How the Widal test is clouding India’s sense of its typhoid problem.

The Widal Test’s propensity for erroneous results is obfuscating India’s typhoid burden, increasing expenses, and risking more antimicrobial resistance.

Widal Test:

• It is a test done for diagnosing typhoid fever.
• Typhoid fever, also known asenteric fever, is a bacterial infection caused by the bacterium Salmonella Typhi, and it is commonly spread through contaminated food or water.
• A person with typhoid fever will experience symptoms like fatigue, high fever, headache, diarrhoea or constipation, abdominal pain, weight loss, and red spots.
• These symptoms mimic those of malaria, dengue, influenza, and typhus, to name a few, making it difficult to diagnose without proper testing.
• As with other infections, our immune system produces antibodies in the blood against the bacteria, causing enteric fever.
• The widal test is a serological test that detects antibodies against the bacteria in a patient’s blood sample, indicating whether or not they have been infected with the bacteria.
• It is used to help diagnose a current or recent infectionor to determine if an individual has had a previous typhoid infection.
• It’s a point-of-care test and doesn’t need special skills or infrastructure.
• Developed in the late 1800s by a French physician, it is no longer used in many countries because of its flaws .The World Health Organization (WHO)has said that due to the various factors that can influence the results of a Widal test, it is best not to rely too much on this test.

Limitations:

• A single positive Widal test report doesn’t necessarily mean a typhoid infection is present, and a negative report doesn’t confirm the disease’s absence.
• To diagnose an active infection, clinicians must test at least two serum samples taken at least 7-14 days apart, so that they may detect a change in the concentrations of the antibodies. But getting two samples is rarely feasible and time-consuming.
• In areas with a high and continuous typhoid burden, certain levels of antibodies against the bacteria may already be present in the blood. Without knowing the baseline cut-off, it isn’t possible to correctly interpret the test.
• The reagents used in the Widal test to reveal the presence of various antibodies can cross-react with antibodies produced against infections by other bacteria, viruses or parasites, or even in typhoid-vaccinated individuals, leading to false positives.
• Prior antibiotic therapy can also affect antibody levels and yield a false negative.

Road Ahead:

• Adoption of Best-Practice Strategies: Better point-of-care tests need to be discovered that can replace the Widal test.
• Until they’re available, clinicians can use best-practice strategies that provide a rational diagnosis and subsequent treatment options based on the regional data of effective antibiotics available against the bacteria.
• These options should be coupled with ensuring adequate and safe food and water and functional sanitation to address the disease’s root cause.
• Improving Access to Better Diagnostic Tests: Doing a blood or bone marrow culture is often not feasible as it requires laboratory infrastructure lacking in most parts of the country.
• Healthcare workers can instead benefit from a ‘hub and spoke’ model, with sample collection sites at the periphery and district hospitals and medical colleges as the hubs that process samples.
• The latter facilities could also serve as research centres that generate regional prevalence and susceptibility data.
• Improved Surveillance: To effectively combat AMR attributed to the overutilization of the Widal test, improved surveillance measures are imperative.
• As per the latest report of Indian Council for Medical Research from 2021, the number of samples tested to determine susceptibility varied widely, ranging from one in the ‘East’ region to 126 samples in the ‘North’.
• Given that typhoid also has symptom-free carriers, constant environmental vigilance and data-sharing are crucial.

Bombay High Court deems Look Out Circulars by public sector banks against default borrowers without statute unconstitutional.

• The Bombay High Court recently invalidated a section of a central government memorandum, which allowed public sector banks to seek the issuance of lookout circulars (LoCs) for wilful defaulters.
• The court ruled in the case of Viraj Chetan Shah v Union of India, stating that this provision violated fundamental rights to life (Article 21) and equality (Article 14).

Wilful Defaulter:

• A wilful default occurs when a borrower deliberately fails to repay a loan despite possessing the means to do so.
• Large defaulter: it is a borrower with the balance of Rs. 1 crore or more. Whose account has been marked as doubtful or a loss.
• Misuse of Funds: Another scenario of wilful default arises when the borrower diverts the borrowed funds for purposes other than the intended use.
• Asset Disposal: Wilful default also includes all situations where the borrower sells or disposes of the asset pledged as collateral for the loan.
• Penalty Threshold: Any borrower classified as a wilful defaulter with an outstanding balance of Rs 25 lakh or more is subject to penal provisions.
• Threshold Application:  The Rs 25 lakh limit also applies when funds are misused.

Prohibitions and Rules for Wilful Defaulters in India

• The concept of a wilful defaulter in India carries significant weight, essentially blacklisting borrowers from financial opportunities.
• Designation Authority: Commercial lenders like banks and NBFCs have the power to designate borrowers as wilful defaulters.

Consequences: This designation comes with severe consequences, prohibiting access to:

1. Additional credit facilities from the designating lender.
2. Any credit for new ventures.
3. Issuing equity shares (listed companies).
4. Launching an Initial Public Offering (IPO).
5. Submitting a resolution plan under the Insolvency and Bankruptcy Code.

Evolution of Institutional Arrangements:

• The designation of wilful defaulters by commercial lenders has undergone significant institutional changes over time.
• Central Vigilance Commission Directive (1998): It initiated the first layer of institutional design in 1998.
• It instructed the Reserve Bank of India (RBI) to gather information on wilful defaults exceeding Rs 25 lakh.
• Parliamentary Standing Committee Recommendations (2000): This committee has recommended blacklisting wilful defaulters from institutional finance and equity markets.
• However, it didn’t propose adequate procedural safeguards
• Penal measures: The RBI circular in 2002 introduced penal measures, which were updated over time due to judicial intervention.
• RBI kept on updating these through circulars, primarily on account of judicial intervention
• The Insolvency and Bankruptcy Code (IBC) of 2016: it allowed  creditors to take over a defaulted company regardless of the default being wilful or not.
• Procedural Safeguards: These safeguards were prioritized  in 2019 when the supreme court rulings emphasize the need for proper procedures before designating a wilful
• Natural Justice: Borrowers must be granted access to relevant investigation material before being labelled a wilful defaulter.
• Right to Respond: This aligns with the concept of allowing inspection of documents in securities law enforcement proceedings.
• The rights of wilful defaulters: In September 2023, the RBI provided an initial guideline proposing changes to the procedures aimed at better protecting the rights of wilful defaulters and those with significant defaults.

Reasons for Criticism with Lenders Classifying Wilful Defaulters:

• Lender as Judge: Banks and NBFCs, who are parties to the loan agreement, are responsible for classifying borrowers as wilful defaulters. This raises concerns about impartiality.
• Shifting Blame: A lender’s poor initial credit assessment could lead to a default.
• However, the system incentivizes the lender to classify the borrower as wilful, deflecting blame.
• No Impact on Lender: Wilful defaulter designation doesn’t affect the lender’s financial obligations, further raising questions about their objectivity.
• This structure violates the principle of natural justice: “nemo judex in causa sua” (no one can be a judge of their own cause).

NPCI issues guidelines for merchant acquisition on BHIM Aadhar Pay

• The National Payments Corporation of India (NPCI), in a circular, has issued guidelines that put the onus of verifying merchant details on acquiring banks for BHIM Aadhar Pay.

BHIM Aadhar Pay:

• BHIM Aadhaar Pay enables Merchants to receive digital payments from customers over the counter through Aadhaar Authentication.
• It allows for any Merchant associated with any acquiring bank live on BHIM Aadhaar Pay, to accept payment from customers of any bank by authenticating customer’s biometrics.

Prerequisite :

• To be able to effect the same, merchants should have an Android mobile or any supported device with BHIM Aadhaar Pay app and certified biometric scanner attached with mobile phone/Kiosk/Tablet on USB Port or Micro-ATM/POS, mPOS.
• Both Customer and Merchant should have their Aadhaar linked to their Bank Account.

Reference Guidelines for Merchant Acquisition Standards- BHIM Aadhaar Pay:

• The NPCI issued these guidelines to an acquiring member bank’s key responsibilities and accountabilities when managing merchants.
• An Acquiring Member Bank must monitor its Merchant activity (viz., on-boarding criteria, transaction monitoring & control, training, assessment of the portfolio metrics, etc.) periodically.
• These monitoring standards for merchants is a baseline for the level of oversight on Merchant performance.
• Acquiring Member Banks can use both manual as well as digital modes of merchant due diligence.

Acquiring Member Bank should ensure the following points are in place and the same is adequately addressed:

1.Board approved policy for Merchant acquisition:

• Implement policies that include standards to ensure quality / business conduct to mitigate risk to the NPCI operated payment system in terms of financial or reputational risk.
• The policies must be approved by the Acquiring Merber Bank’s Board of Directors and should have a periodic review mechanism.

2.Agreements with various stakeholders (as appropriate) :

• Merchant agreement in place with each merchant/ aggregator (as appropriate) before any service is provided.

3.Merchant underwriting :

• It has advised members to assign appropriate Merchant Category Code (MCC) while taking on board merchants.

4.Merchant portfolio and risk monitoring :

• They are required to ensure that cash withdrawal transactions are not allowed on the BAP service’s merchants by categorizing Merchant Criteria &  Prohibited Merchants.

5.Merchant training

• Third party agent risk oversight and governance

National Payments Corporation of India (NPCI):

• It is an umbrella organization for operating retail payments and settlement systems in India.
• It is an initiative of the Reserve Bank of India (RBI) and Indian Banks’ Association (IBA) under the provisions of the Payment and Settlement Systems Act, 2007, for creating a robust Payment & Settlement Infrastructure in India.
• It has been incorporated as a “Not for Profit” Company under the provisions of Section 25 of Companies Act 1956 (now Section 8 of Companies Act 2013),
• Objective : with an intention to provide infrastructure to the entire Banking system in India for physical as well as electronic payment and settlement systems.
• Focus:  To bring innovations in the retail payment systems through the use of technology for achieving greater efficiency in operations and widening the reach of payment systems.

India hosts 46th Antarctic Treaty Consultative Meeting and 26th Meeting of the Committee for Environmental Protection .

• India is scheduled to host the 46th Antarctic Treaty Consultative Meeting (ATCM 46) and the 26th Meeting of the Committee for Environmental Protection (CEP 26) from May 20 to 30 in Kochi, Kerala. Organized by the Ministry of Earth Sciences (MoES) through the National Centre for Polar and Ocean Research (NCPOR).

Antarctic Treaty Consultative Meeting:

• It is pivotal in the international community''s ongoing efforts to safeguard Antarctica''s fragile ecosystem and promote scientific research in the region.
• It is convened annually under the Antarctic Treaty System, these meetings serve as forums for Antarctic Treaty Consultative Parties and other stakeholders to address Antarctica''s pressing environmental, scientific, and governance issues.
• What is the CEP?
• It was established under the Protocol on Environmental Protection to the Antarctic Treaty (the Madrid Protocol) in 1991.
• The CEP advises the ATCM on environmental protection and conservation in Antarctica.

Key facts on Antarctic Treaty:

• It was signed in 1959 and entered into force in 1961.
• It established Antarctica as a region dedicated to peaceful purposes, scientific cooperation, and environmental protection. Over the years, the Treaty has garnered widespread support, with 56 countries currently party to it.

Provisions of the treaty

• Antarctica shall be used for peaceful purposes only
• Freedom of scientific investigation in Antarctica and cooperation toward that end… shall continue
• Scientific observations and results from Antarctica shall be exchanged and made freely available
• India has been a Consultative Party to the Antarctic Treaty since 1983.
• It participates in the decision-making process along with other 28 Consultative Parties to the Antarctic Treaty.
• India’s first Antarctic research station, Dakshin Gangotri, was established in 1983.
• At present, India operates two year-round research stations: Maitri (1989) and Bharati (2012).
• The permanent research stations facilitate Indian Scientific Expeditions to Antarctica, which have been ongoing annually since 1981.
• In 2022, India enacted the Antarctic Act, reaffirming its commitment to the Antarctic Treaty.
• The Antarctic Treaty Secretariat (ATS) serves as the administrative hub for the Antarctic Treaty System.
• ATS was established in 2004 and coordinates the ATCM and CEP meetings, reposits and disseminates information, and facilitates diplomatic communication, exchanges, and negotiations related to Antarctic governance and management.