Needed, a resilient health care system
Why in News
- The pandemic has shown investments are required in the areas of critical care, emergencies and primary health care.
Healthcare Systemin India
- The second surge of Covid-19 in India has indeed been ferocious, brought untold misery to numerous, overwhelmed the healthcare system and affected every aspect of our daily lives.
- The COVID -19 Pandemic showed that India needs to invest wisely in ensuring a resilient health system that will serve us well in normal times and during times of disaster.
Resilient Health System
- A resilient health system is that which has ability to prepare for/learn from shocks, one that is enduring and has equity as a central principle, is comprehensive, and addresses the whole spectrum of health-care needs: preventive, promotive, primary, secondary and tertiary.
- Central and state governments, civil society, the private sector, academics and researchers must come together immediately and develop a long-term vision as well as time-bound plans to ensure adequate investments in infrastructure, human resources, information systems, procurement and supply chains for medicines and diagnostics, health security, and mutually beneficial ways to share best practices and resources for capacity building.
- The policy commitment to spend 2.5% of GDP on health by 2025 should be met and we need to aspire for a five per cent spend by 2030, with two-thirds being committed to primary health care.
- A key guiding principle in making investments is that no individual in this country should face financial hardship in accessing care, be it by way of access or use of services.
- The pandemic has shown investments are required in meeting the needs for critical care and emergencies, and in strengthening primary health care.
Investments vital
- This is the time to invest in improving health literacy and emphasizing the value of preventive and promotive health, including underscoring the value of multi-sectoral convergence, by enhancing allocations in health-related sectors such as nutrition, drinking water, sanitation, housing and transport.
- Greatest strength of nation is health workforce. Their selfless service during the pandemic has kept us afloat. However, there are shortages and their distribution is skewed.
- This is the time to take advantage of recent legislation pertaining to reforms in medical education and allied health professions and leverage the numerous institutions created in the public and private sectors for pre-service and in-service training by developing and enforcing standards of education.
- Our human resource investments must recognise the invaluable role of our frontline workers, and ensure adequate remuneration and dignified working conditions.
- There’s a need to invest in high quality information systems to provide us with actionable data in real time that serves the needs of service providers, programme managers and policymakers.
- An integrated alert system with animal husbandry, agriculture and environment has to be developed. Digital health tools must have safeguards to address date security and privacy concerns.
- India has a rich resource in non-governmental organisations: in service delivery, advocacy, community education, relief and rehabilitation, NGOs have played an important role. The government needs to facilitate their functioning.
- The private, for-profit sector must collectively reflect on its role in the pandemic and develop robust internal mechanisms to be seen as a reliable, credible partner. A well-regulated private sector with transparent and clear rules of operation would complement the health system, particularly in the delivery of secondary and tertiary care.
- Primary health care and essential public health functions should be publicly funded. The government must play its stewardship role of setting standards and ensuring adherence in the public and private sectors.
- The pandemic has shown that health is everybody’s concern. The role of communities in resilient health systems is paramount. They need to be central to decision-making and be involved in planning and monitoring.
- Community collectives and local government institutions need to be nurtured and strengthened. Mechanisms of social audit of health care institutions to ensure accountability must also be strengthened.
- Government medical and public health research and training departments and institutions need clarification of their mandates and changes in their institutional functioning. The pandemic has shown that their role is critical.
- Recent initiatives in the health sector have already set the stage. Ayushman Bharat and health insurance/assurance under PMJAY are a step towards universal health coverage; 22 new AIIMS and 157 new medical colleges sanctioned recently need to completed quickly.
- The e-Sanjivini experience, the tele-learning and the tele-conferencing platform need to be expanded.
- The reformative legislation of National Medical Education Act and the National Commission of Allied Health Professionals Act need careful implementation to reap long-term benefits.
- The learnings from the pandemic experience need now to be incorporated in both policy and practice.
GS PAPER – III
Ending encryption
Why in News
- Recently, the WhatsApp moved to the Delhi High Court against the Information Technology (Intermediary Guidelines and Digital Media Ethics Code) Rules 2021 came into force.
- The WhatsApp moved the Delhi High Court against the specific rule that mandates a “significant social media intermediary providing services primarily in the nature of messaging shall enable the identification of the first originator of the information on its computer resource as may be required by a judicial order”.
Information Technology (Intermediary Guidelines and Digital Media Ethics Code) Rules 2021
- The Information Technology (Intermediary Guidelines and Digital Media Ethics Code) Rules, 2021 were notified on February 25, 2021 under the Ministry of Electronics and Information Technology.
- The Information Technology (Intermediary Guidelines and Digital Media Ethics Code) Rules 2021 has been framed in exercise of powers under section 87 (2) of the Information Technology Act, 2000.
- It supersedes the earlier Information Technology (Intermediary Guidelines) Rules 2011.
Salient features of new IT Rules
- Due Diligence to Be Followed by Intermediaries:
- In case, due diligence is not followed by the intermediary, safe harbour provisions will not apply to them.
- Section 79 of the IT Act provides safe harbour protection to the intermediaries for any kind of third-party content.
- Grievance Redressal Mechanism:
- There is a provision to establish a grievance redressal mechanism for receiving resolving complaints from the users or victims.
- Intermediaries shall appoint a Grievance Officer to deal with such complaints and share the name and contact details of such officer.
- Grievance Officer shall acknowledge the complaint within 24 hours and resolve it within fifteen days from its receipt.
- Ensuring Online Safety and Dignity of Users, Especially Women Users:
- Intermediaries shall remove or disable access withing 24 hours of receipt of complaints of contents that exposes the private areas of individuals, show such individuals in full or partial nudity or in sexual act or is in the nature of impersonation including morphed images etc.
- Such a complaint can be filed either by the individual or by any other person on his/her behalf.
- Two Categories of Social Media Intermediaries:
- The Rules also make a distinction between social media intermediaries and significant social media intermediaries which will be based on the number of users on the social media platform.
- The Rules require the significant social media intermediaries to follow certain additional due diligence.
- Additional Due Diligence to Be Followed by Significant Social Media Intermediary:
- Appointment:
- Chief Compliance Officer,
- Nodal Contact Person for 24×7 coordination with law enforcement agencies,
- Resident Grievance Officer who shall perform the functions mentioned under Grievance Redressal Mechanism.
- Monthly compliance report: A monthly compliance report should be publish mentioning the details of complaints received and action taken on the complaints as well as details of contents removed proactively by the significant social media intermediary.
- Physical contact address: Significant social media intermediary shall have a physical contact address in India published on its website or mobile app or both.
- Voluntary User Verification Mechanism: Users who wish to verify their accounts voluntarily shall be provided an appropriate mechanism to verify their accounts and provided with demonstrable and visible mark of verification.
- Giving Users an Opportunity to Be Heard: In cases where significant social media intermediaries remove or disables access to any information on their own accord, then a prior intimation for the same shall be communicated to the user who has shared that information with a notice explaining the grounds and reasons for such action.
- Removal of Unlawful Information:
- An intermediary upon receiving actual knowledge in the form of an order by a court or being notified by the Appropriate Govt. or its agencies through authorized officer should not host or publish any information which is prohibited under any law in relation to the interest of the sovereignty and integrity of India, public order, friendly relations with foreign countries etc.
Disadvantages of Act
- Given the specification that a “significant social media intermediary” is one with more than 50 lakh registered users, WhatsApp’s messenger service would clearly be affected.
- WhatsApp’s contention is that for compliance and traceability, it would have to break its end-to-end encryption service that allows messages to be read only by the sender and the receiver.
- Its argument is that the encryption feature allows for privacy protections and breaking it would mean a violation of privacy. The question to be asked is whether the traceability guidelines (by breaking encryption) are vital to law enforcement in cases of harmful content.
- A release by the Ministry of Electronics and IT has said that the traceability measure will be used by law enforcement as the “last resort” and will come by only in specific situations, such as “for the purposes of prevention, detection, investigation, prosecution or punishment of an offence related to the sovereignty and integrity of India or child sexual abuse material, punishable with imprisonment.
- The assertion suggests that this requirement is in line with the Puttaswamy judgment that clarified that any restriction to the right of privacy must be necessary, proportionate and include safeguards against abuse.
- But the Government, as the law stands now, can already seek access to encrypted data under Section 69(3) of the IT Act, and Rules 17 and 13 of the 2009 Surveillance Rules that require intermediaries to assist with decryption when they have the technical ability to do so and when law enforcement has no other alternative.
- Besides, it can still seek unencrypted data, metadata and digital trails from intermediaries such as WhatsApp.
- The trouble with enforcing traceability is that without safeguards such as having any independent or judicial oversight, government agencies could seek any user’s identity on vague grounds and this could compromise the anonymity of whistleblowers and journalistic sources, who can claim to be acting in the public interest.
- WhatsApp’s contention that “requiring messaging apps to ‘trace’ chats is the equivalent of asking us to keep a fingerprint of every single message sent and fundamentally undermines right to privacy” is, therefore, not hyperbole.
- If anything, the Government needs to revisit its position on traceability commitments of intermediaries and instead revise the IT Act, 2000 in line with existing global best practices besides legislating the long pending Data Protection Bill.