UPSC, GS-2, MAINS, PRELIMS, GEOPOLITICS, HEALTHCARE, CURRENT AFFAIRES

INDIA AND GLOBAL , ASIAN GEOPOLITICS IN 2025 AND AHEAD [GS-2]

• Q. It is among the leading nations in the world when it comes to economic growth and political stability. 
• Q. India today projects an atmosphere of peace, which is seemingly out of place in a world that is undergoing a profound shift in its economic and geo-political landscape. 
• Q.  India is today privy to the rise of new economic and political groupings. 
•  Q. The year 2024 was a period of pronounced political uncertainty across the globe. Much of the world was a mute witness to the multiple and concurrent conflicts that threaten peace and stability today. 
• Q. The year 2025 seems poised to bring in a host of fresh troubles that will require deft handling on the part of India’s policymakers.
• Q.  be wise for India’s leaders to heed the message contained in an ancient Chinese saying that says ‘the wind sweeping through the tower heralds a rising storm in the mountain’.

• 1.  Europe and West Asia. 
•   Gaza, with the ongoing Ukraine conflict contains the seeds of a much wider conflict in the future. 
• India has, however, managed to steer itself successfully within this geo-political landscape.   

• 2. India’s largest neighbour, China.
•  Much is being made of the recent border negotiations and an apparent disengagement at the Line of Actual Control in Ladakh. 
• This was followed by the first formal meeting between Prime Minister Narendra Modi and China’s President Xi Jinping meeting in five years, as well as the resumption of the Special Representatives’ talks on border issues.
•  however,  disengagement does not mean ‘dispute resolution’. 
• The border conflict still remains alive and unchanged. Far more needs to be done to reach any kind of détente. India, hence, cannot afford to ‘take its eye off the ball’. 
• China has, taken a series of steps to strengthen security cooperation with nations of the Global South, which are aimed at outflanking India.
•  In September 2024, China and African nations jointly agreed to progress the China-sponsored Global Security Initiative (GSI) and deepen cooperation in areas such as counter terrorism, disaster management and public health.
•  China took full advantage of the absence of the Indian Prime Minister during the Shanghai Cooperation Organisation Summit held in Pakistan in October. 
•  at the Summit  china  muted India’s voice at a forum that is perceived as being anti-West. 
• Mr. Xi again took full advantage of the Asia Pacific Economic Cooperation Summit, in Peru in November, to strengthen ties with ‘traditional enemy- Japan , 
• Japanese Prime Minister Shigeru Ishiba has agreed with Mr. Xi to promote a ‘mutually beneficial relationship ...based on common strategic interests’. 

•  The churn in South and West Asia It is in India’s traditional area of influence, viz., South Asia, 
• after the ouster of the Sheikh Hasina regime in Bangladesh as to whether India indeed has a proper ‘neighbourhood policy’. 
• Today, India appears almost isolated in the region and with the eclipse of Ms. Hasina and the emergence of a caretaker regime (which is openly hostile to India), India appears friendless. 
•  Both Nepal and Sri Lanka today appear to look like ‘fair weather friends’
• Maldives stands, is indeed a subject to debate. 
• Pakistan has always been inimical to India, and 
• Afghanistan today does not seem to figure prominently in India’s calculations. 
• Bhutan, under the present King, does not display the same warmth towards India, appearing more intent on balancing relations with China. 

•  Far more problematic impact of the current churn in West Asia, 
• The ouster of the Assad regime in Syria 
•  How India deals with the situation resulting from the collapse of the erstwhile Bashar al-Assad regime, and the takeover of the reins by a Sunni group. the ‘Hayat Tahir al Shams (HTS)’ is unclear. 
• Its leader, who carried the nom-de-guerre Abu Mohammed al Julani, - reverted to his real name, Ahmed Hussain al Sharaa. 
• The HTS leader was previously linked to al Qaeda, and even briefly flirted with the Islamic State (ISIS),
•  The HTS was able to wage a successful offensive against the Assad regime largely because it could identify with the Sunni majority in Syria, 
•  Assad regime - become more reliant on Russia and Iran to maintain its hold over the country. 
• From India’s viewpoint, the Assad family (belonging to Syria’s Alawite group, a minority sect of Shia Islam) was initially viewed as a stabilising force in the Gulf region, in the wake of the Arab Spring.
•  India, home to a Shia and Sunni population, had greatly welcomed this. 
• More recently, many of these perceptions had altered.
•  One by one, elements of the so-called ‘axis of resistance’ are being dismantled.
• 
  
•  Israel, despite its progrom in Gaza, seems to be gaining the upper hand in West Asia.
•  Iran has been a loser — and it might well result in Iran’s influence across West Asia declining. 
• It may also no longer be the same revolutionary force in West Asia, that it was perceived to be following the 1979 revolution in Iran.
•  The Ayatollahs in Iran are also set to face a major setback, and a major churn in Iran cannot be ruled out. 
• The Shia world as a whole would be the overall loser, and militias such as the Hezbollah could well be cut to size. 
•  the pro-Palestine movement would be adversely affected and Palestine may not persist as a live issue.
•  Global jihad could also face a death blow. 

•  The biggest gainers will in all likelihood be Israel and Türkiye. 
• Russia’s influence has suffered with the fall of the Assad regime. 
• But given Russia’s relations with Türkiye’s strongman, Recep Tayyip Erdoğan, and the pragmatic approach taken by Russian President Vladimir Putin, Russia could well retrieve the situation.
•   digital threat  notwithstanding the developments in the geo-political arena,-  is set to achieve a quantum leap during 2025. 
• The situation warrants careful assessment and sending out of a dire warning about the dangers present in the digital arena. 
• Some of this was evident during the latter part of 2024, but this is likely to grow exponentially during 2025. Convergence among technologies is threatening national infrastructure in a manner that had never previously been envisaged. According to data available with Agencies, there was a dramatic rise in cyber attacks occurring in India in the recent period. 
• Almost all major companies and Government institutions were hit by denial of service and ransomware attack
•  All this is set to increase in geometrical progression during 2025 and the following years

HMPV

•  Five years after the SARS-CoV-2 virus over whelmed hospitals in Wuhan, China, acute respiratory diseases caused by viruses including the human metapneumovirus (HMPV) in children and the elderly, and influenza and respiratory syncytial virus (RSV), are increasing in the country, especially in its northern provinces. 
• However, the sharp rise in acute respiratory diseases is not unusual during this time of the year, and as per a Chinese official, the overall number of cases in 2024 would be “smaller” than in 2023. 
• Surprisingly, while the World Health Orgation and the U.S. Centers for Disease Control and Prevention have not raised a red flag so far and there is almost nil reporting in the inter national media, 
• the Indian media is awash with reports of an HMPV “outbreak” in China. 
• A recent meeting of the Joint Monitoring Group un der the aegis of the Union Health Ministry noted that the situation in China is “not unusual in view of the ongoing flu season”, and the “usual pathogens that are expected during the season” are causing the present surge in respiratory diseases. 
•  The HMPV virus was first identified in children in 2001 in the Netherlands. 
• Infection with HMPV usually occurs by the age of five years with reinfection occurring throughout life as immune protection induced by the virus is too weak to prevent repeated infections. 
• The virus causes upper and/or lower respiratory tract infections, with lower respiratory tract infections being among the most common. 
• While the virus often causes only mild disease, it can lead to severe illness requiring hospitalisation in children, immunocompromised populations and the elderly.
•  Globally, 3%-10% of hospital admissions and 1% of acute lower respiratory infection-related deaths in children under age five in 2018 are attributed to HMPV, as per a 2021 paper. 
• The study al so found that children younger than six months, especially those in low- and lower-middle-income countries, are at greater risk of death caused by the HMPV virus. 
• Detection of a large number of HMPV cases among children aged less than 14 years in China is a reflection of the heightened surveillance and testing for the virus. 
• On the contrary, India does not have any approved inexpensive tests that are widely available for diagnosing the virus. 
• When testing for HMPV in patients with acute respiratory disease should be routine, as the virus has been in circulation for years globally, including India, and fatality is 1% in young children, India is only now expanding the number of laboratories testing for HMPV beyond the Indian Council of Medical Research (ICMR) network due to the spike in HMPV cases in China. 
• What is also urgently needed is a regulatory framework that facilitates a rapid approval of diagnostic tests in the context of local and global outbreaks of novel and less known pathogens

INDIA  NEEDS TO PRIORITISE PREVENTIVE CARE

• India is facing a healthcare crisis that is growing both in scope and cost. 

• We face an alarming dichotomy today: while life expectancy of Indians is expected to increase further, many are facing disease burden earlier. 

• As the country sees an alarming rise in non-communicable diseases (NCDs) such as heart disease, stroke, diabetes, and cancer, the financial burden on individuals and the healthcare system continues to escalate. 
•  NCDs accounted for about 65% of all deaths in 2022, up from about 50% in 2010-13, as per the National Family Health Survey-5. 
•  The prevalence of risk factors for NCDs is worryingly high. One in four adult men are hypertensive. 
•  One in eight are diabetic. 
• Further, breast, lung, and cervical cancer are on the rise, with the median age of diagnosis occurring earlier than global averages.
•  Millions of people who are facing these conditions could have been managed better, at often lower costs, had they been diagnosed earlier.
•  In this context, shifting the focus from reactive treatment to proactive prevention is crucial, 
•  to improve health outcomes 
• to control the ever-increasing healthcare expenses. 
•  A growing economic burden The Union Budget for 2024 allocated ₹87,657 crore to the Ministry of Health and Family Welfare, marking a 13% increase from the previous year. 
• While this is a step forward, experts agree that this allocation remains insuffcient given the scale of India’s health challenges.
•  The National Health Accounts show the total current health expenditure estimate in 2021-22 as ₹7.9 lakh crore, growing at a rate more than overall inflation. 
• The share of household health expenditure, including insurance contributions, while decreasing over time, still drives nearly 50%+ of the spend. This remains one of the highest globally. 
•  The World Health Organization (WHO) projects that the economic burden of NCDs in India will surpass ₹280 lakh crore by 2030 — a cost equivalent to ₹2 lakh per household. 
• This escalating cost, driven by rising healthcare expenses and productivity losses, poses a severe threat to financial stability, particularly for middle and lower-income families.
•  Regular screenings, especially for high-risk individuals, could significantly reduce the incidence of serious, life-threatening and debilitating conditions and its resultant cascading economic and social effects. 
• In a large hospital network, for every 1,000 people screened, at least three people are identified for pre-emptive cardiac or cancer interventions. 
•  Targeted but periodic screening investigations for individuals such as mammograms for breast cancer, pap smears for cervical cancer, X-ray or low-dose computed tomography for lung cancer, ultrasound for liver disease, echo cardiography and treadmill stress test for heart disease beyond the physical vitals and blood tests enable early intervention. 
•  Unfortunately, comprehensive health checks (which can cost anywhere between ₹8,000 and ₹15,000 in metro cities today) are perceived as expensive. 
• If the government were to enable a step change in preventive health services adoption, it could significantly reduce the overall financial burden on individuals and the healthcare system. 
•  Tax incentives, subsidised screenings, and public awareness are key policy tools that can enable this. 
• As part of the Finance Act, 2013, the Union government made efforts to encourage preventive healthcare by offering a ₹5,000 tax deduction under Section 80D of the Income Tax Act for health checks. 
• However, this amount has remained stagnant for the last decade, despite the 12-14% estimated healthcare inflation rate and the rising cost of healthcare services. 
• Thus, it would be prudent for our policymakers to consider revising the tax deduction limit to at least ₹15,000 in the Union Budget for 2025-26. 
•  This would incentivise more individuals to undergo preventive health checks, potentially saving the nation several thousand of crores infrastructure healthcare costs. 
•  The incremental tax foregone to the exchequer from such a measure is estimated to be less than ₹5,000 crore, a worthy investment towards improving the health of the nation. 
•  The path forward We need to prioritise preventive care to mitigate the increasing economic and financial burden of chronic diseases. 
• A three-pronged approach can potentially drive a change in the adoption of preventive health services.
•  First, we need to strengthen early intervention capabilities through the Ayushman Health and Wellness Centres, including capturing trends effectively and enabling risk-driven targeted screening using AI-enabled imaging modalities to offer lower cost screenings at-scale. 
•  Second, we need to improve the adoption of screening at private centres by encouraging insurers and private health providers to offer a subsidised minimum screening programme for every individual between 40-60 years. 
• For example, for women after the age of 40, a mammogram is necessary annually or once in two years, based on her risk factors.
•  Exploring part funding through allocations from proceeds from the healthcare cess or the proposed 35% GST slab on tobacco and sugar products can help reduce funding needs. 
•  Finally, the increase in tax deduction limit can further incentivise people to complete comprehensive health checks. By prioritising preventive care over reactive treatments, India can pave the way for a healthier and more economically resilient future.