Society & Social justice

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E-Cigarettes and the Rising Health Risks

Context: According to WHO’s first global estimate of e-cigarette use (2024), teenagers are nine times more likely to vape than adults, raising major public health concerns worldwide.

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About E-Cigarettes:

  • E-cigarettes are battery-operated devices that heat a liquid into an inhalable aerosol.
  • The liquid typically contains nicotine, propylene glycol, glycerin, flavouring agents, and other chemicals.
  • Known as vape pens, ENDS (Electronic Nicotine Delivery Systems), or ENNDS (Electronic Non-Nicotine Delivery Systems).
  • Though they may not contain tobacco, they often deliver addictive nicotine doses similar to conventional cigarettes.

WHO’s Key Findings (2024):

  • 15 million teenagers (13–15 yrs) use e-cigarettes globally.
  • Youth are 9× more likely to vape than adults.
  • Total vapers: over 100 million, including 86 million adults (mostly in high-income nations).
  • Tobacco use declined from 1.38 billion (2000) → 1.2 billion (2024).
  • Regional trends:
    • Southeast Asia: Male tobacco use fell from 70% → 37% (2000–2024).
    • Europe: Now the highest tobacco prevalence (24.1%) globally.

Legal Framework in India:

The Prohibition of Electronic Cigarettes Act, 2019

  • Complete Ban: Prohibits production, import, export, transport, sale, distribution, storage, and advertisement of e-cigarettes.
  • Penalties:
    • Manufacture/sale/advertisement → Imprisonment up to 1 year or ₹1 lakh fine (first offence); up to 3 years or ₹5 lakh (repeat offence).
    • Storage → Up to 6 months jail or ₹50,000 fine.
  • Exemption: Permitted only for research and testing purposes.

Implementation Challenges in India:

  • Online Accessibility: Over 60% of e-cigarette products remain available on e-commerce platforms (Voluntary Health Association of India, 2023).
  • Youth Appeal: Flavoured variants and influencer marketing target adolescents.
  • Lack of Support Systems: Only 1 in 5 tobacco users has access to quitting support or therapy (GATS 2022).
  • Product Evasion: New disposable or flavoured devices enter India through unregulated channels.

Way Forward:

Digital Surveillance: Deploy AI-based systems to monitor illegal online sales (like the EU’s Track & Trace model).

Youth Awareness: Launch anti-vaping campaigns under the National Tobacco Control Programme (NTCP)—similar to New Zealand’s Vape-Free Schools.
Quit Support Expansion: Strengthen helplines like mCessation, which has helped over 3 million users attempt quitting.

Inter-Agency Coordination: Form a Nicotine Product Enforcement Task Force involving MoHFW, IT Ministry, and Customs.

Health Ministry Advisory on Cough Syrups for Children

Context: The Directorate General of Health Services (DGHS) under the Ministry of Health and Family Welfare has issued a fresh advisory to all States and Union Territories on the rational use of cough syrups in children. The move comes after reports of child deaths in Rajasthan and Madhya Pradesh, allegedly linked to syrups containing Dextromethorphan.

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About Dextromethorphan

  • Dextromethorphan (DXM) is a cough suppressant used in many over-the-counter syrups.
  • It acts on the brain’s cough centre to reduce coughing but can cause serious side effects in children — such as drowsiness, breathing difficulty, and accidental overdose.
  • Long-term effects on the developing brain remain unclear, making it unsafe for paediatric use.

Key Guidelines Issued by DGHS

  • Avoid Routine Use: Most coughs in children are self-limiting and do not require medication.
  • Age Restriction: Cough syrups must not be prescribed for children below two years.
  • Clinical Evaluation: For older children, use only after proper medical evaluation — with accurate dosage and for the shortest possible duration.
  • Avoid Polypharmacy: Syrups containing multiple drug combinations should be avoided.
  • Non-Drug Remedies: Encourage hydration, steam inhalation, and rest as safer alternatives.
  • Pharma Compliance: Manufacturers must strictly follow Good Manufacturing Practices (GMP) and use pharmaceutical-grade excipients.

Contamination and Safety Investigations

  • The Health Ministry clarified that syrups linked to the incidents were free from diethylene glycol (DEG) and ethylene glycol (EG) — two highly toxic industrial chemicals responsible for several global poisoning incidents.
  • In Rajasthan, the formulation in question contained Dextromethorphan, which is not recommended for children under national and WHO safety standards.

Chemical Toxicity Explained

  • Diethylene Glycol (DEG): Used in antifreeze; causes kidney failure, neurological damage, and death.
  • Ethylene Glycol (EG): Another toxic antifreeze component that leads to acute kidney injury if ingested.

Significance

  • Reinforces paediatric drug safety and the need for rational prescription practices.
  • Aims to prevent avoidable child fatalities from inappropriate or contaminated medicines.
  • Strengthens pharmaceutical quality control and public health accountability.

Conclusion:

The DGHS advisory highlights India’s growing vigilance in paediatric pharmacovigilance. Rational use of medicines, strict enforcement of safety standards, and public awareness are key to protecting children from preventable drug-related tragedies.

PM E-DRIVE Scheme: Boosting India’s EV Transition

Context: The Ministry of Heavy Industries (MHI) has released operational guidelines for the PM E-DRIVE (Electric Drive Revolution in Innovative Vehicle Enhancement) scheme, a flagship initiative to accelerate India’s electric mobility transition.

About PM E-DRIVE Scheme

Launched in October 2024, the scheme has a financial outlay of ₹10,900 crore and is effective till March 2026, with certain components extended till March 2028. It builds on earlier initiatives such as FAME-I and FAME-II, but with a larger budget and broader scope.

Objectives

  • Promote adoption of electric 2-wheelers, 3-wheelers, ambulances, trucks, and buses.
  • Support public transport electrification to enhance mass mobility.
  • Establish a robust EV charging infrastructure across the country.
  • Encourage domestic EV manufacturing through a Phased Manufacturing Programme (PMP).
  • Reduce vehicular emissions and improve air quality, aligning with Aatmanirbhar Bharat.

Key Components

  1. Demand Incentives/Subsidies:
    • Upfront subsidies for purchase of EVs.
    • Capped at 15% of ex-factory price or fixed limits for eligible categories.
  2. Grants for Capital Assets:
    • Acquisition of e-buses and expansion of charging infrastructure.
    • Upgradation of testing facilities under MHI.
  3. Public Charging Stations:
    • Nearly 72,300 charging stations to be deployed with an outlay of ₹2,000 crore.
    • BHEL as the nodal agency for demand aggregation and a Unified EV Super App for real-time tracking and payments.
  4. Governance Mechanism:
    • Implementation through Project Implementation & Sanctioning Committee (PISC) chaired by Secretary, MHI.
    • Periodic review of incentives, charging infrastructure, and EV uptake.
  5. State-Level Incentives:
    • Road tax waivers, toll exemptions, and reduced parking fees encouraged.

Significance

  • Strengthens EV supply chain and boosts domestic manufacturing.
  • Supports India’s climate commitments under the Paris Agreement.
  • Helps reduce dependence on fossil fuels and enhances energy security.
  • Encourages private sector participation through Viability Gap Funding (VGF).

Queer Couples’ Rights in India 

Context: Recently, a same-sex couple moved the Bombay High Court challenging the discriminatory levy of gift tax under the Income Tax Act.

Relevance of the Topic : Mains: Evolution of Rights of Transgenders/ Queer Couples’ and related issues. 

Under the Income Tax Act, no such tax on gifts is levied on heterosexual couples. No such exemption exists for queer couples, which violates Articles 14 and Article 15 of the Constitution.

The case highlights the persistent problem of how to operationalise queer rights recognised in court verdicts and government advisories without a legal framework of relationship recognition.

Who are Queer Couples?

  • Queer couples are partners where one or both identify as lesbian, gay, bisexual, transgender, or other non-heteronormative identities.
  • Such couples do not fall within the conventional legal framework of marriage in India, as the marriage laws (like the Hindu Marriage Act, 1955 or Special Marriage Act, 1954) recognise only heterosexual unions.
  • They may cohabit, share financial and emotional responsibilities, and live as families, but the state does not currently grant them the same legal status and protections as heterosexual couples.

Evolution of Queer Rights in India: 

  • Navtej Singh Johar v. Union of India (2018): The SC decriminalised consensual same-sex relations by striking down Section 377 of the Indian Penal Code.
  • Deepika Singh v. Central Administrative Tribunal (2022): The SC expanded the definition of family beyond marital ties to include non-traditional households. ​​The legal understanding of “family” may include manifestations like queer families as well as single parents.
  • Supriya Chakraborty v. Union of India (2023): The SC upheld the validity of the Special Marriage Act, 1954, and held that the right to marry is not a fundamental right for queer persons. There is no unqualified fundamental right to marry under the Constitution. But it unanimously recognised that queer persons have the right to relationship, cohabitation, and choice of partner. The SC also directed the Union Government to set up a Cabinet Secretary-led committee to identify entitlements of queer couples in the absence of marriage recognition.

Right To Marry in India:

  • As per Article 21 of Indian Constitution, Marriage is an element of the Right to Life. Article 21 guarantees the Right to Marry the person of one's choice.
  • For Queers: The government has already acknowledged the right to love, right to cohabit, right to choose one’s partner, right to one’s sexual orientation as fundamental rights under Article 21.

Policy Measures after the 2023 Verdict

  • The Department of Food and Public Distribution issued an advisory directing states to treat queer partners as members of the same household for ration cards.
  • The Department of Financial Services issued an advisory clarifying that queer persons can open joint bank accounts and nominate their partners.
  • The Ministry of Health and Family Welfare issued guidelines prohibiting discrimination in hospitals and allowing queer partners to claim the body of a deceased partner.

These measures are steps forward, but they remain limited to advisories and face challenges in practical implementation.

Challenges in Realising Queer Rights: 

  • Even if courts or government issue favourable orders, queer couples require a recognised mechanism to prove that they are in a partnership.
  • Departments and authorities lack a uniform way to identify queer couples who should receive entitlements.
  • Without a recognised proof of association, advisories and court verdicts risk remaining ineffective in practice.

The Bombay High Court admitted the petition of the same-sex couple challenging discriminatory taxation of gifts. A favourable ruling could extend equality in tax treatment to queer couples. However, implementation of such a verdict will still require a credible method to verify who qualifies as a partner in a queer relationship.

The Deed of Familial Association (DoFA) as a Possible Solution

  • In 2023, Justice N. Anand Venkatesh of the Madras High Court suggested that the Tamil Nadu government should consider recognising a Deed of Familial Association (DoFA).
  • A DoFA would allow queer partners to submit affidavits of their free will to a District Magistrate or other authorised officer to register their association.
  • The issuance of a DoFA would give official proof of a queer relationship that could be presented before departments or institutions.
  • It could help operationalise court orders, advisories, and government circulars by creating a uniform recognition of queer partnerships.

Such a mechanism would reduce arbitrariness, help protect rights, and ensure that entitlements already granted are actually accessible.

Also Read: Embracing Diversity: Paving the Way for Transgender Inclusivity and Equality 

Denial of Land Inheritance Rights to Tribal Women

Context: The Supreme Court’s judgment in Ram Charan vs Sukhram (July 2025) held that excluding daughters from ancestral property violates the fundamental right to equality. This has brought tribal women’s inheritance rights into sharp focus.

Relevance of the Topic: Mains: Issues faced by Women: Land Inheritance Rights 

Land Inheritance Rights of Tribal Women: 

  • Tribals in Scheduled Areas are governed by their customary laws in matters of marriage, succession and adoption. 
  • Despite women contributing more in farms than the men, none of the tribal customary laws prevalent in the Scheduled Five Area States give land inheritance rights to females in ancestral properties. 
  • The consequence is stark landlessness among women. As per the Agriculture Census 2015-16, only 16.7% of Scheduled Tribe women possess land compared to 83.3% of men. 

Reasons for Denial of Land Inheritance Rights to Tribal Women: 

  • Fear of Land Alienation: The belief that if tribal women marry outside their community, inherited land may pass into non-tribal hands.
  • Communitarian Nature of Tribal Land: Tribal land is often perceived as communitarian property, where individual ownership is discouraged, and this argument is used to justify women’s exclusion.

The idea of codifying gender-equal inheritance laws for tribal communities has had a contentious history. The opposing argument is that replacing tribal customs with codified laws would undermine tribal identity. However, it perpetuates systemic gender discrimination and economic marginalisation of women.

Problems with Customary Exclusion: 

  • Denial of land rights undermines women’s economic independence and entrenches cycles of poverty and dependence.
  • It perpetuates patriarchal control over resources and denies women equal status within families and communities.
  • The communitarian ownership argument fails in practice, as proceeds from land sales or acquisitions rarely benefit the village community, instead accruing to male members.
  • Violation of fundamental rights: Denial of inheritance rights violates fundamental rights.
    • Article 14 guarantees equality before law.
    • Article 15 prohibits discrimination on the grounds of sex. 
    • Article 21 guarantee of dignity is compromised when women are deprived of property and economic security.
  • It also contradicts constitutional morality, which demands that customs and traditions must conform to the principles of equality and justice. 

Judicial Interventions: 

  • Madhu Kishwar vs State of Bihar (1996), the SC refrained from striking down tribal succession customs, fearing disruption of settled traditions.
  • Prabha Minz vs Martha Ekka (2022): Jharkhand High Court ruled in favour of Oraon women, and upheld the right of females on inheritance, despite being barred by customary law.
  • Kamala Neti vs Special Land Acquisition Officer (2022): The SC held that a woman belonging to a Scheduled Tribe (ST) is entitled to an equal share in inherited tribal land. The SC urged the Central Government to amend Section 2(2) of the Hindu Succession Act, 1956 which expressly exempts tribal women from the scope of the Act. 
  • Ram Charan case (2025), the SC held that excluding daughters from ancestral property violates the fundamental right to equality.

Way Forward

  • Codify Tribal Succession Act that ensures equal inheritance rights for women while being sensitive to tribal socio-cultural contexts. Codification of succession laws on the lines of Hindu and Christian laws would harmonise customary autonomy with constitutional equality.
  • Greater awareness and sensitisation within tribal communities to counter fears of land alienation and to highlight the role of women as equal stakeholders.
  • Continued judicial scrutiny to ensure that customs failing the test of reasonableness and public policy are struck down.

Empowering tribal women through property rights is essential not only for gender justice but also for achieving inclusive tribal development and social justice.

Mental Health is a Fundamental Right: SC

Context: In July 2025, the Supreme Court of India in a landmark verdict ruled that mental health is an integral part of the Right to Life under Article 21 of the Indian Constitution. The Court also issued 15 strong guidelines for schools and coaching centres to protect student well-being. 

Relevance of the Topic:Prelims: Key Provisions of Mental Healthcare Act 2017. Mains: Mental Healthcare in India: Challenges, Govt. Initiatives & Way Forward. 

Mental health is more than the absence of mental illnesses. It is the foundation for the well-being and effective functioning of individuals. It includes mental well-being, prevention of mental disorders, treatment and rehabilitation.

Mental Health is a Fundamental Right: 

  • The Supreme Court in the Sukdeb Saha vs the State of Andhra Pradesh (2025) judgement explicitly recognised mental health as an integral component of the constitutional Right to Life under Article 21.
  • This interpretation significantly broadens the scope of Article 21 to encompass psychological well-being, extending beyond mere physical survival. 
  • The judgment laid down binding guidelines (Saha Guidelines) for educational institutions and coaching centers across India. They aim to establish a preventive, remedial, and supportive framework for mental health protection and prevention of suicides by students. 

Saha Guidelines: 

The SC has ordered a package of binding interim orders referred to as Saha Guidelines for educational institutions and coaching centers across India. 

  • Schools, colleges, hostels and coaching institutes are required to proactively develop support systems to address the issue of mental health. 
  • The SC has directed all States and Union Territories to notify rules within two months for registering private coaching centres and enforcing these guidelines. 
  • District-level monitoring committees, chaired by District Magistrates, have been tasked to oversee compliance and handle complaints. 
  • Until Parliament passes a full code, these guidelines will have legislative force.

Significance of the ruling: 

  • Placing psychological integrity in Article 21 means that the Court has opened up room for these victims (suicide victims) to be heard and safeguarded. 
  • It opens the door for restorative measures i.e., counselling, reform in institutions, mechanisms of accountability that go beyond retribution to prevention.
  • It will strengthen the implementation of the Mental Healthcare Act, 2017. The Act enshrines the right to receive mental health care in India.  

Key Provisions of Mental Healthcare Act 2017

The Act provides the legal framework for providing services to protect, promote and fulfil the rights of people with mental illnesses. The Act is in line with the United Nations Convention on the Rights of People with Disabilities (UNCRPD).

  • The Act guarantees mental health services for all. The government is responsible for creating opportunities to access less restrictive options for community living such as halfway homes, sheltered accommodations, rehab homes, and supported accommodations.
  • It decriminalised the attempt to suicide which hitherto was criminal offence under section 309 of Indian Penal Code, and mandates care instead of punishment.
  • It provided for the concept of ‘Advanced directive’, i.e. a person (suffering from mental illness) shall have the right to specify the manner in which he/she wishes to be treated or not to be treated. The person shall have the right to nominate representatives to take decisions on their behalf regarding treatment. 
  • All States are required to establish a State Mental Health Authority and Mental Health Review Boards (MHRB) bodies that can further draft standards for mental healthcare institutes, oversee their functioning and ensure they comply with the Act. 

WHO’s data on Mental Health

As per the recent data from the World Health Organisation: 

  • More than 1 billion people globally are living with mental health disorders (including anxiety and depression). 
  • Mental health conditions affect people of all ages and income levels, and are the second leading cause of long-term disability, contributing to loss of healthy life. 
  • The prevalence of mental health disorders can vary by sex, and women are disproportionately impacted. 
  • Depression and anxiety alone cost the global economy an estimated $1 trillion each year.
  • Progress made in reducing suicide mortality is quite low (only 12% reduction achieved) to meet the United Nations Sustainable Development Goal (SDG) of a one -third reduction in suicide rates by 2030. 

Challenges: 

  • India has a significant shortfall of mental health professionals, with roughly 0.7 psychiatrists per 100,000 people, far below the WHO’s recommended ratio of 3 per 100,000 people.
  • Systemic neglect of mental health and stigma and reluctance to seek help.  
  • Inadequate funding for community-based programmes and the effective utilisation of funds. E.g., India’s direct mental health budget has remained at roughly ₹1,000 crore in recent fiscal years.
  • Inconsistent implementation of the Mental Healthcare Act 2017. 

Way Forward

  • Active policy interventions and resource allocation by the government. 
  • Measures to train and sensitise the community/society to reduce the stigma around mental health.
  • Awareness to educate society about mental diseases as done by Accredited Social Health Activist (ASHA) by the Ministry of Health and Family Welfare.
  • Steps to connect the patients with each other by forming a peer network, so that they could listen and support each other.
  • People experiencing mental health problems should get the same access to safe and effective care as those with physical health problems.
  • Telemedicine and digital health platforms can extend the reach of mental health services, particularly in areas with a shortage of mental health professionals.

Also Read: Bridging Health Cover: Mental Healthcare in India 

Transforming mental health services is one of the most pressing public health challenges. However, the national tele-mental health programme has expanded, educational development and awareness programmes are happening at an advanced pace. 

Women’s Economic Empowerment Index

Context: India aspires to become a $30 trillion economy by 2047, but women who constitute nearly half the population contribute only 18% to the GDP. Their invisibility in data makes gender-disaggregated data crucial for inclusive growth.

Relevance of the topic:

Prelims: Gender budgeting, WEE Index (Uttar Pradesh)

Mains: Role of gender data in inclusive growth, governance reforms, women’s economic empowerment.

Almost 196 million employable women in India are outside the workforce. The biggest barrier to women’s economic empowerment is not merely the lack of opportunities but their invisibility in data. Without gender-disaggregated data their participation gaps across education, skilling, employment, and entrepreneurship will remain stalled. 

Women’s Economic Empowerment Index: 

  • The WEE Index was recently launched by Uttar Pradesh. It aims to track the impact of government schemes on women's economic participation across all 75 districts of the state.
  • It is India’s first district-level tool to track women’s participation across five economic levers:
    • Employment
    • Education and skilling
    • Entrepreneurship
    • Livelihood and mobility
    • Safety and inclusive infrastructure
  • The index shifts focus from participation numbers to structural barriers that limit women’s empowerment. E.g., Data showed women dominate skilling enrolments but remain very low in entrepreneurship due to poor access to credit. 

Why Gender Data is Needed?

  • Inclusive Growth: Inclusive economic growth cannot occur if half the population remains invisible in policy datasets. Gender-disaggregated data ensures women’s contribution is measured, valued, and integrated into growth strategies.
  • Making Gaps Visible: Without a gender lens, existing indices on health, economy, and infrastructure mask inequities. Data reveals critical drop-off points such as high female dropout rates after Class 12 and post-graduation, or the gap between skilling enrolment and entrepreneurship.
  • Catalyst for Reforms: Visibility of inequities prompts departments to act. E.g., In Uttar Pradesh, data on low female representation among bus drivers and conductors, led to new recruitment strategies and women-friendly infrastructure such as women’s restrooms in bus terminals.
  • Shifting beyond Participation Rates: Gender data helps track retention, leadership roles, re-entry into work, and quality of employment, not just surface-level participation. It highlights systemic barriers such as limited access to credit for women entrepreneurs despite high skilling enrolments.
  • To improve Gender Budgeting: Gender budgeting is often confined to welfare schemes or finance departments. True gender budgeting requires applying a gender lens to every rupee spent in sectors like education, infrastructure, energy, and housing, and this is only possible if robust gender-disaggregated data exists.
  • Guiding Policy and Investment: Data makes it possible to design district-wise gender action plans, guiding budget allocations and infrastructure priorities.

A robust framework such as the WEE Index can be replicated and scaled in other states as well. It can help the states translate intent into implementation: turning data into district-wise gender action plans that guide budget allocations, infrastructure priorities and programmatic reforms.

Also Read: Budgeting for a gender-inclusive ‘Viksit Bharat’ 

New GST Reforms in the Healthcare Sector

Context: India’s recently rationalised the Goods and Services Tax (GST) structure. Among other sectors, GST reforms were announced in the Healthcare segment. The reforms mark a turning point in the journey towards achieving universal health coverage. 

Relevance of the Topic: Mains: Issues relating to development and management of services relating to Health. 

GST Reforms in the Healthcare Sector

  • Rationale: To make medical care more affordable and accessible for millions, especially for individuals struggling with high costs of treatment or health products.

Key Highlights of GST Reforms in the Healthcare Sector: 

  • Removal of GST on Insurance:
    • Complete removal of GST on individual health and life insurance premiums. Earlier, an 18% GST rate was applied to the health insurance premiums.
    • The reform covers all types of individual life insurance: Term, Unit Linked Insurance Plan (ULIP), Endowment, health insurance plans such as family floaters and senior citizen policies. Even reinsurance is included. 
  • GST cut on Medicines:
    • GST on most medicines is lowered to 5%, and tax on life-saving drugs is cut to zero. This simplifies compliance and lowers prices in supply chains for health product manufacturers and service providers. 
  • GST cut on Medical Devices: 
    • Medical devices and diagnostic kits are now largely under a uniform 5% GST slab, from 12% GST or 18% GST earlier. E.g., CT scan machines are now taxed at only 5% compared to 18% earlier. This reduces the procurement costs of devices and would potentially lower patient charges over time. 
    • Common services such as blood tests, X-rays, and MRIs at laboratories may also become a little cheaper. 
  • GST exempt on Critical Care Units (unchanged):
    • All critical care units i.e., Intensive Coronary Care Unit (ICU), Critical Care Unit (CCU), Intensive Coronary Care Unit (ICCU), and Neonatal Intensive Care Unit (NICU) are fully exempt from GST regardless of cost. This ensures that lifesaving care remains tax-free. 
    • Non-intensive care unit (ICU) rooms above ₹5,000 per day would attract 5% GST without input tax credit. 
  • GST exempt on Core Medical Services (unchanged):
    • Core medical services provided by hospitals, doctors, and paramedics remain GST-exempt, keeping treatment itself untaxed.
  • Push towards Preventive Healthcare: 
    • GST on gymnasiums, fitness centres, yoga studios, salons, barbers and wellness services is down from 18% to 5%. 
    • Cigarettes remain heavily taxed at 28% GST plus compensation cess, which adds up to an effective tax of between 52% and 88%. 
    • A new 40% sin goods slab has been announced but will only apply once cess liabilities are cleared. 
    • Sugary drinks (whether aerated, sweetened, or flavoured) have been moved to the new 40% slab, up from 28% plus cess, to discourage consumption. 

Significance: 

  • Increase insurance coverage: Insurance coverage in India is only ~3.7% of GDP at present, compared to a global average of 6.8%. However, clear monitoring is required to ensure insurance providers pass on the GST benefit to the consumers.  
  • Reduce OOPE: Share of Out-of-Pocket Expenditure (OOPE) in Total Health Expenditure was around 47% in FY20. Cutting costs for life-saving medicines, simplifying taxes on equipment, and lowering rates on preventive services supports the entire health-care chain and would reduce OOPE. 

Also Read: Universal Health Coverage (UHC) 

Himachal Pradesh declared a Fully Literate State

Context: In September 2025, Himachal Pradesh was declared ‘fully literate’. It became the fifth state/UT in India to achieve this milestone after Goa, Ladakh, Mizoram, and Tripura.

Relevance of the Topic: Prelims: Government initiatives/schemes to promote literacy; State of literacy in India. 

What does Fully Literate Mean?

  • The Ministry of Education defines literacy as the ability to read, write, and compute with comprehension i.e., to identify, understand, interpret and create, along with critical life skills such as digital literacy, financial literacy etc. 
  • A state/UT is considered “fully literate” once it achieves 95% literacy.
  • Himachal Pradesh has achieved a literacy rate of 99.3%, qualifying it for the tag.

The declaration is part of the ULLAS (Understanding Lifelong Learning for All in Society) programme launched in 2022 to achieve 100% literacy by 2030.

What is the ULLAS Programme? 

  • ULLAS (Understanding Lifelong Learning for All in Society) is a literacy programme for people over 15 years of age who may not have attended school.
  • It was launched in 2022 with the aim of achieving 100% literacy by 2030, which is one the 17 Sustainable Development Goals of the United Nations.
  • The program is also in line with the National Education Policy (NEP) 2020 which calls for adult education initiatives to achieve 100% literacy.

How does someone attain literacy?

  • Under the ULLAS program, adult learners are taught basic reading, writing, and math (arithmetic like addition, subtraction, multiplication, and division) that a child in school would learn up to class 3.
  • They are also taught how to read and measure time, make sense of calendars, use currency notes, write cheques, and safely make digital transactions.
  • This training is provided either through a mobile App or offline, by students or community volunteers.
  • After that, the Functional Literacy Numeracy Assessment Test (FLNAT), a 150-mark reading, writing and numeracy test, is administered in a person’s chosen language.
  • On passing the test, the learner is certified by the National Institute of Open Schooling (NIOS) as having acquired foundational literacy and numeracy

To learn who requires training under the ULLAS program, states conduct door-to-door surveys, or rely on other data. Those identified as not being literate are given requisite training and administered the FLNAT.

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State of Literacy in India

  • Census 2011: 
    • In the 2011 Census, any person aged 7 years and above who could read and write with understanding in any language was considered literate.
    • As per this Census, the literacy rate among women was 64.6%, while among men it was 80.9%.
    • The Census also measured adult literacy, defined for those aged 15 years and above, and found the national figure to be 69.3%. 
  • National Sample Survey (NSS) 71st round:
    • The National Sample Survey (NSS) 71st round (January-June 2014) showed an adult literacy rate of 71% for India.
  • Periodic Labour Force Survey (PLFS) 2023-24: 
    • PLFS 2023-24 reported a national literacy rate of 77.5% for the population aged 7 years and above.
    • As per PLFS, 22.3% of people in India aged 15 and above were not literate.
    • Among the states and UTs, the highest proportion of illiterate adults was in Bihar (33.1%), followed by Andhra Pradesh (31.5%) and Madhya Pradesh.

Need for Separate Enumeration of Particularly Vulnerable Tribal Groups

Context: The Ministry of Tribal Affairs (MoTA) has requested the Registrar General and Census Commissioner of India (RGI) to consider enumerating particularly vulnerable tribal groups (PVTGs) separately in the upcoming Census. 

Relevance of the Topic:Prelims: Key facts about Particularly Vulnerable Tribal Groups. Mains: Challenges faced by PVTGs & significance of Separate Enumeration. 

Particularly Vulnerable Tribal Groups

  • PVTGs are a sub-category of Scheduled Tribes (STs) created based on the recommendations of the Dhebar Commission (1960-61) which had investigated the various issues faced by STs, and in consultation with state governments. 
  • The Commission identified the disparity in socio-economic and living conditions between different tribal groups, and said that some tribal groups were more vulnerable than others. They are characterised by:
    • either a declining or stagnant population
    • geographical isolation
    • use of pre-agrarian practices (such as hunting and gathering)
    • economic backwardness
    • relatively low literacy 
  • 75 PTVGs have been identified across the country, spread over 18 states and 1 Union Territory (Andaman & Nicobar). Among the 75 listed PVTGs, the highest number are found in Odisha (13), followed by Andhra Pradesh (12).

Challenges Faced by PVTGs: 

  • Outdated List: Baseline survey has not been conducted in States and UT’s which is impacting the implementation of welfare programmes designed for PVTGs. Moreover, regular census does not comprehensively capture data of PVTGs. The criteria for identifying PVTGs is questionable, especially the marker of geographical isolation. 
  • Land Alienation: A mounting pressure from external groups who seize their lands for various purposes such as mining, industrialisation, and other uses, leading to the displacement and forfeiture of traditional livelihoods for numerous PVTGs. 
  • Lack of Access to basic services: Due to a dearth of infrastructure and resources in their remote regions, as well as discriminatory and neglectful treatment by government officials, PVTGs frequently encounter impediments to obtaining basic amenities such as healthcare, education, and clean water.
  • Exploitation: PVTGs are often subject to exploitation and discrimination by more powerful groups, including non-tribal populations and the government. They are often denied their rights to resources, participation in decision-making processes, and representation in government bodies.
  • Socio-Cultural: PVTGs have a unique culture and way of life, but they are increasingly under threat of assimilation into mainstream society. This is due to factors like education, urbanisation, and migration, which can erode traditional knowledge and practices.  Impact of
  • Climate Change: PVTGs are particularly vulnerable to the effects of climate change, which can impact their livelihoods and access to natural resources. This includes changes in rainfall patterns, rising temperatures, and increased frequency of natural disasters like floods and droughts. 

Way Forward

  • Conducting a Baseline Survey: A comprehensive survey should be conducted to identify PVTGs living in different parts of the country to capture critical information about PVTGs, such as their population size, geographical location, economic conditions, social and cultural practices, and access to basic amenities like health care, education, and livelihood opportunities.
  • Developing a Vulnerability Index: A vulnerability index should be developed for each PVTG based on factors such as health, education, livelihood, and social protection, among others. It will enable policymakers to tailor interventions that are targeted and effective.
  • Rights-based Approach: Suitable measures should be taken for protection and promotion of their rights (especially to their land rights and customary habitats). Strict controls need to be imposed so that no development can take place on PVTGs land and habitats without their free, prior, and informed consent.
  • Livelihood strategies: Development of livelihood strategies for PVTGs should factor in their often nomadic lifestyle and their unique skills and indigenous knowledge. Focus should be on conservation and enhancement of their traditional skills. E.g., Todas in dairy and horticulture. 
  • Governance: There is a need to develop a comprehensive framework to assist the PVTGs in a manner that empowers them to determine their own development path at their own pace. 
  • Service Delivery: Service providers need to be well incentivised to perform their duties and remain stationed in the areas where PVTGs reside. Residential clusters should be created where government officials of different categories and different departments can be accommodated.
  • Accountability Mechanism for officials: Ensure the accountability of government officials working in the areas of PVTGs. 

Significance of Separate Enumeration of PVTGs

PVTGs have never been enumerated separately in any census, till date. 

  • Separate Enumeration of PVTGs would accurately capture the number of PVTG households, individuals, and their distinctive demographic, cultural and socio-economic features, and issues. 
  • Such information would help in the better implementation of targeted schemes for PVTGs, such as the Pradhan Mantri Janjati Adivasi Nyay Maha Abhiyan (PM JANMAN), and other government schemes, especially in health and education. It will help in understanding if the PVTG classification criteria is still relevant.

Also Read: Tribal Welfare Outreach Campaign Launched Across 500+ Districts in India 

NIRF India Rankings 2025 

Context: Recently, the Ministry of Education has announced the NIRF India rankings 2025. NIRF India rankings 2025 covered 7692 institutions (the highest ever) across 17 categories including a newly added Sustainable Development Goals (SDG) category. 

Relevance of the Topic:Prelims: Key facts about NIRF Rankings 2025.  

National Institutional Ranking Framework

  • The National Institutional Ranking Framework (NIRF) is an annual ranking framework to rank various educational institutions across the country since 2016.
  • Released by: Ministry of Education 
  • Categories: NIRF ranks different educational institutes in the 17 categories: Engineering; Management; Pharmacy; Law; Medical; Dental; Architecture and Planning; Agriculture and allied sectors; Colleges; University; Research; Innovation; Overall; Open Universities; Skill Universities; State Public Universities; Sustainable Development Goals. 
  • Institutions are evaluated based on five key parameters: Teaching, learning, and resources (30%), research and professional practice (30%), graduation outcomes (20%), outreach and inclusivity (10%), and peer perception (10%). 

Key Highlights of NIRF India Rankings 2025: 

  • Indian Institute of Technology Madras retains its 1st position in Overall Category for the seventh consecutive year, and in Engineering for tenth consecutive year.
  • University: Indian Institute of Science, Bengaluru 
  • Management: IIM Ahmedabad 
  • Medical: All India Institute of Medical Sciences (AIIMS), New Delhi 
  • Colleges: Hindu College 
  • Law: National Law School of India University, Bengaluru.
  • Indian Institute of Technology Madras tops the Sustainable Development Goals (SDGs) category introduced for the first time in 2025. 
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Associated Challenges:  

  • Risk of False Data: While the rankings claim to rely on verifiable metrics and third-party audits of research, it depends heavily on bibliometric data and self-declared inputs from institutions. 
  • Peer Perception Parameter: It is the feedback gathered from subject experts and employers. It can be subjective and prone to influence and prejudice, as it relies more on an institution’s reputation than its actual reputability. This can be often to the disadvantage of suburban or State-run higher education institutions. As it accounts for 10% of the total weight, it can skew the rankings.
  • Outreach and Inclusivity Parameter (OI): The NIRF focuses only on outcomes related to regional and gender diversity. It conspicuously omits data on students who are economically and socially disadvantaged and with disabilities, despite these factors each having a 20% weightage within the OI component. 

Sickle Cell Anaemia and the battle for Disability Justice

Context: In 2024, the Indian government issued revised guidelines under the Rights of Persons with Disabilities (RPWD) Act, 2016. These guidelines provide a framework for assessing the extent of disability of people with two copies of the sickle cell gene, or with both sickle cell and beta thalassaemia, or Hb D.

Relevance of the topic:

Prelims: Key facts about Sickle Cell Anaemia; Rights to Persons with Disabilities Act 2016.

Mains: Issues in the Rights of Persons with Disabilities (RPWD) Act, 2016.

The RPWD Act 2016 marked a step towards protecting the rights of persons with disabilities, and promoting their full inclusion in society. The law aligns with the UN Convention on the Rights of Persons with Disabilities and promises dignity, equality, and non-discrimination. 

About Rights to Persons with Disabilities Act, 2016

  • The Act defines persons with disabilities as a person with physical, intellectual, or sensory impairment which, in interaction with barriers, hinders his full and effective participation in society equally with others. 
  • Types of disabilities covered under the Act are increased from 7 to 21. It includes various physical and mental disabilities like acid attack victims, dwarfism and Autism Spectrum Disorder.
  • Persons with benchmark disabilities are entitled to free school education up to 18 years of age, reservations in higher educational institutions, development assistance programmes, and government employment.
  • Reservation: It mandates a 4% reservation in public employment and 5% reservation in educational institutions for PwD. 
  • The Act mandates both public and private institutions to make infrastructure accessible and provide ICT consumer products for PwD.

Sickle Cell Anaemia

  • It is an inherited or genetic blood disorder that affects haemoglobin, the protein in Red Blood Cells (RBCs) that carries oxygen to all parts of the body.
  • Healthy RBCs are soft and round. In SCD, the haemoglobin is abnormal, which causes the RBCs to become hard and sticky and look like a sickle.
  • These rigid, sticky cells die early and often get stuck in blood vessels, clogging the flow of blood. As a result, different parts of the body do not get the oxygen they need. This can cause pain and other serious health problems such as infection, acute chest syndrome and stroke. 
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Treatment: 

  • It is a lifelong illness. The only cure comes in the form of gene therapy and stem cell transplants, however, both are costly and still in developmental stages. 
  • Sickle Cell Anaemia Elimination Mission (2023) aims to eliminate sickle cell disease as a public health problem by 2047. 

Sickle cell disease (SCD) is a painful, progressive, and disabling blood disorder, disproportionately affecting marginalised communities like Tribals. 

Narrow lens of disability in Rights of Persons with Disabilities Act 2016

  • Not-inclusive: The Act extends reservations in public sector employment under the 4% quota for persons with vision and hearing loss, locomotor disabilities, and intellectual disabilities.  However, individuals with SCD and other blood disorders are not included in the quota.
  • Subjectivity in benchmark disability: The benchmark disability under the Act must meet a certain threshold of impairment, specifically 40% or more. However, different hospitals, medical boards, and doctors can assign different disability percentages to the same person, depending on their personal judgment.
  • Certification bottlenecks: A medical authority, including chief medical officer, evaluates and certifies disability. Diagnosis reports of confirmatory tests must be from a government or standard lab. The certification process can be largely inaccessible for Adivasi and Dalit patients in rural or remote areas. 

Way Forward

  • Extending job reservations to individuals with SCD and related blood disorders would acknowledge their condition as a significant, lifelong disability. 
  • Reforming the certification process to account for fluctuating and invisible disabilities would reflect a rights-based lens rather than a purely biomedical one.
  • Improve Accessibility: Mobile medical units in tribal and rural areas for on-site certification and treatment.

Disability is not only shaped by physical health, but also by social exclusion, structural barriers, and policy gaps. The continual reliance on biomedical scoring and exclusion of people with SCD from full protections undermines the very purpose of recognising the condition under the Act. 

Unless India’s recognition of SCD brings real rights and protections, it risks becoming exclusion disguised as inclusion. 

Also Read: The Rights of Persons with Disabilities Act, 2016 remains only a legal document without intense sensitisation of government functionaries and citizens regarding disability. Comment.