Content :

1. Rephasing global development finance
2. Integrating compassion, prioritising palliative care

Rephasing global development finance

Context

• India’s Global Outreach: India’s development aid to the Global South has nearly doubled—from ~$3 bn (2010–11) to ~$7 bn (2023–24)—primarily through Lines of Credit under its IDEAS programme.
• Evolving Strategy: With rising debt burdens in partner countries and shrinking global ODA, India is shifting focus from credit-heavy models to a more balanced mix of grants, grants, capacity building, and triangular cooperation.

Relevance : GS 2(International Relations )

Practice Question : “India’s development cooperation strategy with the Global South is undergoing a strategic recalibration from concessional credit to collaborative models like Triangular Cooperation. Discuss the rationale behind this shift and examine its implications for India’s foreign policy and global leadership.”(250 words)

Why It’s in the News

• Triangular Cooperation Rising:
  • India is increasingly partnering with Global North donors like Germany and the UK for co-funded projects in third countries such as Ghana, Cameroon, Malawi, and Peru.
  • TrC investments are now estimated at $670 mn–$1.1 bn, highlighting a shift toward shared, co-created development solutions.

• G20 Platform for TrC:
  • During its G20 presidency (2023), India leveraged global platforms to promote TrC, expanding collaborations that span grants to investment-driven initiatives (e.g., Global Innovation Partnership with the UK).

Trends & Modalities

• India’s development assistance increased from $3 bn (2010–11) to $7 bn (2023–24).
• IDEAS scheme is the main vehicle through Lines of Credit (LoC).
• Five modalities of engagement:
  • Capacity building
  • Technology transfer
  • Market access
  • Grants
  • Concessional finance

Policy Shift (2025–26 Budget)

• MoF red-flagged LoC-heavy model due to rising global debt risks.
• PM Modi proposed Global Development Compact (VoGS 2024) – promotes a balanced approach to engagement.

Global Context & Development Finance Crisis

• ODA shrinking: From $214 bn (2023) to ~$97 bn (projected) – 45% drop (OECD-DAC).
• Rising SDG financing gap: From $2.5 tn (2015) to $4+ tn (2024).
• Rising borrowing costs + weak repayment capacity in Global South.
• Collapse of agencies like USAID, FCDO reflects donor fatigue.

Triangular Cooperation (TrC): An Emerging Alternative

What is TrC?

• Partnership model between:
  • One Global North donor
  • One pivotal Global South country (e.g., India, Brazil, Indonesia)
  • One partner country (recipient from Global South)

Why TrC Matters?

• Promotes co-creation, shared learning, and context-specific solutions.
• TrC funding (2022 est.): $670 mn – $1.1 bn.
• Expands India’s global footprint through strategic partnerships.

India’s TrC Examples

• India–Germany Joint Declaration (2022): TrC projects in Africa & Latin America (e.g., Ghana, Cameroon, Malawi, Peru).
• Global Innovation Partnership (GIP) with the U.K.
• G20 2023: India expanded TrC discussions with US, UK, EU, France.

Challenges in India’s Traditional Approach

• LoC model unsustainable in a debt-distressed world.
• Rising risk of non-performing LoCs and capital market unpredictability.
• Global South borrowers face low creditworthiness, high exposure.

Way Forward

• Refocus on grant-based, capacity-focused cooperation over debt-heavy LoCs.
• Embrace TrC as a core pillar: fosters resilience, builds global legitimacy.
• Leverage India’s soft power in technology, digital public goods, training, health, and energy access.

Quick Data Sheet

Additional Information :

Historical Evolution

• Nehru’s Afro-Asian solidarity, ITEC programme (1964), IBSA & BRICS cooperation.
• Shift from ideological non-alignment to pragmatic economic engagement post-1990s.

Comparative Global Models

• Compare India’s approach with:
  • China’s BRI (infrastructure, debt-heavy)
  • USA’s Millennium Challenge Corp (MCC) (grant-based, selective)
  • OECD-DAC traditional aid (conditional and donor-driven)

India’s Unique Model (Development Compact)

• Highlight India’s emphasis on partnership, not patronage.
• Demand-driven, transparent, respecting sovereignty.

Soft Power & Capacity Building

• ITEC, ICCR scholarships, Pan-African e-Network, yoga diplomacy.
• India as a knowledge and digital public goods provider (like UPI, CoWIN, DIKSHA exports).

Strategic Geography

• India’s cooperation focus in:
  • Africa (East, West, Horn of Africa)
  • Indian Ocean Region
  • Latin America
  • CARICOM and Pacific Island countries

Institutional Mechanisms

• EXIM Bank, Ministry of External Affairs (DPA–Development Partnership Administration), RIS (Research & Information System for Developing Countries).
• Trilateral working groups (e.g., India-Germany-Africa model).

Private Sector & Philanthropy Role

• Role of Indian corporates (L&T, TATA, Bharti) in Africa/ASEAN infrastructure and training.
• Involvement of Indian NGOs in social sector aid.

Digital Public Infrastructure as Aid

• India offering DPI stack (UPI, DigiLocker, Aadhaar) to developing countries under Digital Public Goods Alliance.
• G20 endorsement of DPI in Global South.

Climate Finance & Green Development

• India’s potential to lead in green tech transfer, solar energy (ISA), biofuels, EVs, and climate-resilient infra.
• Link with SDG 13 (climate action) and SDG financing gap.

TrC Potential in Multilateral Diplomacy

• TrC as a tool to:
  • Gain influence in G77, G20, BRICS+.
  • Build issue-based coalitions in WTO, UNSC reform, etc.
  • Act as bridge between Global North & South.

Integrating compassion, prioritising palliative care

Context:

• Rising Need, Poor Access: Over 7–10 million Indians need palliative care annually, yet only 1–2% receive it, highlighting a massive access gap.(Who 2024)
• Growing NCD Burden: Rising cases of cancer, diabetes, and chronic illnesses necessitate integration of palliative care into mainstream health services to ensure dignity in terminal care.

Relevance : GS 2(Health , Social Issues)

Practice Question : “Despite being essential for ensuring dignity in illness, palliative care remains marginalised in India’s healthcare system. Examine the challenges in expanding access to palliative care and suggest measures for its effective integration into public health policy.”(250 words)

What is Palliative Care?

• Palliative care is specialised medical care that focuses on relieving pain, stress, and other symptoms of serious or terminal illnesses—improving quality of life for patients and their families.
• It addresses physical, emotional, psychological, social, and spiritual needs, and is applicable at any stage of illness, not just end-of-life care.

Why in News ?

• India’s underfunded and underutilised palliative care system has come under scrutiny due to its limited access, especially for rural and disadvantaged populations.
• Health experts advocate integrating palliative care into MBBS curriculum, Ayushman Bharat, and expanding it through task-shifting and nursing capacity to address systemic gaps.

Achievements / Positive Developments

• Included in National Health Policy (2017).
• ICMR & AIIMS have pilot projects on pain and palliative care.
• WHO-recognised palliative care centres exist in Kerala (community model).
• India’s doctor-population ratio (1:834) is better than WHO norm (1:1000).

Challenges

• Only 1–2% access despite 7M+ need (WHO, 2024).
• Lack of trained professionals and inadequate curriculum coverage.
• Uneven access — rural and poor patients most excluded.
• Low funding, weak insurance integration, and lack of infrastructure.
• Poor public awareness, stigma, and confusion with hospice/end-of-life care.

Recommendations

• Curriculum Integration: Add palliative care to MBBS & allied health training.
• Task-Shifting: Leverage India’s 34.3 lakh nurses and 13 lakh allied health workers.
• Insurance Inclusion: Expand Ayushman Bharat to cover palliative services.
• Public Awareness Campaigns: To redefine palliative care beyond end-of-life.
• NGO + Private Sector Partnerships for last-mile delivery.

Data Sheet

Global Best Practice

• U.S. Model: Strong palliative ecosystem with insurance-backed hospice care, early intervention, and end-of-life funding mechanisms — a model India can adapt considering cost and cultural context.

Additional Information

• Curriculum Integration: Pallium India guided the draft MD Palliative Medicine through MCI—boosting professional training .
• Community Delivery: Community Medicine and ASHAs are now trained in rural palliative outreach through Ayushman Arogya Mandir sub-centres .
• Urban Infrastructure Boost: Delhi’s rollout of 33 Ayushman Arogya Mandirs includes palliative care in primary health facilities .
• Elderly-Focused Models: Kerala’s Vayomithram provides mobile palliative clinics for seniors at municipal level .
• Policy & Insurance Gains: Ayushman Bharat (PM-JAY) offers palliative care packages; linked with NCD control program .

Key Takeaways

• India’s palliative care access remains critically low at under 4% — a sharp contrast to global need.
• Though policies exist (NPPC, NDPS reform, NHP 2017), implementation remains patchy, especially beyond Kerala and urban centres.
• Integration under Ayushman Bharat and training via ASHAs and community health workers can significantly bridge rural-urban and knowledge gaps.
• NGO-led initiatives—Pallium India, CanSupport—play a pivotal role in training, advocacy, and service delivery.
• Continued policy reform, funding, and curriculum integration are essential to transform palliative care into an accessible, equitable health service.