MAINS Current Affairs includes New Lancet Report Outlines Citizen-Focused Healthcare Framework for India & The Importance of ‘Pax Silica’ For India

Health

1. New Lancet Report Outlines Citizen-Focused Healthcare Framework for India

Context

The latest report by the Lancet Commission presents a rights-oriented, citizen-first blueprint for achieving Universal Health Coverage (UHC) in India, in line with the Viksit Bharat 2047 vision.

About

The recommendations in the report encourage community ownership, openness, and fairness — foundational pillars of UHC — aimed at ensuring accessible, high-quality and affordable healthcare for every individual.

It stresses the pressing need to upgrade India’s public health system by linking services across primary, secondary, and tertiary levels. 

Guiding Principles of the Commission

• A shift from a disease-specific, facility-driven and fragmented model to a holistic, organised and people-centred healthcare system.
• A shift from citizens acting as passive users of services to informed participants with rights who actively engage with the health system.
• A shift from focusing solely on formal qualifications to valuing provider skills, ethics and motivation, while strengthening frontline workers and practitioners of Indian medical systems (Ayurveda, Yoga, Unani, Siddha, Homeopathy).
• Ethical and responsible use of emerging technologies to support the redesigned health system and advance citizen-centred care.
• Explicit recognition of rights and health equity as core components of UHC, with reduction of disparities treated as a key indicator of progress.

What is Universal Health Coverage?

Universal Health Coverage ensures that everyone can access the complete spectrum of quality healthcare services without suffering financial strain.

Essential elements of UHC include:

• Access to Care: All individuals should be able to reach essential healthcare when required.
• Quality Services: Healthcare must be safe, effective and reliable.
• Financial Protection: No one should fall into financial distress because of medical costs.

UHC is grounded in the universal right to health, reinforced by global agreements and the Alma-Ata Declaration (1978), which highlighted comprehensive primary healthcare.

Need for Universal Health Coverage in India

• Historical Commitment: The Bhore Committee (1943–46) strongly favoured universal healthcare rather than insurance-based models.
• Evolution of Policy Post-Independence: The 1983 National Health Policy endorsed “Health for All,” focusing on primary healthcare and fair distribution of resources.
• Move toward Insurance-Driven UHC: Schemes like RSBY (2008) and Ayushman Bharat–PMJAY expanded UHC but promoted an insurance-centric approach.
• Weak Public Health Structure: Long-term underinvestment in primary care has caused low-quality public services, infrastructure gaps, and workforce shortages.
• NSS Data: Increasing dependence of the poor on private facilities has resulted in rising out-of-pocket payments and higher household debt.
• Post-Covid Lessons: The pandemic revealed inequalities in insurance-focused access, exclusion of informal labour and migrants, and the vulnerabilities of hospital-heavy systems.

Constitutional Basis for UHC

The Directive Principles (Part IV) lay the foundation for the right to health.

• Article 39(e): Mandates protection of workers’ health.
• Article 42: Calls for humane working conditions and maternity benefits.
• Article 47: Obligates the state to improve nutrition, living standards and public health.

Local bodies like panchayats and municipalities also have roles in strengthening health services under Article 243G.

Challenges in Implementing UHC in India

• Resource Limitations: India suffers from major financial constraints in the health sector, with low government spending relative to global standards.
• Current public health expenditure is around 2.1% of GDP, below the NHP goal of 2.5%.
• Infrastructure Shortfalls: Numerous regions, especially rural areas, lack adequate facilities, hospitals, equipment and trained staff.
• Workforce Deficiency: A significant shortage of medical professionals, especially in remote districts, leads to inequalities in care availability and quality.
• Fragmented Health System: India’s coexistence of public and private providers creates uneven access and quality differences.

Additionally, health is primarily a State subject, while funds and large programmes are centrally operated, resulting in varied performance across states.

Economy

2. The Importance of ‘Pax Silica’ For India

Context

• Recently, the United States convened the inaugural Pax Silica Summit, emphasizing reducing coercive dependencies, securing the flow of critical minerals, and promoting trusted digital ecosystems.

About ‘Pax Silica’

• The term ‘Pax Silica’ derived from Latin ‘Pax’ (peace) and ‘Silica’ (a core compound in semiconductors).
• It symbolizes the pursuit of technological peace and prosperity through resilient, transparent, and cooperative supply chains.

Need for ‘Pax Silica’

• Supply Chain Security: To ensure reliable and diversified access to Rare Earth Elements (REEs) and critical minerals essential for semiconductors and AI technologies.
• Reducing Dependence on China: To counter China’s dominance and coercive control over global REE supply chains and technology exports.
• Resilient Technology Ecosystem: To build resilient, transparent, and trusted global supply chains for frontier technologies like AI and semiconductors.
• Economic Stability and Strategic Balance: To safeguard the global economy from disruptions caused by monopolized production or geopolitical tensions.
• Allied Technological Collaboration: To bring together technological powerhouses (US, Japan, South Korea, Netherlands, Israel) and resource-rich nations (Australia, UAE, Qatar) for joint innovation.
• Building Trusted Digital Infrastructure: To establish ethical AI frameworks, cybersecurity standards, and secure semiconductor ecosystems among like-minded nations.
• Encouraging Sustainable Mining and Innovation: To promote responsible extraction, recycling, and green manufacturing of critical minerals.
• Maintaining U.S. Technological Leadership: To reaffirm the US’s leadership in global innovation governance and ensure technological primacy in the emerging AI–semiconductor era.

Composition of Pax Silica

• United States and Japan: Innovation and R&D giants in semiconductors and AI.
• Australia: Leading exporter of lithium and a key player in REE mining.
• Netherlands: Home to ASML, a global leader in advanced lithography systems.
• South Korea: Dominant in memory chip manufacturing.
• Singapore: Longstanding chip manufacturing base linked with U.S. firms.
• Israel: Specializing in AI software, cybersecurity, and defense technologies.
• United Kingdom: The world’s third-largest AI market with a vibrant innovation ecosystem.
• Qatar and UAE: Financial powerhouses investing heavily in AI and advanced technologies.
• Observers at the inaugural summit included Canada, the European Union, OECD, and Taiwan, all of whom may become members as the initiative evolves.

India’s Prospective Role in Pax Silica

• Expanding Digital Infrastructure: India’s fast-growing digital economy and AI adoption align with Pax Silica’s goals.
• Semiconductor Ambitions: Through India’s Semiconductor and AI Missions, the country is investing heavily in chip design and fabrication.
• Strategic Partnerships: Collaboration with Japan, Israel, Singapore, and the U.S. in chip manufacturing and R&D.
• Human Capital Advantage: India’s large pool of STEM graduates and returning AI engineers bolster its capacity to contribute to global innovation.
• Resilient Supply Chains: India’s experience with the Quad Critical Minerals Initiative makes it a natural partner for Pax Silica’s objectives.

Benefits For India

• Access to Advanced Technology: Greater opportunities for technology transfer and joint R&D.
• Investment and Industrial Growth: Attraction of global investments in AI and semiconductor sectors.
• Enhanced Global Standing: A role in shaping global tech governance alongside major economies.
• Supply Chain Security: Reduced vulnerability to REE export disruptions from China.
• Integration into Global Value Chains: Entry into advanced semiconductor and AI production networks.

Challenges For India

• Strategic Autonomy: Balancing its non-aligned foreign policy with participation in a US-led bloc.
• Economic Gap: India’s developing tech ecosystem lags behind established Pax Silica members.
• Policy Divergences: India’s subsidy- and protection-based industrial policy may conflict with the market-driven approaches of high-income members.
• Expectation Gap: As the first developing and non-U.S. ally member, India must manage differing expectations within the group.

Strategic Implications

• Dual Supply Chain Order: The world may evolve into two REE and technology ecosystems, one led by China, the other by Pax Silica.
• India’s Alignment Choice: India is likely to align with Pax Silica’s democratic and transparent framework, while maintaining strategic flexibility.
• Regional Stability: Pax Silica may foster technological cooperation and economic peace across the Indo-Pacific.

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