8th November 2018
Answer questions in NOT MORE than 200 words each. Content of the answer is more important than its length.
Links are provided for reference. You can also use the Internet fruitfully to further enhance and strengthen your answers.
GS II: INTERNATIONAL
Q1. The change of name of United States the Pacific Command to U.S. Indo-Pacific Command does not hold much for India. Comment.
- Some had interpreted Washington’s use of the label “Indo-Pacific” to mean that the U.S. has made India the central point of the Indo-Pacific. But the National Security Strategy (NSS) document of 2017, (which outlined America’s top security concerns, have corroborated the Indian interpretation. The NSS 2017 views the Association of Southeast Asian Nations (ASEAN) and APEC as “centerpieces of the Indo-Pacific’s regional architecture”.
- The Indo-Pacific, as described in the NSS, represents the most populous and economically dynamic part of the world and “stretches from the west coast of India to the western shores of the United States”.
- That strategic vision does not cater to India’s interests. The NSS 2017 has omitted some of India’s most vital interests, including the Bay of Bengal and the Arabian Sea. Also left out is the Strait of Malacca, which links the Indian and Pacific Oceans and is India’s gateway to trade with Southeast Asia, Japan and South Korea.
- America’s concept of the Indo-Pacific seeks to counter China’s assertiveness in Asia. China is the main security threat to U.S. primacy in Asia. It also has a long-standing border dispute with India. That gives India and the U.S. a shared interest in countering China’s growing military power and territorial revisionist tendencies.
- India itself is unclear about what it means by the Indo-Pacific. New Delhi has tended to present the term “Indo-Pacific” as raising India’s strategic stature. But at the Shangri-La Dialogue in June, India hailed ASEAN as the foundation of the Indo-Pacific and asserted that a geographical definition could not be a strategy to contain any country.
- America wants India to offer more investment to Asian countries. But India needs Chinese investment to upgrade its own infrastructure and is nowhere near competing successfully against China as an investor in Southeast Asia. In 2016, two-way trade between India and ASEAN moved up to $71.6 billion. In contrast, two-way trade between China and ASEAN stood at more than $452 billion. Moreover, Mr. Trump’s contemptuous labelling of India as the “tariff king” points to strong differences over trade practices.
- At another level, maritime power is the key to international clout in the 21st century. About 90% of India’s trade passes through the Indian Ocean. India has less than 20 submarines in service; China 78. That is one reason why India needs the intelligence-sharing and drones promised by the U.S. at the 2+2 Dialogue in September to detect Chinese submarines in the Indian Ocean. Significantly, of India’s three services, its Navy gets around 15% of the defence budget. The U.S. Navy and Marines get the lion’s share of the U.S. military budget.
- Moreover, in April 2017, China successfully launched its second aircraft carrier, which was domestically built. But it will be many years before India’s second home-built aircraft carrier becomes operational. Unsurprisingly, the U.S. is sceptical about India’s capacity to counter the growing influence of China in the Indian and Pacific Oceans.
- Dependent on the U.S. and Russia for most of its arms — and on the U.S. and China for much of its trade — India’s simultaneous efforts to cultivate good relations with the U.S., Russia and China highlight the conceptual differences between New Delhi and Washington on the Indo-Pacific and on how best to counter China in Asia. India-U.S. ties could also be encumbered by India’s need for greater economic strength, its red tape and its trading methods.
GS III: S&T-HEALTH
Q2. What do you understand by the vaccine-associated paralytic poliomyelitis (VAPP)? Can switching to inactivated polio vaccine (IPV) help in reducing vaccine associated cases?
- With wild polio virus strains reduced by 99.9% since 1988, the world is inching towards eradicating polio. But unfortunately, more children today are affected by the live, weakened virus contained in the oral polio vaccine (OPV) that is meant to protect them. The weakened virus in the vaccine can circulate in the environment, occasionally turn neurovirulent and cause vaccine-derived poliovirus (VDPV) in unprotected children. While the wild-type virus has caused 22 and 25 polio cases in 2017 and 2018 (as on October 30, 2018), respectively, in just two countries (Pakistan and Afghanistan), VDPV was responsible for 96 and 75 polio cases in more countries during the same periods.
- While circulating VDPV strains are tracked, and outbreaks and cases are recorded and shared, little is known about vaccine-associated paralytic poliomyelitis (VAPP) cases, particularly in India. VAPP occurs when the virus turns virulent within the body of a recently vaccinated child and causes polio. The frequency of VAPP cases varies across countries. With high-income countries switching to the inactivated polio vaccine (IPV) that uses dead virus to immunise children, the VAPP burden is concentrated in low-income countries which continue to use the OPV.
- In spite of the World Health Organisation asking all countries using the OPV to include a “continuous and effective system of surveillance” to monitor the frequency of VAPP in 1982, India did not comply. Data on VAPP became available only years after active polio surveillance was initiated in 1997. However, even after 1997, India did not count VAPP cases.
- The justification that VAPP cases can be ignored as they are “sporadic and pose little or no threat to others” is ethically flawed.
- Many member countries autonomously chose the IPV over the OPV, mainly to avoid any risk of VAPP. In India, the VAPP cases can be avoided once the government stops using the OPV to immunise children.
- The WHO had suggested a rate of 1 case of VAPP per million births and had estimated the annual global burden of VAPP to be approximately 120 cases in 2002. Under these circumstances, India’s share would been merely 25 VAPP cases per year, based on the annual birth cohort of 25 million. But the observed number of cases in India in 1999 was 181. This indicates that the actual risk is seven times the expected number. That would have meant that there were 100-200 VAPP cases in India each year. The global estimated incidence of VAPP was then revised to 200-400 cases.
- The IPV produces humoral immunity (involving antibodies in body fluids) so the immunised child does not get paralysis, but it can’t stop the circulation of wild polio viruses. For instance, no polio cases were seen in Israel but wild polio viruses were detected in the environment. The viruses will continue to circulate in the community.
- It is easier to administer the OPV than the IPV and the cost per dose of OPV is also lower than that of the IPV. However, the OPV fared poorly on two important counts: safety and efficacy.
- While high-income countries preferred the IPV, India and other low-income countries continued to rely on the OPV. India licensed the IPV only in 2006 but did not introduce it in routine immunisation.
- The IPV is essential for post wild-type polio virus eradication, to get rid of VDPV and VAPP. The globally synchronised switch from trivalent to bivalent OPV in mid-2016 was accompanied by administering a single dose of the IPV prior to administering the OPV. A single dose of the IPV primes the immune system and the antibodies against the polio virus, seen in more than 90% of immunised infants, notes a paper in The Lancet.
- With no way of monitoring VAPP cases in India, there is no way of knowing if the use of a single dose of IPV followed by immunisation using bivalent OPV has led to a reduction in the number of VAPP cases.