Daily News Compilation (HINDU) 11th June - Editorials

Talking to Pakistan in its language

Author talks about five responses which India can give to Pakistan if an event like 26/11 occurs again.

All of them involve great risks.

1. The first is to keep doing nothing. The threat of a major India-Pakistan crisis after 26/11 led the United States to mount intense pressure on Pakistan. In the years since, the LeT hasn’t mounted a single major operation on Indian soil. Its affiliate, the Indian Mujahideen, has had restraint thrust upon it by Pakistan’s Inter-Services Intelligence (ISI) Directorate. But at time USA intervened because it had its interest in Afghanistan but now with the US troops withdrawing this is not a feasible option anymore.

2. Second choice might be coercion. In 2001, after terrorists attacked Parliament, India mobilised troops. Pakistan was forced to respond — but its smaller economy suffered disproportionately. The stratagem is time-tested. In 1953, Prime Minister Jawaharlal Nehru mobilised troops in Punjab to deter a Pakistani attack into Kashmir.

Mr. Vajpayee’s strategy worked, forcing Pakistan to dramatically scale down the jihad in Jammu and Kashmir. It only worked, though, because the U.S. played mediator — much like after 26/11 — and it was hideously expensive, in money and lives.

3. The third choice is to do limited strikes on jihadist training camps across the LoC, using air power or missiles. In the five years since 26/11, India’s ability to conduct such strikes has been significantly enhanced. However, the tactic hasn’t had great success. In August 1998, the United States fired missiles into Afghanistan, seeking to avenge bombings which killed 224 people. In all, 75 missiles, each priced at $1.5 million, killed six minor jihadists . Moreover, Pakistan could hit back, targeting Indian industrial infrastructure, which is much more expensive than tent-and-donkey cart training camps.

4. Fourth, the Prime Minister could tell Indian troops to target the Pakistan Army along the LoC, using artillery and infantry — a task aided by the fact that its defences along stretches of the Neelam valley have been degraded by troops having to be moved to fight the Tehreek-e-Taliban elsewhere. The fighting that will follow though will make it more difficult to secure the LoC against jihadist infiltration — leading to heightened violence in Kashmir.

5. Mr. Modi could, finally, authorise the use of covert means, like bomb-for-bomb strikes or targeted assassination of jihadist leaders. Mr. Modi’s intelligence services, though, don’t have this arrow in their quiver — and it will be a while, most experts say, before they can acquire it.

The Army-Islamist axis

Pakistani military commanders know their on-off war against jihadists has no hope of glorious victory: their resources are too thin, and many in their own ranks are sympathetic to the enemy. India is the enemy they need to restore their legitimacy as the Praetorian Guard of the national project. In the face of threats from an existential adversary, their enemies would be compelled to fall in line.

Pakistan Prime Minister Nawaz Sharif may wish to build a durable relationship with India, but he is no position to defy the generals. He is beholden, moreover, to Islamists who aided his election.

The truth is that Pakistan’s “democratic transition does not mean the army is ready to surrender its control over security and foreign policies.”

New Delhi has long hoped that engaging Pakistan’s democratic leadership will catalyse that transformation. It has absorbed the blows dished out by the Army, hoping things will eventually change. Doing nothing, though, has proved both politically unsustainable and strategically ineffectual.

Quality health care with public funds

There are six practical steps that he could implement as Prime Minister to rapidly ensure better health for all Indians.

1. First, the government has an opportunity to issue a clarion call for universal health insurance (UHI). The government could declare a deadline before which most private spending can be replaced by taxpayer-financed health services. Can India afford this? Yes. India already spends about 6 per cent of its GDP on health care. But 80 per cent of this is out-of-pocket and drives over 40 million Indians below the poverty line every year. In addition, the quality of health care also differs. UHI should not be about insurance for the well-off, but instead prevent large expenses for the poor.

>> One of the main challenges is to raise revenue: VAT and other tax reforms can raise about 3 per cent of GDP, at least half of which should be used for the first phase of providing UHI. 

>>The second challenge is to regulate downward any growth in private indemnity insurance. UHI will free the current out-of-pocket spending and channel funds toward far more productive uses. A single-payer system is an example of enhancing the reach of health care through a wide range of private providers. It is also a fine way to weed out unscrupulous practices in the health-care system. Gujarat’s Chiranjeevi Yojana is one example of how private services can be delivered using public finance.

2. While strengthening the public health-care system, the government could concurrently adopt a few bold, high-impact interventions within three years to improve health care. In India, around 1.5 million children continue to die before their fifth birthday, mostly due to conditions that are avoidable. Thus, a second priority should be to include a rapid scale-up of the introduction of new vaccines against diarrhoea and pneumonia among children. 

3. The most feasible priority will be to reduce smoking. Smoking kills about 1 million Indians every year. The number of cases of tubercolosis has risen because of smoking. While all kinds of smoking are harmful, prolonged cigarette smoking has already been shown to rob Indians of a full decade of life on an average. All cigarettes must be taxed on their tobacco content and not length. The Asian Development Bank has found that tripling the tax rate can save about 8 million lives. Contrary to common misconception, this will not drive cigarette smokers toward bidis as the two markets are different. Finance Minister Arun Jaitley knows that the value of 1 million lives is far, far greater than the purported revenue made by the tobacco industry. More practically, tripling of the tax would yield another 0.3 per cent of GDP in revenue.

4. Preventing vascular deaths

A fourth priority should be to tackle adult vascular deaths — the leading cause of deaths in the country, killing over 1 million Indians between the ages of 30 and 69 per year. Data show that about two-thirds of people who die from such diseases suffered a heart attack or stroke earlier. In such patients, low-cost generic risk pills that combine aspirin with a statin drug in order to reduce cholesterol and lower blood pressure can reduce by two-thirds the chances of suffering another stroke or even dying. Low-cost treatments of acute heart attacks are also now possible. The vibrant Indian generic drug industry knows how to deliver high-quality drugs at low cost (and indeed was largely responsible for the major turnaround in HIV treatment in Africa). What is needed is a change in regulation that would allow any drug that has already shown to be effective to be packaged with other drugs, provided they have met the standards of manufacturing.

5. A fifth priority should be to control malaria. India has made substantial progress in reducing the number of cases of malaria and the number of deaths caused by the disease (although the official numbers of rural Indians dying from malaria remains underestimated). Specific measures need to be taken to prevent a big resurgence of malaria.

This would involve a change in the Indian malaria programme to a proper use of combination drugs. These treatments must be made widely available in rural areas, particularly in Odisha and the northeast. More pressingly, India can lead in fighting resistance to effective malaria drugs that are emerging from the Greater Mekong Region. This means that Foreign Minister Sushma Swaraj, who was earlier a capable Health Minister, must substantially boost India’s foreign aid to combat drug and insecticide-resistant malaria in Asia. India can contribute $100 million to a regional malaria fund, and establish a public-private partnership to provide subsidies to reputable drug manufacturers (many of whom are in India). This is not only good science and good economics, but also good politics. Leading malaria control in Asia will enhance India’s health profile in the region.

6. Finally, a major effort should be made to improve health reporting. The Census should be strengthened, expanded and paired with the economic census and other surveys. This new central information hub will help track and report on development and progress.

Summarizing in a table:

Steps	Why needed	How to go about them
Universal health insurance (UHI)	India already spends about 6 per cent of its GDP on health care. But 80 per cent of this is out-of-pocket and drives over 40 million Indians below the poverty line every year.	1.      To raise revenue: VAT and other tax reforms can raise about 3 per cent of GDP, at least half of which should be used for the first phase of providing UHI.  2.       To regulate downward any growth in private indemnity insurance and to weed out unscrupulous practices in the health-care system we can have Single Payer system 3.       Gujarat’s Chiranjeevi Yojana is one example of how private services can be delivered using public finance
Strengthening the public health-care system: Preventing child deaths	In India, around 1.5 million children continue to die before their fifth birthday, mostly due to conditions that are avoidable.	1.      To include a rapid scale-up of the introduction of new vaccines against diarrhoea and pneumonia among children.  2.       Novel delivery models must be tested and scaled to deliver vaccines to every doorstep.
Reduce smoking	Smoking kills about 1 million Indians every year.	1.       All cigarettes must be taxed on their tobacco content and not length. 2.       The Asian Development Bank has found that tripling the tax rate can save about 8 million lives.
Preventing vascular deaths	Vascular deaths — the leading cause of deaths in the country, killing over 1 million Indians between the ages of 30 and 69 per year.	1.       low-cost generic risk pills 2.      Low-cost treatments of acute heart attacks 3.       change in regulation that would allow any drug that has already shown to be effective to be packaged with other drugs, provided they have met the standards of manufacturing.
Controlling malaria	Specific measures need to be taken to prevent a big resurgence of malaria.	1.       change in the Indian malaria programme to a proper use of combination drugs. These treatments must be made widely available in rural areas, particularly in Odisha and the northeast.  2.      boost India’s foreign aid to combat drug and insecticide-resistant malaria in Asia. 3.       India can contribute $100 million to a regional malaria fund, and establish a public-private partnership to provide subsidies to reputable drug manufacturers
Improve health reporting		The Census should be strengthened, expanded and paired with the economic census and other surveys

An unusual recipe

News: Radical plan of action unveiled by the European Central Bank on June 5 in Frankfurt. 

The objective is to spur growth and avert the threat of deflation in the sluggish Eurozone economy.

Some of the steps of action are:

1. ECB cut its benchmark interest rate to a record low and took the unprecedented step of lowering the bank deposit rate to below zero. Essentially that means the ECB will be charging lenders to park their funds with the central bank. The hope is that banks will lend to credit-starved businesses, especially small ones and those in the periphery of the Eurozone. 

2. A large liquidity enhancing package has also been announced. The moves are also expected to weaken the euro, thereby making exports from the zone competitive, and push up an inflation rate that had dropped to a four-year low of 0.5 per cent in May. 

As was amply demonstrated in Japan, deflation has several deleterious consequences. It cuts into business profits, raises real debt, and discourages household consumption and investment. 

Why important for India?

The ECB’s package is nevertheless important because if it succeeds in reviving the Eurozone economy, India’s trade and other economic relations with an important grouping will benefit. The ECB has also promised to supplement its interest rate action with a massive bond purchase programme, akin to the U.S. Federal Reserve’s quantitative easing. If the plan of an ultra-soft monetary policy in Europe materialises, it will help India and other developed countries face with greater equanimity the consequences of the Fed’s ongoing programme of withdrawal of its quantitative easing.

Building on traditional links

• Visit by China’s Foreign Minister Wang Yi was a sign that Beijing wants to lose no time in establishing contact with the Narendra Modi government and acquainting itself with its strategic and foreign policy objectives.
• Foreign Minister Wang struck all the right notes during the visit, describing India and China as “natural partners”, and the sensitive issue of the border dispute as “a question left over by history” to which there had to be a “fair” solution but which should not be allowed to adversely affect other aspects of India-China relations. 

Clearly, China’s top leadership is eager to send positive signals to the new government.

• At a time when most of China’s neighbours are increasingly irritated by and resentful of its actions, whether in the South China Sea or in the matter of airspace restrictions, Beijing is eager to shake off its tag as a difficult neighbour.
• India’s strategic partnerships with China’s rivals do not constitute a zero sum game – much the same way as Beijing’s partnerships with India’s rivals do not — and should not be perceived as such.