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01st April 2024

Global Forest Expansion and impact on Tribals

Context

Context

A symposium at the University of Arizona discussed the rights of indigenous people. It highlighted concerns about how the Kunming-Montreal Global Biodiversity Framework, combined with India's Forest (Conservation) Amendment Act of 2023, will particularly impact the country's tribes, already affected by the establishment of national parks.

1: Dimension-Implication for indigenous community

  • Resource at the cost of indigenous community:The goals of GBF seems to tilt the scale in favour of corporate houses eyeing forest resources at the expense of the indigenous communities living with nature.
  • PAs as hunting grounds for elites:PAs were initially created “as recreational opportunities, hunting grounds for western colonial elites”.
    • The concept has not changed much with ecotourism or sustainable ecotourism projects reducing the indigenous peoples to animals in a zoo, made to sit in “model replicas” of traditional houses wearing traditional dresses and ornaments, and playing traditional musical instruments.

2: Dimension- GBF and India’s Case

  • Threatened indigenous people: About 84% of India’s national parks (89 out of a total of 106) were established in areas inhabited by the indigenous peoples and meeting the GBF targets will threaten their existence.
    • For instance, the initiative to upgrade the Kumbhalgarh Wildlife Sanctuary in Rajasthan to a tiger reserve will affect 162 tribal villages located inside and outside the sanctuary
    • The expansion of the Nauradehi Sanctuary in Madhya Pradesh is set to affect 62 villages of mostly tribal people.

3: Dimension- Required measures to protect the tribal lands

  • Consent:First, it has to recognise the right to free, prior, and informed consent as guaranteed under the Panchayats (Extension to Scheduled Areas) Act and make further amendments to the laws to make the tribals custodians of the PAs as nature has largely been protected because of their special relations with the forests and their denizens.
  • Creating PAs in non-tribal areas: If tiger reserves can be created in areas where there are no tigers such as Sahyadri (Maharashtra), Satkosia (Odisha), Kamlang (Arunachal Pradesh), Kawal (Telangana), and Dampa (Mizoram, PAs can be created in non-tribal areas.
  • Addressing human right issues: There is need to address human rights violations in the PAs seriously such as access to education, healthcare, and housing.
  • Respect and recognition for preservation: Thousands of indigenous people living within the PAs must be respected and recognised for preserving the biodiversity and the ecosystem and not punished.

Case Study: Indigenous People and Forest

  • Indonesia:Indigenous peoples have been denied the right to housing, health, education, electricity, and security in Indonesia’s Ujungkulon National Park while Heng Saphen living, an indigenous leader living inside the Beng Per Wildlife Sanctuary of Cambodia was convicted by a kangaroo court for cultivating on her own land.
  • Cambodia:About 18% of Cambodia’s Botum Sakor National Park stand protected after much of its land was sold off to private firms.
  • India:Involving the private sector in forest conservation is a bad idea and India has taken a step in that direction with the Forest (Conservation) Amendment Act to 2023 to include zoos, safaris, ecotourism facilities, etc., as forest activities.

Fact Box

About Kunming-Montreal GBF

  • The 15th Conference of Parties (COP15) to the UN Convention on Biological Diversity (CBD) adopted the Kunming-Montreal Global Biodiversity Framework (GBF).
  • The framework has 23 targets that the world needs to achieve by 2030.
  • Objectives: The new frameworks have four goals to achieve by 2050:
    • To halt the extinction and decline of biodiversity.
    • To enhance and retain nature’s services to humans by conserving.
    • To ensure fair and equitable benefits to all from the use of genetic resources.
    • To close the gap between available financial and other means of implementation and those necessary to achieve the 2050 Vision.
  • In adopting the GBF, all parties committee to setting national targets to implement it.
  • Target 3 of the Kunming-Montreal GBFaims to “increase terrestrial, inland water, and of coastal and marine areas, especially areas of particular importance for biodiversity and ecosystem functions and services” to at least 30% of the world’s terrestrial area. At present, protected areas (PAs) cover about 16%.

India’s forest cover

  • Forest cover’, in India, refers to land greater than one hectare in size where the tree canopy density is greater than 10%.
  • India’s total forest cover rose to 38,251 sq. km from 2001 to 2021.

UPSC PYQ

Rehabilitation of human settlements is one of the important environmental impacts which always attracts controversy while planning major projects. Discuss the measures suggested for mitigation of this impact while proposing major developmental projects. (UPSC 2016)

India's Infrastructure Boost along China Border

Context

India is ramping up efforts to enhance infrastructure and connectivity along the LAC with China, extending beyond the Kameng region. While Kameng and Tawang have witnessed development over the past decade, other areas are now catching up to match China's infrastructure standards along the LAC.

1: Dimension- Need for infrastructure development in India's North-East

  • The need for infrastructure development in India's North-East is paramount to enhance connectivity, promote economic growth, and address regional disparities.
  • Improved infrastructure can facilitate smoother movement of goods and people, boost tourism, and unlock the region's vast potential for development.

2: Dimension- The rate of development

  • Highway:Work on the 2,400-km trans-Arunachal highway is expected to be completed this year.
    • The new, almost 1,800-km-long frontier highway, on which work has commenced, will fill a critical void facilitating inter-valley movement. It will start from Bomdila in Arunachal’s west and end in Vijaynagar, near the Indo-Myanmar border.
    • Another 3,000 km of road infrastructure is also under planning and construction in the State. 
  • Operational tracks: A number of operational tracks are being built by the Army to ensure last-mile connectivity in the forward areas, and in addition, a large number of projects have been sanctioned under the Prime Minister Gati Shakti project for infrastructure development.
  • Bridges:A total of 34 new bridges have been constructed between 2020 and 2023.
  • Connectivity across river:Another infrastructure development is the connectivity across the Lohit river, which, for India, starts from Kibithoo and flows to Tezu, and then joins the Brahmaputra in Assam, a distance of almost 350 km, dividing the stretch into east and west banks. 
  • From 2G to 4G: The Universal Service Obligation Fund (USOF) was established to provide access to “basic telegraph services” to people in remote and rural areas at aordable and reasonable prices.

3:Dimension- Vibrant village program and its significance

  • The VVP was approved as a Centrally-sponsored scheme in 2023 (in Kibithoo)for the development of 2,967 villages in 46 blocks across 19 districts in the borderStates of Arunachal Pradesh, Himachal Pradesh, Sikkim, Uttarakhand, and the Union Territory of
  • The objective is comprehensive development of these villages to improve the quality of life of people, thereby reversing outmigration.
  • The VVP is an effort to counter China’s model villages — called Xiaokang and located very close to the LAC opposite Uttarakhand, Sikkim, and Arunachal Pradesh — which have raised apprehensions in the security establishment.

Fact Box

LAC’s Division

  • The Indian Military has divided the Line of Actual Control into 3 sectors – 
    • Western sector across Ladakh and the Chinese-held Aksai Chin
    • Central sector across Himachal Pradesh and Uttarakhand
    • Eastern sector across Sikkim and Arunachal Pradesh

The Army’s demarcation of Arunachal Pradesh

  • For administrative purposes, the Army classifies Arunachal as Kameng, derived from the name of the river that flows through the State.
  • Tawang district is part of the Kameng area, while the remaining part of the State is considered separate and was earlier referred to as the Rest of Arunachal Pradesh (RALP).
  • Of the 3,488-km-long Line of Actual Control (LAC), 1,346 km falls in the eastern sector, comprising Sikkim and Arunachal.
  • While the Tawang and Kameng areas are under the Army’s IV Corps (Tezpur)
  • RALP is under the III Corps (Dimapur).

Kibithoo

  • Kibithoo is one of the easternmost villages in Anjaw district of Arunachal Pradesh.
  • Inhabited by people of the Meyor tribe, it is located about 7-8 km from the Line of Actual Control (LAC), the contested line that separates India and China. 

UPSC PYQ

  1. “Investment in infrastructure is essential for rapid and inclusive economic growth.” Discuss in the light of India’s experience.  (UPSC 2021)
  2. Border management is a complex task due to difficult terrain and hostile relations with some countries. Elucidate the challenges and strategies for effective border management. (UPSC 2016)

Natural Gas: Cleaner but not clean

Context

Amidst global energy politics, the narrative of natural gas being 'cleaner' in comparison to coal requires closer scrutiny, especially considering the continuing overuse of oil and gas by developed countries despite their share of the carbon budget.

1: Dimension- The Race for adoption of natural gas

  • In race towards energy transition, natural gas has emerged as a key player, often touted as a 'bridge fuel' for nations aiming to reduce reliance on coal and oil.
  • Advocates highlight its cleaner profile compared to other fossil fuels, emitting 50% less CO2 during combustion, positioning it as a crucial element in the pathway towards renewable energy and electrification.
  • Furthermore, the Intergovernmental Panel on Climate Change (IPCC) has underscored the urgency of phasing out coal over reducing gas usage for the 1.5°C pathway, particularly impacting coal-dependent Global South countries.

2: Dimension- Significance of Natural Gas for India

  • Economic benefits: India is largely dependent on import of fossil to meet energy needs. Adoption of natural gas will reduce import costs and thus foreign exchange.It will create new employment opportunities to harness demographic dividend.
  • Environmental benefits: It will help in achieving target of increasing non fossil fuel energy consumption to 40% by 2030.
  • Social benefits: It will tackle health challenges due to rise in pollution by fossil fuels. AS per WHO, estimates that globally about seven million people die prematurely each year from diseases linked to air pollution

3: Dimension-The other side of natural gas

  • Natural gas produces half as much carbon dioxide (C02) when burned than coal, but that doesn't make it harmless.
  • Rising production of natural gas is emerging as one of the biggest drivers of climate change.
  • Methane releases from the natural gas supply chain are a key factor in equalising overall GHG emissions between gas and coal, creating emissions parity. 

The evolution of Neuroscience & Concerns

Context

Neuroscience is increasingly applied in India to solve business challenges, such as understanding consumer behaviour; ethical considerations arise particularly concerning informed consent and transparency.

1: Dimension- Significance of neuroscience

  • Understanding Brain Function:The nervous system controls essential body functions and processes thoughts, emotions, and behavior through neural connections in the brain.Neuroscience aims to study these neural connections and their role in information processing, both in healthy states and when damaged.
  • Impact on Human Health:Neuroscience contributes to understanding various conditions like Down syndrome, autism, ADHD, addiction, schizophrenia, Parkinson's disease, and immune disorders.
  • Technological Advancements:Recent technologies like membrane clamp electrophysiology, PCR, and genome sequencing have enhanced our understanding of cellular and molecular processes in the brain.Future advancements are anticipated to provide even deeper insights into how neurons function collectively, the origins of diseases, and the unique aspects of the human brain.

2: Dimension- Ethical concerns

  • Informed Consent and Privacy:Informed consent from research participants, especially when invasive techniques are used, and protecting their privacy regarding sensitive brain-related data.
  • Cognitive Enhancement and Manipulation: The use of neuroscience for cognitive enhancement or manipulation, raises questions about fairness, autonomy, and unintended consequences on individuals and society.

Fact Box: What is Neuroscience?

  • Neuroscience is a multidisciplinary science that combines physiology, anatomy, molecular biology, developmental biology, chemistry, philosophy, computer science, mathematics, linguistics and medicine.
  • It is the scientific study of the structure and function of the human brain and nervous system.
  • Neuroscientists study the cellular, functional, behavioral, evolutionary, computational, molecular, cellular, and medical aspects of the nervous system, which contains billions of cells called neurons, or nerve cells.

Ethics Question Case Study:

A prominent pharmaceutical company has developed a groundbreaking neurotechnology that enhances cognitive abilities, memory retention, and learning capacity. The technology, when implanted in the brain, significantly boosts intellectual performance and productivity. However, the company faces ethical dilemmas regarding the widespread deployment of this technology.

Question:

  • Discuss the ethical implications of introducing neuroenhancement technologies like the one described in the case study.
  • How should policymakers balance the potential benefits of such advancements with concerns related to individual autonomy, societal fairness, and unintended consequences?
  • Evaluate the ethical framework that should guide the regulation and ethical use of neurotechnologies in society.

Vaikom Satyagraha

Context

The centennial commemoration of the Vaikom Satyagraha (March 30, 2024), brings attention to a significant chapter in India's history thatforegrounded social reform amidst the growing nationalist movement, bringing Gandhian methods of protest to the state of Travancore.

About the Satyagraha:

  • Vaikom, a temple town in the princely state of Travancore, saw the start of a non-violent agitation on March 30, 1924 — the first among temple entry movements that would soon sweep across the country.
  • Vaikom Satyagraha lasted for 604 days (20 months) from March 30, 1924 to November 23, 1925.
  • It was a mass Temple entry movementfor lower caste people.
  • Leaders involved:
    • Led by:TK Madhavan, KP Kesava Menon, K Kelapaan (Congress Leaders)
    • Supported by:Mahatma Gandhi, Periyar, C Rajagopalachari, Chattampi Swamikal, Sree Narayana Guru
  • The nonviolent movementdemanded the right of members of lower castes to walk on the roads leading to the Vaikom Temple, now in the district of Kottayam.
  • The authorities denied their request, stating that it would lead to social unrest and disturbance.
  • This denial was met with widespread protests and demonstrations, which eventually led to the involvement of Mahatma Gandhi, who arrived in Vaikom in 1925.
  • Gandhi was able to iron out a compromise: three out of the four roads surrounding the temples were opened upfor everyone but the fourth, eastern road was kept reserved for Brahmins.
  • Outcome:The protests eventually led to the historic Temple Entry Proclamation issued by the then king Chithira Thirunal Balarama Varma on November 12, 1936. It abolished the ban on 'lower castes' from entering Hindu temples in the Princely State of Travancore.

India grants GI Tags to over 60 items

Context

Over 60 products from across India have been given the Geographical Indication (GI) tag. 

The important products

  • Tripura:
  • Pachra-Rignai, which is a traditional dress worn on special occasions
  • Matabari Peda, a sweet preparation
  • Uttar Pradesh (Banaras)
  • Banaras Thandai, a drink made by blending milk with a nutritious mix of nuts, seeds and spices
  • The Banaras Tabla, Banaras Shehnai, Banaras Lal Bharwamirch and Banaras Lal Peda.
  • Assam:
  • Six traditional crafts from Assam — Asharikandi terracotta craft, Pani Meteka craft, Sarthebari metal craft, Jaapi (bamboo headgear of rural Assam), Mishing handloom products, and the Bihu dhol.
  • Others:
    • Bodo Dokhona, the traditional attire of Bodo women
    • Bodo Eri silk, referred to as the fabric of peace or ahimsa (non-violence), which comes from the silkworm Samia ricini that feeds mostly on the leaves of the castor plant (Ricinus communis), and cassava
    • Bodo Jwmgra (a traditional scarf)
    • Bodo Gamsa (traditional dress of Bodo men)
    • Bodo Thorkha (a musical instrument)
    • Bodo Sifung (a long flute)
  • Meghalaya:
    • Meghalaya Garo Textile weaving (Garo dakmanda)
    • Meghalaya Lyrnai Pottery
    • Meghalaya Chubitchi (traditional drink)
    • Lakadong turmeric

Fact Box: GI Tag

  • The Geographical Indication is awarded to products that have a specific geographical origin, and that have characteristics related to a particular location.
  • Till date, around 635 products in India have been given the GI tag.
  • The first GI tag in the country was given two decades ago to the famous Darjeeling tea.

Bharat Ratna

Context

President Droupadi Murmu presented the Bharat Ratna to five recipients -- socialist icon Chaudhary Charan Singh, former Prime Minister PV Narasimha Rao, former Bihar Chief Minister Karpoori Thakur, agriculture scientist MS Swaminathan and Bharatiya Janata Party (BJP) patriarch L.K. Advani.

Important contributions

  • V. Narasimha Rao was commended for his leadership in economic reforms and his involvement in the freedom struggle against the Nizam rule in Hyderabad.
  • Chaudhary Charan Singh’s contribution to the abolition of zamindari, his expertise in land reforms and his close ties with farmers were remembered.
  • S. Swaminathan was praised as the “Father of India’s Green Revolution” for his role in making India self-reliant in food production.
  • Karpoori Thakur’s commitment to helping marginalised communities was recognised, along with his role as a freedom fighter and an advocate for equality and inclusive development.

Fact Box: Bharat Ratna

  • The Bharat Ratna is the highest civilian award of the Republic of India.
  • Instituted on 2 January 1954, this prestigious award is conferred in recognition of “exceptional service/performance of the highest order”, without distinction of race, occupation, position, or gender.
  • Initially limited to achievements in the arts, literature, science, and public services, the criteria were expanded in December 2011 to include "any field of human endeavor".
  • Recommendations for the award are made by the Prime Minister to the President.
  • The Bharat Ratna recipients rank seventh in the Indian order of precedence. 

Katchatheevu Island

Context

Documents obtained through an RTI application has shed light on India's wavering approach to the Katchatheevu island dispute with Sri Lanka.

About Katchatheevu Island

  • Located in the Palk Strait, which separates India and Sri Lanka, lies the small, deserted island of
  • Fisherman from Sri Lanka and India rely heavily on the waters surrounding Katchatheevu as their fishing grounds. 
  • Originally, under the Madras Presidency of British India, Katchatheevu was a princely kingdom that was a component of the Ramnad Kingdom.
  • The island was incorporated into the Indian state of Tamil Nadu following India’s independence in 1947.

Details revealed in the document

  • The documents show that Sri Lanka is making up for its small size by pursuing the 1.9 square kilometer of territory around 20 km from the Indian beach with tenacity.
  • This is based on claims that New Delhi disputed for decades before finally giving in to.
  • Soon after independence, Ceylon, then known as Sri Lanka, asserted that the Indian Navy, then known as the Royal Indian Navy, could not hold exercises on the island without its consent.
  • In 1974, India’s then Prime Minister Indira Gandhi handed over the territory in Palk Strait to Sri Lanka.
  • Multifaceted issues:The decision to cede Katchatheevu has been a source of contention in Tamil Nadu, particularly for fishermen who continue to face arrest by Sri Lankan authorities.
    • Handing over Katchatheevu to Sri Lanka has impacted Indian fishermen, mostly from Tamil Nadu, who often get detained by the Sri Lankan Navy.

TERMS OF THE DAY

S.No.

Term

About

1.        

Antiretroviral therapy (ART)

ART is a combination of medications used to treat HIV (human immunodeficiency virus). It works by stopping HIV from reproducing. It can reduce levels of HIV and keep immune system healthy. It’s not a cure, but many people reach undetectable levels of HIV.

2.        

Carbon budget

Carbon budgets measure how much CO? is produced by industry, homes and all other parts of the economy to calculate by how much emissions must be cut in the future. 

3.        

Neurons

Neurons are the fundamental units of the brain and nervous system, the cells responsible for receiving sensory input from the external world, for sending motor commands to our muscles, and for transforming and relaying the electrical signals at every step in between.

4.        

Protected areas

Protected areas are those in which human occupation or at least the exploitation of resources is limited. 

5.        

Zamindari System

The Zamindari System was a land tenure system prevalent in India during the British colonial period. Under this system, the British East India Company and later the British Raj granted large tracts of land to intermediaries known as zamindars, responsible for collecting revenue from the peasants working on the land

Editorial

Compounding crises: On the impact of a summertime water crisis

Context:

Recent analysis of Central Water Commission data reveals that only 23% of the holding capacity in South India's reservoirs is filled, indicating a looming water crisis.

Factors Contributing to the Crisis:

  • Impact of El Niño Events: The current water crisis in South India is exacerbated by the ongoing El Niño event, one of the strongest recorded in history. El Niño events lead to erratic monsoons, further aggravating water scarcity.
  • Escalating Climate Change: Meteorologists predict worsening conditions due to climate change, with 2023 being the warmest year on record and projections indicating further temperature increases. This exacerbates drought conditions and intensifies water scarcity.
  • Upcoming General Election: With millions of voters expected to spend additional time outdoors during the general election, water demand is likely to rise further, adding pressure to already strained water resources.

Persistent Challenges and Compounding Factors:

  • Inadequate Preparedness: Despite previous water crises and improved policies and forecasting, there remains a gap in preparedness and implementation of effective measures on the ground.
  • Structural Issues: Unplanned urban growth, over-extraction of groundwater, low water reuse efficiency, and encroachment on catchment areas persist, exacerbating the water crisis.
  • Climate Change Compounding Effects: Climate change exacerbates water scarcity and increases the likelihood of simultaneous crises, such as droughts and disease outbreaks, further impacting socio-economic conditions, particularly among marginalized groups.
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Editorial

Workers, not tech, should be state’s priority

Context:

 The Aadhaar-Based Payment System (ABPS) and its implications for the Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS) have sparked critical attention due to various challenges and issues.

Challenges in ABPS Implementation:

  • Technological Hurdles: Numerous challenges plague the ABPS-MGNREGS linkage, including Internet connectivity issues, fingerprint recognition problems, and difficulties faced by the disabled. These challenges hinder the smooth functioning of the payment system and adversely affect beneficiaries.
  • Database Management Issues: Despite a significant budgetary allocation to MGNREGS, issues such as unrecorded working days, name duplication, errors in linking, and elimination of names persist. The deletion of 5.2 crore workers from the database in 2022-23 and the ineligibility of 34.8% of job card holders for ABPS highlight the magnitude of the problem.
  • Dependency on Technology: The ABPS places rural workers at the mercy of technology, prioritizing technological solutions over employment security. This approach undermines the core objective of MGNREGS, which is to provide socio-economic security to rural households through guaranteed wage employment.

Technology vs. Worker Empowerment:

  • Misconception of Technology's Role: The design and deployment of ABPS have positioned technology as the focal point, sidelining the welfare of workers. Rather than empowering workers, technology has become an overbearing element in their lives, overshadowing employment security.
  • Ideal Objectives of Employment Guarantee Schemes: Schemes like MGNREGS aim to provide work security and alleviate socio-economic distress, not serve as platforms for technological interventions. The state's techno-centric approach risks undermining the scheme's ideals of inclusion and equity.
  • Need for Balanced Approach: While technology has the potential to support socio-economic development, it must not overshadow the core objectives of employment guarantee schemes. Lessons from past failures in technological interventions during the COVID-19 pandemic emphasize the importance of prioritizing workers' welfare over technological advancements.

Revisiting Developmental Imaginaries:

  • Alignment with Sustainable Development Goals (SDGs): Rural employment guarantee schemes contribute significantly to achieving SDGs, directly and indirectly. However, the state's techno-centric approach must align with the goals of inclusivity and socio-economic empowerment.
  • Budgetary Allocation Considerations: The substantial budget allocated to MGNREGS should prioritize rectifying technological maladies and ensure efficient delivery of benefits to beneficiaries. Fundamental developmental imaginaries need reconsideration to place workers' welfare at the forefront.
  • Socio-Economic Security Priority: In an era of growing inequality and rural distress, technology can play a supportive role, but the primary focus should always be on ensuring the livelihood security of workers. The state must strike a balance between technological advancements and socio-economic welfare.
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Editorial

The ART of India’s HIV/AIDS response

Context:

India commemorates the 20th anniversary of the launch of Free Antiretroviral Therapy (ART) for Persons living with HIV (PLHIV) on April 1, 2004.

Evolution of Free ART Initiative

  • Origins of the Initiative:Launched amidst global efforts to combat HIV/AIDS, the Free ART initiative aimed to address the challenges of limited access and affordability of antiretroviral drugs for PLHIV in India.
  • Impact and Expansion: Over the past two decades, the initiative has significantly expanded, with the establishment of around 700 ART centres and provision of free ART drugs to approximately 1.8 million PLHIV.
  • Achievements: The initiative has contributed to reducing the prevalence of HIV, with notable declines in new infections and AIDS-related mortalities, aligning with global targets set by UNAIDS.

Complementary Initiatives and Adaptations:

  • Comprehensive Approach: Success of the Free ART initiative attributed to complementary measures such as free diagnostic facilities, prevention of parent-to-child transmission services, and management of opportunistic infections.
  • Adaptive Strategies: Programme evolved over time, incorporating early initiation of ART, 'Treat All' policy, and rapid ART initiation to enhance effectiveness and reduce virus transmission.
  • Patient-Centric Services: Introduction of patient-centric services, including provision of longer medication supplies, facilitated adherence to treatment and minimized clinic visits, enhancing overall healthcare delivery.

Challenges and Future Directions:

  • Persistent Challenges: Despite successes, challenges such as delayed enrolment, patient adherence, and sustained supply of ART drugs persist, necessitating focused attention and intervention.
  • Integration and Capacity Building: Emphasis on integration with other health programmes, private sector engagement, and continuous capacity building crucial for addressing evolving healthcare needs.
  • Policy Lessons and Way Forward: The Free ART initiative underscores the importance of political will, sustained funding, and community engagement in delivering quality healthcare services. Its success provides valuable insights for strengthening other public health programmes and advancing towards disease elimination goals.
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