Curious Bends – the misery index, twin births, ethnic inequality and more

1. India’s heat wave has been made worse by its humidity

“But at least these places had a “dry heat,” and overnight temperatures have been falling into the 80s. Along the coast, temperatures were slightly lower, but much higher humidity levels created a punishing heat index that persisted throughout the night. In Mumbai, for example, the heat index bottomed out just below 100 degrees Fahrenheit, and only for a few hours overnight Wednesday. In severe heat waves, oppressively hot overnight temperatures are extremely deadly, because there’s just no chance for overheated bodies to cool off. That means the “misery index”—a creation of Web developer Cameron Beccario that factors in both heat and humidity—is off the charts nearly nationwide.” (4 min read, slate.com)

2. We’re producing enough electricity—but doing a bad job of distributing it

“There are no takers for all the generation capacity that is in place. There is demand but they don’t have the money to pay for the power due to the health of the [state distribution companies],” a senior government official told ET, adding that discoms across all states had incurred accumulated losses of Rs 2.51 lakh crore in 2012-13. In 2014-15, 22,566 MW of capacity was commissioned, which officials and experts said were stuck in the pipeline for years till they were put on the fast-track by the UPA in its fag end through the Cabinet Committee on Investments.” (4 min read, economictimes.com)

3. The strange and mysterious science of twin births

“Twins have fascinated both scientists and Bollywood directors alike. Why are there are some places with a statistically higher incidence of twin births? Much higher! Is it the water, the air, or could it be the yam? Padmaparna Ghosh and Samanth Subramanian investigate the mysteries behind twin births, getting behind the science, the statistics and some plain old superstition to uncover the theories and the conspiracies.” (12 min listen, audiomatic.in)

4. The connection between Cristiano Ronaldo and a remote dengue fever outbreak

“Break Dengue, a site funded by drug companies, NGOs, and other health groups, posits an unlikely potential factor in Madeira’s outbreak: global football star Cristiano Ronaldo. The epidemic’s origins trace back to a charter flight of tourists from Venezuela, according to Ana Clara Silva, an epidemiologist at Madeira’s health institute, who spoke at a recent infectious disease conference in London. Break Dengue’s Gary Finnegan noted that the tourists were quite possibly making a pilgrimage to the Portuguese soccer mega-star’s birthplace, as Ronaldo is a major tourist draw for Madeira.” (3 min read, qz.com)

5. In an ethnically divided country, the poor feel their poverty more keenly

“The authors show that as a country’s ethnic inequality falls, average GDP per person rises. A one-standard-deviation decline in a country’s ethnic Gini index—the equivalent of moving from the level of Nigeria to that of Namibia—is associated with a 28% increase in GDP per person. It seems likely that ethnic inequality leads to low levels of development, not the other way around. After all, in other tests the authors find that ethnic inequality mostly reflects unequal geographical endowments, such as more fertile land and distance to the coast. What explains these results? When there is inequality along ethnic lines, the paper suggests, those grouped at the bottom feel their poverty more keenly. The rich are easier to identify, and thus an easier target. All told, ethnically imbalanced societies may be more prone to conflict, which is hardly good for growth.” (2 min read, economist.com)

Chart of the Week

“In 2000, United Nations member countries agreed to ambitious development targets that they hoped to reach by 2015. These are the Millennium Development Goals (MDG). Among them was to reduce the number of people suffering from undernourishment—enough to cut the global hunger rate in half. Now 2015 is here, and it turns out the world is actually doing a pretty good job on that measure. The UN has released its annual report on hunger, which it defines as chronic undernourishment—the inability to acquire enough food for at least one year. Here’s what it found: since 1990 31 more countries have met the UN goal of cutting hunger in half or bringing it under 5% of their populations.” (2 min read, qz.com)

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Tuberculosis’s invisible millions – in cases and money

Tuberculosis (TB) has killed more than a billion people in the last 200 years. That’s more than any other infectious disease in that period. And, what’s worse is that, according to the World Health Organisation (WHO), less than half the cases worldwide are ever diagnosed.

India suffers the most. It has the highest burden of TB in the world: More than 2 million suffer from the disease, and this is despite years of work to control the disease.

TB was declared a global health emergency by the WHO in 1993. Then, in 2001, the first global “Stop TB Plan” came into effect, with an international network of donors and private and public sector organisations tackling TB-related issues around the world together.

The disease is prevalent among both rich and poor countries, but has more disastrous consequences in the latter because of limited access to healthcare, poor sanitation and undernutrition. The matter is worsened because of co-morbidity, where those with weakened immune systems—having suffered from diabetes or AIDS—fall prey to TB and die.

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And even between developing economies, there is significant variation in treatment levels because of difficulties in identifying new infections. In 2012, while China and India together accounted for 40% of the world’s burden of TB, the prevalence among 100,000 people was at least 167 in India and less than half that in China (about 68).

Technology can help

In an article in the journal PLOS Medicine, Puneet Dewan from the Bill & Melinda Gates Foundation and Madhukar Pai of McGill University have called for global efforts to identify, treat and cure the 3 million “missed” TB infections every year.

“Reaching all these individuals and ensuring accountable, effective TB treatment will require TB control programs to adopt innovative tools and modernize program service delivery,” they write.

In January 2015, the WHO representative to India, Nata Menabde, said the decline of TB incidence in the country was occurring at 2% per year, instead of the desired 19-20%. She added that it could be pulled up to 10% per year by 2025 if the country was ready to leverage better the available technology. The WHO’s goal is to eradicate TB by 2050. But for India that may prove to be too soon. 

This is also what Dewan and Pai are calling for. The tech interventions could be in the form of e-health services, the use of mobile phones by doctors to notify centers of new cases, and disbursing e-vouchers for subsidized treatment.

And their demands are not unreasonable, given India’s progress so far. First, India has met one of the United Nations’ ambitious Millennium Development Goals by cutting TB prevalence to half in 2015 compared to prevalence in 1990. Second, according to Menabde, India is also on track to halve TB mortality by the end of this year compared to that in 1990. The accomplishment testifies to commitment from public and private sector initiatives and places the country in a good position from which to springboard toward stiffer targets. Continued support can sustain the momentum.

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In 2012, the previous government made TB a notifiable disease—mandating medical practitioners to report every TB case detected—going some way in reducing the number of “missing” cases. It also banned blood tests to diagnose TB for the lack of a clinical basis. While the delay in implementing these measures contributed to the rise of multidrug-resistant strains of the disease, they also revitalised efforts to meet targets set by the WHO at an important time. Then bad news struck.

Causing self-harm

India’s health budget for 2015-16 has not even managed to keep up with inflation. It is a mere 2% more than the previous year. For TB, this budgetary belt-tightening has meant taking a few steps back in the pace of developing cures against multi-drug resistant strains and in efforts to improve the quality of treatment at frontline private-sector agencies, which already provide more than 60% of patient care.

Dewan and Pai think TV programs, such as Aamir Khan’s Satyamev Jayate, and Amitabh Bachchan’s admission that he is a TB survivor will promote enough awareness to force changes in healthcare spending—but this seems far too beamish an outlook when the funding cuts and regulatory failures are factored in.

A new draft of the National Health Policy (NHP) was published in December. Besides providing a lopsided insight into the government’s thoughts on public healthcare, it made evident that ministers’ apathetic attitude, and not a paucity of public support, was to blame for poor policies.

Nidhi Khurana, a health systems researcher at the Johns Hopkins Bloomberg School of Public Health, summed up the NHP deftly in The Hindu:

The NHP refutes itself while describing the main reason for the National Rural Health Mission’s failure to achieve stronger health systems: “Strengthening health systems for providing comprehensive care required higher levels of investment and human resources than were made available. The budget received and the expenditure thereunder was only about 40 per cent of what was envisaged for a full revitalisation in the NRHM framework.” If this is not the case against diminished public funding for health, what is?

Curious Bends – Mars Orbiter, friendly elephants, waterless urinals and more

Special look: India’s Mars Orbiter Mission

1. One small step for India may become a big step for humanity

“Martin Rees, the British Astronomer Royal, expects that humans will have settlements on Mars within two centuries. But he is not sure if Western countries can achieve this. It will need the determination of nations such as India and China. Or, perhaps like the International Space Station, it will have to be a global collaboration where each country brings in expertise and money to build a sustainable colony beyond Earth.” (4 min read)

2. India’s Mars Orbiter has made it to the top, but is it a one-hit wonder?

“Even if it has launched a spacecraft to Mars, the payload limit and the lack of an inclusive scientific agenda still stand in the way of taking full advantage of scientific interest and infrastructure on the ground. Going ahead, untying this knot is what will keep from reducing MOM’s achievement to an exhibition of ego rather than scientific temperament.” (4 min read)

3. No room for jugaad on Mars

“ISRO built a top-class launch vehicle and payload, and we should not cheapen its success by harping on any number. India’s space programme is a testament to a culture of tackling hard challenges because they are hard, not because they are easy. Of doing the best, and not the cheapest. Jugaad in India was born as a necessity in impoverished conditions, and instead of elevating it to godhood we should be trying to escape a culture of jugaad as quickly as possible. ISRO is showing us the way.” (4 min read)

In other news

1. Elephants can learn to live with humans, and a Darwinian explanation might not suffice

When forest officials dug a protective trench around a reserve in South India, an elephant named Bharathan took to the highway, scared off a guard and carefully stepped around a checkpost. In another instance, Bharathan waited for a local jackfruit vendor to take a break before raiding his stock. His stories regale local villagers. However, his behaviour has left both biologists and anthropologists scrambling for an explanation. (8 min read)

2. Exploit urinals for cheap fertilisers, says Indian inventor

Human urine contains three nutrients essential for plant growth: phosphorous, potassium and nitrogen. According to an Indian inventor, each person produces four to five kilograms of these nutrients annually. He believes that is reason enough to replace modern “flush and forget” sanitation systems with waterless urinals that he has designed. They separate, store and transport these elements for use in fertilisers. (3 min read)

3. Monsanto is expanding its offerings in India but will farmers trust it?

Monsanto, the “agri-tech company the world loves to hate”, is moving into a market that Indian farmers could do with. It plans to offer them an integrated suite of services, especially merging agriculture and Big Data to provide remote sensing, modelling and marketing options to growers. However, whether its services will sell is another question because of two concerns. One: Monsanto’s reputation in India is bad at best. Two: India’s data-protection laws are virtually non-existent. (4 min read)

Chart of the week

One in every nine persons in the world goes hungry, according to the Food and Agriculture Organisation. It estimates that since 1990, the number of hungry people globally has declined by over 200 million, helping the world meet one of its Millennium Development Goals. However, the unevenness of progress means food security is increasingly dependent on political will. The biggest strides have been taken in Southeast Asia, East Asia and Latin America; the smallest, in South Asia and sub-Saharan Africa. Down To Earth has more.

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