Four Reasons

Mothers attend to their newborn babies at the special newborn care unit at the district hospital in Sangareddy in Telangana state, Oct. 19, 2017. According to IndiaSpend, in 2018 India will see progress on many fronts, including reductions in infant and maternal mortality rates. (Money Sharma/AFP/Getty Images)

MUMBAI —  The seeds of many positive changes were sown in 2017 and could bring news to cheer Indians in 2018. Here's a look at four positives.

Renewed fight against TB: The government, in March 2017, increased its focus on tuberculosis – a preventable, airborne infectious disease that killed 423,000 Indians in 2016 – with the release of the National Strategic Plan for Elimination of Tuberculosis.

The plan is to reduce the incidence of TB from 217 new cases per 100,000 in 2015 to fewer than 44 new cases by 2025. As part of this plan, funding for TB prevention and care doubled from $280 million in 2016 to $525 million in 2017.

The government also changed the TB treatment drug regimen – from multiple drugs at a time to a single daily dose in a fixed-dose combination. Daily doses are considered more effective than alternate day doses of several pills recommended earlier.

Further, the government started rolling out universal drug sensitivity testing for all TB patients to detect drug resistance to rifampicin, the main anti-TB drug. This will be aided by the increase in the number of cartridge-based Nucleic Acid Amplification Test machines which help detect drug-resistant TB.

India has a long way to go in eliminating TB, new cases of which reduced to 2.7 million in 2016, down 3.57 percent from 2.8 million in 2015, according to data from the WHO.

To achieve its goal of TB elimination, India needs to reduce its incidence by 10 percent every year. For this, the government needs to include the private sector, which treats at least half of the TB cases in the country. It also needs to improve treatment completion and cure rates through counselling, offer social support to TB patients, and actively find patients in high-risk communities.

Declining infant/maternal mortality: In 2016, there were 90,000 fewer infants deaths than 2015 and the infant mortality rate too declined by eight percent in the same period.

The gender disparity in infant deaths is also closing: In 2016, the infant mortality rate was 33 per 1,000 for boys and 36 per 1,000 for girls; in 2015, the figures were 35 and 39, respectively.

There were reductions in maternal mortality too. By 2013, India's maternal mortality ratio was lower than the global average. From 254 deaths per 100,000 live births in 2004-06, the ratio fell to 167 in 2013. The global average in 2016 remained higher at 179.

The percentage of institutional deliveries in India rose – from 39 percent in 2005-06 to 79 in 2015-16. But infant mortality and under-five mortality were higher than global average.

India prevented one million deaths among children under five years of age between 2005 and 2015. Interventions, including timely treatment of diarrhea, vaccinations for tetanus and measles, and an increase in hospital births enabled this improvement, said experts.

India's next challenge is to meet the 2030 Sustainable Development Goals on child and neonatal mortality. These goals were agreed upon under the United Nations Development Program and involve the reduction of child mortality to 25 per 1,000 live births and neonatal mortality to 12 per 1,000 live births.

This would require an average annual decline of 4.1 percent in child mortality and 5.3 percent in neonatal mortality from 2015 onwards. India could achieve this by improving education, prenatal care and nutrition, and reducing maternal anemia and tobacco use.

Scavenger deaths: In 2017, a year that saw about nine deaths every month because of manual scavenging, India finally decided to have an official count of how many people clean sewer lines in violation of laws banning such practices.

Some 102 workers were reported to have died while cleaning sewer lines manually, a task banned in 1993 by the Employment of Manual Scavengers and Construction of Dry Latrines (Prohibition) Act. The penalties on scavenging increased in 2013 through the Prohibition of Employment as Manual Scavengers and their Rehabilitation Act.

On March 21, 2017, the Safai Karmachari Andolan (Sanitation Workers' Movement) wrote to the Home Ministry to direct the National Crime Records Bureau to count such deaths separately. The Andolan is a body that fights the practice of forcing Dalits, lowest on the Hindu caste hierarchy, to clean others' excreta.

The National Safai Karmacharis Finance and Development Corporation – a not-for-profit under the Social Justice Ministry to help sanitation workers get out of manual scavenging – will survey 15 major states over six months to determine how many are still trapped in scavenging. This was decided by Social Justice Minister Thaawar Chand Gehlot in November.

As many as 180,000 people still clean latrines manually. Of this number, 1,470 have died since 2010, claimed Safai Karmachari Andolan's Bezwada Wilson, winner of the 2016 Ramon Magsaysay award.

States, however, claim there are about 13,000 manual scavengers, of whom 270 have died, according to data presented to Social Justice Minister Gehlot in Nov. 14.

State governments have to pay Rs. 10 lakh to families of workers who die while cleaning sewers. The government is set to mandate that contractors and private individuals also pay another Rs. 10 lakh each to such families.

The Swachh Bharat Abhiyan, the Modi government's sanitation scheme launched Oct. 2, 2014, had increased the workload of sanitation workers without any improvement in their lives, according to Milind Ranade, general secretary of Mumbai's sanitation workers' union.

Right to privacy: In a historic verdict, a nine-judge constitution bench of the Supreme Court ruled in August that the right to privacy is a fundamental right under the Indian Constitution.

"The right to privacy is protected as an intrinsic part of the right to life and personal liberty under Article 21 and as a part of the freedoms guaranteed by Part III of the Constitution," wrote Justice J.S. Khehar, then chief justice of India.

This ruling holds significance for the future of Aadhaar, the government's 12-digit biometric identification program that intends to link with all schemes and services citizens avail of.

The Supreme Court has yet to rule on a clutch of petitions challenging the Aadhaar bill. In the meantime, the government continues to mandatorily link bank accounts, mobile services and welfare schemes to Aadhaar.

In a recent hearing on the matter, the SC extended the deadline for Aadhaar linking by three months to March 31, 2018.

Chief Justice Dipak Misra observed that the court's earlier orders were passed based on the government's executive decisions, and now needed to be tested against the Aadhaar Act notified March 26, 2016. The apex court will begin hearing final arguments on the program's legality Jan. 17.

Various sections of civil society have opposed the Aadhaar program over privacy and security concerns. Personal information obtained under the program could be misused and deprived sections of the Indian population without access to Aadhaar enrollment may be further marginalized, they have pointed out.

Apart from the Aadhaar program, the right to privacy judgement is also likely to affect future judgments on cases related to freedom of sexual orientation, right to eat what one wants to, right to medically terminate a pregnancy, freedom to criticize the government and right to control dissemination of personal information in the physical and virtual world, among others.

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