“

The death of the charismatic Fidel Castro at the age of 90 eight days back on November 25 signifies the end of an era. While defying the might of the US, he remained an undefatigable symbol of resistance till he breathed his last. As it turned out he lived long enough to see the rollback of Washington’s sanctions for 54 years that crippled the Cuban economy. 

Spearheading the Cuban revolution, he played a crucial role in overthrowing President Fulgencio Batista in 1959 at the age of 32. Castro was an authoritarian who violated human rights, jailed his critics and remained highly intolerant. His die hard supporters found in him a person who challenged the US domination of Latin America while bringing healthcare and education to the poor.

Castro inspired socialist movements across the globe. He is believed to have thwarted more than 600 attempts to assassinate him by none other than the Central Intelligence Agency (CIA). Attempts were made to even make his beard fall which made him popular along with trying poison pills and toxic cigars. 

The Island nation of only 11 million people largely backed Castro. There is more to the Cuban icon or El Comandante as the people called him. He was much more than being the flag bearer of the underdog. At the same time those who opposed and despised him as a tyrant had to leave the shores of their country with most of them choosing the US. 

Given his anti-US stance, Castro had no option but to join hands with the Soviet camp during the Cold War years. It was surprising that he overcame the Bay of Pigs invasion by the powerful US as well as the Cuban missiles crisis. 

The revolutionary had to pay a telling cost for this resulting in an extraordinarily harsh trade imbargo against the tiny Island state isolating it economically. At the same time Castro supporters vouch for Cuba’s achievements in universal education and health care despite a debilitating resource crunch. This led to Castro being hailed by the Leftist movements globally. 

What hurt Havana under Castro was that it could not become part of the international system. His defiance of the ‘Yankees’ for more than six decades while extending support to national liberation struggles in Latin America, Asia and Africa turned him into a Third World icon. He refused to give up his belief in socialism. 

The clout of Castro’s global standing emerged from the Non-Aligned Movement (NAM). It may be recalled Castro arrived in New Delhi in 1983 to hand over the Presidency of Non-Aligned Movement (NAM) to India. Indira Gandhi was the Prime Minister then and the nation will never forget the bear hug the tall, bearded Cuban leader gave her spontaneously. 

His slogan of “”socialism or death”” inspired the nationalisation of natural wealth by governments across Latin America as a counter to the appropriation of oil and mineral resources by multinational corporations. 

The process of resumption of diplomatic ties between Havana and Washington under the leadership of his brother, Raul Castro, who took over in 2008 continues to be fragile. However, U S President Barrack Obama paid a historic visit to the Caribbean nation after a gap of  88 years earlier this year for a rapproachment between the two neighbours aimed at enlarging economic cooperation.

After the collapse of the Soviet Union, it seemed Castro’s communist rule would collapse. On the contrary Cuba’s survived thanks to financial interventions by Venezuela now facing bankruptcy. 

Cubans had to endure prolonged power cuts and shortages of food besides other basic items. Stubborn as Castro was, he asked the people to endure this “”special period”” which they did stoicly. 

While undertaking some reforms he allowed the disgruntled to leave by makeshift boats that compelled US President Bill Clinton to agree to more orderly migration. Unlike other dictators he did not use power for personal gain.

With Fidel Castro no more, the challenge is immense for his brother Raul Castro who has announced stepping down as President in 2018. The question is will Cuba be able to maintain its egalitarian legacy while ensuring political and social freedoms. Havana desperately needs to recover from the past by giving a major push for integrating with the global order.

(T R Ramachandran is a senior journalist and commentator. The views are personal.) ”

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Paving the way for a much-needed boost to the Army’s firepower, India on Wednesday signed the Letter of Agreement and Acceptance (LOA) with the U.S. for getting 145 M777 ultra light artillery guns. The deal, worth Rs. 5,000 crores, was given a go-ahead by the Union Cabinet on November 17. The Defence Ministry had approved the deal in October to strengthen the Army’s firepower. The air portable 155mm/39 calibre gun, with maximum range of 30 km, is manufactured by BAE Systems.

In a statement, BAE systems welcomed the signing of LOA and said: “”The company anticipates signing a contract in the coming weeks with the US Department of Defense to supply these M777 Howitzers to the Indian Army.”” According to the BAE Systems, the M777 is a highly portable gun and will prove to be a big positive in the defence arsenal. The gun is portable by land, sea and air and can be easily moved and re-deployed as per the defence forces’ needs in all theatres of war. 

 It said that India will join the U.S., Canadian and Australian forces in gaining the M777’s unmatched strategic and tactical mobility.

“We look forward to providing the Indian Army with the combat-proven M777,” said Dr. Joe Senftle, Vice President and General Manager for Weapon Systems at BAE Systems. “Our plan to establish a domestic Assembly, Integration and Test facility further demonstrates our commitment to ‘Make in India’ and remains a firm part of our strategy to work with the Indian defense sector across Air, Land, Sea and Security.”

At half the weight of other 155mm towed howitzers, the M777 provides a rapid reaction capability and a proven pedigree that delivers decisive firepower when needed most in sustained combat conditions.

With more than 1,090 M777s in service, it is the only battle-proven 155mm Ultra-lightweight howitzer in the world. It will remain at the forefront of artillery technology well into the future through the use of technical insertions, long-range precision guided munition developments, and flexible mobility options, the manufacturer said.

Earlier this year, encouraged by Prime Minister Narendra Modi’s call to “Make in India”, BAE Systems announced a plan to establish an Assembly, Integration & Testing (AIT) facility in India which will expand our global supply chain and is an integral part of the offset offer to the Government of India.

The offset offer commits to investing in, and the development of, a number of Indian defence suppliers, providing them with access to the BAE Systems group across Air, Land, Sea and Security programs. The conclusion of this procurement will enable BAE Systems to make an investment of over $200 million in those Indian defence suppliers, it said.”

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The National Human Rights Commission in its latest order has directed the Ministry of Home Affairs to make appropriate proposals to the President of India for commutation of sentence of four death row convicts in the light of Supreme Court judgments on “undue, unexplained and inordinate delay in executive due to pendency of mercy petitions.’’ The Ministry has to submit action taken report to the NHRC within three months.

The Asian Centre for Human Rights (ACHR) has welcomed the recommendation of the human rights panel on commutation of the death sentence of four death row convicts — Krishna Mochi, Nanhe Lal Mochi, Bir Kuer Paswan and Dharmendra Singh @ Dharu Singh — who were convicted in the Bara massacre case of 13 February 1993 in light of the Supreme Court judgments on undue, unexplained and inordinate delay in execution due to pendency of mercy petitions. This is the first ever recommendation made by the NHRC on commutation of death sentences and ACHR described it as a historic step in the right direction. The matter had been taken up with the Commission by the ACHR.

On 8 June 2001, the Sessions Judge, Gaya-cum-Designated Court under Terrorist and Disruptive Activities (Prevention) Act, 1987 found Krishna Mochi, Nanhe Lal Mochi, Bir Kuer Paswan and Dharmendra Singh alias Dharu Singh guilty and awarded the death sentence.  On 15 April 2002, the Supreme Court confirmed their death sentence though Justice M B Shah had dissented against the award of death sentence. Following the confirmation of the death sentence, these death row convicts filed mercy petitions with the President in 2003 and the prison authorities of Bihar forwarded their mercy petitions to the President of India on 3 March 2003. However, their mercy petitions were lost!

On 6th February 2014, ACHR filed a complaint with the NHRC against the refusal and/or failure to consider the mercy petitions filed by the four death row convicts, who are currently lodged in District Jail, Bhagalpur. The NHRC issued notices to the MHA and the State Government of Bihar to submit their replies.

After perusing the replies of the MHA and the State Government of Bihar, the NHRC in its substantive order said: “From a careful analysis of the facts and materials placed before the Commission it emerges that the four convicts in question had submitted their mercy petitions prior to 07.07.2004. This is clear from the admission of the Inspector General (Prisons and Correctional Services), Government of Bihar that the mercy petitions of the four convicts were forwarded to the Secretariat of President of India through the Home Department, Government of Bihar vide letter dated 07.07.2004. But according to the Ministry of Home Affairs, and the Secretariat of the President of India, the mercy petitions had not reached the Ministry of Home Affairs, or the Secretariat of the President of India. If the claim of the Inspector General (Prisons and Correctional Services), Bihar that the mercy petitions were sent to the President’s Secretariat through the Home Department (Special) Bihar vide letter dated 07.07.2004 is correct, where did they go and what happened to those petitions? The fact remains that the mercy petitions submitted by the four convicts prior to 07.07.2014 were not considered by the competent authority even after 12 years. It is only after the intervention of the Commission that new mercy petitions dated 31.3.2013 along with the connected documents were sent to the Ministry of Home Affairs on 28.03.2016. Even these mercy petitions are still pending consideration by the competent authority.”

The NHRC further stated “In the case of Shatrughan Chauhan (supra), the death sentence of 15 death row convicts was converted to life imprisonment on the ground of delay in deciding their mercy petitions by periods ranging from 5-12 years. In the case of Ajay Kumar Pal, the delay involved was 3 years and 10 months. From the above mentioned judgments of the Supreme Court, it is clear that Krishna Mochi, Nanhe Lal Mochi, Bir Kuer Paswan and Dharmendra Singh, who are death row convicts and who had submitted their mercy petitions prior to 07.07.2004 have a strong case to get their death sentences commuted to life imprisonment as their mercy petitions remained un-disposed off for more than 12 years and their death sentences were not executed for more than 12 years. Even the new mercy petitions dated 31.3.2013, referred to in the letter dated 28.3.2016 of the Special Secretary (Law), Government of Bihar addressed to the Joint Secretary (Judicial), Ministry of Home Affairs, Government of India have not yet been disposed off, despite expiry of a period of three years and six months.”

In the light of these, the NHRC recommended to the Government of India to submit appropriate proposals to the President of India, in the light of the judgments of the Supreme Court referred above. Necessary action in this regard may be taken by the Union Home Ministry within three months.””

“As an important limb of the democratic system, the Supreme Court should steer clear of activism in areas beyond its purview by ruling on Wednesday that cinema halls shall play the national anthem before a film starts. This has added a new dimension with certain legal luminaries suggesting that the bench should review its order at the next hearing fixed for February 14, 2017. It is churlish for any institution to assume that by standing up during the national anthem in a cinema hall is the ultimate test of patriotism. This is taking things too far as opinions differ in the ongoing debate on nationalism. In other words having a contrary view to Prime Minister Narendra Modi’s sudden demonetisation to fight the menace of black money, counterfeit currency and terrorism does not necessarily make one an anti-nationalist. It is advisable for the courts to avoid non-judicial issues evidenced with the so called movie hall nationalism. The universal principles of democracy find no reflection in the court’s order on the national anthem. The job of the judiciary including the Supreme Court is to interpret laws. Making laws is the prerogative of the legislature. Clear separation of powers is the key to a democratic system of governance. There is no ambiguity in the message of the founding fathers of the Constitution. Respect to the nation and its symbols would not be enforced by state diktat or extracted through legal compulsion. It may not be out of place to recall some of the observations of the Supreme Court in this case. It is compulsory for all citizens to now stand up and listen to the national anthem before they watch a movie in a theatre. “”When the national anthem is played or sung in a cinema hall, its doors must remain locked so that no one can create any kind of disturbance that will amount to disrespect to the Anthem,”” Justices Dipak Mishra and Amitava Roy said in an interim order. The court gave the directions on a PIL filed by a retired army officer Shyam Narayan Chowskey. The petititon sought appropriate directions to the authorities to ensure that due respect is given to the national anthem and that it is played before the start of feature films in cinemas.Justice Mishra is in line to be the Chief Justice of India after Justice J S Kehar, who is expected to take over from Chief Justice of India T S Thakur in the new year in January. The Supreme Court took note of Article 51 (A) of the Constitution which makes respecting the National Anthem a fundamental duty of every citizen, emphasising “”it is the sacred obligation of every citizen to abide by the ideals enshrined in the Constitution. One such ideal is showing respect for the National Anthem and the national flag.”” An enforced or coercive nationalism will inevitably be shallow. Patriotism is a value that most people cherish. Why is it necessary to display one’s patriotism frequently. Is it to bring round the dissenter. Given the country’s National Anthem bringing to the fore its unity in diversity, why has it become necessary for the judiciary to make the playing or the singing of the anthem mandatory through its order. Have cinema halls been chosen because they were required to play the National Anthem and given up some 30 years back. What is odd is that the directive has come from the Supreme Court and not the government. Under the circumstances questions have been raised why is the judiciary trying to overreach itself.This comes at a time when the Supreme Court is exercised over the shortage of judges in the higher judiciary and blames the Executive for stonewalling in this regard. The apex court has said that its order must be enforced in ten days in cinema halls all over the country. Lets wait and see if that is practical or will the court change its order in the middle of February next year. (T R Ramachandran is a senior journalist and commentator. The views are personal.)”

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Pakistani army chief is the most powerful person in Pakistan. There is a saying that most countries have an army but Pakistani Army has a country. There were speculations that General Raheel Sharif who formulated an image of a hardliner, anti India and a powerful Chief of Pakistani army would not step down without giving a befitting reply to India of its surgical strike of September 29.

Nonetheless General Sharif belied all assumptions and like a true soldier handed over charge to General Qamar Javed Bajwa on November 29 exactly two months after the surgical strike which damaged his macho image. General Sharif made history by being the first Chief of Army Staff in last 20 years, who retired without seeking any extension. But Nagrota terror attack happened!
Pakistan was carved out from India in 1947 but all the four provinces including Balochistan, Pakhtoon Khawa, Sindh and Punjab in West Pakistan had intense desire to become autonomous states. Secondly after the partition, the then leaders of Pakistan including Quaid-e-Azam Muhammad Ali Jinnah thought that Indian leaders have not accepted the partition of the country and they will attack and again merge the new born nation. Pakistan’s Western neighbour Afghanistan had also refused to accept the creation of a new country hence Jinnah and other leaders favoured a strong centre and a powerful army. Therefore Pakistani leadership spent limited resources of the country in strengthening the armed forces and with the passage of time army became very powerful and it had not allowed the civilian institutions to grow.
In the past Nawaz Sharif preferred Raheel Sharif as his reputation was of a professional soldier who had an aversion towards politics but with the passage of time he started deciding Pakistan’s relations with most of the important countries like India, Afghanistan, Saudi Arabia and United States. Raheel Sharif, against the wishes of Nawaz Sharif, started Operation Zarb-i-Azb in North Waziristan and eradicated several terrorist outfits which were responsible for terrorist activities in Pakistan and considered as ‘bad terrorists’ by Inter Services Intelligence. Nawaz Sharif who promised before elections to negotiate with terrorist outfits was overruled.

Nawaz Sharif who is a businessman knows that both India and Pakistan can progress if they have friendly relations and in the beginning he wanted to have amiable relations with India but Pakistani Army which thrives on anti-India rhetoric countermanded him and despite best efforts of Prime Minister Modi, relations between India and Pakistan deteriorated.
Nawaz Sharif who selected several Army Chiefs knows well that Pakistani Army will remain supreme and the civilian administration cannot counter Army as an institution. Besides this the public image of army is far superior in comparison to the political leadership which is considered to be thoroughly corrupt. The names of family members of Nawaz Sharif already appeared in ‘Panama Papers” for having ‘offshore holdings’. General Bajwa played a positive role towards democracy in 2014 when Tahirul Qadri and Imran Khan were protesting against Nawaz Sharif government and were demanding his resignation. Analysts claim that General Bajwa’s pro-democracy image also helped him in becoming Chief of Pakistani army.eneral Bajwa, superseded Lieutenant-General Syed Wajid Hussain, Lieutenant-General Najibullah Khan, Lieutenant-General Ishfaq Nadeem Ahmed including Lieutenant-General Javed Iqbal Ramday who had been posted in 10 Corps and has experience of Kashmir affairs which is a hot spot at this juncture.

General Zubair Mahmood Hayat was appointed as the Chairman of Joint Chiefs of Staff Committee (CJCSC). Although the post of CJCSC is senior to Army chief but Pakistan Army Chief is the most powerful person in the country. He took over as Chief after a tenure at the GHQ as the Inspector General of the Training and Evaluation from 2015 to 2016 and as the Corps Commander X Corps from 2013 to 2015 which is responsible for the area along the Line of Control. Bajwa also served as a peacekeeper in the UN mission in Congo as a brigade commander. Commissioned in 16 Baloch Regiment on 24 October 1980, in 1982, he was shifted to the Sindh Regiment.

Pakistani press and public feel that General Bajwa being apolitical and relaxed person would return back the power to the civilian government. The analysts mention that as Bajwa has a leaning towards democracy and is a low-profile general hence it will be easy for the civilian government to deal with him.

General Sharif lost his uncle in 1965 India Pakistan war while his real elder brother who was his mentor was also killed in 1971 war with India. Hence General Sharif had an inherent aversion towards India. It is anticipated that General Bajwa who has no repugnance towards India may be helpful in easing out the current tense atmosphere between both the countries. However, strategic experts claim that ISI sponsored two terrorist attacks on at Nagrota in which seven army personnel including two majors were killed was a blunt message to General Bajwa that he should not meddle with low intensity war launched by ISI against India.

Pakistan watchers unanimously feel that Indian security forces should not expect any major change in Pakistani sponsored terrorist activities because of change of army chief. Pakistani Defence Minister Khawaja Asif told a Pakistani news channel that “The focus will remain on country’s eastern border and the armed forces backed by the nation will meet all challenges”. He further mentioned that “The legacy of General Raheel Sharif would continue in the light of the examples he set”.

General Bajwa would face problems at many fronts especially with its Eastern as well as Western neighbours. After surgical strike of India Pakistani forces enhanced shelling on Indo-Pak border and ISI is infiltrating terrorists at a large scale. The tension between both the nuclear countries is enhancing and General Bajwa may try to tone down the tension.

The terrorist incidents in Afghanistan are also enhanced and Afghan government alleges that ISI sponsored terrorist outfits are responsible for these terrorist acts. Pakistan should genuinely reduce its assistance to terrorist groups operating in Afghanistan so that relations between both the countries improve. US administration under Donald Trump will be much more stringent against terrorism in comparison to his predecessor and Pakistani army and government have to work hard to inculcate friendly relations.

Pakistani masses are fed up with several terrorist activities in the country hence Bajwa had to be more stringent with the terrorist outfits. The Pakistan analysts mention that operation Zarb-e-Azb will continue with more vigour and strength not only in tribal areas and Karachi but it will also expand in other areas. General Bajwa should also try to control ISI which is sponsoring terrorism in India so that the relation with its eastern neighbour is improved. Nonetheless the primary task of General Bajwa would be to inculcate cordial relations with the civilian government which is essential for the progress of the country as well as for a smooth foreign policy.
(Jai Kumar Verma is a Delhi-based security analyst. He has served in Indian missions in Dubai, Washington and Islamabad. The views in the article are personal. This article first appeared on November 30 in Aviation and Defence Universe and is being reproduced here with the author’s permission.)”

“Prime Minister Narendra Modi on Sunday stressed the need to wipe out the terror network, saying it was endangering the entire region. A declaration released at the end of the summit also called for immediate eradication of terror to help Afghanistan which has faced destruction due to conflicts in its various regions. Addressing the Heart of Asia Summit in Amritsar, Punjab, Mr. Modi said that terrorism and externally induced instability pose the gravest threat to Afghanistan’s peace, stability and prosperity. “”And, the growing arc of terrorist violence endangers our entire region. As such, support for voices of peace in Afghanistan alone is not enough,” he told delegates at the summit which is chaired by Afghanistan.
Without naming Pakistan, Prime Minister Modi said that support for peace in Afghanistan must be backed by resolute action. “”Not just against forces of terrorism, but also against those who support, shelter, train and finance them,” he said in a veiled reference pointing towards Pakistan.
Mr. Modi asserted that silence and inaction against terrorism in Afghanistan and our region will only embolden terrorists and their masters. “”Our bilateral and regional commitments of material assistance for Afghanistan’s development and humanitarian needs must continue and increase. Our cooperative endeavours in Afghanistan should contribute to its infrastructure and institutional capacity, and self-propelling engines of growth,” he said.He said the need of the hour is to stand our ground and continue with our line of effort. “”We must protect and build on the gains of the last fifteen years and march ahead. Because, at stake is not just the future of Afghanistan that has invested in a vision of development, democracy, and pluralism. But, the peace and stability of this entire region, and beyond,” he added. 

Pointing to the need to reflect with urgency on what more must be done so that its citizens can self-sustain peace and economic growth, Mr. Modi said the question is of resolve and action and of putting Afghanistan and its people first. 

“”For this, First, an Afghan-led, Afghan-owned and Afghan-controlled process is key. It is the only guarantor of durability of solutions. Second, we must demonstrate strong collective will to defeat terror networks that cause bloodshed and spread fear,” he told the summit. 

Mr. Modi said that Afghanistan should be at the centre of our connectivity networks, not peripheral to them. “We cannot deny that the more connected Afghanistan is with the regional arteries of trade, capital and markets, the more assured would be its economic growth and progress. President Ghani and I have converged on the priority of strengthening trade and transport linkages with other partners in the region,” he added. 

Pointing out that welfare of Afghanistan and its people was close to India, he said that successful  record of our partnership in projects, big and small, in Afghanistan speaks for itself. The principal dimension of our cooperation has always been its people centric nature. 

He said that India’s joint efforts were directed at educating Afghanistan’s young and nurture their skills; provide health care and improve agriculture; build infrastructure and institutions; and allow traders and small businesses in Afghanistan to connect with immense commercial and economic opportunities in India. 

Mr. Modi urged the delegates to re-dedicate to making Afghanistan a Geography of Peace — a place where reason and peace succeeds; progress and prosperity prevails and democracy and plurality wins. He asked the 6th Ministerial Conference of the Heart of Asia- Istanbul Process on Afghanistan to remember that every passing day we help Afghanistan to achieve successful political, security and economic transitions, we are also helping ourselves create a more peaceful region and world.”

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Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) pose a serious health risk. According to the World Health Organisation (WHO), the risk of developing TB is estimated to be between 26 and 31 times greater in people living with HIV (PLHIV). In 2015, there were an estimated 10.4 million new TB cases worldwide, of which PHLIV accounted for 1.2 million (11%) cases. TB caused 400,000 deaths among the PLHIV of the 1.4 million who died of TB in the same year.  The TB-HIV co-infection is potentially lethal combination.

When a person develops HIV, his/her immune system loses its ability to fight off infections, making him or her more vulnerable to other infections like TB. People living with HIV are especially vulnerable to tuberculosis in countries where TB is common. Roughly, 75% of PLHIV who contract TB live in sub-Saharan Africa. In some countries in this region, up to 80% of individuals with active TB disease are also HIV-positive.

TB-HIV increasingly poses a risk to people living in other regions. Roughly 30% of all people who become sick with tuberculosis live in Asia, where TB accounts for 40% of AIDS deaths. Eastern Europe has the fastest-growing HIV epidemic globally, making this region vulnerable to increasing TB-HIV co-infection as well, according to the WHO.

According to Dr Anthony D. Harries, Senior Advisor and Director, Department of Research, International Union Against Tuberculosis and Lung Disease (The Union), a healthy person has a 5-15% life time risk of contracting TB whereas a person with HIV has an annual 5-15% risk of contracting TB.

“”Antiretroviral Therapy (ART) suppresses HIV replication and this leads to a gradual increase in CD4 cell counts. These increased CD4 cell counts protect against TB. Studies have shown that CD4 count of less than 100 can have a TB rate of 25.5 per 100 per year as against a CD4 count of more than 700 where this rate falls to 2.7. In the case of an individual who is not infected with HIV, the rate is less than 0.62 per 100 per year,’’ Dr Harries explains.

Isoniazid Preventive Therapy (IPT) also reduces the overall risk of TB by 33% in PLHIV, Dr Harries says while adding that synergizing IPT to ART would greatly benefit the patients as studies had shown a 37% reduction in TB among people living with HIV as compared to ART alone.

According to WHO, measures have been taken to integrate TB-HIV care in countries around the world, with increasing success. For example in 2014, 77% of people living with HIV who were also diagnosed with active TB, were placed on anti retroviral treatment (ART). Still, opportunities are being missed as only 47% people on ART were screened for TB, only 51% people diagnosed with TB were tested for HIV, and only half of the estimated number of people living with HIV who developed TB were diagnosed and provided with TB care.

The Union has committed to addressing this lethal co-epidemic through an integrated care approach known as Integrated HIV Care for Tuberculosis Patients Living with HIV/AIDS (IHC). This approach aims to strengthen collaboration and build capacity of affected countries’ general health systems to deliver high-quality HIV and TB care.

Between 2000-2014, WHO estimates that 8.4 million lives have been saved through integrated and collaborative TB-HIV activities. There are still many more lives to save and more needs to be done to achieve universal access and to eliminate HIV-associated TB deaths. To begin, WHO recommends that all patients with presumptive or diagnosed TB should be tested for HIV.

According to WHO, the funding required for a full response to the global TB epidemic in low- and middle-income countries was estimated at US$ 8 billion per year in 2015, excluding research and development. As much as US$ 6 Billion could be mobilized from domestic sources, leaving a balance of US$ 2 billion needed from international donors. This gap fuels not only the spread of TB but also has serious implications for the health and safety of those living with HIV. Ending TB is crucial to the survival of those with HIV.

People living with HIV also face the threat of drug-resistant TB. If diagnosis is delayed, people living with HIV are at high risk of death from multidrug-resistant and extensively drug-resistant TB (MDR & XDR-TB).Integrated care is very important for patients at risk of co-infection with drug-resistant TB and HIV.

People living with HIV are also more likely than people who are not infected with HIV to have extra pulmonary TB. Between 40-80% of HIV infected people with TB have extra pulmonary disease, compared with 10-20% of people without HIV.”

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Ingenious are the ways of the bureaucracy all over the globe. It keeps itself busy with minders, reminders and rejoinders.

So the Indian bureaucracy can’t be expected to be any different. But the moot question does it need the authority of the Cabinet Secretary and Secretariat to send routine reminders to ministries and departments that report to the institution.

The Cabinet Secretary is the top most executive official and senior-most civil servant in the Government of India. The Cabinet Secretary is the ex-officio head of the Civil Services Board, the Cabinet Secretariat, the Indian Administrative Service (IAS) and head of all civil services under the rules of business of the Government of India.The Cabinet Secretary is under the direct charge of the Prime Minister. Though there is no fixed tenure, the average tenure of the Cabinet Secretary has been less than 3 years. His or her tenure however, can be extended.

The senior-most civil servant has at its disposal a Secretariat. The administrative head of the Secretariat is the Cabinet Secretary who is also the ex-officio Chairman of the Civil Services Board. In the Government of India (Allocation of Business) Rules, 1961 “”Cabinet Secretariat”” finds a place in the First Schedule to the Rules. The subjects allotted to this Secretariat are Secretarial assistance to Cabinet and Cabinet Committees and Rules of Business.

This case best illustrates the point. On November 10 the Secretariat sent a note to all the central government Ministries and Departments maintaining that it is mandatory for them to seek ex-facto approval of the Cabinet or the concerned Cabinet Committee even in the cases where the sanction of the Prime Minister is obtained.

An official memorandum by a director level officer in the Secretariat S.G.P. Verghese maintained that “”the note for seeking ex-post facto approval of the Cabinet o concerned Cabinet Committee should be forwarded to Cabinet Secretariat latest with n one month of the approval under Rule 12″”.

“Attention is also drawn to Cabinet Secre ary’s D.o letter no. 1/48/6/2015-Cab. dated 14.08.2015 which conveyed the directions of the Prime Minister that “”all MoUs that are signed by the Departments and are required o be brought before the Cabinet for post facto approval or information, under extant provisions, must be submitted within one month of the signing of the MoU. In case of any delay, the Note should detail the specific reason(s) and justification(s) in submitting the Note before the Cabinet after the prescribed time period”.

The memorandum complained that in spite of the clear instructions on the subject, instances of delayed submission of notes by Ministries/ Departments have been observed. In many cases, the Ministry/ Department have not detailed reason(s) and justification(s) for the de ay in submitting the note beyond the prescribed time period. “This has been viewed seriously.”

We shall wait and watch if indeed the reminder would be `viewed seriously’ by the ministries and departments addressed. The past gives no reason for any optimism. 

About the author: The author is a practicing hack, a cynic to core.”

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Expressing deep concern and shock over the verdict of the Delhi High Court, lifting the ban imposed on 344 Fixed Dose Combinations (FDCs) of drugs by the Government a few months back, the Jan Swasthya Abhiyan (JSA) has said it was a huge setback to efforts aimed at bringing a semblance of order into the absolute anarchy that exist in India’s pharmaceutical market.

All the 344 FDCs that were banned are irrational and there is no scientific rationale for their continued use. Most of them are being manufactured in gross violation of regulatory procedures and should not have been allowed to be marketed in the first place, a statement issued by JSA has said.

“”Medical students are not taught about their use as no text book of Medicine or Pharmacology recommends the use of these combinations. There is also a large volume of evidence from across the world that speaks to the necessity of discontinuing the use of these FDCs. In fact, the 344 FDCs banned constitute the proverbial tip of the iceberg, and there are thousands of other FDCs that also need to be banned. The use of FDCs is generally discouraged except in a handful of cases, none of which are addressed by the FDCs that were banned,”” the statement said.

The World Health Organization’s Model list of Essential Medicines includes only 24 FDCs (out of 358) and India’s National list of Essential Medicines includes only 16 FDCs (out of 348). Yet, an estimated 40% of the Indian market for drugs comprises of FDCs.

The challenge of the ban order by drug companies, including by some of the largest MNCs like Pfizer, Glaxosmithkline and Abbott, was a disingenuous attempt by them to preserve their profits and to profiteer at the expense of public health. Most of these FDCs are not even registered in countries with strong regulatory systems. Further, as these drugs have no therapeutic validity their sales are driven by unethical marketing practices of drug companies, such as financial and other inducements offered to prescribers, the JSA has said.

 Pointing out that the use of FDCs increases cost of medication, exposes populations to a larger array of adverse effects and limits the choice of therapy as they may combine drugs with different dosage schedules, the JSA has said expenses borne by patients account for more than 70% of all healthcare costs and within these, 70% is accounted for by expenses incurred in buying medicines. The continued use of FDCs contributes to a big drain on the finances of individual patients. Further, some of the cough syrups in the ban order are primarily being used as addictive substances and not as therapeutic agents. Criminal investigation agencies and the narcotics bureau have filed several cases on charges of smuggling of the addictive cough syrup Phensedyl (one of the drugs in the banned list).

Access to essential, rational and affordable medicines is a core component of right to health care. In several judgments the Supreme Court of India and High Courts have upheld the fundamental right to health as part of the right to life with dignity over technical procedural issues. However, the lifting of the ban seems to be predicated on perceived procedural issues which fundamentally abrogate the right to life and health care.  Besides, the Delhi High Court order does not appear to address the issues of rationality of the FDCs and the resultant adverse effect on public health. Drug companies should not see this order as a vindication of their stand that these FDCs are rational, the JSA said while calling upon the esteemed judiciary of the highest courts to support and uphold people’s fundamental right to access affordable and rational medicines over the interest of the profiteering corporations who might see the lifting of the ban as a renewed opportunity to inundate the market with irrational FDCs.

The JSA has also appealed to all individual physicians, associations of medical professionals and hospitals not to prescribe the FDCs concerned. It has strongly urges the Government to appeal against the order lifting the ban in the Supreme Court of India. It must also, where appropriate, plug legal and regulatory loopholes so that the ban order can be restored. It is of utmost importance that the government, as a custodian of public health, act decisively to defend it and strengthen regulatory mechanisms. Many of the FDCs covered by the earlier ban are sold over the counter and nothing short of a complete ban can address the threat to public health posed by these drugs. The JSA also appealed to the judiciary to take a broad and informed view of while adjudicating on issues where the private commercial interests of companies come in direct conflict with public health.”

“Coming down heavily on Pakistan for its support to terror groups operating from its soil including Lashkar-e-Tayyaba (LeT) and Jaish-e-Mohammad (JeM), the just concluded Heart of Asia Conference in Amritsar has demanded concerted regional and international cooperation to eliminate terrorism in all its forms and manifestations as well as dismantling of terrorist sanctuaries and safe havens in the region as also disrupting all financial, tactical and logistical support for terror networks.Specific mention of LeT and JeM and Haqqani network along with other groups indulging in heightened  violence in Afghanistan and the region is a boost for India considering that these Pakistan-based terror outfits were not named in the BRICKS Goa declaration. Some 40 countries including Pakistan, represented by Sartaj Aziz, advisor to Prime Minister Nawaz Sharif on foreign affairs participated in the two-day conference, which concluded on Sunday.Without naming Pakistan, Prime Minister Narendra Modi spoke strongly about the need to demonstrate strong collective will to defeat terrorism. He said that silence and inaction against terrorism in Afghanistan and the Southeast Asian region will only embolden terrorists and their masters.Resolute action must be taken not just against forces of terrorism but also against those who support, shelter and finance them, he said.Reflecting Modi’s assertion, Afghan President Ashraf Ghaniunambiguously named Pakistan for promoting terrorism and said no amount of financial assistance can help stabilise the war-ravaged nation if “”support to terrorists”” from the neighbouring country continued. Ghani referred to USD 500 million pledged by Pakistan for reconstruction of Afghanistan and bluntly told Aziz that this money can “very well be used for containing extremism because without peace, any amount of assistance will not meet the needs of our people.”Ghani also said military operations in Pakistan have brought about selective displacement of terrorists networks.Maintaining that state-sponsored sanctuaries exist in Pakistan, he, quoting a Taliban leader said, “ as Mr Kakazada (Mullah Rahmatullah Kakazada), one of the key figures in the Taliban movement, recently said, if they did not have sanctuary in Pakistan, they would not last a month.”He also said that about 30 terrorist groups, as named by the UN, are trying to establish their base in Afghanistan and there was a need to identify cross-border terrorism and a fund to combat the scourge.Describing terrorism as the biggest threat to peace, stability and cooperation in the region the conference in its declaration pressed for dismantling terrorist sanctuaries and safe havens in the Heart of Asia region.It called upon all states to take action against these terrorist entities in accordance with their respective national counter-terrorism policies and UN Global Counter Terrorism Strategy 2006.In his statement, India’s Finance Minister Arun Jaitley — who led the Indian delegation in the absence of ailing external affairs minister Sushma Swaraj — said, “For the first time, a Heart of Asia Declaration expressed concern at the violence caused in Afghanistan and the region by terrorist groups like Al Qaeda, Daesh, LeT and JeM, etc.” Observers feel the declaration is a clear message to Pakistan — without naming it — that it should dismantle the safe havens of terrorism on its soil.The Amritsar Declaration said, “We remain concerned by the gravity of the security situation in Afghanistan in particular and the region and the high level of violence caused by the Taliban, terrorist groups including ISIL/ DAESH and its affiliates, the Haqqani Network, Al Qaeda, Islamic Movement of Uzbekistan, East Turkistan Islamic Movement, LeT, JeM, TTP, Jamaat-ul-Ahrar, Jundullah and other foreign terrorist fighters. Acknowledging the support that terrorism derives in our region, we demand an immediate end to all forms of terrorism, as well as all support to it, including financing of terrorism. We recognise that terrorism is the biggest threat to peace, stability and cooperation in our region. We encourage the international community to continue to assist the Government of Afghanistan. We strongly call for concerted regional and international cooperation to ensure elimination of terrorism, in all its forms and manifestations, including dismantling of terrorist sanctuaries and safe havens in the Heart of Asia region, as well as disrupting all financial, tactical and logistical support for terrorism.”“We welcome and support Afghanistan’s initiative in taking the lead in exploring a regional counter-terror strategy, in accordance with the established principles of the UN charter, which we agreed was necessary when we last met in Islamabad in December 2015. We note the progress that has been made since the last Ministerial with an Ambassadorial meeting of the CT-CBM participating countries at which a draft framework strategy was shared by Afghanistan for further consideration and development. We call for convening an early meeting of experts to discuss the draft framework strategy with the view to its finalisation for consideration by senior security officials,” it said.Mr Jaitley said, the three big issues of the conference were—-Countering terrorism to create stability and security in Afghanistan, Providing Afghanistan connectivity to strengthen economic activities, and Development, which is essential for the progress of Afghanistan.The participating countries included——apart from Afghanistan and host India——Azerbaijan, China, Iran, Kazakhstan, Kyrgyz Republic, Pakistan, Russia, Saudi Arabia, Tajikistan, Turkey, Turkmenistan, the United Arab Emirates, and the United Nations. The Conference also saw the presence and participation of guest countries Austria, Bulgaria, Latvia and Uzbekistan. The other supporting countries and international and regional organisations included Australia, Canada, Denmark, Egypt, European Union, Finland, France, Germany, Iraq, Italy, Japan, Poland, Norway, Spain, Sweden, the United Kingdom, the United States, Aga Khan Development Network (AKDN), Asian Development Bank (ADB), Conference on Interaction and Confidence Building Measures in Asia (CICA), Collective Security Treaty Organisations (CSTO), Economic Cooperation Organisations (ECO), North Atlantic Treaty Organisation (NATO), Organisation of Islamic Cooperation (OIC), Organisation for Security and Cooperation in Europe (OSCE), Shanghai Cooperation Organisation (SCO), and South Asian Association for Regional Cooperation (SAARC).(The writer is a Delhi-based freelance journalist. He has had a long stint in various editorial capacities, including West Asia correspondent, for the PTI news agency.) “