Sunday, October 15, 2017

e-Eye Of The Tiger

E-surveillance was an innovative idea where 10 watch towers kept a 24/7 vigil over the area within their range through thermal and infra-red cameras.

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Image: Sourabh Bharti

This article is an exclusive extract from the author’s forthcoming memoir, Environment Through Finance Eyes.

Amid the farrago of lacklustre activities that informed the Ministry of Environment, Forests and Climate Change’s various divisions, with most things trundling along without a goal, there were a few bright spots that lifted my periodic blues. Among the brightest was the Project Tiger under the National Tiger Conservation Authority (NTCA), which continued quietly to do the good work it had been tasked to do the past many years. It was led by Rajesh Gopal, the Additional Director General and the Member Secretary of NTCA, an inspirational leader ably supported by a band of dedicated officers like Satya Prakash Yadav, DIG, and Himmat Singh Negi, IG, at the NTCA headquarters, apart from a string of passionate wildlife forest officers in the field spread across the country in the 50 Tiger Reserves.
Not many people in the Ministry understood what Project Tiger was doing. “Why do we place such an enormous amount of 180-odd crore rupees to care for the tigers?” one senior officer once asked me, out of wide-eyed curiosity and to improve his knowledge on the rationale of governmental spends on plan schemes. What he meant was why must we waste such huge sums feeding tigers – who at times also turn into man-eaters! – when possibly the same money could be better spent on other schemes for the impoverished.
To be fair, he didn’t say exactly that. But I got the drift of his question. I explained to him whatever little I knew. That the tiger is an umbrella species, and as top carnivores they play a crucial role in ordering and preserving landscapes in pristine form in its natural pecking order – thereby maintaining biodiversity. Once you care for the tiger population, other species, including co-predators and preys like smaller carnivores and the varying conglomerate of herbivores in the hierarchy, are taken care of, even down to the habitat and grasslands that herbivores feed off. Tigers in the wild sit atop the food chain, ensuring a bio-eco-balance that sets off a natural cascade among other carnivores (such as leopards), herbivores (like deer, antelopes, wild buffalo) and omnivores (like wild boars), and conserve healthy grassland; it is an evocative symbol of forest protection. Since tigers live in the deep wild, a healthy population of this territorial animal also ensures healthy forests that act as carbon sinks for all living beings on earth.
My words, telescoping vast landscapes with their natural offerings and efficacy on fauna and flora and the planet’s ecosystem to a few bald sentences, would naturally have sounded rather confusing to his disbelieving ears. He veered our conversation off to a different tangent. I wasn’t surprised.

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Image: Sourabh Bharti

The first time I ventured out to explore and understand Project Tiger in October 2013, I chose the Corbett Tiger Reserve (CTR) in Uttarakhand. It was close to Delhi and I could see the variety it offered to understand what Dr. C. R. Babu, Chairman of the Centre for Environmental Management of Degraded Eco-Systems – one of the Ministry’s Centres of Excellence – had earlier retailed to me: his success story in eradicating Lantana grass in Corbett. Satya Prakash Yadav (‘SP’ to me; ‘SPY’ to his batchmates!) accompanied me.
The Corbett Reserve is spread across 1,300 sq. km with the Ramganga River and two of its tributaries – Sonanadi and Pallain – flowing through it. Arriving at Kalagarh, we took the boat to reach Dhikala. During the monsoon, with this area pounded by incessant rain, Dhikala is completely cut off; the only way to get there from Kalagarh is the waterway. It highlighted the perils for the forest staff during the rainy season – these foot soldiers whose commitment and passion makes the difference in the cause of tiger conservation. Little do babus sitting in air conditioned chambers at New Delhi ever appreciate the efforts put in by these unsung frontline personnel when they seek a visit to the tiger reserves for a couple days to de-stress their minds.
A few things stand out in my memory from this visit. One was visiting the E-Surveillance Control Room at Kalagarh. E-surveillance was an innovative idea where 10 watch towers kept a 24/7 vigil over the area within their range through thermal and infra-red cameras. The pilot project, in its first year, seemed to be bearing fruits from the point of view of surveillance and anti-poaching activities. The Corbett Reserve was the designated field site for this pilot project. The southern boundary of the reserve – between Kalagarh and Dhela– abutting agricultural fields and human habitations, was highly porous. Unauthorised human ingress into these areas, as also of elephants and tigers entering human habitations and farmlands, often led to conflicts.
Once the broad parameters of the project were agreed upon, the Binomial team set upon designing the hardware and software. Detailed field surveys and discussions led to further refinements in system requirements and design. Finally, in 2012, e-Eye was born. The system comprised of a series of short range infra-red night vision and long range thermal camera stations, mounted on high towers. The cameras were connected to a central Control Room using WiMAX and remotely operated by authorised personnel. They had powerful zoom capabilities, panning and tilting and working even in adverse weather conditions. Power requirements were met with solar panels deployed at each tower location.

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Image: Sourabh Bharti

When the system finally went online, Corbett managers were pleasantly surprised with the outcome. The network of cameras covered an area of about 300 sq. km, tracking movements of any object over 20 kg body weight, and thus capable of detecting human movements as well as that of wild animals. Any kind of suspicious movement generated alerts, which were forwarded to field stations in the Reserve for appropriate action.
E-Eye also generated some fantastic images of various wild animals doing their own things but, more importantly, helped generate several alerts about human activity. Each of these alerts was responded to at the field level by Rapid Response Teams and periodically verified by senior officials, making sure that the integrity of such information was maintained. This was a direct deterrent on criminal activity. People illegally entering the forests could expect a team of field staff to swoop in on them shortly; it served as a huge psychological barrier for criminals. They were jittery of being tracked down and dealt with. This also boosted the confidence of the field staff. And, soon enough, a criminal with a proven track record in the Reserve area tried to damage one of the camera towers! He was caught on camera vandalising, quickly arrested and dealt with.
With an estimated initial cost of around Rs 3.5 crore, though, E-Eye didn’t come cheap. The hardware also needed periodic maintenance and upgrading, even the software required regular upgrades. This involved additional costs. The results though were very satisfactory, encouraging the NTCA to introduce it in Kaziranga Tiger Reserve where rhino poaching is a daily challenge. E-Eye is an excellent example of how scientific tools can be leveraged to strengthen field level protection. True, it is no substitute for traditional foot patrolling but surely can complement it. The fact that cameras keep a 24/7 vigil, regardless of weather conditions, helped monitor larger areas and deploy scarce human resource more strategically. Further, the system had huge potential for exploitation given the high volume of data it generated. It could monitor potential human-wildlife conflict, as also when elephants and tigers moved outside the reserve, alerting villagers of such movements, and with the Rapid Response teams averting any untoward incidents. E-Eye has opened up possibilities; with its unwavering eye, tigers, elephants, rhinos and other endangered animals can now breathe easy and have a run of their habitat!
(Reproduced from the Indus Dictum, where it was first published)

Tuesday, October 3, 2017

Not Republic Of Fifth Column But Culture Of Transparency

"Will leveraging contemporary technology to bring citizens face to face with governance help?"
By Sudhansu Mohanty

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This article is the final installment in a 3-part series about Ethics in Public Governance by the author, Sudhansu Mohanty.

Pause and run the proposed PPP model through a patient’s/caregiver’s lens. The usual gripe against private hospitals holds: all-round over-invoicing, billowing especially during ICU stays when patients are out-of-bounds for caregivers; blood drawn many times over at the same time, expensive medicines administered on the same day/time that impugns maximum prescribed doses; generic drug not administered even when available and branded ones used instead; wanton diagnostic tests, and a plethora of other glaring incongruence that breaches every known medical ethics and moral vocabulary. Hospitals claiming to touch people’s lives indulge in every possible shenanigan and skullduggery to maximise profit. The list is endless. Healthcare today is a smart industry and health-tourism is the buzzword. “Practice two things in your dealings with disease: either help or do not harm the patient” – a part of the Hippocratic Oath – has evanesced, long forgotten. I feel queasy.
Cut to the chase for poor patients. “There will be no reserved beds or no quota of beds for free services,” says the Niti Aayog. “The State Government can refer as many patients as it can up to the capacity available in the Project facility.” How on earth is that going to happen without funds in the government kitty? In effect, the patients fall back on the PHC – now rendered more decrepit before the other PPP-half – for lesser mortals. Two treatment standards, we’re back to square one – India and Bharat!
Interestingly, on the issue of coronary stents brought out in Part-II of this seriesyesterday, with companies manufacturing coronary stents in India reportedly creating an artificial shortage in market/hospitals in the wake of price capping in February 2017, the Department of Pharmaceuticals (DoP) has, in its order of September 27, 2017, invoked Section 3 (i) of DPCO, 2013 that empowers the Government to “achieve adequate availability and to regulate the distribution of drugs, in case of emergency or in circumstances of urgency or in case of non-commercial use in public interest, direct any manufacturer of any active pharmaceutical ingredient or bulk drug or formulation to increase the production and to sell such active pharmaceutical ingredient or bulk drug to such other manufacturer(s) of formulations and to direct formulators to sell the formulations to institutions, hospitals or any agency as the case may be.”
The DoP has directed the companies manufacturing coronary stents in India to:
  • Maintain production/import/supply of the coronary stents;
  • Submit a weekly report on coronary stents produced and distributed. They will also submit a weekly production plan for the next week to NPPA and DCGI.
The DoP has also empowered NPPA and DCGI to extend these directions to any other producers of coronary stents in India during this three-month period. This order will be valid for three months (except for Absorb Classic BVS and Absorb GT I BVS stents of Abbott Healthcare) and NPPA and DCGI will recommend withdrawal or extension as the case may be, two weeks before the expiry of the period.

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Related: Openness In Judicial And Corporate Governance by Sudhansu Mohanty

Abbott’s (one of the global behemoths in healthcare) Absorb and Absorb Gt1 Bioresorbable Vascular Scaffold (BVS) is another dodgy saga with safety concerns and issues of clinical trial red-flagged by drug regulators across the world, among them the US, EU, Denmark, Japan and Australia, as widely reported in the media. Adding to this in India was their reluctance to comply with NPPA’s price cap order. To quote a Times of India report of early-September 2017: “A few cardiologists in India, closely identified with promoting these stents, had opposed price control of bioresorbable stents, which sold at about Rs 1.9 lakh before the Rs 31,000 cap imposed by the drug pricing authority. In the US, the price was about $1,500 or about Rs 1 lakh and in Europe it was even lower at about 900 Euros. The use of bioresorbable stents in India was more than five times as high as in developed countries, but there has been no investigation into the safety of patients implanted with these devices.”
Two other different, but related, issues suck. Recall the substantial increase in the Mediclaim premium this year over last year’s rate. So, either the citizen pays directly or the government pays courtesy citizen’s taxes. Add the draft pharmaceutical policy by the department of pharmaceuticals now in the works, with focus not on controllingbut on regulating drug prices – quite in line with the Aayog’s proposal to delink the Drug Price Control Order from the National List of Essential Medicines – and you’ll wonder if World Bank’s unseen hand isn’t on an overdrive. Sylvia Karpagam in a recent piece in The Wire has shown the abysmal failure of the PPP model in Rajiv Gandhi Super-Speciality Hospital for tertiary care in Karnataka’s Raichur district and theKaruna Trust for 80 primary healthcare centres across eight States. Intuitively, our Indian healthcare and compassion – a baffling mix of the sublime, the profane and the gratuitous (avarice) – in times of madcap upward material mobility in a consumerist era trumps doctors’ nobility towards patients. Hippocratic Oath is out the window!
My much-harried friend and batch-mate, a Chief District Medical Officer and a subject specialist, works round-the-clock and earns salary that is less than my government pension. Little wonder the rampant absenteeism of government doctors lies in poor remuneration and the urge to indulge in private practice at sufferance of their job responsibility. Couple this with bureaucratic supremacist spirit – a colonial legacy that epitomises our feudal mindset – which belittles their human dignity, and you’ll appreciate their callousness.
The way to go is to incentivise them “commensurate with existing market conditions” (Aayog’s words, not mine!) and create facilities that private entities would with PPP-pinned funds, rid the chalta hai attitude, invoke an arm’s length system to transparently and measurably monitor, and hold them accountable, and watch the changes. I see no reason why, in the same district locale, they’ll bite WB-Aayog’s PPP bait, not the socially-inclined and socially-respectable governments. With doctor’s commissions for diagnostic tests/procedures de-incentivised, the patients will likely be spared the fleecing that many corporate hospitals indulge in today. And compassion will likely coalesce with healthcare; doctors will heal patients – those God’s children on a worldly visit!
This is yet far from complete. For, unsurprisingly, we have lately added another, a fifth estate to our democratic construct not limited to the putative fifth column of immorality and post-truth – beyond the bought-out press, paid news, fake news, advertorial news – that Gauri Lankesh’s death has driven home: ELIMINATION! No need for hyperventilation in entrepôts of raucous cacophony in select TV studios; extirpate the root, so that the voices of such humans are shushed for good. And all this in times of smart histrionics, of bluff and bluster spoken in high octaves! Goebbels sure will be turning and blanching in his grave for his lack of innate smarts! Are we now living in a new Republic of the Fifth Column! Pity the protagonists do not realise ideas are bullet-proof, amenable to traversing time, space and distance – there for keeps!

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Related: Propriety Is Key To Citizen’s Quality Of Life by Sudhansu Mohanty

Academic plagiarism has assumed menacing proportions. The cases are galore – with the list bearing names of many eminences conferred with Padma awards and more. Modesty forbids me from spelling out the names and their tales. But I must state what I, as a member of the UGC-appointed Committee, recently witnessed firsthand: how plagiarism by the former VC of Pondicherry University (subsequently dismissed) has wrought irreparable damage on a university. The malaise is all over. One wonders how much with growing awareness and vigil, plagiarism detection tools like Turnitin and Copyscapes et al, can fix this malaise.
I am inclined to believe (now more or less convinced) that perhaps the deterrence to such potential recklessness lies in tightening governance’s value system. Maybe, an arm’s-length system and an Ombudsman to oversee operations coupled with zero-tolerance to dishonesty and corruption are necessary to bring about ethics in public governance. Yet, given extant obfuscation and opacity, will it be enough to stymie unholy impulses? Will leveraging contemporary technology to bring citizens face to face with governance help? Will such an interface, not ex-ante but ex-post ‘oversight’ governance, aid stakeholders to see for themselves the processes and rationale of decision-making that is already available under Section 4 of the RTI Act, 2005, as proactive disclosure. Never mind the Delhi High Court’s ruling keeping the Attorney General out of the RTI’s purview and the Supreme Court remaining implacably opposed to render itself transparent on personal details of public interest, as evidenced in smothering CIC’s order to part with information under the RTI Act.
Is transparency, then, the answer? Will it help to offer on a platter official document in public domain post-decisions for citizen ombudsman? Will the fear of exposé – disciplinary action and social disapproval for “wrongful acts” – deter unsavory impulses? Possibly, yes; no one likes to be proceeded against; we live on self-respect and dignity amid a 24/7 media. We’ve the technology and we’ve the besetting issue of dishonesty that refuses to die. Sunlight, it seems, is the best and maybe the onlydisinfectant for public acts.
At the cost of sounding presumptuous, I would say en passant that when I took over as the Controller General of Defence Accounts to helm the Department looking after the financial management and internal audit of the entire Government of India defense budget outlay of approx Rs 3.4 lakh crore, I invoked transparency. All relevant official documents, all pesky issues of officers’ placement and spends from taxpayers’ money were uploaded. It was bloodless; but it had a magical effect. Disaffection with placements was eliminated, with the networkers exposed and running for cover; unnecessary, wasteful expenditures were arrested, with everyone privy to ways of the corrupt and the nepotistic; and with each checkmating the other. Alas, once I moved over to the Ministry of Defence, transparency was given a royal heave-ho and opacity granted its pride of honour!
Leveraging technology to invoke openness and transparency is an option – a culture of transparency seems the viable answer to curb corruption in public life. But it is nuanced, multilayered. It’ll need tempering through accountability, an effective check and balance mechanism, an arm’s length system not open to tweaking by any public functionary, not to forget public discussions to rework and re-engineer the entire architecture of governance processes to introduce the moral vocabulary sorely missing in public governance. Be you ever so high, the law is above you, as the 17th century English church man and historian Thomas Fuller would say. It’ll take time but a beginning must be made. Political will is the key. But will that be forthcoming? And I wonder how relevant our experiential existential formula is today: Experience = CL (Capacity to Learn) x DL (Desire to Learn) x No. of years of service!
(Reproduced from Indus Dictum)

Sunday, October 1, 2017

Openness In Judicial And Corporate Governance

"Eminent Indian lawyers view that video recording of the Supreme Court proceedings will help the common man to view justice delivered live, giving full expression to their fundamental right."
By Sudhansu Mohanty

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[… continued from Part-I]
Developments in the last few days though have been very disturbing. Justice Jayant Patel, the senior-most puisne judge of the Karnataka High Court, who ordered CBI probe in the Ishrat Jahan case, has put in his papers in the wake of his transfer to the Allahabad High Court, ostensibly for overlooking him for appointment as Chief Justice of a High Court despite his seniority. Justice Jayant Patel has done the most honorable thing by putting in his papers. A High Court judge for close to 16 years – appointed in December 2001 – the treatment meted out to him is unfortunate. After having acted as the officiating Chief Justice of the Gujarat High Court for 7 months from August 2015 to February 2016, it would have been appropriate to appoint him as a Chief Justice of a High Court. Instead, first he was transferred to the Karnataka High Court in February 2016; and now after being a judge for 17 months in Karnataka High Court and just 10 months away from retirement, he was transferred to the Allahabad High Court. His is quite similar to 1973 and 1977 cases of supersession of Supreme Court judges in the wake of judgments in Keshavananda Bharati (1973) and ADM Jabalpur(1976) cases respectively – the only difference being that the Ishrat Jahan case is not as recent as the earlier two cases vis-à-vis the supersession dates. But memory is long and it pays not to forget! This shall doubtless go down as yet another sad day for the Indian judiciary.
But the appointment procedures were different in the 1970s, when it was entirely in the hands of the executive. Things changed with the introduction of the collegium system. The apex court asserted its primacy in the NJAC case. But to what effect? This one unquestionably is a complete failure of the Supreme Court collegium; it has failed to assert its independence by completely surrendering to the rampaging executive! Can one read any meaning to this? He had directed CBI investigation in the Ishrat Jahan case, and had also monitored it for 6 months and is there anything one can infer? This is more a failure of the higher judiciary (compared to earlier occasions in the 1970s) than as a triumph of the executive. The judiciary buckled, thereby ensuring executive’s supremacy! Rather ominous for the nation and the rule of law.
It is just as well that Dushyant Dave, the respected Senior Advocate in the Supreme Court has come out strongly against the failure of the collegium in the following words:
“Justice Patel’s resignation is a reflection on the vindictiveness of PM Modi and BJP President Amit Shah. It is a sad reflection on the so-called independence of the Collegium which failed him and the judiciary by compromising with the Executive and agreeing to bypass him with juniors being elevated. The conduct of Collegium shows that their words in NJAC judgment are totally hollow.
Justice Patel has come out like a shining star while those who participated in his ouster have come out as small men. I salute Patel J. and extend my warmest wishes for happiness that he deserves which he can only find according to him, outside judiciary. Hope this raises a real debate on functioning of collegium and the injustices perpetrated by it.”
More than 200 lawyers of the Karnataka High Court have signed an open letter to the Chief Justice of India against the transfer and supersession of Justice Patel. They have also decided to strike work on October 4, 2017. Even the Gujarat High Court Advocates Association has passed a resolution to file a petition in Supreme Court challenging the transfer of Justice Patel from the Karnataka High Court to the Allahabad High Court. But what’s going to come off it? Your guess is as good as mine.
In the US, the President nominates and the Senate recommends after elaborate scrutiny by the Senate Judiciary Committee composed of lawmakers from both parties. It’ll be worth emulating the US practice with appropriate changes, which will likely inject transparency in higher judicial appointment. The same method could as well be followed for other constitutional and statutory offices, like CIC/ICs, C&AG, CEC/ECs etc.

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Related: Propriety Is Key To Citizen’s Quality Of Life by Sudhansu Mohanty

Move over to another aspect: Live Streaming of Court proceedings. Strange as it may sound, it is the US Supreme Court Justices who have opposed cameras in the courtrooms. Eminent Indian lawyers though view that video recording of the Supreme Court proceedings will help the common man to view justice delivered live, giving full expression to their fundamental right as guaranteed under Article 19(1)(a). Justice delivered in real-time from the judges’ mouth and not from Twitter! We are a mature democracy. Regardless of whichever part of the “globalville” we live in today, live-streaming will educate an information-hungry nation on issues that affect them intimately. It would mean doorstep delivery of justice, apart from being user-friendly, as we witness history being made in front of our eyes. It would also promote transparency and accountability in the administration of justice and inspire confidence in the judiciary. The cliché of “justice must not only be done but also seen to be done” will ring truer.
Several eminent lawyers opine that “other than criminal cases and family law where the privacy of an accused is compromised or a family dispute is required to be protected by privacy”, all other cases of constitutional importance could be live-streamed. Imagine viewing live the hearings in the Triple Talaq and the Right to Privacy cases. All the more reason since the Lok Sabha and the Rajya Sabha proceedings are streamed live. Recall the much-loved, much-WhatsApped Caught in Providence Chief Judge Frank Caprio, in An Honest Boy: I love this Judge. Imagine the good that tiny clip can do to society. Much like tele-medicine benefiting patients in far-off places, live-streaming of court proceedings will, too.
Look around the corporate world and take one recent issue pertaining to reduction of price of stent in private hospitals. In February 2017, the National Pharmaceutical Pricing Authority (NPPA) had capped the price of bare metal stents at Rs 7,260 per piece, and of drug-eluting and biodegradable stents at Rs 29,600 each. It was slightly increased to Rs 7,400 and Rs 30,180 respectively in March, after adjusting with the latest wholesale price index (WPI). Seven months after the government capped the price of coronary stents, leading to a cut in their price by about Rs 1 lakh, the hospitals are yet to reduce the package cost of an angioplasty – a procedure in which a stent is used to open a narrowed or blocked artery to improve blood flow. Insurance companies say that the expenditure for the procedure hasn’t seen a corresponding drop. Though the overall cost of an angioplasty is said to be cut by Rs 30,000-40,000, in reality the cutback in stent costs has been offset by an increase in the cost of other components for the procedure. How ethical is that? Doubtless, the hospitals need to be more transparent. Hospitals should make a profit, not a king’s ransom. Fair pricing, transparency is the need of the day.
Another correlated issue sucks: Niti Aayog’s recent Three Year Action Agenda, 2017-18 to 2019-20 on Access to Medicines. To say the least, it is disturbing. “A balanced approach towards regulation is needed for achieving the twin objectives of access to effective medicines and a strong pharmaceutical industry,” so says the Agenda document. “There is a trade-off between lower prices on the one hand and quality medicine and discovery of breakthrough drugs on the other. It is therefore recommended that the Drug Price Control Order may be delinked from the National List of Essential Medicines.”
The Prime Minister and the Health Minister speak in one voice to reduce cost of medicines and plugging for generic drugs as the Niti Aayog speaks in another nuanced voice! Essential medicines, says the WHO are “those drugs that satisfy the healthcare needs of the majority of the population; they should therefore be available at all times in adequate amounts and in appropriate dosage forms, at a price the community can afford”. While the National List of Essential Medicines (NLEM) is a list of essential medicines in India prepared by the Ministry of Health & Family Welfare, the Drug Price Control Orders (DPCO) are issued by the Government under section 3 of the Essential Commodities Act, 1955, to enable the Government to put a ceiling price for such essential life saving medicines and ensure that these medicines are available at a reasonable price to the general public.

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Related: Oblong Arm of the Law by Sudhansu Mohanty

That said, it might sound paradoxical to say that while generic drugs should be the order of the day, in today’s India few generic drugs pass the quality test. The 1980s and 1990s was a time of the generic drug “robber barons” thanks to poor laws and populist aspirations of the then governments bent on low drug prices sans quality of drugs. Little wonder India, though placed 4th in global generic drug market, has earned the ignominy of manufacturing 75 percent of world’s counterfeit generic drugs, soaring high above Egypt with 7 percent and China with 6 percent.
To be fair, the government indeed has, in April 2017, made changes to the Drug and Cosmetics Act of 1940, making it mandatory for genetic drug manufacturers to submit Bioequivalence (BE)/Bioavailability (BA) study reports for approval as against the earlier practice of merely submitting the BE/BA reports for genetics of patented drugs in the first 4 years of introduction. Nothing more is asked of them, thus making it a field day for genetic drugs to flood the market. Once in an indigo moon the finished drug was submitted for testing at the Central Drugs Standard Control Organization (CDSCO). Little wonder barely that 0.01% of the genetic drugs in the Indian market are tested for its potency and efficacy. So the amendment to the Drugs and Cosmetics Act (1940) is a welcome development. But the issue now is one of regulation and implementation. Anyone who has worked in the government knows its innards. The system is so apathetic and opaque that a complaint of poor/inadequate potency will keep meandering about in the corridors of government Bhavans; the callousness of our Brother Babus is phenomenal!
There can be no two views that the need is to increase the number of test labs all over the country in government medical colleges, increase the number of pharmacists/pharmacologists, put a strict testing process in place, and go transparent with test results by uploading them in public domain. Any complaint from a consumer must be attended to with a sense of immediacy and the same too put out on the website. But will the government bite such “dangerous” transparency that will jeopardise big pharma companies’ interest? I doubt if this will happen. To expect the government to seed a billion Lokpals to oversee is a pipedream! We are then back to square one despite the recent amendment to the Drug and Cosmetics Act.
Large pharmaceutical companies invest huge money in developing a new drug; the amount could be more than US$ 2-3 billion. Naturally they will like to get return on investment – through patent and royalty. India too seeks big bang R&D in drugs, and Indian firms are interested. Perhaps that explains why the government is speaking with a forked tongue: while the PM and his Ministers speak about mandating generics, the Niti Aayog suggests “a trade-off”!
The Niti Aayog’s recent proposal to introduce the Private-Public Partnership model in select district hospitals only fortifies this suspicion. Some commentators view it “as ill-designed, driven by ideology more than welfare and a strange hybrid that has no precedent anywhere in the world, calling it strategic, bizarre or hare-brained”. The Aayog justifies space to private hospitals in “select district hospitals to private players through a transparent, competitive PPP framework for the treatment of non-communicable diseases (NCDs) by harping on failings of our publicly provided health services”, pointing at Gorakhpur tragedy. Rampant absenteeism of doctors – varying from 28 percent to 68 percent across different states – the Aayog cites copiously to show that government doctors contribute less effort vis-à-vis their private counterparts and they prefer to pontificate: Long-term measures to restructure the MCI are on anvil (Pray, who will? Remember Ketan Desai!); and observe that District hospitals will provide basic services for diagnosis and treatment of NCDs “at affordable rates or free of cost for those patients for whom the government chooses to cover” through insurance or budgetary grants. The public exchequer will pick up the insurance and reimbursement tab. How generous!
[…to be continued]
(Reproduced from the Indus Dictum)

Saturday, September 30, 2017

Propriety Is Key To Citizen’s Quality Of Life

"Serious governance deficit in Indian public policy is now a byword."
By Sudhansu Mohanty

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Today perhaps we live in the most vexing time since independence – in a societal mindset where nothing seems to work normally; where ordinary activities that shouldbe done ordinarily as a matter of routine, never get done. So seldom are such occurrences of ordinary work that when they do actually happen on those chance occasions, they truly appear extraordinary – even surreal! So rare is the issue of honesty in public life that even when we come across an honest (but inept and inefficient) government official, we applaud him for his honesty. “He’s but an honest man!” we chime incredulously. As though he’s not supposed to be honest! As though that’s what the Conduct Rules prescribe for public servants! Such, sadly, is the depth and conviction of our collective social moral depravity!
As a democracy governed by the Constitution, the rule of law with separation of powerand checks and balances and with four columns: executive, legislature, judiciary, and the media, each with its assigned role, as also to checkmate abuse of power and transgression of bounds by other columns, the dynamic action should have held to maintain social equilibrium while ensuring change and progress. What then has gone wrong?
Peel off the epidermis and see the hypodermis. The so-called dynamic action has morphed to dynamic inaction. James Boren, tongue-in-cheek once said: “When in doubt, mumble; when in trouble, delegate; when in charge, ponder. A good bureaucrat is one who cuts the red tape length-wise!” To it, add Robert Klitgaard’s formulaic solution to corruption: C(orruption) = M(onopoly) + D(iscretion) – A(ccountability). Let me wrap my ideas around these two formulae.
Serious governance deficit in Indian public policy is now a byword. Lack of transparency, age-old Indian tradition of promoting family/clan/sub-national loyalty, culture of materialism that’s gotten more pronounced with economic liberalisation in a globalised world, and the urge to get-rich-fast, are the ingrained basis for all distorted priorities. Ethics is at the heart of the problem.
A peek at the psychology and compulsions of the early man, and it’ll tell us that the raison d’être of the social compact has been smothered – in the schematic social contract versus individual aspirations construct – and individual aspirations have triumphed. True, human aspirations and ingenuity have, from time to time, trumped compacts/contracts/rules; in short, regulations have failed the smothering primordial human urge to self-aggrandise. Are there lessons to learn here?
I wouldn’t know. The world has seriously changed with the internet highway and information technology, but I clearly see the vestiges of the past still colonising, even perpetuating most public acts. If I can’t still get over the shock of what, in my bureaucratic diapers in 1982, I’d seen – of how white ants ate away roadrollers or how cyclones were “manufactured” in the trans-Himalayan belt to score off inventories! – today I see variants of the same syndrome in new-fangled avatars. It’s as though we’re twiddling contemporary technologies with feudal habits!

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RelatedPush For National Integration? by Tuktuk Ghosh

Corruption, though, is not mere financial. As damaging as financial malfeasance is intellectual dishonesty, manifested in policy-making shrouded in official records. While financial misgivings are palpable, intellectual dishonesty – covert and subterranean – haemorrhages soundlessly till fixed; it skews and wrinkles public morality. The damage is incalculable. The clutch of scams and mega-scams that struck India circa 2008-12 evanesced citizen’s monk-like forbearance. Loss of taxpayers’ money apart, it showed how scams billowed to skew developmental agenda.
Propriety – financial and intellectual – is a key determinant of citizen’s quality of life. It encompasses legislation, governance, healthcare, education, commerce and business, agriculture and rural development, the justice system etc. Yet, the architecture of rule of law designed to fasten the order, often fails squelching unholy human impulses. Human nature – possessive, hedonistic, self-interested – has often trumped regulations. With the dishonest networked across professions, the countervailing institutions have failed, swaying to interest groups’ agenda. The people’s movement against corruption in 2011 for creation of Lokpal turned out a false dawn. Was it because the four pillars of democracy – executive, legislature, judiciary, and media – didn’t wish to disturb the applecart? How does such mindset affect governance?
Even 26 years post-liberalisation, the Indian rural folks still look up to government intervention for poverty alleviation. Governments hold the fund and welfare entities for the poor. For a feudal society with traditional bespoke mindset, state patronage remains the Holy Grail for majority aspirations. Nor are most men in the four organs of governance immune to quid pro quo: bought-out press and paid news; post-retirement sinecures; rewards and gratifications, are just a few examples. Socio-financial iniquities have burgeoned; unrest – born off a growing educated young middle class finding it hard to navigate opaque archaic government procedures and a corrupt officialdom in day-to-day living – leveraging technology and social media bristles asking moral questions: Doesn’t it diminish human beings? Doesn’t it breach basic human dignity?
The malaise is all-pervasive. In a way it’s natural, for regardless of profession, men are cut from the same societal cloth with symptoms of the same ecosystem. Look at the role of legislature and judiciary: Haven’t they been hubristic and for the highbrow as is often alleged, granting preferential treatment to the networked and the connected? How has the Supreme Court played its part in dispensing justice? Have judges transcended society’s feudal mindset? A host of recent cases come to mind: highway liquor ban, contempt notice to a former Supreme Court judge, national anthem case, judges seeking post-retirement employ, the delayed hearing in the Aadhaar case, to cite a few.
Restraint, rather self-restraint, is the authentic signifier of a mature institution. Absence of restraint even in the face of palpable injustice or manifest illegalities can corrode public confidence. The judiciary will do well to realise this. The rippling effect it creates in terms of revenue loss or employment as in the highway liquor ban case is simply beyond their ken to evaluate. The hubris of power to grant complete justice isn’t par for the course. Else, the very fabric of separation of power, one of the basic tenets of the Constitution, will be cast aside. For the protector of the Constitution, it is tantamount to the fence eating the crop!

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RelatedRidding Bureaucracy Of Deadwood by Julio Ribeiro

As one columnist wrote, “The judge’s role, in any version of constitutional democracy, is to be a gatekeeper of constitutional boundaries, an ever-vigilant defender of rights, not to author more restrictions on civil liberties… If this is the role judges seek for themselves, then they must make themselves accountable under judicial review. The immunity from judicial review under Article 13 is to reserve the interpretive authority of the court, given the inevitability of disagreement emerging over its interpretations, not to shield episodes of absurd judicial law-making.” Have they then been the Caesar’s wife? How does the judiciary morally explain its dueling with the executive on appointment of judges through an opaque “collegiate system” when the Constitution consciously divvies responsibility between the two to avoid monopoly of either and grant fairness to selection? How fair is that? Does it pass muster of disinterested observers and provide oxygen to public faith?
In an interesting piece in The New Yorker, Evan Osnos refers to an article “On the intersection of health and politics” published in Brain, the British medical journal in February, 2009, titled Hubris Syndrome: An Acquired Personality Disorder? One of the authors was David Owen, former British Foreign Secretary, also a physician-neuroscientist; the authors propose creation of a psychiatric disorder for leaders who exhibited “impetuosity, a refusal to listen to or take advice and a particular form of incompetence when impulsivity, recklessness and frequent inattention to detail predominate.”This seems to hold good across professions, across nations.
Historically, the United States has relied greatly on checks and balances and freedom of expression including dissent. Senator John McCain, the Republican who ran for president against Barack Obama in 2008, reinforced this tradition when he wrote in the Washington Post:
“We must respect [President Donald Trump’s] authority and constitutional responsibilities. We must, where we can, cooperate with him. But we are not his subordinates. We don’t answer to him. We answer to the American people. We must be diligent in discharging our responsibility to serve as a check on his power. And we should value our identity as members of Congress more than our partisan affiliation.”
Sardar Vallabhai Patel once said: “Today my secretary can write a note opposed to my views. I have given that freedom to all my secretaries. I have told them: ‘If you do not give your honest opinion, then please you had better go’.” True protocol prescribes hierarchies, and offices carry authority. Yet the separation of powers, the rule of law, and the equal value of human beings are fundamental principles of the Indian state, notwithstanding what we often run into in real life. This makes it important when officers and judges demonstrate loyalty to the Constitution and respect for the citizen’s fundamental rights! Justice H. R. Khanna perhaps is more well-known today for his dissent in the ADM Jabalpur case than any of his contemporaneous CJIs!

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RelatedOblong Arm of the Law by Sudhansu Mohanty

Move over and see the mode of appointment of judges in higher judiciary, which has been the subject of much debate, not to forget the NJAC case. Not too well-known though is Justice Chelameswar’s letter to the earlier CJI put out in public domain in end-August 2017 – of how successive CJIs had “treated members of the collegium as supplicants” and how ‘informal meeting’ has transformed into a collegium meeting to nominate judges to the higher courts. To wit: “It is the law of this land that no meeting can be convened without a proper notice and an agenda, be it a meeting of a panchayat board or a cooperative society or a company or other bodies, statutory or constitutional. If you (Justice Khehar) believed these collegium meetings are beyond all principles of law propounded by their court, God save this country.
“If these discussions across the coffee table are to be treated by you as meetings of collegium where important decisions in discharge of the obligations arising from the Constitution are to be taken, I feel sad for this country. But I am of the view that such a procedure falls short of the legal requirements of a meeting. I believe collegium meetings are too solemn events to be conducted so casually.”
He inter alia writes in his 12-page letter that members of the collegium “are not participants in the decision making process but supplicants” making requests to the Chief Justice. “With great respect, I must tell you that it is not so. The judgment in the second judges’ case is the law declared by this court even today. It obliges the CJI to consult his collegium, either two or four, as the case may be depending upon the purpose of the consultation. Each participant is entitled to make suggestion and objection to the proposals. It is only after an appropriate discussion any final decision could be taken – not on personal requests of members of collegium and grace of the CJI… It is this understanding of the successive CJIs that the puisne judges (senior-most judges) who are members of the collegium (for that matter even others) are lesser mortals which creates all those problems which we are going through. Chief Justice is nothing more than first among equals. The other consulate judges, whether they are members of the collegium or beyond the collegium, are equal participants in the decision-making process, entitled to make suggestions and ask for information.”
Also responding to the CJI’s veiled threat to remove him from the collegium, Justice Chelameswar was categorical that the CJI wasn’t constitutionally empowered to do so. “I do not have to cite any authority for that. The second judges’ case not only obliges the CJI to consult the members of the collegium, it also obliges the CJI to consult in certain circumstances those judges of this court who are outside the collegium but well versed with the affairs of a particular HC as and when any decision regarding that HC is to be taken.” And, on the ex-CJI’s threat to expand the collegium, he wrote, “Membership of the collegium is fixed by a constitution bench of nine judges of this court and clarified by the third judges’ case. I am astounded to know that the CJI believes that such a position could be altered by a mere administrative decision. Such an authority was denied even to Parliament by the judgment of this court in NJAC case (a five-judge bench headed by Justice Khehar had by majority struck down NJAC).” Further that if any recommendations were forwarded by the collegium without his comments and if the government acted on it, “they would be utterly unconstitutional.”
[…to be continued]
(Reproduced from Indus Dictum where it was published on Sept 30, 2017)