'Modicare' to cost Rs 11K crore a year, claim govt sources

Agencies
February 3, 2018

New Delhi, Feb 3: Prime Minister Narendra Modi's plan to provide health insurance for about half the country would require an estimated Rs 11, 000 crore in central and state funding each year, sources familiar with the matter said.

The National Health Protection Scheme, which the government dubs "Modicare", was announced in Thursday's budget for 2018/19 and would provide 100 million families, or about 500 million poor people, with health cover of Rs 50, 0000 per year for free treatment of serious illnesses.

Several states now offer health insurance but these schemes are generally small and poorly implemented. Modi faces a national election next year and the new health programme is seen as a signature initiative to woo voters in the countryside, many of whom struggle with high healthcare costs.

The government estimates the cost of insuring each family under the new scheme at about Rs 1,100, said a government official who had direct knowledge of the matter and did not want to be identified.

Officials at NITI Aayog, India's federal think tank, on Friday said the government's estimated premium for insuring each family would be 1,000-1,200 rupees, confirming the funding would be shared between federal and state governments.

"This is a turning point for the health sector," Vinod K Paul, a member of NITI Aayog, told reporters.

Officials have said "the world's largest government funded health care programme" would have a central allocation of 20 billion rupees in 2018-19, but added that more funds would be made available as the programme is rolled out over the year.

Some critics have raised doubts whether 20 billion rupees in federal funding is enough to support the programme for 2018-19.

However, the government official said of the Rs 11000 crore in premiums required to fund the programme, the federal government would contribute about 70 billion rupees with the 29 states providing the rest.

The 50 billion rupees in federal funding on top of the budget allocation of Rs 2, 000 crore would be made available as the scheme details are worked out over the coming months, the official said.

"Government health insurance companies have readily agreed to fund the programme (at this cost)," the official said.

A second source familiar with the planning said the government could also partly use the funds raised from a newly imposed 1 percent health cess on taxable incomes, and the health scheme would also benefit from the planned merger of three state-run insurance firms announced in Thursday's budget.

"It's a big pool (of people). When you have a mammoth insurance company, the task becomes easier," said the source, adding that the government's premium payments for the scheme were expected to be low and manageable.

Modi's government on Thursday also raised the federal health budget by 11.5 percent for 2018-19.

The measures are Modi's latest attempt to reform a public health system that faces a shortage of hospitals and doctors. The government has also in recent years capped prices of critical drugs and medical devices and increased health funding.

Still, India spends only about 1 percent of its GDP on public health, among the world's lowest, and the health ministry estimates such funding leads to "catastrophic" expenses that push 7 percent of the population into poverty each year.

A top official at a state-run insurance company said the government would take 4 to 6 months to finalize the contours of the health plan since it would take time to get hospitals on board.

Nevertheless, a government-sponsored health programme will come as a major boost for the private hospital sector in India. Overburdened public hospitals mean nearly 70 percent of healthcare delivery is in the hands of private players.

The scheme "will be a game changer", said Prathap Reddy, chairman of Apollo Hospitals Enterprise Ltd.

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News Network
May 20,2020

United Nations, May 20: Highlighting India's long-standing history of promoting inclusive and peaceful societies, a top UN official on Tuesday voiced concern over incidents of "increased hate speech and discrimination" against minority communities in the country following the adoption of the Citizenship Amendment Act.

Under-Secretary-General and UN Special Adviser on the Prevention of Genocide Adama Dieng, however, welcomed Prime Minister Narendra Modi’s call for unity and brotherhood in the wake of the COVID19 pandemic.

Dieng said in a note to the media on Tuesday that he is "concerned over reports of increased hate speech and discrimination against minority communities in India" since the adoption of the Citizenship Amendment Act (CAA) in December 2019.

The Indian government has maintained that the CAA is an internal matter of the country and stressed that the goal is to protect the oppressed minorities of neighbouring countries.

The CAA, which was notified on January 10, grants Indian citizenship to non-Muslim minorities migrated to India from Afghanistan, Pakistan and Bangladesh till December 31, 2014, following persecution over their faith.

"While the objective of the act, to provide protection to minority communities is commendable, it is concerning that this protection is not extended to all groups, including Muslims. This is contrary to India’s obligations under international human rights law, in particular on non-discrimination,” Dieng said.

The Special Adviser recognised "India’s long standing and well recognised history of promoting inclusive and peaceful societies, with respect for equality and principles of non-discrimination.”

He also welcomed recent statements by Prime Minister Modi that the COVID-19 pandemic “does not see race, religion, colour, caste, creed, language or border before striking and that our response and conduct...should attach primacy to unity and brotherhood.”

Dieng encouraged the Government of India to "continue to abide by this guidance by ensuring that national laws and policies follow international standards related to non-discrimination and to address and counter the rise of hate speech through messages of inclusion, respect for diversity and unity.”

He further reiterated that he would continue to follow developments and expressed his readiness to support initiatives to counter and address hate speech.

The hate speech and the dehumanisation of others goes against international human rights norms and values, he added.

“In these extraordinary times brought about by the COVID-19 crisis it is more important than ever that we stand united as one humanity, demonstrating unity and solidarity rather than division and hate,” he said.

Dieng also expressed concern over reports of violence during demonstrations against CAA in some regions of India.

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Agencies
May 23,2020

New Delhi, May 23: The nationwide lockdown will no longer help India in its fight against COVID-19, and in its place community-driven containment, isolation and quarantine strategies have to be brought into play, leading virologist Shahid Jameel said.

The recipient of Shanti Swarup Bhatnagar Prize for Science and Technology also stressed that testing should be carried out vigorously to identify coronavirus hotspots and isolate those areas.

"Our current testing rate at 1,744 tests per million population is one of the lowest in the world. We should deploy both antibody tests and confirmatory PCR tests. This will tell us about pockets of ongoing infection and past (recovered) infection. This will provide data to open up gradually and let economic activity resume," Jameel told PTI in an interview.

He stressed that testing has to be dynamic to continuously monitor red, orange and green zones and change these based on that data.

About community transmission of COVID-19 in India, Jameel said the country reached that stage long ago.

"We reached community transmission a long time ago. It's just that the health authorities are not admitting it. Even ICMR's own study of SARI (severe acute respiratory illness) showed that about 40 per cent of those who tested positive for SARS-CoV-2 did not have any history of overseas travel or contact to a known case. If this is not community transmission, then what is?" he posed.

Lockdown bought India time in its fight against coronavirus, but continuing it is unlikely to yield any further dividend, Jameel said.

"Instead, community-driven local lockdowns, isolations and quarantines have to come into play. Building trust is most important so that people follow rules. A public health problem cannot be dealt with as a law-and-order problem."

The nationwide lockdown, initially imposed from March 25 to April 14, has been extended thrice and will continue at least till May 31. The virus has claimed 3,720 lives and infected over 1.25 lakh people in the country so far.

Jameel has expertise in the fields of molecular biology, infectious diseases, and biotechnology. He is the CEO of Wellcome Trust/Department of Biotechnology's India Alliance and is best known for extensive research in Hepatitis E virus and HIV.

He said COVID-19 will eventually be controlled through herd immunity, which is acquired in two ways – when a sufficient fraction of the population gets infected and recovers, and with vaccination.

"It is estimated that for SARS-CoV-2 at least 60 per cent of the population would have to be infected and recovered, or vaccinated. This will happen over the course of the next few years," Jameel said.

Herd immunity is reached when the majority of a population becomes immune to an infectious disease, either because they have become infected and recovered, or through vaccination. When that happens, the disease is less likely to spread to people who aren't immune, because there just aren't enough infectious carriers.

"India has 1.38 billion people, a population density of about 400/sq km and a healthcare system ranked at 143 in the world. If we allow 60 per cent people to get infected quickly in the hopes of herd immunity, that would mean 830 million infections," Jameel said.

"If 15 per cent need hospitalization that means about 125 million isolation beds (we have 0.3 million). If five per cent need oxygen and ventilatory support, this amounts to about 42 million oxygen support and ICU beds; we have 0.1 million oxygen support beds and 34,000 ICU beds. This would overwhelm the healthcare system causing mayhem," he said.

Jameel said if the population level mortality is 0.5 per cent that would mean 40 lakh deaths. "Are we prepared to pay this price for herd immunity in the short term? Clearly not," he said.

He said it is unlikely that a vaccine would be available by the end of the year.

"Even then, we don't know yet how long it would give protection – weeks, months, one year, a few years? I don't think we will return to pre-coronavirus days for at least the next 3-5 years. This is also a chance to evaluate if we want to return to those unsustainable, environment-damaging ways. COVID-19 is a timely warning to reform our way of living," he said.

Jameel said it is hard to predict but plausible that COVID-19 would return in second or third wave.

"Later waves come when we don't understand the disease and become lax. A comparison to Spanish Flu is not entirely valid because in 1918 no one knew what caused it. No one had seen a virus till the mid-1930s as the electron microscope needed to view those was invented in 1931," he said.

"Today we know a lot more about the pathogen, its genetic makeup, how it transmits and how to prevent it. We need to be sensible and follow expert advice," he said.

If there is any scientific evidence linking deforestation, rapid urbanisation, climate change with pandemics like COVID-19, he said zoonotic viruses -- those that jump from animals to humans -- happen so when wild animal–human contacts increase.

"Deforestation destroys animal habitats bringing them closer to humans. When you cut forests, bats come to roost on trees closer to human habitations. Their viruses in secretions/stool get transmitted to domestic animals and on to humans. This happened clearly with Nipah virus outbreak in Malaysia in 1997-98 from fruit bats to pigs to humans," he said.

"COVID-19 possibly arose in wet animal markets due to dietary habits that bring all kinds of live and dead wild animals in close contact with humans," Jameel added.

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Agencies
May 6,2020

New Delhi, May 6: The Central Board of Indirect Taxes and Customs (CBIC) has extended the validity of electronic way (E-way) bills, whose expiry date fell between March 20 and April 15, till May 31.

"Notification No. 40/2020-Central Tax issued to extend the validity of e-way bills till May 31 for all those e-way bills which were generated on or before March 24, 2020 and had expiry between the period from March 20 to April 15, 2020," the CBIC tweeted on Tuesday.

E-way bill is produced by transporters and businessmen before a Goods and Services Tax (GST) inspector for moving goods worth over Rs 50,000 from one state to another.

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