Editorial 1: The Marburg virus and the recent outbreak caused by it
Context:
- World Health Organisation (WHO) recently convened an urgent meeting after central African nation Equatorial Guinea confirmed its first outbreak of the highly infectious Marburg virus disease, or MVD.
About MVD:
- Marburg virus disease (MVD) is a severe illness that causes viral haemorrhagic fever in humans (it was formerly known as Marburg haemorrhagic fever). The virus was first identified after simultaneous outbreaks in Frankfurt and Marburg, Germany — from where it derives its name — and Belgrade, Serbia in 1967.
- Like Ebola, the Marburg virus is transmitted to primates from bats which are considered natural hosts of the virus. Fruit bats infected with the virus do not show obvious signs of illness, but it can cause serious illness or death in humans.
- It spreads among humans via direct contact with the bodily fluids of infected bats, or surfaces contaminated with fluids, like bedsheets and clothes. The disease can also spread during burial ceremonies if there is direct contact with the body of the deceased.
- Both the Marburg and Ebola viruses belong to the Filoviridae family and the diseases caused by the two present clinical similarities.
Fatality rate:
- The virus takes between two and 21 days to incubate. As per WHO, the disease has an average fatality rate of 50%. A person infected with the virus experiences sudden illness with symptoms like high fever, severe headache and discomfort. Many develop severe haemorrhagic signs within 7 days.
- “Muscle aches and pains are a common feature. Severe watery diarrhoea, abdominal pain and cramping, nausea and vomiting can begin on the third day. Diarrhoea can persist for a week. The appearance of patients at this phase has been described as showing “ghost-like” drawn features, deep-set eyes, expressionless faces, and extreme lethargy,” the WHO states.
- During the severe phase of the illness, patients sustain high fevers. Involvement of the central nervous system can result in confusion, irritability, and aggression. In fatal cases, death often occurs eight or nine days after the onset of symptoms, usually preceded by severe blood loss and shock.
- As of now, there are no authorised vaccines or drugs to treat the Marburg virus disease. The WHO, however, says that rehydration with oral or intravenous fluids and treatment of specific symptoms can improve chances of survival.
The outbreak in Equatorial Guinea
- The above diagram shows the distribution of MVD cases over recorded history.
- After 1967, cases have been reported in Angola, the Democratic Republic of the Congo, Kenya, South Africa and Uganda. In a 2004 outbreak in Angola, MVD killed 90% of the 252 infected. Last July, there were two reported MVD deaths in Ghana.
Managing the virus:
- “Advance teams have been deployed in the affected districts to trace contacts, isolate and provide medical care to people showing symptoms of the disease. Efforts are also underway to rapidly mount an emergency response, with WHO deploying health emergency experts in epidemiology, case management, infection prevention, laboratory and risk communication to support the national response efforts and secure community collaboration in the outbreak control,” the WHOstated. The U.N. health body also convened an urgent meeting to review vaccine candidates and their status.
Way forward:
- Most zoonotic diseases now in news, including COVID-19, swine flu, bird flu as well as MVD, must be dealt with in a holistic manner. Here comes the concept of One Health Approach (OHA): it is an approach that recognizes that the health of people is closely connected to the health of animals and our shared environment.
- One Health’ vision derives its blueprint from the agreement between the tripartite-plus alliance comprising the Food and Agriculture Organization of the United Nations (FAO), the World Organisation for Animal Health (OIE).
- Its purpose is to encourage collaborations in research and sharing of knowledge at multiple levels across various disciplines like human health, animal health, plants, soil, environmental and ecosystem health in ways that improve, protect and defend the health of all species.
Editorial 2: Social security and the story of two Budgets
Context:
- Presenting the Union Budget 2023-24 on February 1, the Finance Minister asserted that ‘since 2014, the central government has ensured a better quality of life, and a life of dignity’ for all its citizens.
- But Budget figures help distinguish rhetoric from the truth. This year, severe cuts in various social security and welfare schemes such as food security and the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA), have undermined the already precarious lives of large numbers of poor people in India.
Status of social security schemes:
- A segment that has been sidelined is the crores of the elderly and other social security pensioners who are being callously pushed towards destitution. Since 2007, social security pensions being given by the central government under the National Social Assistance Programme (NSAP), have remained frozen at an appallingly low sum of ₹200 for the elderly and ₹300 per month for widows and persons with disabilities. In addition, only those who appear on the obsolete and discredited Below Poverty Line (BPL) lists prepared as in Census 2001 are given pensions.
- As a result, the budget for the NSAP has remained constant, at approximately ₹9,000 crore, and steadily reducing in real terms. This year, the NSAP saw a reduction of ₹16 crore, decreasing from ₹9,652.31 crore in FY2022-23 (BE) to ₹9,636.32 crore for FY 2023-24 (BE), making a mockery of a so-called model of “inclusive growth”.
Case study: Rajasthan
- The Rajasthan Budget of 2023-24 was a lesson in contrasts. A landmark, pioneering, Minimum Income Guarantee and Pension law is to be enacted in the State, providing 125 days of work through the rural or urban employment guarantee, and a minimum social security pension of ₹1,000 per month, with an automatic increase of 15% per annum.
National Social Assistance Programme (NSAP)
- NSAP is a centrally sponsored social security scheme that provides non-contributory income security to the elderly, widows, and persons with disabilities from “BPL families”.
- The central government’s contribution to the three main schemes under this programme, the Indira Gandhi National Old Age Pension Scheme (IGNOAPS), the Indira Gandhi National Widow Pension Scheme (IGNWPS), and the Indira Gandhi National Disability Pension Scheme (IGNDPS), has remained the same over the last 15 years.
- The percentage share allotted to NSAP of the total expenditure budget has steadily declined from 0.58% in FY2014-15(BE) to 0.21% in the current budget (FY2023-24). In addition to the central contribution, State governments are encouraged to match the amount as the central contribution under the NSAP’s guidelines. But as the central government contribution remains pathetically low, trends across 36 States/Union Territories indicate that a majority of the States are providing several times the suggested amount.
- In Contrast, today, Rajasthan provides social security pensions to over 90 lakh people, with the NSAP covering only a small part of the pension of 10 lakh pensioners. After this Budget announcement in Rajasthan, the total amount spent on pensions is expected to go up to ₹11,500 crore, approximately 30% more than the entire national social security pensions budget under NSAP.
Criteria for social security schemes:
- It is not just the amount, but also the numbers receiving pensions that is of importance. Central assistance to States/Union Territories under NSAP is determined based on the BPL population of the State. For calculating the estimated number of beneficiaries under each scheme for each State, the central government relies on the population figures of Census 2001.
- Additionally, the stringent criteria of providing disability pensions only to those with a disability level of 80% or more, has excluded lakhs of the disabled even within the obsolete BPL category.
- In 2013, the Rajasthan government changed its eligibility criteria to expand the coverage of pensioners by making economically vulnerable women above 55, and men above 58 eligible for old-age pension. It also permitted widows with adult children to receive a widow pension, and included anyone with more than 40% disability to receive a disability pension. As a result, the number of social security pensioners in the State grew from 14 lakh to above 90 lakh now, all of whom will come under the cover of the proposed law.
Ensure minimum conditions and dignity
- Other States, and even the Government of India should follow the example of Rajasthan and take the necessary steps to change their existing schemes into an Act that provides more credible entitlements, strengthens accountability, and offers the same legal protection as other welfare laws.
- The Central government must recognise that pension is a right for work done by unorganised sector workers, who are contributing seminally to the GDP and economy all their lives. People’s movements and campaigns have demanded a universal and non-contributory minimum monthly pension equal to 50% of the minimum wage that is periodically adjusted to inflation. This rights-based approach is not based on charity, but on the recognition of the right to ensure minimum conditions for workers to live their retired lives with dignity.
Conclusion:
- For the vulnerable working people, senior citizens and the disabled, rights-based entitlements provide a measure of dignified living which should be the objective of any democracy, regardless of the immediate electoral implications. Ultimately, it is our compassion, and commitment to meet the basic needs of our most marginalised people that will gauge us as a society, and as a nation.
