Millennium Development Goals:
Will India Catch The Bus?
The world is in a race against time. In the year 2000, 192 United Nations (UN) member states, including India, set for themselves eight developmental goals - ambitiously entitled 'The Millennium Development Goals' (MDGs). By 2015, they pledged to eradicate extreme poverty and hunger among a slew of other promises that include achieving universal primary education and reducing child mortality. Today, the MDGs have emerged as the dominant framework of development, internationally.
The year 2010 presents a crucial moment to assess the ground covered over the last decade and the distance that remains to be traversed over the next five years. In fact, that is just what the United Nations General Assembly will do when it meets this September. How well is India placed to catch the MDGs bus? The Government of India has just done its own assessment. And the picture that emerges in this document, entitled the 'Millennium Development Goals: India Country Report 2009', is a very mixed one.
According to the Report, as many as 25 States/Union Territories in India are likely to have halved their 1990 levels of poverty earlier or around 2015. There is optimism that the country will be able to achieve universal primary education by 2015 and eliminate the enrolment gap between boys and girls by then. The government also claims that it is on course in controlling the incidence of HIV/AIDS, malaria and tuberculosis and expects to achieve the MDGs target for sustainable access to safe drinking water by the designated year.
Ground for some cautious cheer? Well, there are many who would contest even the basic assumption that India will be able to peg down its poverty levels in a meaningful way. On one issue, however, everybody agrees, including the government: Among the gravest challenges facing India today is its persistently high Infant Mortality Rate (IMR).
Change on this score has been tragically sluggish. The Report estimates that going by present trends, the country would have achieved, by 2015, an IMR of only 46 per 1000 live births, as against the required 26.7 per 1000 live births. It also notes that the "incidence of neo-natal deaths has not changed over the last seven years in the heartland states".
Expectant mothers in the country are not doing too well either, although things have improved immeasurably since 1990, when the country's Maternal Mortality Rate (MMR) was 437 per 100,000 live births. According to the Country Report's projections, India is expected to bring down its MMR to 135 per 100,000 live births by 2015, which falls short of the required 109 per 100,000 live births.
The deaths of these innumerable children and mothers are a severe indictment of the country and point to significant and overlapping inequalities of gender, class, caste and region. Not surprisingly, it is the poorest states - like Bihar, Jharkhand, Chhattisgarh, Madhya Pradesh, Orissa and Uttar Pradesh - constituting India's heartland, and the most marginalised communities - whether Dalits, Tribals or the Minorities - that report the highest mortality levels.
If India's IMR and MMR are to be pegged down, the country will have to focus urgently on three central concerns: hunger/malnutrition; health care; and sanitation. Malnutrition is directly related to poverty and food security. According to the National Family Health Survey - 3 (2005-2006), about half the children in India are stunted, and more than a third of our women have a Body Mass Index below 18.5 per cent, an indicator of serious nutritional deficiency and the inter-generational transfer of malnutrition from mother to child.
Health care remains another huge concern. According to a recent Planning Commission assessment, the shortfall of primary health centres and sub-centres in 2008 has remained almost the same as in 2005, and the number of auxiliary nurse midwives has, in fact, decreased over the same period. Today, there is a 50 per cent shortfall in trained health workers, radiographers, lab technicians and doctors. At the existing rate, only 62 per cent deliveries will be attended by skilled personnel by 2015 - with rural areas being particularly under-serviced.
Sanitation, unfortunately, has never been a policy priority for India despite that fact that drinking water contaminated by faecal matter is a major cause of child deaths. The Report admits that India has the lowest sanitation coverage in the world - in 2007-08, an estimated 66 per cent of rural households did not have toilet facilities.
"The more we wait, the more difficult it will be to address such concerns and achieve the MDGs," predicts Siba Sankar Mohanty, National Campaign Coordinator, Wada Na Todo Abhiyan (Keep the Promise movement), a national campaign to hold the government accountable for its promises, that involves more than 4,000 civil society organisations across 29 States and Union Territories in the country.
Mohanty argues that since the Suresh Tendulkar Committee has assessed the actual population living below poverty in India at 37 per cent instead of the earlier figure of 27 per cent, it means that achieving the targets will be that much more difficult. He also argues that the government needs to get back to delivering basic services, like health and education, instead of linking their access to the vagaries of the market.
According to Bhopal-based Yogesh Kumar, Executive Director of the Samarthan Centre for Development Support, there has been a huge governance failure. "My state, Madhya Pradesh, has the highest level of malnutrition in the country, especially among Scheduled Castes and Scheduled Tribes, but the government has just not woken up to the issue. Forget additional resources, even the resources that are available are not being put to best use. As for the affected people, they are so disempowered they do not even know they have the right to demand better government accountability," says Kumar.
The irony, according to Alok Vyas of the Jaipur-based CECOEDECON, a group working for the last 27 years among Rajasthan's farmers, is that while agriculture continues to be the main source of livelihood for at least 60 per cent of Indians - in Rajasthan the figure is around 70 per cent - there has been precious little investment in the sector. "Farmers have been squeezed out, and many have sold their assets to become migrant workers in the cities. Nobody in government is taking agriculture seriously," he says.
India is still awaiting its tryst with its developmental destiny. The MDGs represent a web of overlapping deprivations. Achieving them will not only change the face of the country, it could go some way in addressing the million mutinies that are raging, or will rage in the near future. All insurgencies, after all, are fuelled by a sense of grievance and powerlessness among ordinary people, whether in the Northeast or in Chhattisgarh.
In September the governments of the world will meet at the UN to present their assessments on the status of MDGs in their respective countries. Annie Raja, General Secretary of the National Federation of Indian Women, wants the Government of India to make the effort to understand the concerns of civil society. "Before the Government of India makes its presentation on MDGs at the UN, we demand that our views be taken into consideration," says Raja.
The clock is ticking. If India does not get its act together now, 2015 will go down as the year of broken promises.
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