Dead Policy Walking: Will Budget 2017 Curb Daily Death Parade?
The death of one man is a tragedy. The death of millions is a statistic. Must India lose thousands of lives every day in untimely deaths?
January 29, 2017, 7:16 pm
The death of one man is a tragedy. The death of millions is a statistic. The old aphorism, frequently attributed to Joseph Stalin, is a visible reality on the landscape of governance. Analysis of data released by the government and multilateral agencies indicates that every year nearly 20 lakh people — roughly 5,000 per day or around 225 per hour — die untimely deaths at the intersection of poor policy and systemic failures.
Must India lose thousands of lives every day to pneumonia and diarrhea?
Must so many die on killer roads?
Is gasping for breath — and dying of pollution-related diseases a given?
It is true that death (along with taxes) is inevitable. But must untimely deaths be inevitable? Especially when the problems are known and so are the solutions.
Will Budget 2017 leverage resources to fix the parade of daily deaths that are really the consequence of dead policy walking? It is a question that begs an answer if India is to be taken seriously on its claims of a humane society that values life.
Through these data points, across just four critical issues, consider the extent of the tragedy that haunts headlines.
136 Children Under The Age of Five Die Of Disease Every Hour
In 2015, over 12 lakh children died before they reached the age of five. To put the United Nations Inter-agency Group data in perspective, that is over 3,200 children a day or a shocking 136 child deaths every hour.
With 46 of every 1,000 children dying before they reach the age of five, India accounts for one in five or 20 percent of all under-five children deaths in the world.
India is worse off than its BRICS peers and data shows that life expectancy at birth for a child is longer/better in Sri Lanka, Bhutan, Nepal, and Bangladesh.
What do children die of? They die because of premature birth, of under-nutrition, pneumonia, diarrhea besides other diseases. A study by the International Vaccine Access Center at the John Hopkins Bloomberg School of Public Health revealed that India topped the list for pneumonia and diarrhea deaths — 296,279 deaths in 2015 — that’s 33 deaths per hour.
Add women losing lives at childbirth. The maternal mortality rate is 167/1,00,000 births as per the government of India and 174/1,00,000 births as per the World Health Organisation 2016 report.
Either way, the fact is every year over 40,000 women die in childbirth. Which means over 100 children are rendered motherless every day.
Can it be argued that the heathcare infrastructure — 1.5 lakh sub-centres, 25,308 primary health centres and 5,396 community health centres — is adequate for over 80 crore living in 5,93,171 inhabited villages? Barely a third of households have access to piped water and 44 percent defecate in the open. Yes, there is the Integrated Child Development Scheme or ICDS launched in 1975 and a trail of acronyms — JSY, JSSK, RMNCH, SNCU, KMC, HBNC, IANP… and so on.
Sure, the mortality rate has declined over the years. But the scale of the problem — reflected in 12 lakh — demands new thinking.
- How about directly funding reverse osmosis drinking water systems for villages?
- Can the Defence Research and Development Organisation’s portable toilet technology be scaled for mass adoption?
- Would the Centre fund sewage gas plants via startups and local bodies?
- Why not design a model public-private partnership that involves private healthcare providers operating mobile clinics, pay per Aadhaar authenticated check-up, and setting up telemedicine facilities at primary health centres?
Will Budget 2017 decentralise functions and goad states to adopt best practices, spend more and better?
India’s Killer Roads Claim 16 Lives Every Hour
Earlier this week, Delhi was outraged when a BMW driver rammed into a cab and killed 30-year-old Uber driver, Nazrul Islam. The Delhi accident was one of the nearly 5 lakh accidents — 1,300 per day — reported across India. Yet, the outrage on road deaths is sporadic — focused on incidents rather than the scale of incidence and fatality. In 2015, 5,00,279 persons were injured and 1,46,133 persons were killed in road accidents. Translated, that is a shocking 400 deaths every day or 16 lives every hour.
Contrary to notions that traffic accidents are an urban menace, the bulk of accidents happen in rural areas, in fine weather, and in broad daylight — mostly between 3 pm and 6 pm. Drivers’ fault accounted for three of four accidents and deaths — and drivers without a licence were involved in 45,191 accidents. Incredible as it sounds, 60 percent of vehicles on Indian roads ply without any insurance cover.
The cause of the killer epidemic is embedded in the monstrously corrupt licensing system and archaic methods of regulation.
There is also poor capacity, signage, and design to blame. Nearly half the accidents are at junctions.
The sad fact is that public discourse has seemingly rationalised the volume of accidents and fatalities. Between 2006 and 2015 India’s killer roads and manic driving habits resulted in 43 lakh accidents that left over 50 lakh injured and over 13 lakh dead. And 7 of 10 killed were in the prime of life between 15 and 44.
This is unacceptable. The Road Transport and Safety Bill has many good ideas but is stalled in the committee-ministerial circuit.
There is a crying need for overhauling the operating system and the regulation of road safety.
There is a need for designing a national standard for the issue of a driving licence, making driving school learning mandatory as in many countries.
Perhaps the Centre could focus attention on the loss of lives by linking road and highways funding to road safety — in creating capacity, modern training manuals and overhauling regulation by inducting technology.
Will Budget 2017 leverage resources to engineer a paradigm change in mindset to ensure safer mobility?
Air Pollution Triggered Diseases Kill 70 Persons Every Hour
Every winter Indians across the metros with million-plus populace and towns wake up to the reality of severe ambient pollution levels. Air pollution is a year-round issue but the grey-smog-filled skyline serves as an annual reminder of the perils of severe air pollution.
A World Health Organisation study released in September 2016 revealed that severe air pollution caused the deaths of 6,21,138 persons — that is, 1,700 persons every day or 70 persons every hour of the day.
Of the 6.2 lakh deaths;
- over 2.4 lakh were caused by Ischemic Heart Disease,
- 1.95 lakh died of strokes,
- 1.1 lakh died of cardio-pulmonary obstructive disorder,
- and over 26,000 died of lung cancer.
This is not the first alarming report. In 2015, a WHO study of 124 cities revealed that only eight cities had certifiable air quality.
It is estimated that nearly 660 million people in India live in areas with an annual concentration of fine particulate matter far in excess of guidelines.
Every study emphasises that the situation will worsen with rising population and business-as-usual approach.
The immediate focus of governments has been on automobile pollution but that is not the only culprit. There is road dust, pollution from power plants, and particulate material from unregulated construction. The government estimates that India generates over 530 million tonnes of construction and demolition waste every year. Then there is indoor pollution in semi-urban areas, as well as the burning of agricultural waste in rural India and municipal solid waste across cities.
Tackling air pollution calls for a multi-pronged approach. Theory and law state the principle of polluter pays. In practice that is observed only in the breach. It is not enough to issue guidelines. In March 2016, Union Environment Minister Prakash Javadekar issued a new set of rules for managing construction waste. Implementation was however left to states and local bodies, which lack funding for capacity creation.
The big elephant is waste management. The Centre could create a tax-incentivised kitty to:
- Fund local bodies to set up projects for solid waste disposal.
- Tackle perennial road dust and for recycling grey water.
- Reclaim waste water.
- Bring in thermal hydrolysis technology, address both urban air pollution and water scarcity.
The world over, individuals and institutions are seriously moving towards e-mobility. Can the government incentivise adoption of electric vehicles? ISRO has made its lithium ion battery technology that powered the mars mission available to automakers for mass rapid transport. This could also be leveraged for last-mile freight inside cities and for personal mobility.
Will Budget 2017 incubate innovative policy and reward imagination so that citizens breathe a little easier?
Accidents On Railway Tracks Claim 68 Lives Every Day
Last week, 39 passengers were killed when seven bogies and the engine of the Hirakhand Express derailed near Kuneru in Andhra Pradesh. In the 62 days between November 20 and January 21, 234 persons lost their lives in three accidents.
Undeniably horrific as this is, the data reflects only part of the story. The National Crime Records Bureau tells us that 27,581 persons lost their lives in accidents and at level crossings in 2014. Replying to the member of Parliament Subhash Bhamre in the Lok Sabha, Railways Minister Suresh Prabhu put the figure for 2014 at 24,393. Between 2012 and November 2015, 81,038 persons had lost their lives. The fact is, every year around 25,000 people lost their lives on the railway tracks. Translated that is 68 lives every day.
The Anil Kakodkar committee had observed in 2012 that the Indian Railways needed to invest at least Rs 1.2 lakh crore (roughly $18 billion) to fix the many gaps in safety. That is easier said than done, given the state of its finances. Railways operations cost 93 paise or more of every rupee earned leaving little for safety. One stark data revealed in Parliament in December 2016 is that Railways has 1,22,763 vacancies in the critical department of safety.
The crux of the problem is the penurious state of railways operations. In its report, the Bibek Debroy committee had observed, “it becomes difficult to compute the costs and benefits of any project or activity.” The crisis was identified as early as in 2001 by the Rakesh Mohan committee.
Since then, 11 committees have studied and advised the railways over the course of eight ministers. The railways’ operations have been studied by over 20 committees which delivered 144 recommendations.
The aspiration for bullet train is in stark contrast to the reality of accidents. The twain can scarcely co-exist. The solutions are in the recommendations of the many committees — particularly the exhaustive report the Debroy committee. Unless the railways is corporatised, the 16 rail public sector undertakings hived-off, and structural reforms are undertaken, the quest for safety will only be a quest.
Will India see the unveiling of these measures in Budget 2017, will the Railways get the funds to make rail travel safer?
The focus on the deaths brings is meant to bring to the fore the chasm of sloth that divides intent and outcomes. A modern democracy can scarcely continue to be apathetic, inured to the scale of multiple tragedies.
An annual budget is a signal event in India’s political economy. It may be defined as a quantitative articulation of a financial plan for a year, an income-expenditure statement. However, at a political level, it is and can be more — to refocus attention, redistribute pain and gain to enable subscription of support for the regime. The convergence of economics and politics is an opportunity to incentivise real change.
Will Budget 2017 deliver?
Shankkar Aiyar, political-economy analyst, is the author of Accidental India: A History of the Nation’s Passage through Crisis and Change.
The views expressed here are those of the author’s and do not necessarily represent the views of BloombergQuint or its editorial team.
Shankkar Aiyar is the author of Accidental India: A History of the Nation’s Passage through Crisis and Change