical practice, they start prescribing these formulations. Most of these products are not backed by reliable trials or even pre-clinical and toxicity data. The number of pharmacies that manufacture classical formulations(given really in Ayurveda) has reduced to a bare minimum over the years, which shows how commercialisation has taken over the sector.

The Damage due to poor Scientific understanding – Negative Publicity as Pseudoscience: A group of scientists and physicians has recently started a social media campaign calling all Ayush systems ‘pseudoscience’.

  • Levels of Toxicity high: These activists conduct chemical analysis of many Ayush formulations and demonstrate that many of these products contain high doses of unwarranted constituents such as antibiotics, corticosteroids and heavy metals.
  • Documentation of Adverse events reported: They also publish and share various clinical case reports where adverse events are reported after exposure to Ayush interventions.
  • The myth of non-falsifiability of ancient texts: Academia, at present, has made Ayurveda a pseudoscience by teaching the young students that whatever is written in ancient texts is the ultimate truth and cannot be challenged. This renders the system unscientific.

Way forward:

  • Support rational Ayurveda: It should be based on experimental rationality, i.e. through scientific evidence.
  • Support even those who conduct tests on Ayurvedic medicine and publish negative results: These activities are crucial and need the support as this would make Ayush academicians and policymakers introspect seriously about the current system. The only way to make Ayurveda a real science is to present evidence before the scientific community showing that it works.
  • Removing vagueness & subjectivity:  An objective evaluation of complex Ayurveda practices is very difficult in the standard accepted format of ‘double blind randomised controlled trials’. The practical alternative is to go for longitudinal observational studies.
  • Need for regulation: ‘Commercialization of the sector’ needs to be regulated to ensure that propriety formulation products go through robust pre-marketing studies. Even classical formulations that contain toxic substances such as heavy metals need to be regulated.
  • Focus on Quality rather than Quantity: Further, maintaining only a manageable number of colleges is essential to ensure that all students get good clinical exposure. The indiscriminate growth of new Ayush colleges is another matter of concern.




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