Topic 1 : Govt. body hikes prices of essential medicines again, says ‘it’s miniscule’
Context
The National Pharmaceutical Pricing Authority (NPPA) enforced an increase in the Maximum Retail Price (MRP) this year of 0.00551 percent for scheduled formulations (of drugs) from the beginning of the fiscal year 2024–25.
Implications for customers
- Annual hikes in the prices of drugs listed in the National List of Essential Medicines (NLEM) are based on the WPI.
- The price surge will mean that consumers have to pay more for routine and essential drugs, including painkillers, anti-infection drugs, cardiac drugs, and antibiotics.
| Wholesale price index refers to the price of goods at a wholesale stage i.e. goods that are sold in bulk and traded between organizations instead of consumers. It is released by the Office of Economic Advisor under the Ministry of Commerce and Industry and has the base year 2011-2012. |
What are Essential Medicines?
- As per the World Health Organisation (WHO), Essential Medicines are those that satisfy the priority healthcare needs of the population.
- Ministry of Health and Family Welfare hence prepared and released the first National List of Essential Medicines (NLEM) of India in 1996 consisting of 279 medicines.
- The list is made with consideration to disease prevalence, efficacy, safety and comparative cost-effectiveness of the medicines.
- Such medicines are intended to be available in adequate amounts, in appropriate dosage forms and strengths with assured quality.
- They should be available in such a way that an individual or community can afford.
NLEM in India
- Drugs listed under NLEM — also known as scheduled drugs — will be cheaper because the National Pharmaceutical Pricing Authority (NPPA) caps medicine prices and changes only based on wholesale price index-based inflation.
- The list includes anti-infectives medicines to treat diabetes such as insulin — HIV, tuberculosis, cancer, contraceptives, hormonal medicines and anaesthetics.
- They account for 17-18 per cent of the estimated Rs 1.6-trillion domestic pharmaceutical market.
- Companies selling non-scheduled drugs can hike prices by up to 10 per cent every year.
- Typically, once NLEM is released, the department of pharmaceuticals under the ministry of chemicals and fertilisers adds them in the Drug Price Control Order, after which NPPA fixes the price.
Who regulates Drugs prices?
- The NPPA was set up in 1997 to fix/revise prices of controlled bulk drugs and formulations and to enforce price and availability of the medicines in the country, under the Drugs (Prices Control) Order, 1995-2013.
- Its mandate to implement and enforce the provisions of the DPCO in accordance with the powers delegated to it
- To deal with all legal matters arising out of the decisions of the NPPA
- To monitor the availability of drugs, identify shortages and to take remedial steps
- The NPPA is also mandated to collect/maintain data on production, exports and imports, market share of individual companies, profitability of companies etc., for bulk drugs and formulations and undertake and/ or sponsor relevant studies in respect of pricing of drugs/ pharmaceuticals.
Way forward
- The selection of essential medicines is only the first step to improve the quality of health care.
- It should be followed by the appropriate use of the selected medicines. Each individual should receive the right medicine, in an adequate dose for an adequate duration, with appropriate information, planning of treatment follow-up, and at an affordable cost.
Topic 2 : On global indices measuring democracy
Introduction
The V-Dem Institute’s recent democracy index termed India as “one of the worst autocratisers”. Similar indices have downgraded India’s democratic standing in recent years. The Indian Government has however refuted these assessments. It now plans to release its own democracy index, which will counter recent downgrades in ratings and severe criticisms by international groups.
Why does India care about a democracy index?
- From the Varieties of Democracy (V-Dem) project to Freedom House, there is a consensus that India’s democracy is in peril.
- Ahead of the election season, these indices and “negative commentary” by think tanks and agencies threaten India’s sovereign ratings and its ranking on the World Bank’s Worldwide Governance Indicators.
- India has previously denounced all global rating assessments of Indian conditions, from democracy and press freedom to hunger, human development and happiness.
- Foreign Minister S. Jaishankar in 2021 called the makers of these indices “self-appointed custodians,” who are “not motive-less.”
- The grouse with democracy assessments is that the methodology is flawed, sample sizes are inadequate, and that these indices favour cultural bias and subjective opinion over objective metrics.
- India, for instance, ranks between Niger (which is ruled by a military junta) and the Ivory Coast, and is in the same category as Palestine.
Data used in Indices
- There are many approaches to measuring democracy, some using facts, some judgment and some a mix of both.
- The four broad types of data that these indices use are — observational data (OD) which is data on observable facts, such as voter turnout rates; ‘in-house’ coding, where researchers assess country-specific information using academic material, newspapers, etc.; expert surveys, where selected experts from a country provide a subjective evaluation; and representative surveys, where a selected group of citizens offer judgments.
- The Office of the United Nations High Commissioner for Human Rights has endorsed the use of observational, objective data over judgment-based methodology for assessments to make them “more broadly acceptable.”
- Others, however, find fact-based metrics “insufficient”, and expert intervention necessary, to capture on-ground realities of governance.
Limitations of Indices
- The first and the most frequently cited criticism is that there is a degree of subjectivity that tugs at the indices’ credibility and precision.
- Regardless of the scholarly pool and aggregation model used, evaluations are still based on the judgment of researchers and coders, rather than tangible characteristics.
- V-Dem’s “egalitarian” indicator, for instance, assesses the equality of social groups in the political arena — an equivocal question in comparison to say, how many political parties are present in the country.
- Another concern is over the scope of countries included in these indices. Only some survey non-independent and micro-states. Smaller countries may thus be overlooked in certain cases.
- The next criticism is of a perceived ideological discrepancy, partly due to the amorphous definition of democracy itself. Lesotho, which suffered a military coup in 2014, is assigned a higher score than India.
Conclusion
Therefore, there is no singular, perfect democracy index, just like there is no singular definition of democracy. Indices are important as they offer ways to benchmark the strengths and weaknesses of regimes, and make different components comparable over time periods and geographies.
