UPSC CARE Mains Practice 13th november 2025

UPSC CARE Mains Practice 13th November 2025

Mains Practice Questions for the Day

1Q. Discuss the significance of India’s AI Governance Guidelines (2025) in balancing innovation with accountability. How can India ensure ethical and inclusive AI governance?

(GS Paper 2 – Health, Governance)

Introduction:

The Transplantation of Human Organs and Tissues (Amendment) Rules, 2025, notified under THOTA 1994, remove the mandatory requirement for clinical specular microscopes in corneal transplant centres. The reform aims to democratise access to corneal transplantation and strengthen India’s National Organ Transplant Programme (NOTP).

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Significance of the 2025 Amendment

Eases Infrastructure Requirements: Removal of the mandatory Clinical Specular Microscope lowers barriers for small and rural eye hospitals, making corneal transplant centres easier to establish.
Boosts Eye Donation: Encourages more institutions to participate in corneal retrieval and storage, addressing the chronic shortage of donor corneas.
Strengthens NOTP: Aligns with the government’s goal of equitable access by ensuring that high-quality transplantation services reach Tier-2, Tier-3 and tribal regions.
Addresses Corneal Blindness: India has 1.2 million corneal blind persons, with 25,000–30,000 new cases annually (IJO data). The amendment widens service availability and promotes early intervention.
Reduces Costs: Smaller centres avoid high-cost equipment, making corneal transplantation financially viable.
Promotes Ethical and Safe Transplantation: Strengthens regulated pathways under THOTA and enhances accountability in eye banking.

Challenges

Shortage of trained corneal surgeons and technicians persists, especially in rural India.
Limited awareness about eye donation continues to constrain donor availability.
Logistical gaps in eye-banking such as cold-chain management and tissue transport.
State-level variation in THOTA implementation affects uniform access.
Socio-cultural resistance to eye donation remains a barrier in several regions.

Conclusion:

The 2025 amendment is a progressive step toward accessible, affordable, and equitable corneal transplantation. Sustained investment in awareness, capacity building, and eye-banking systems is essential for reducing India’s corneal blindness burden.

2Q.India has recorded a 21% decline in TB incidence between 2015 and 2024, nearly double the global average. Discuss the key factors behind this progress and examine the remaining challenges in achieving the target of a TB-Free India by 2025. (GS PAPER II – Governance, Health, Social Justice)

Relevance: GS Paper-3(Environment),

Introduction:

The WHO Global TB Report 2025 highlights a 21% decline in India’s TB incidence—from 237 per lakh (2015) to 187 per lakh (2024)—one of the steepest reductions among high-burden nations and almost double the global decline of 12%. This progress reflects strengthened surveillance, improved diagnostics, and community-centric interventions under the National TB Elimination Programme (NTEP). However, significant gaps remain before India can realise its ambitious 2025 elimination target.

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Key Factors Behind India’s Progress

1. Strengthened Surveillance & Case Detection

Active case-finding, house-to-house screenings and targeted tests in high-risk groups.
Missing TB cases reduced from 15 lakh (2015) to less than 1 lakh (2024)

2. Technological Interventions

Deployment of CB-NAAT/GeneXpert, TrueNat, digital X-rays.
Faster confirmation of drug-resistant TB and improved reporting.

3. Decentralisation of TB Services

Diagnostic and treatment services extended to district/sub-district levels.
Medical College Task Force: 560 colleges supporting diagnosis and research.

4. Community Participation

Pradhan Mantri TB Mukt Bharat Abhiyan (PMTBMBA) mobilised volunteers and corporates.
Awareness campaigns increased early reporting and adherence.

5. Nutritional and Social Support

Ni-kshay Poshan Yojana: ₹1,000/month nutrition support, ₹3,202 crore disbursed.
EDNS supplements for underweight patients improved recovery.

6. Digital Health Infrastructure

Ni-kshay Portal enabled real-time case tracking, DBT monitoring, adherence checks.

7. Improved Treatment Coverage & Success

Coverage increased from 53% (2015) to 92% (2024).
Treatment success rate reached 90%, above global average (88%).

Persistent Challenges to Achieving TB-Free India by 2025

1. Burden of MDR-TB

India remains a major contributor to global MDR-TB cases.
Treatment remains costly, toxic, and prolonged, affecting adherence.

2. Social Determinants of Health

Malnutrition, overcrowding, poor ventilation, tobacco use, and poverty sustain transmission.
India accounts for a large share of global undernutrition-linked TB.

3. Private Sector Participation

Despite improvements, under-reporting persists in private healthcare facilities.
Quality of diagnosis and treatment remains uneven.

4. Delayed Care-Seeking Behaviour

Mild early symptoms and stigma cause diagnostic delays.
Leads to increased transmission and higher mortality.

5. Health System Capacity Gaps

Human resource shortages, rural diagnostic gaps, and supply chain delays affect service delivery.
Variations in performance across states.

6. Financial and Logistical Constraints

Sustaining DBT, nutritional support, and community-based models requires continued funding.
Post-COVID health fatigue also poses operational challenges.

Conclusion:

India’s 21% decline in TB incidence reflects the success of robust surveillance, expanded diagnostics, decentralised service delivery, and community mobilisation. However, eliminating TB by 2025 remains extremely challenging given the persistence of MDR-TB, social determinants, and health-system gaps. A realistic pathway forward requires sustained investments, stronger private sector integration, enhanced nutrition support, and accelerated adoption of new diagnostics and shorter regimens. Continued political commitment, coupled with community-driven action, remains essential to achieving a TB-free India in the near future.