India is facing a mounting burden of noncommunicable diseases (NCDs) such as diabetes, cancers, and cardiovascular diseases. NCDs affect more than 20 percent of the Indian population and their prevalence is projected to expand substantially as the population aged 60 and over increases. Left unchecked, the costs of managing chronically ill and aging sectors of the population grow exponentially.

To control costs and address the growing chronic disease burden, India’s public programs must integrate curative hospital services with the most cost-effective preventive and primary interventions, argue Karen Eggleston, APARC’s deputy director and the director of the Asia Health Policy Program (AHPP), and Radhika Jain, a postdoctoral research fellow with AHPP. India must also urgently expand and improve the evidence base on economic evaluations of both preventive and curative health interventions in the country.

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In a correspondence piece published by BMC Medicine, Eggleston and Jain examine the features and limitations of a study that takes an important first step in that direction: a cost-effectiveness study of the Kerala Diabetes Prevention program (K-DPP) that adds such evidence on how to prevent diabetes cost-effectively in India and other low- and middle-income countries.

The study’s authors present a cost-effectiveness analysis of 1007 participants in the K-DPP, and their estimates indicate that K-DPP was cost-effective. Indeed, Eggleston and Jain determine that the analysis shows potential cost-effectiveness in “nudging” the participants towards a healthier lifestyle through suggestive reductions in tobacco and alcohol use and waist circumference. The results of the cost-effectiveness analysis of the K-DPP “highlight the importance of continued research on community-based promotion of healthy lifestyles,” say Eggleston and Jain.

Evidence-based approaches to chronic noncommunicable disease intervention are essential for providing cost-effective care and creating models for future programs like the K-DPP. Eggleston and Jain conclude that future studies advancing evidence-based approaches to chronic noncommunicable disease intervention — ones that cover larger and more representative populations over longer time periods — remain important for more generalizable assessments to inform policy decisions.

India-China border tensions along the disputed Line of Actual Control show no signs of letting up and the prospects of peace in the conflict between the nuclear-armed rivals are daunting. How do the Indian and Chinese militaries compare against each other?

FSI Center Fellow at APARC Oriana Skylar Mastro and our South Asia Research Scholar Arzan Tarapore join the Observer Research Foundation’s ‘Armchair Strategist’ podcast to discuss the Indian and Chinese strategic power postures, military modernization and reform by the two Asian neighbors, the ways they can marshal both military and non-military forces, and the possible outcomes of a confrontation along their Himalayan border. Listen here:

Based in Delhi, the Observer Research Foundation (ORF) is a leading South Asian nonprofit policy research institution whose work spans a wide range of topics, including national security, economic development, cyber issues and media, and climate and energy.

This article by Oriana Skylar Mastro originally appeared in The Interpreter, a daily publication of the Lowy Institute.

There is no end in sight for the ongoing China-India border crisis. In June, China and India’s border dispute along the LAC (Line of Actual Control) resumed after a decades-long halt to the fighting, with the deaths of 20 Indian soldiers and an unspecified number of casualties on the Chinese side. After a few months of relative calm, tensions erupted in late August with “provocative military movements” near Pangong Tso Lake and a Tibetan soldier’s death in India’s Special Frontier Forces. Only a few weeks ago, both sides accused each other of firing warning shots, the first use of live fire in 45 years.

Although China and India’s foreign ministers recently agreed to disengage at talks in Moscow during the Shanghai Cooperation Organisation meeting, troops remain massed at the border. China is reportedly building military infrastructure. Many worry that increased tensions could lead to war, especially given India’s limited options.

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As the second- and fourth-largest militaries in the world – and two nuclear powers at that – soon enter the fifth month of a standoff, the world has been relatively silent. All countries, especially the United States, should help China and India avoid an armed confrontation. Wars happen, especially over territory. And it wouldn’t be the first time the two countries have fought over this issue. Fifty-eight years ago, the two countries found themselves at war when massed Chinese artillery opened fire on a weak Indian garrison in Namka Chu Valley, in an eastern area China considers Southern Tibet and India calls Arunachal Pradesh. China launched a simultaneous assault against the western sector, clearing Indian posts north of Ladakh. After 30 days of sporadic fighting, the war came to an end with a unilateral Chinese withdrawal from much of the territory it had seized.

But such a unilateral ceasefire is extremely rare. Most contemporary conflicts end through a negotiated settlement. This means getting the two countries to talk to each other face-to-face during a war can be necessary for war termination. But my research shows this does not come easily – states are often concerned that a willingness to talk will communicate weakness to their adversary, who, in turn, will be encouraged to continue the fighting. Only when states are confident their diplomatic moves will not convey weakness, and their adversary does not have the will or capabilities to escalate is a belligerent willing to come to the negotiating table.

Continue reading Mastro's comments in The Interpreter >>

This analysis by Arzan Tarapore was originally published at The Monkey Cage by The Washington Post.

Last week, the India-China border standoff came the closest it has yet to war. As Taylor Fravel explained, the long-standing border dispute dates from the 1962 Sino-Indian War. The dispute came to a boil in May when a large force of Chinese soldiers crossed the Line of Actual Control (LAC), the disputed border between the two countries since 1962. A deadly skirmish in June temporarily raised tensions, but it was the result of tragic happenstance rather than large and risky military maneuvers.

Tensions have escalated more seriously since late August because both sides have jostled for tactical advantage, creating incentives for each side to outflank or even fight the other.

Here’s where things stand in this crisis.

Aggressive tactical maneuvers led to rising tensions

A new phase of the four-month-long border crisis opened when Indian special forces quietly occupied several peaks in the mountainous Chushul sector of Ladakh during the night of Aug. 29-30. These peaks sit on India’s side of the LAC, just south of a divided lake — Pangong Tso — but had been left unoccupied in accordance with confidence-building agreements. They were the site of tenacious fighting in the 1962 border war and hold particular tactical significance because they overlook an important pathway through the mountains between India and China.

Occupying the high ground in Chushul was designed to prevent Chinese forces from establishing an even stronger position. India also may have calculated that it could negotiate a withdrawal from those tactically valuable peaks in return for a Chinese withdrawal from areas seized after May.

Tensions rose. Indian and Chinese troops also scrambled to secure high ground overlooking new Chinese fortifications on the north bank of Pangong Tso. They reinforced their positions with additional aircraft and armor and accused each other of firing the first gunshots on the LAC since 1975. Some Indian analysts warned that China might risk war to reverse India’s occupation of the Chushul peaks.

Continue reading Arzan's full analysis on Monkey Cage at The Washington Post >>

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This op-ed by Arzan Tarapore originally appeared in The Hindu.

Over four months ago, the Chinese army entered territory that India has long considered its own, and never left. In effect, the multiple incursions have changed the Line of Actual Control (LAC) and India has lost territory, at least for the time being. How could this happen?

In part, it was a failure of the warning-intelligence system. Either Indian intelligence services did not collect sufficient data of Chinese intentions and early moves, or they did not interpret it correctly, or their policy and military customers failed to take the warning seriously. Wherever the fault lay, the system apparently failed.

In part, however, the problem also lay in the Army’s concepts for defending the country’s borders. It is, as the current crisis shows, simply not postured or prepared for the type of security threat China presents. (Continue reading the full article in The Hindu.)

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