EDITORIAL

War cries, Mismanagement...

If any evidence were needed to show that the politics of this country is diseased to the core, the fact that the politicians of this country have not desisted from politicking over the greatest threat to the nation today would prove it overwhelmingly. But people do not need any proof; they believe it for a truism that politicks here is grown foetid to the core with this disease. But perhaps some of this disease has rubbed on-this people,.....more

...And Autonomy

If Farooq’s opponents have been trying to steel the thunder from his very apt cry for a total war on terrorism by bringing in the mismanagement of his Government over the past several years, his attempts to play the autonomy card are no less an attempt to keep sly agendas for politicking at hand. Perhaps, no issue in this State has been so misconstrued, misrepresented as the issue of autonomy. For a plain fact, the nation is unable to understand ....... .more

Indian Role in Anti-terrorism
War Damages National
Interest

By Balraj Puri
Whosoever may be responsible, more than the other, for recreating tension between India ...
more

Concern at Bank health

By K Viswanatha Rao
One of the steps favoured by the Reseve Bank o f India (RBI) in its mid-term monetary and credit Policy announced on .. .
more

Was Pt Nehru an agnostic ?

By Babu Ram Sharma
Was the late Pt Jawahar Lal Nehru, P M, an agnostic ? perhaps not. He was an amalgam of materialistic philosophy..
.more

Investing in Health

By Aarti
The mysterious death of over 11 new-born babies in quick succession on 3 and 4th November this year at Lucknow’s King George’s Medical College ........
.more

EDITORIAL

War cries, Mismanagement...

If any evidence were needed to show that the politics of this country is diseased to the core, the fact that the politicians of this country have not desisted from politicking over the greatest threat to the nation today would prove it overwhelmingly. But people do not need any proof; they believe it for a truism that politicks here is grown foetid to the core with this disease. But perhaps some of this disease has rubbed on-this people, too. Or, how else would they know all, be capable of assessing every actor in the political arena and still not act to throw them out. Not only do they not throw them out but the people even suffer them to play out the antics to their fullest, go witness their games of prevarication and falsehood, and reward and punish them not for their work but for this play-acting, this power to befool them the more. Like bin Laden’s sympathizers trying to justify terrorism in a veiled manner, they seek excuses to deflect the peoples’ attention from the most pressing issue before the. nation.

A case in point is the opposition to the POTO. We have Chief Ministers some even in the beleaguered northeastern states, who are not able to walk around their capitals without the security agencies, telling the nation that they have ‘enough laws to deal with terrorism’. Political parties act as if there was nothing the matter with the World, as if there were no terrorism around and see this very apt ordinance as a sinister agenda of a particular party. They have cleanly forgotten that they themselves had brought in more draconian laws in their time, to deal with a far lesser menace. None wants to think that when a nation of America’s power, commitment and uniformity of focus, needs a much more drastic law how would India's worn-out laws help. Because none would. So it is with other issues. From state to state, region to region, all that the politicians are seeking is a political advantage. In this state it is through the cries of ‘mismanagement’. None would hold that Farooq government has been a model one. It has failed on more than one count. And, so have almost all the governments, all over the country. Today, we have governments of all formations coalitions and parties in theil country and none has been able to deliver the promises they have made.

But is that why there is terrorism in this states? Much needless confusion has been minted in this state and the nation by linking administrative failure with the rise of terrorism. Terrorism is a phenomenon that has little to do with discomfituresover the distribution of Kerosene oil, or rise in unemployment. Those who are positing these as the ‘causes of terrorism’ are misleading not only the people of this state but the whole nation. Indeed, the people who would collude with the enemy, over simple administrative bottlenecks, or start pushing the enemy’s agenda because they are not get enough employments, for example, would be anti-nationals by definition. But we are aware that this terrorism here is sponsored, manufactured and exported into this nation with agendas that aim at dismemberment even decimation of this nation. How can that be attributed to simple mismanagement, which is almost universal phenomenon with political governance ? How can a war cry against this menace be a deflection of public attention? This is a threat to the nation here, and all the nationalists would do better than deflecting attention from that threat.

...And Autonomy

If Farooq’s opponents have been trying to steel the thunder from his very apt cry for a total war on terrorism by bringing in the mismanagement of his Government over the past several years, his attempts to play the autonomy card are no less an attempt to keep sly agendas for politicking at hand. Perhaps, no issue in this State has been so misconstrued, misrepresented as the issue of autonomy. For a plain fact, the nation is unable to understand the rationale of a section of the people of this multiethnic state wanting to have 'full autonomy' which the others vehemently oppose. Within the state Jammu and Ladakh are dead against autonomy of any sort. Their clamour, strong and unmistakable, has been that the state should see more integration with the nation as a whole, instead of any further relaxation in this balance of power between the union and the state. They validly ask why does half a crore of people in Kashmir need a special power, special status, if the other hundred crores, including crores of Muslims, can do with the usual powers and status? They see the home minister’s assurance that there would be a greater devolution of powers to all the states, which would include this, state, as more than adequate. But there lies a catch here. The state of Jammu and Kashmir already enjoys more powers than any other state in the union and more powers than any union...No, any federation can give to its constituents. There simply is no scope to enlarge the powers of this state.

But there is a more sinister side of this devolution. It is the special status, the demand for and pounding in of the notions of distinctness that have provided fuel to the terrorist mills. It is not the civic problems, or the discomfitures over goods and services that have provided Pakistan a fertile ground to sow its terrorism here, but the insistence that this here is a place that is 'special', this is a state that is somehow 'different' from the other states other peoples of the country, that unless special powers are granted here the people would not get justice. By drilling in these dis-satisfactions the powers and politicians of this state have, knowingly or unknowingly, supplied ideological justification for the terrorism. Politicians use many planks for politicking. But some things are just not available for that game. Foremost here is the integrity of the nation, its oneness, its uniformity of treatment to all its citizens. Politicking here is not allowed. It weakens the nation; it gives ready excuses to the enemies and it deflects the attention of the people, State and the nation from the challenges facing it.

Indian Role in Anti-terrorism War Damages National Interest

By Balraj Puri

Whosoever may be responsible, more than the other, for recreating tension between India and Pakistan, in particular over Kashmir, India was none too pleased with the advice it received from all world powers to talk to Pakistan, including in Kashmir.

But why did India have to queer the pitch in its relations with Pakistan and raise the issue of Kashmir at this hour. Soon after offering "unconditional and unambiguous support" to the global anti-terrorism fight, India started a persistent campaign, for including Kashmir in the fight against the terrorists. India drew parallel between the way terrorists struck at America on September 11 and their attack at the assembly in Srinagar on October 1. There was a similar parallel between the way Taliban provided safe heaven to bin Laden and the way Pakistan harboured terrorists who operate in Kashmir. India also warned the anti-terror coalition against inclusion of Pakistan in it in view of its post record and its close collision with Taliban. Fears were expressed that withdrawal of sanctions on US aid to Pakistan would be used by it to increase its armed strength which would pose threat to India. Our foreign minister Jaswant Singh is reported to have cancelled his meeting with Joseph Bidden, head of the US foreign relations committee, because he had supported the US move to lift sanctions against Pakistan.

India's efforts to include Kashmir on international agenda was responded by Osama bin Laden's Al Queda which in its video taped statement "ordered the Americans to stop support to Hindus in Kashmir." It, for the first time, put Kashmir on international terrorist agenda. It was almost a literal echo of the voices of some naive Hindus who were looking for an opportunity in what is being perceived as a clash of civilisations between the West and Islam for settling score with the latter; in particular with Pakistan by joining the former camp.

The official interpretation of Al Qaida's threat attributes it to the influence of the ISI. It is based on the presumption that understanding between Pakistan and Taliban has remained unaffected after the former joined the American war against the latter. The ban on SIMI, inter alia, is being justified on grounds of its links with the ISI and the Talban.

True, the ISI had links with the Al Qaida, Taliban and possibly SIMI. General Musharraf himself was a patron of the Rabta Trust, which is now banned in America and Pakistan. The CIA and the ISI which had jointly created the Taliban are jointly trying to destroy them. If there are doubtful elements in the ISI, they are more a threat to Pakistan than to India. Already to ward off such a threat Musharraf sidelined the ISI chief and his two army generals.

Even Taliban pose a greater threat to Pakistan than to India. According to a survey of a Pakistan paper, Musharraf is the most hated person in Afghanistan. With Pushtoon community in Frontier Province and Baluchistan virtually in revolt against the Pakistan's Afghanistan policy, prospects of revival of a movement of an independent Pushtoonistan are haunting Pakistan. In the rest of the country also, jehadi forces are threatening the pro-America government. How the Pakistan government suppresses this threat within the country and supports them in Kashmir should become a more serious problem for it than for India.

At a time when Pakistan is fighting a war for its integrity and survival, why did India started crying wolf and tried to divert international attention from war against terrorism to the threat it perceived on its western border? Expectedly it just succeeded in reducing its status to that of parity with Pakistan and received sermons for restraint.

Similarly whatever be the outcome of the jehad of terrorists against the government in Pakistan, their jehad against India in Kashmir is bound to receive a set back. But why was India in a hurry to seek priority for its fight against jehadis and thus tried to shift undivided attention of the anti-terrorism coalition away from its first target in Afghanistan? Notwithstanding India's brave declarations of its capacity to fight terrorism in Kashmir on its own, why had the Prime Minister to rush a missive to President Bush — like a damsel in distress — telling him that there was a limit to India's patiance when the state assembly was attacked by the terrorists. What immediate relief we expected from America? But why single out a single world leader for such an appeal? If it was a diplomatic move, to win international sympathy, why not a similar letter sent to the governments of the other countries? Sole trust in America and excessive expectations from it not only was a national humiliation but also an embarrassment to the super power of the world.

Expectedly we are advised to talk to Pakistan on the Kashmir issue, keeping in view the wishes of the people. The New York Times, reminded India, more bluntly that "it cannot crush Muslim aspirations in Kashmir with the use of force". Much more needs to be done at diplomatic level and within the state to resolve the issue.

How have Kashmiri Muslims reacted to the latest developments? Most of the Muslims everywhere, including those who condemned the terrorist attack on New York, are, in varying degrees, swept by a sort of an anti-America wave. Kashmiri Muslims have not remained unaffected by it. There are many reasons that have cumulatively caused it. Without going into its causes and merits, its effect on Kashmir, includes marginalisation of the Muslim leadership that Pakistan had recognised so far. Anti-America slogans have replaced anti-India and pro-Pak slogans. Whether it turns out to be a loss or gain, will depend upon how the popular Muslim sentiment is interpreted and channelised. That would also apply to the Muslims in the rest of the country — its largest minority. Media has projected Shahi Imam of Delhi as the most representive voice of India Muslims; without understanding the fact that his status is no more than that of Imams of thousands of mosques in the country. His diatribes against America have been cited as proof not only of fundamentalist, fanatic and extremist character of the entire Muslim community but also of their lack of patriotism. Vociferous demands are being made for his arrest and trial for sedition and disloyalty.

Explanations were sought from moderate and liberal Muslims about their stand and that of Indian Muslims. They have diowned Shahi Imam and asserted that he did not represent the Muslim mind. But a more important issue is definition of patriotism.

While moderate and liberal Muslims have started speaking out and media has starting taking notice of them, it is necessary to define the limits of patriotism. Shahi Imam may be condemned for the type of language he uses and for his views on most of the subjects. But has he not condemned Pakistan for being a traitor to Islam and said, "common people there will teach General Pervez Musharraf a lesson for betraying the cause of Islam?" Has he not condemned the Pak sponsored jehad in Kashmir as un-Islamic. On Kashmir, his stand is more nationalistic than many liberal Hindus. Condemnation of Pakistan and support of Indian case on Kashmir are certainly very parochial tests of patriotism. But if a Muslim leader passes these tests, should his loyalty be still doubtful? Even a fundamentalist Muslim can be as loyal to the country as any fundamentalist Hindu can be. In no case anti-America outbursts, however wrong, can be equated with disloyalty to India. But six students were asserted in Delhi on the charge of sedition for distributing anti-America leaflets. What could be a better way of undermining the basis of patriotism.

India's stand on a post-Taliban policy is no less uninformed about ground realities and its national interest. Its insistence on key role for the Northern Alliance in the new regime would further alienate the Pushtoons who comprise the most numerous ethnic community of Afghanistan and are totally unrepresented in the alliance. Any regime without due representation to the Pushtoon will be unstable. It is true that they are the ethnic base of Taliban. But it is equally true that they used to rever Gandhi and Abdul Ghaffar Khan. Urges of a community do take different ideological expressions — sometimes from one extreme to the other — depending upon which ideology can give them better expression. But on this account no community can be written off for ever. In their present anti-Pakistan mood, they could be helped to assert their identity through a non-fundamentalist ideology instead of diverting their hostility towards India.

In its post September 11 role, India has neither been able to promote its national interest nor raise its moral and political stature in the world. Within the country Muslim and Hindu fundamentalism got a new impetus. It weakened internal unity and plural character of the country which would further undermine its international role at this crucial turn of history.

A re-assessment of the realities and realignments in the world, its own potential and strategic priorities is called for by the leadership of India if its aspires to play a role befitting its size, strength, geo-political position and civilisational background in the interest of world peace and its own enlightened self-interest.

Concern at Bank health

By K Viswanatha Rao

One of the steps favoured by the Reseve Bank o f India (RBI) in its mid-term monetary and credit Policy announced on October, 22 may appear to help the banks but will harm them eventually. This is interest on deposits at variable rates.

Interestingly, the RBI zeroed in on this facility after observing, rightly, of course, that the banks have been able to mobilise huge savings, as the saving public don’t have other risk free avenues.

True, we have the Public Provident Fund (PPF) operated by select banks and post offices and various insurance policies on offer from the LIC (now from private sector players as well) besides some Post Office schemes. But these are primarily variations of the same recurring deposits and can be tapped after a long wait.

Real estate and gold are preferred destinations for parking idle funds. But both are often un-affordable, at least the middle class vath limited sources of income. These are prone to the market moods and as such fluctuations in their value is the norm, not the exception.

The corporate sector is virtually closed as a savings option these days, During the three months from April to June this year, only one company entered the capital market to mop up just Rs. 10 crore. In the same period last year, there were forty-one public issues for Rs. 410.80 crore.

Merchant Bankers and their ilk are aware of the poor response that awaits them to any invitation to contribute to the paid-up capital. The root cause is not the lacklustre performance of the corporate sector. But the awareness among the public that public contribution to the paid - up capital is treated as a non-refundable, interest free loan.

There is also another aspect to the public apathy. It has something to do with the window dressing of the bottom-lines. By different methodologies, a profit can be shown as a loss. There is no law on the statute book, which stipulates payment of dividend at a minimum fixed per centage. Since it is not compulsory, there is no in-built incentive to offer dividend either.

This is not the case with bonus; in fact, the Supreme Court has decreed that bonus is a deferred wage and must be paid at the lower rate (in the slab) of one month’s wages. If the Apex Court had not ruled thus, every enterprise covered under the bonus act will certainly try to wriggle out of the commitment by showing a loss, yes, in a perfectly legal manner.

Given these realities, banks have become the preferred destination for parking funds for varying periods. The depositor naturally expects and gets a fixed rate of interest at present to meet what can be described as inevitable and irreducible demands like rent, ‘insurance and unavoidable expenses, which keep looking up north, simply by efflux of time.

The RBI credit policy aptly noted that the holders of deposits in the banks generally belong to the fixed income groups. They expect a reasonable interest in excess of the long-term inflation rate. Well, rate of inflation, is, simply put, increase in the cost of (a basket of) consumer items over time. When the apex bank decrees a cut the interest rates, as happened now it causes disquiet among the fixed deposit holders.

Many avenues of parking funds today have become risky propositions, where the principal itself is not safe. The RBI seems to be acutely aware of this and hmce smugly suggested variable interest rate structure.

The fact of the matter is that the depositors, despite their all-absorbing concern for security of their savings cannot be expected to take a raw deal. Certainly not. The minimum they are willing to accept and want is cushion against inflation. As inflation continues, they would love a return that would ease the pressures caused by inflation.

The RBI credit policy refers to this facet of public deposits as a constraint on the banking system in its ability to effect further cut in the lending rates. If there is more money with a bank it can lend more. More money can come in if the interest rate is attractive. To keep paying this interest and to make a small profit too alfter meeting all other expenses, some body should pick up the tab and that some body is naturally the borrower from the bank. In other words, the lending rates are dictated by the interest rate on deposits. The question is how to reduce the lending rate without undermining the growth of bank deposits.

To help the banks to ‘gain freedom’ from the above said cycle, the central bank has mooted the new idea of variable rate of interest on deposits. In a sense, it is not a new idea, even in the Indian context. The banks already enjoy the freedom to offer variable interests on long-term deposits.

That the facility has not been popular with the depositors is a different thing. For various reasons, the depositors have tended to favour fixed interest rate regime. This tended to suit the conservatives and status-quoists among the bankers. Result? The flexibility that banks have in lowering their lending rates in the short run is effectively reduced.

For public sector banks the average cost of fund mobilisation is over seven percent. For many of the private sector banks, it is even higher. The non-interest operating expenses generally stand at around 2-3 per cent. This and the high level of sticky loans (non-performing assets in the banking jargon) push up the bank-lending rate,

Recently, the Vajpayee government has taken steps to reduce the interest on Provident Fund and National Savings Schemes (in the official jargon these are contractual savings schemes). Yet, an expert committee set up by the government under the chairmanship of RBI deputy governor Y V Reddy has advocated a more sustainable and flexible interest rate regime for these savings instruments.

The RBI now has veered round the view that the Reddy prescription is good enough to the banks as well for their long-term deposits. There is a caveat. Depending on the business cycle and inflationary cycle, the interest rates could vary in both directions. As a consequence, the advisory doesn’t necessarily imply a poor yield on the deposit. Then where is the catch? Why there are no suitors?

Even according to the credit policy document, the banks have parked a huge percentage of their money (36.3 per cent) in government securities. And it is in far excess of the minimum prescribed under the Statutory Liquidity Ratio (SLR) This year (up to October 5, 2001) this investment was significantly higher at Rs.43, 664 crore. Around this time of last year, the SLR need attracted Rs.25, 636 crore.

Whatever be the reasons for ‘the attraction’ towards the government securities, the fact of the matter is, these fetch poor yields, an interest of about ten percent or even less. Banks should learn to make better use of their funds and they should try to earn more. In a general sense that is not the case now. Under the latest RBI directive, the banks have to keep a minimum of 5.5 per cent of net demand and term liabilities as cash reserve ratio. This will fetch them an interest of 6.5 per cent

Let us look at this issue more closely. If a bank has a deposit of Rs. 100, the SLR norm takes away 36.3 per cent and gets an interest of Rs. 4. CRR requirement impounds another 5.5 per cent and the return (interest money) is Rs. 0. 3575. Whatever the bank wants to earn either by way of a profit or to pay for the interest (on the deposit) it has to do make up with the balance of Rs. 58.

Here in lies the crux of the problem the new variable interest regime will throw up. A bank will put its best foot forward to earn more if there is a compulsion to pay. If there is no fixity on the interest liability, the attitude is bound to be different. They will offer an interest they can afford. The looser is the depositor. He belongs to the unorganised sector unlike say a bank employee, who has the protection of his union.

So, what would happen is most ‘ordinary’ deposits will tend to be for just a year or less. Because, as things stand, the variable interest regime is unlikely to encompass such deposits. Also, because, inflation as officially calculated is much less than what it is actually.

Banks will do well to remember that the depositor makes sacrifices to save and naturally , therefore expects to get back his principal with compensation for the inflation. The depositor knows that the money will not remain idle with the bank and believes that it will be put to productive use, benefiting him in the process. There is bound to be a feeling of being let down if there is no fixity of interest even on long- term deposits.

While on the issue of wage board recommendations, the Supreme Court had observed thus: The rates recommended by the wage board should be paid as these depended more on the capacity to earn, not on what is shown as earned.

The analogy applies to the Banks.

--Syndicate Features

Was Pt Nehru an agnostic ?

By Babu Ram Sharma

Was the late Pt Jawahar Lal Nehru, P M, an agnostic ? perhaps not. He was an amalgam of materialistic philosophy and ethos of Hinduism. He himself acknowledges as being a queer mixture of the east and the west due to the Impact of these two great cultures on his personality. He was a true Janni and Karam Yogi. He was also a staunch humanist.

To him inner development of the individual and society was conditional to their outer development as they interact on each other. The visible world, wrote pandit Ji, is undergoing change in time and space and continually touching on the invisible world which no thinking person can ignore. The modern man is much more involved in himself and things external. Religion, he said supplies deeply felt need of human nature. Religion is a binding force and not a divisive one. All the religious teach brotherhood and service of mankind Pt. Jawaharlal Nehru was keenly concerned and worked zealously to better the lot of the poor and to make India great. He acknowledged the influence of his birth background and environment on him and gave credence to the karma theory of cause and effect, ethical valus according to Dharam Yuga. The Hindu Religion as per its Great books, the vedanta (upnishads) and the Bhagavad Gita went up in his estimation, he wrote. He did not approve of rituals. Interestingly, he compared some of the latest conclusions of science with the fundamental ideas underlying the Advaita vedanta theory; ''These ideas were that the universe is made of one substance whose form is perpetually changing and further that the sum total of energies remains always the same. Also that the explanations of things are to be found within their nature and that no external beings or existences are required to explain that is going on in the universe with its corallary of a self evolving universe. Pt Ji was a great intellectual and endowed with a logical and scientific bent of mind. Indian religion divinifies all living beings. It is based on Karma philosophy and welfare of all the beings of the world; ''Sarva Bhavanta  Sukhina''. It is a fearless search for truth: The Hindu prayer is: ''Lead me from untruth to Truth darkness to light, ignorance to wisdom and death to Immortality! Hindu religion treats humanity as one 'Katumb Kam' one are family. Pt Nehru considered religion as a synthesising force and pitied people for communalising it: Pt Ji was not only a votary of materialistic Philosophy but also of truly religions humanism. He loved the oppressed of the world and fought for them. His temper and approach was scientific He was intensely religious in his quest for truth justice, fair play and freedom from enslavement of mankind. He was a patriotic Internationalist and loved human life of sincere action and achievement. Such a life is envied even by the angels as per our scriptures:

Investing in Health

By Aarti

The mysterious death of over 11 new-born babies in quick succession on 3 and 4th November this year at Lucknow’s King George’s Medical College hospital is too poignant for words. Contrary to the alleged shortage of oxygen cylinders in the paediatric neo-natal unit by the bereaved parents and resident doctors on duty, the hospital Chief’s version that no single factor was responsible for the tragedy and such deaths were "routine" has evoked sharp reactions from several quarters. Besides a two-member expert team constituted by the Prime Minister’s office to make an on-the-spot enquiry, apparently after one of the parents faxed details of the episode, that the State Government and the Medical College were also forced set up their own inquiry committees portrays the gravity of the matter.

The Lucknow incident, a tip of the iceberg, is symptomatic of a deeper malaise so dormant in our public health system despite several efforts to stem the rot. India perhaps has the world’s largest health service systems to provide preventive, rehabilitative and curative health care. Besides some 146 medical colleges, over the past five decades, primary health centres have grown from 725 to 1,63,181; hospitals/dispensaries from 9209 to 43,322; beds (private and public) from 117,198 to 8,70,161; allopathic doctors from 61,800 to 5,03,900 and nursing personnel from 18,054 to 7,37,000. But there are only 407 doctors and 214 nurses and 1,500 beds to serve every one lakh people (ideally the doctor to nurse ratio ought to be 1:3) when compared to 2,340 doctors, 3,204 nurses and 5,900 beds for the same number of people in US. According to estimates, while less than 20 per cent of the population seek out patient services, less that 45 per cent avail of the facilities for in-door treatment in public hospitals. As such, about 300-million odd unorganised casual workers, earning a meagre per capita income of Rs 35 per day end up spending around Rs 75 per capita expenditure on health. The cause for worry is the plight of about 135 million people who do not have access to any basic health services.

In the recent past, the CP Singh Inquiry Committee(set up in wake of the public outcry on the medical treatment given to former Union minister Rangarajan Kumaramangalam, who died evidently due to wrong diagnosis) made some far-reaching recommendations. Among others, the suggestion to effect compulsory registration of all clinical laboratories has been made compulsory. This is aimed to check the growing complaints of wrong diagnosis (resulting in wrong treatment and death) and improving the monitoring the mandatory provisions of public health care system in secondary and tertiary hospitals in the country.

When the National Health Policy was conceived in 1983, it had set the goal of ‘Health for All’ by the year 2000, through the universal provision of comprehensive primary health care services. This objective could not be realised due to systemic faults in the implementation of several well-intended programmes. Resource crunch, ignorance and complete lack of awareness of even fairly common illnesses and their treatment amongst a vast majority of our population coupled with the uniformed medical approach to incurable and dangerous diseases has compounded the situation.

Various studies indicate that infant mortality is declining. Still, 1 in 15 children in India die before age one. Primarily, over two-thirds of all infant deaths occur in low birth weight category because about 33 per cent of all babies born weigh 2500 grams or less at birth and vary dramatically among major states, ranging from 16 in Kerala to 86 or more in Uttar Pradesh and Madhya Pradesh. Government initiatives like reproductive and child health care programmes have made inroads in many areas. But with just 30-49 per cent of births in India registered, as per an UNICEF study, not only population statistics are incorrect but also Government’s plans for the future often go awry. The percentage of outlay provided for health and family welfare, as a percent of the total outlay during the Ninth Five Year Plan at 4.01, shows an increase when compared to that of the Eighth Five Year Plan when it was 3.24. Yet, our percentage of public expenditure on health to total health expenditure being significantly low and the aggregate expenditure in the health sector hovering at 5.2 per cent of the gross domestic product, the current annual per capita public health expenditure is just about Rs 160.

Despite mobilising external assistance from various bilateral and multilateral agencies for implementing national health programmes and for upgrading rural hospitals in selected states, for a plethora of reasons including rising population, the health delivery services leave much to be desired. For want of a systematic approach, coupled with lack of public awareness and the apathetic attitude of regulatory authorities, more and more people are feared to get infected with deadly diseases like AIDS, Hepatitis B etc, through toxic bio-medical wastes produced and disposed unscientifically by hospitals.

The condition of several government hospitals in the country is appalling - some are literally on the brink of a collapse both, for want of sufficient funds and lack of management planning. Dilapidated buildings and poorly ventilated or leaky rooms, rickety furniture, obsolete, inadequate, unusable equipment and paucity of essential drugs are just some of the many problems. The presence of medical and para-medical personnel, often much less than required by the prescribed norms, coupled with the grossly inadequate facilities have been responsible for overcrowding, leading to a steep deterioration in the quality of services. Many public health centres and sub centres in the rural areas are either not visited for months together by doctors assigned to them or medicines allocated are sold off in the market. Private nursing homes, corporate hospitals and sophisticated medical institutes, conforming to international standards, are available only in the metros and few other cities to those who can afford. But since the emphasis is largely curative rather than promoting preventive medicine, the costs are relatively high.

With issues like life expectancy at birth, infant mortality and the causes of death still remaining the most pressing health concerns in the country and our health care system wilting under pressure, the thrust of all efforts should be on long-term plans and permanent solutions. The draft New Health Policy-2001, hoped to be translated into a reality soon, aims to create a beneficiary interest in the public health system. The health sector expenditure is to be hiked to 6 percent of GDP, with 2 percent of GDP being contributed as public health investment, by the year 2010. The Central Government’s contribution would also rise to 25 percent from the existing 15 percent. While envisaging a more effective supervision of the public health personnel, through community monitoring, the Primary Health System is to be revived by providing some essential drugs under Central Government funding through a decentralised health system. By 2005, State sector health spending is to be increased from 5.5 to 7 per cent of the budget; polio is to be eradicated and leprosy eliminated. Zero level growth of HIV/AIDS is to be achieved by 2007. By 2010, plans are on to reduce mortality by 50 per cent on account of TB, malaria and other vector/water borne diseases and prevalence of blindness to 0.5 per cent. By improving nutrition, the proportion of low birth weight babies is to be reduced from 30 to 10 per cent and infant mortality rates to 30/1000 and maternal mortality rates to 100/lakh. While utilisation of public health facilities is to increased from the current level of less than 20 to over 75 per cent, health expenditure by the Government as a per cent of GDP from the existing 0.9 to 2.0 per cent, share of Central grants to constitute at least 25 per cent of total health spending

Notwithstanding well-intended plans, building faith in the public health system by enhancing the efficiency of delivery of basic health services is the first step. Systemic flaws in the implementation of several national programmes for the control/eradication of diseases need to be addressed effectively. Management planning and control measures to periodically appraise the existing health policies and the interventions merit consideration. In spreading health awareness through education, campaigns need to be undertaken only after ascertaining the mind-set or level of understanding of the target audience to achieve the desired results. Empowering the local bodies with the active participation of women can enable them to play a greater role in the day-to-day administration of such projects.

The approach to health challenges, beyond reflecting concern and compassion for the underprivileged, must also deliver a comprehensive package that includes primary education, particularly for women, to fight poverty - a key determinant of health and a major consequence for ill health. Investing in health, being a social good must be looked beyond an economic investment. Above all, it needs to be recognised that the health of people is not only a desirable goal but is also an essential investment in human resources.

 



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