Editorial 1 : Low-cost MRI machine can improve access to diagnostics in India
Context
Scientists have designed a magnetic resonance imaging (MRI) scanner that costs a fraction of existing machines, setting the stage for improving access to this widely used diagnostic tool.
MRI
- A MRI helps visualise minute details in the human body, with which doctors can diagnose disorders and select treatments for the brain, the heart, various cancers, and orthopaedic conditions.
- These scanners work by using strong magnetic fields, measured in units called tesla (T), and radio waves to generate images of internal organs.
- The strength of these magnetic fields in clinical MRI setups range between 1.5 T and 3 T — or 4-8-times stronger than the typical magnetic field in a sunspot on the Sun.
Around 50-times cheaper
- This potentially life-saving medical technology remains inaccessible to most of the population, especially in low- and middle-income countries like India because of the scanner’s high cost and the infrastructure required to handle such a powerful instrument.
- This includes shielding the room that houses the machine to contain the effects of strong magnets; liquid helium to cool the magnets when they heat up during operation; and the electric power required to operate the scanner.
- A 3-T MRI machine can cost anywhere between 9 and 13 crore rupees. To address this problem, a team led by Ed Wu at the University of Hong Kong designed and built an MRI machine using low strength magnets and store-bought hardware.
- This simplified machine costs around $22,000, or about Rs 18.4 lakh. The machine uses 0.05 T magnets and doesn’t need a shielded room or helium coolant to operate. It can be plugged into standard wall-power outlets.
- This will usher in an entirely new class of MRI scanners that are affordable, low-power, and compact.
Good for access and emergencies
- Aside from acute interventions to help stroke patients, low-cost scanners could help in traumatic accidents to assess a patient’s injury at the accident site.
- Using a lower power magnet also has the advantage of preventing metal items such as oxygen cylinders, wheelchairs, and stethoscopes from being pulled into the MRI machine.
- An MRI machine with low strength magnets may generate fewer artefacts due to implants or prosthetics in the final image; such artefacts have been known to mislead doctors about the original anatomy of the tissue.
- Many of these objects are made of titanium, which is paramagnetic, i.e. weakly affected by a magnetic field.
- However, Some low-cost MRI providers may not offer additional services such as expert radiologist interpretation, which could affect the accuracy and usefulness of the scan results.
Conclusion
In conclusion, low-cost MRI options offer increased affordability and accessibility to essential medical imaging services. However, they may come with drawbacks such as reduced image quality, limited availability of specialized services, and potentially longer wait times. Ensuring the balance between affordability and diagnostic accuracy is crucial for making informed healthcare decisions.
Editorial 2 : Is it time for proportional representation?
Context
The results of the Lok Sabha elections were declared last week. The ruling National Democratic Alliance (NDA) has won 293 seats with a 43.3% vote share while the Opposition bloc INDIA (including Trinamool Congress) has secured 234 seats with a 41.6% vote share. Other regional parties and independents polled around 15% but ended up with only 16 seats in total.
What is first past the post system?
- We follow the First Past the Post System (FPTP) in our elections to the Lok Sabha and Legislative Assemblies.
- Under this system, the candidate who polls more than any other in a constituency is declared elected.
- This is the system that is followed for elections in democracies like the U.S., the U.K. and Canada.
- The primary advantage of the FPTP system is that it is simple and the most feasible method in a large country like India.
- Secondly, FPTP provides greater stability to the executive in our parliamentary democracy because the ruling party/coalition can enjoy a majority in the Lok Sabha/Legislative assembly without obtaining majority of the votes (more than 50%) across constituencies.
- The issue with FPTP is that it may result in over or under representation of political parties when compared to their vote share.
What is proportional representation?
- The Proportional Representation (PR) system ensures representation of all parties based on their vote share.
- The most commonly used PR system is the ‘party list PR’ where voters vote for the party (and not individual candidates) and then the parties get seats in proportion to their vote share.
- There is usually a minimum threshold of 3-5% vote share for a party to be eligible for a seat.
- India is a federal country and this principle if implemented should ideally be carried out at each State/Union Territory (UT) level.
- The PR system would have resulted in representation of parties according to their vote share.
- The main criticism against the PR system is that it could potentially result in instability as no party/coalition may obtain a majority to form the government in our parliamentary democracy.
- Further, it may result in the proliferation of political parties based on regional, caste, religious and linguistic considerations that may promote casteist or communal voting patterns.
- However, the second criticism is not well founded since the present FPTP system has also not inhibited the formation of parties based on caste or communal considerations.
- This issue can be addressed by specifying minimum threshold for votes polled in order to make a party eligible for seats in legislative houses.
- In order to maintain balance between stability and proportionate representation, the system of Mixed Member Proportional Representation (MMPR) can be considered.
- Under this system, there is one candidate who is elected through the FPTP system from each territorial constituency. There are also additional seats that are filled based on various parties’ percentage of votes.
What are international practices?
- Presidential democracies like Brazil and Argentina have the party list PR system.
- So do parliamentary democracies like South Africa, the Netherlands, Belgium and Spain.
- Germany and New Zealand follows the MMPR system.
- This system is likely to provide the required stability in a parliamentary democracy like India while also ensuring representation for all parties based on their vote share.
Way forward
- The law commission in its 170th report, ‘Reform of the electoral laws’ (1999), had recommended the introduction of the MMPR system on an experimental basis.
- It had suggested that 25% of seats may be filled through a PR system by increasing the strength of the Lok Sabha.
- While it had recommended to consider the entire nation as one unit for PR based on vote share, the appropriate approach would be to consider it at every State/UT level considering our federal polity.
- It is also pertinent to note that the delimitation exercise for increasing the number of seats is due based on the first Census to be conducted after 2026.
- The population explosion that happened in our country during the last five decades has been uneven among various regions.
- Determining the number of seats in Lok Sabha solely in proportion to population may go against the federal principles of our country and may lead to a feeling of disenchantment in the States that stand to lose through such representation.
- However, in the event of increasing the seats during the delimitation exercise, the MMPR system may be considered for incremental seats or at least 25% of the total seats to be filled from each State/UT.
- This could assuage the apprehension of southern, northeastern and smaller States in the northern region by limiting the domination of larger States with increased seats solely through the FPTP system.
