Editorial 1 : Keep water at the centre
Recent context:
- October 16 is observed as World Food Day to mark the founding of the United Nations Food and Agriculture Organisation (FAO) in 1945.
- Its main purpose was to ensure food and nutrition security around the world in the aftermath of World War II.
- This year’s theme for the World Food Day is “Water is Life. Water is Food”.
- While there is ample food being produced on this planet that can easily feed eight billion people, its access is quite skewed across nations.
Far India has progressed in achieving food security, and how it is using its water resources in agriculture.
First on the food security front.
- Having been through a journey of “ship to mouth” in mid 1960s, India has come a long way.
- Only in the last three years, 2020-21 to 2022-23, India exported 85 million tonnes (MT) of cereals, mainly rice, wheat and corn.
- This it did even after giving free food (rice or wheat) to more than 800 million people under the PM Garib Kalyan Yojana. This is a stupendous achievement.
- India has also made major strides in milk production which has shot up from 17 MT in 1951 to 222 MT in 2022-23.
- The country is the largest producer of milk by far. Since 2000-01, poultry and fishery production has been growing at a fast rate.
- So, from the green and white revolution, India has also now ushered in a pink (poultry) and blue (fishery) revolution.
- However, access to sufficient nutritious food remains a challenge for many.
- According to the latest National Family Health Survey,
- almost 16.6 per cent of India’s population is malnourished (2020-22),
- 35 per cent of its children below the age of five years are stunted (low height-for-age) and
- 32 per cent are underweight (low weight-for-age).
- Progress on this front has been rather slow, and in a business-as-usual environment, India will not be able to achieve its Sustainable Development Goal (SDG) of zero hunger (including malnutrition) by 2030.
how is India using its water resources in agriculture?
- India is home to almost 18 per cent of the world’s population, it has only 4 per cent of global freshwater resources. Much of this water is used in agriculture nearly 75 per cent.
- With rising population, and rising incomes, there will be a need to produce not only more food but also save water for drinking purposes as also for manufacturing and growing urbanisation.
- Thus, India needs to adopt a two-pronged strategy with respect to water in agriculture.
- First, on the supply side, it must augment buffer stocking of water during the monsoon season in its reservoirs, and recharge groundwater through check dams and watersheds, etc.
- Second, it must work on the demand side to ensure more rational allocation and efficient use of water across crops.
Issues with respect to climate based investment in irrigation infrastructure
- There is need of not only institutional reforms in the Indian irrigation sector but also in the pricing of water and power for irrigation.
- While almost half of India’s gross cropped area is irrigated today, we need to take it to at least 75 per cent if we have to cope with weather vagaries associated with climate change.
- This would require massive investments. India has not succeeded in attracting private sector investments in reservoirs and canal networks as water is almost free.
- The government does not have enough funds to invest in this, after doling out large food and fertiliser subsidies costing more than Rs 4 lakh crore.
- Under such a scenario, Indian agriculture remains a risky venture in the wake of climate change.
Steps need to be taken to counter the impact of climate change
- If we have to minimise this climate risk, we need a paradigm shift in our thinking.
- There is need to shift focus from land productivity to water productivity.
- For example, we need not look at say so much tonne/hectare, but of kg of grain per cubic metre of irrigation water.
- Once we start looking at productivity from a water angle, we can identify the inefficiencies in the allocation and use of water in agriculture.
- For e.g. while in Punjab land productivity of rice is one of the highest, its irrigation water productivity is the lowest.
- This will create a level playing field across crops and would be good for the environment as well as nutrition. Above all, it will save water disaster as because of over-exploiting groundwater
- Adopting Farming practices such as direct seeded rice (DSR) and alternate wet and dry (AWD) irrigation, or zero till, etc., can also be rewarded as they will save water.
- And also drip irrigation, especially in sugarcane, which can save half the water.
Conclusion: Therefore, in order to ensure the food security it is necessary that the water should be used efficiently that is possible by providing subsidies to farmer to grow water efficient crops and using water saving technology like drip and sprinkle irrigation.
Editorial 2 : We need more doctors
Context
- The demand for doctors exceeds supply in large parts of India. At the same time, the demand for medical education also exceeds the number (supply) of seats.
- Reducing the demand-supply gap in medical education has been an elusive goal and this can impact the gaps in doctor availability to some extent.
Steps taken by government to bridge the gap of doctor’s deficiency
- Over the last decade, the country has made rapid strides in expanding medical colleges and seats at the postgraduate (PG) and undergraduate (UG) levels.
- Between 2010-11 to now, UG seats have nearly tripled, PG seats have almost quadrupled, while medical colleges have doubled.
- Despite this expansion, in 2021, the number of medical graduates per lakh population was 4.1 in India, well below 6.2 in China (2018), 6.9 in Israel (2020), 8.5 in US (2021), and 13.1 in UK (2021).
Why is still there is gap in availability of doctors?
- Two drivers of the increase in medical graduates are the number and size of medical colleges.
- While the number has increased rapidly, the size of medical colleges remains a critical barrier to increasing the supply of doctors.
- As, the average number of UG seats per college is 153 in India as against 220 in Eastern Europe and 930 in China.
- The small size is an outcome of regulatory and financial constraints.
- For instance, a seat expansion in a public medical college from 150 to 200 required an expansion of books in the library from 11,000 to 15,000, daily OPD footfalls from 1,200 to 2,000 and
- a doubling in the number of nursing staff required, as per the draft guidelines for establishment of new medical colleges by upgrading district/referral hospitals (2015).
- Scaling up might be a riskier proposition for private medical colleges.
- Investments in physical infrastructure, hiring teaching faculty and other staff may raise feasibility questions when seats remain vacant and costs are not recovered, often leading to price distortions with high capitation fees.
- Government colleges are only able to provide medical education at lower prices, but their costs continue to remain high, with the gap between the two being bridged by subsidies.
- The lowering of costs will entail regulatory reform to further rationalise some of the human and physical infrastructure requirements and a greater integration to innovation and technology in curriculum design and pedagogy.
Government’s new competency-based curriculum as per global standard
- The competency-based curriculum being implemented by India is similar to the one implemented in the US. The US has innovated in resource utilisation to scale the production of doctors
- Besides its focus on mainstreaming technology and providing better financial incentives to teachers, it employs other innovations.
- The use of practising MD doctors who observe and mentor medical students in a clinical setting; integrating interprofessional education (IPE) into the curriculum
- And where doctors, nurses and pharmacists are taught together, improves quality, reduces teaching faculty requirements and enables optimal utilisation of resources.
Along with quality and scale, equity should also be maintained
- While there is a perceived trade-off between quality and scale, there are also concerns about equity.
- The argument for increased productivity and scale needs to be viewed in the context of the overarching policy goal.
- While scale is needed, the National Medical Commission has currently prioritised equity.
- The previous cap of 250 UG seats has been revised to 150 for new medical colleges from 2024-25.
- Read alongside the requirement of 100 seats per 10 lakh population and restrictions on locating new medical colleges within 15 km of an existing college reveal the government’s focus on evenly distributed, localised production of doctors. But, this will not lead to efficient production due to inter-state migration of doctors from high-producing states like Karnataka and Andhra Pradesh.
Conclusion: Thus, the goal of equity requires attention to incentives and encouraging migration to low-availability areas rather than restricting production. The policy focus, therefore, should be on addressing the barriers to scale.