Sunday, 26 March 2017

South Asian Dialogues on Ecological Democracy (SADED)-Lecture Series : Date: 15 & 16th May 2013



           South Asian Dialogues on Ecological Democracy (SADED)-Lecture Series

Date: 15th May 2013
Time: 2 pm
Place: Gandhi Peace Foundation (GPF), Delhi.

                               ECONOMIC DEVELOPMENT IN INDEPENDENT INDIA         
                                                                                                                             Dr. Arun Kumar                                                                                                     
Dr. Arun Kumar is Professor and is ex-chairperson in internationally reputed and India’s best Jawaharlal Nehru University, Centre of Economic Studies and Planning, New Delhi. His recently published book “Indian Economy Since Independence: Persisting Colonial Disruptions” was presented at the lecture series hosted by South Asian Dialogues on Ecological Democracy (SADED) at Gandhi Peace Foundation (GPF) on May 15th, 2013.

The name of the book is very thoughtfully given. While taking Globalization as the central theme in Indian growth story he denied it as a recent phenomenon and instead went ahead taking 1750 and 1947 as breakpoints in history.

India’s involvement in global trade has existed since eons but the circumstances changed when India got colonized. Two-way globalization always existed in the country, but with the advent of East India Company in the 1750s, we got reduced to one-way globalization and poor from brain. Although, major paradigm shifts in policy happened in 1947 and 1991, 1982 is a crucial year too, for initial impetus to liberalization.

From 1950 onwards, the state played as a dominant actor with main focus on Indigenous growth, the major policy followed was-tremendous increase of investment in agriculture and heavy industry in the 1950s followed by wars, droughts and visibility of initial policy failure in 1960s leading to economic stagnation. The decade of 70s was also a challenge due to growing internal strife and oil shocks but with commencement of green revolution and rise of neo-liberalism we managed to reach a growth rate almost double of “Hindu Growth Rate” from 3% to 6% by the end of 1980s.

1991 onwards was the phase of Market Dominance. It saw the arrival of NEP and dichotomous growth with no acceleration. Later in 2002-03 the policies making with its dependence on phrase “Growth at any cost” led to a great stance of inequality and poverty in the country which pumped up the crisis of 2008-09.

The basic sectoral division of economy into primary, secondary and tertiary is followed by further subdivision into 9 sectors depending upon organized, unorganized, private and public components. Idealistic growth pattern; development of primary sector should be followed by secondary which leads to development of proper tertiary sector. The Indian case is starkly different because in 1950’s our tertiary sector was greater than secondary. Unlike other developed South Asian countries, state dominance for five decades could not add to country, major rationale being- black economy as an integral part of country, which aggravates inefficiency of data followed by failure of governance.

Unemployment rate remained as low as 2 to 2.5% for a very long time after independence but that doesn’t imply that the state succeeded in job creation for most of the people. Instead, “Employment is being confused with underemployment to a great extent” due to existence of organized and unorganized component in the employment market. His analyses showed that 80% of the investment went into large scale industry which gives employment to just 7% of the country’s population today and the rest 93% are employed in medium, small and Cottage industry where only 20% of the total investment in Industry goes. Hence, the growth after 2002-03 with an average growth rate 9.9% and low employment elasticity could be explained as “Jobless Growth”. Technical progress turned out to be labor displacing against “Arthur Lewis” expectation of technology to be labor absorbing.


With total focus of the First Five Year Plan on Agriculture the economy did see some improvement it got in total output in 1950’s which got hampered from shift of interest towards industry in the next plan and aggravated further by drought in mid and end 1960s. With urgent need felt for “food security” came the Green Revolution in early 1970s. With the use of ground water irrigation, High yield variety (HYV) seeds and mechanization agriculture saw a great increase in productivity but the production was concentrated to very few regions and some groups saw shift in crop patterns. The major problem in agriculture persisted because of Asymmetry in price setting with industry- agriculture following competitive pricing unlike industry where prices are either oligopolistic or monopolistic. To tackle this problem CACP (Commission for Agricultural Cost and Prices) introduced a dual pricing policy wherein producers are paid Minimum Support Price (MSP) and poor households are given subsidized prices through PDS.

India followed Infant industry argument for protection of domestic market and gained support from state through reservation for small scale which got diluted by 1991 due to introduction of various acts like Monopolistic and Restrictive Trade Practices Act (MRTPA) in 1969, Foreign Exchange regulation Act (FERA) in 1974 and by 1991 a move was towards- diversification and modernization of industry.

Tertiary Sector after 1991 became a dominant sector which does not necessarily imply quantum growth in the sector, but a portion of the increase could be explained through technological, accounting change and increase in need for services and concentration of black economy. But his analysis showed that the services sector after checking on above explained facts saw tremendous growth. This spurt could be explained through increase in demand for productive and consumptive services, growth in software and telecom post 1991. In a nutshell the growth of service sector post-1991 can be explained with liberalization, scale economies and black economy together.

Government is the biggest economic entity which directs its entire economy with its actions. Tax is received as revenue which is used as government expenditure to finance the development of the country. Tax could be broadly classified into: 1) Direct tax: Corporation tax and Income tax are major examples. 2) Indirect Tax: custom, sales, etc. In the year 1947, 45% of the total revenue from tax collection came from direct taxes which got reduced to mere 13% in 1991. Current share is 40% from direct tax and 60% from indirect tax. The Classification of taxes is important because while direct tax enhances output growth, indirect taxes are collected in the process of consumption hence stagflationary. Taxes like wealth tax and estate duty are progressive and work towards reducing intergenerational equality but due to lobby influence such taxes did not existed post-1991.
In 1991 our economy was open like any other country but the problem existed with the policy of high import duty which discouraged imports without encouraging exports. We imported technology to a great extent and other imports by the rich led to severe BOP crisis by the end of 1980s.Technology is a moving frontier which can be bought from the first world either due to strategic reasons or FDI which comes with FII keeping economy at more risk during the time of crisis.
Poverty is space and time specific and differs from one place to another according to their expenditure habits. But in the Indian case Poverty line represents extreme poverty and policy formed to check this problem was dependent on trickle down approach of Lewis model, which was a failure because the model was suitable for the west and our social and economic conditions were different. Physical infrastructure of the country was Reflection of modernization and elitism. Banking and credit were meant to enhance the business of elite. In order to channel funds to the poor Indian govt. in 1969 nationalized all major banks. Post 1991, succumbing to elite, concentrated urbanization which can never be a solution for development and instead enhanced both rural-urban and urban disparity. Growing energy intensity and dependence on imported energy resulted in many crisis a move towards sustainable development and using telecommunication as an alternative for transportation could be way forward. Social infrastructure saw a rapid expansion post-1947 but quality suffered.


It was tried to overcome the infrastructure gap during colonization by copying western infrastructure which was not suitable for our system. Disadvantage of last start has been confused with advantage, where you have models to learn lessons from and change of perspective should be taken care of. In case of India, the central theme for development is coming from the west. Education system today is copied from west, the policy makers come from foreign universities, and hence most of the ideas are recycled from west. Health, problems reflect a lack of a holistic perspective and the issue environmental damage has been kept aside. Two noble professions health and education is no more left noble due to commercialization.

Conclusion
India is a far more complex structure and cannot be characterized as capitalist or feudal in their pure form. While one can learn from others, development paths cannot be copied. Disruptions continue from pre 1947 leadership lacking in independence of thought. Technology is a moving frontier hence creates a mist so the future is not clear which leads to short-termism and leadership succumbs to it. Markets split up each question into separate ones hence the problem is generated due to interdependence are ignored. There is a great need for long-term solution which includes movement towards sustainable development while checking on major problems like growing inequity and extreme poverty.


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  South Asian Dialogues on Ecological Democracy (SADED)-Lecture Series

Date: 16th May 2013
Time: 10.00 am
Place: Gandhi Peace Foundation (GPF), Delhi.

                  INDIAN ECONOMY SINCE INDEPENDENCE: TRACING THE DYNAMICS OF
                                                           COLONIAL DISRUPTIONS  
                                                                                                                                                                ArunKumar                                                                                                                                                                     
Introduction
Contemporary India is full of contradictions with continuing mass poverty and illiteracy. The average growth rate has risen far from that during independence but sustainability is missing. The growth is guided by corporate sector, which is unsustainable due to contagious effects of financial crisis. Development after independence is a short-term solution and focus needs to be shifted from short term to long term. Colonial disruption is still persisting, which is not to say that all the blame has to be apportioned to the British but that Indians need to share the blame for what happened to them. (Tolstoy in his letters and Gandhi in Hind Swaraj).

Need for a historical View
Our conditions are different from west hence we cannot follow the same policies. Time, space and geographical context are very important – if not included in policy making than becomes ahistorical. In physics, we analyze the world the way it is but in economics, every economist forms his own universe with assumptions suitable to him. For example neo classical had their assumptions and classical had theirs.

Disruption of Indian Society
Globally, colonial rule resulted in disrupted societies. Internal dynamics got adversely affected and social relationships mediated through interest of outside power. Post- independence society got reconstructed under adverse conditions. There is `loss of value of ideas’ in society. Dominant idea amongst the elite that West is modern and therefore superior while indigenous is backward to be discarded. Colonial rule broke the interconnection between elite and layman and there was need of mediating class. Police and other bureaucracy was instrument of control instead of public service like in the west, that’s how our modernity got overpowered by western modernity. Integral development never happened, since we forgot to develop ourselves from grassroots. Surplus generation in agriculture belonged to British. Nationalist leadership from amongst elite agriculture, industry, leadership, reinforced feudal elements in society, education, etc. and left their footprints on important aspects of post- independence India’s social, political and economic life.

In the Second Five Year Plan, India tried to copy west through application of successful Lewis model which did not suit the Indian situation. It’s a top down approach dual sector model according to which development of industry would trickle down to other sectors. This happened in the west because technology was integrated, here we needed inception from grass root. But policymakers while following the Lewis model, decided to fulfill the gap through import of technology (import of television hampered reading habits in India and more people were illiterate). Technology is a moving frontier and need anticipation in order to reach optimal solution. Copying from west is the philosophy we always followed disregarding its long-term consequences. Strategically Indian policymakers remained with Soviet Union while following western model philosophically.

During its entire growth path from 1950’s till today, India has seen repeated crisis of food security, continuing poverty, illiteracy, ill health, and so on but we never followed the policy of learning from mistakes. By late 60s planning commission’s importance was overpowered by World Bank and World Trade Organization where World Bank follows crony capitalism- its tagline changes according to demand of capitalism. Finally, crisis of late 1980s gave a chance for implementation of marketization which Indira Gandhi restricted for almost more than a decade. This new economic policy of free market gave way to marginalization of the marginalized through deleting the difference between necessity and luxury.


Initially in 1947 all problems were seen to have a social basis and needed to be solved collectively driving the state to a dominant position. Later by 1991, this was turned on its head, individual was responsible for her/ his problems and focus was directed towards free market. None of the two paradigm changes in policy making were able to tackle basic problems faced by the nation. However, with the actions of state the marginal got further marginalized. Both strategies of development were of western modernity where elite demanded more and more concessions for them and marginalized the poor by making them the residual. The argument followed was that they are the dynamic elements in society and lead to growth. Agriculture with unorganized sector, biggest employer to nation was overlooked as marginal. The problem we are facing today is not of growth but of employment generation- Jobless Growth.

Conclusion
The colonial disruption led to a backward structure of India’s education structure and economy.
Inadequacy of knowledge generation and borrowed knowledge led Indian intellectuals to become derived intellectuals. Leading to inadequacy in relevant knowledge generation resulting in continuing lack of dynamism in society as a whole. A long term and historical perspective is essential in understanding the nation’s dynamic or for judging the successes or failures of its development strategy. Temporary good growth as at present cannot be the yardstick for success.

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          South Asian Dialogues on Ecological Democracy (SADED)-Lecture Series
Date: 16th May 2013
Time: 4.45 pm
Place: Gandhi Peace Foundation (GPF), Delhi.

                            ROLE OF PEOPLE’S KNOWLEDGE IN HEALTH CARE        
                                                                                                                       G Hariramamurthi                                                                                                                           
Background
India, being one of the lowest in the world in public spending on health and highest in private spending, continues to be ranked among the poorest performers of the world in health indicators. Over 35 per cent of people who are hospitalized fall below the poverty line because of the health expenses; and over 40 per cent have to borrow or sell assets to pay for their health care. The role of private sector is rising at an alarming rate, from 8% in 1947 to as high as 93% of all hospitals, 64 per cent of all beds, 80 to 85 per cent doctors, 80 per cent of all outpatients and up to 57 per cent inpatients.

Indian Medical Heritage
Indian Medical Heritage consists of both the codified stream where AYUSH is sophisticatedly practiced and taught through institutional training, and non-codified stream where mostly oral, ethnic community and ecosystem specific local health traditions are practiced all over India. A national health system survey in India in 2009 reported that moderate to very high levels of household’s use of TRM where more than 6200 plant species in use for managing a range of simple to complex conditions in India alone. Several policies like: Alma Ata Declaration (WHO, 1978);National Policy on Indian Systems of Medicine, India – 2002; Five Year Plan Documents, India, 2007 and 2012 etc exists but lack of new recruits and shrinking social and policy legitimacy explains severe erosion of traditional medicine.

Even though there are about one million community- supported traditional health practitioners spread across almost all the villages of India, there are no public health strategies to engage them in delivering primary health care related services at their villages. It is also alarming to note that most of these local health practitioners are aged above 50 years, meaning that there is an emerging threat of losing their precious knowledge which will be a loss of rich indigenous knowledge. India could certainly make a paradigm shift in its approach to the involvement of local health practitioners who are reportedly available in every village of India.

AYUSH Policy Statement 2002, National Rural Health Mission Statement 2005 and Tenth and Eleventh Five Year Plan Documents 2007 and 2012 recommend the mainstreaming and involvement of AYUSH as well as Local Health Practitioners to make health care accessible to everyone.

There is serious need to identify and promote safe and efficacious local health traditions (LHTs) which could be attained by following understated steps:
1. Prioritization of health conditions
2. Identification of LHTs
3. Analysis of repeated documented remedies supported with literature review
4. Rapid assessment of LHTs
5. Promotion

For instance, storing drinking water in a copper pot is traditional Knowledge for purification of drinking water, application of turmeric on wound acts as an antiseptic.


Conclusion
Universal health coverage in India is feasible only through recognition and strengthening of our people’s knowledge in healthcare. This requires very little investment in identifying, assessing and promoting their knowledge which does not require any external investment to be mobilized. Community supported traditional health practices need to be recognized as legitimate paramedical AYUSH health workers and trained to provide their services in more effective ways.


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         South Asian Dialogues on Ecological Democracy (SADED)-Lecture Series
Date: 16th May 2013
Time: 2.30pm
Place: Gandhi Peace Foundation (GPF), Delhi.

                      TOWARDS A COMPREHENSIVE MANIFESTO FOR PEOPLES’S HEALTH
                              Ritu Priya
For a comprehensive approach to people’s health we need to address the various determinants of health as well as issues arising while strengthening health care through long term policy and action.

Health-care, with increasing national and international commercial interest, has become the second largest growing industry after IT. Universal health coverage being the current international slogan, a country is judged by its poor health indicators and coverage by health services and medical insurance. The slogan of universal health coverage, commercial sector interests increasing middle class interest in issues of public health has resulted in greater attention by the state as well. But the escalating cost of health-care, both financial and iatrogenic i.e. doctor granted illness, and actions of state towards it are not promising.

Over the centuries we have seen drastic changes in health problems. Communicable diseases and malnutrition persisted and health problems such as non- communicable diseases at younger ages, increase in injuries (occupational, accidental, homicide, suicide), toxicities due to environmental contamination, addictions, iatrogenic illness and old age problems, etc. increased as an externality of modernization. This health scenario and an increase in dependence on doctors have enhanced the demand for medical services.

Classically, an ideal design of Health Service Systems is expected to be effective, safe, affordable, sustainable, people empowering with the objective of prioritizing maximum good to maximum number. Historically, there has been knowledge system pluralism in India. Societal dialogue across development models has resulted in the present provisioning and financing of health services. The structure consists of public, private and civil society (charitable, NGO, cooperative) institutions with knowledge system pluralism including both AYUSH and Modern Medicine. Strengthening the public services requires addressing issues of:
·         health planning and budget provisions,
·         Investment in human resources: education and training, postings and transfers
·         A public health cadre
·         Free medicine for all patients, systems for procurement and distribution.

The system of colonial hangover with dominance of modern science and medicine as well as commercial interest in modern medicine led to undemocratic pluralism in relation to AYUSH. There are various debates running in Civil Society (Medico friend circle, Jan Swasthya Abhiyan, Kolkata Declaration), Ministry of Health and Family Welfare (NRHM), Planning Commission, Global Health Forum, etc., related to universal health care service systems and design. Following are the frameworks reflected in debates:
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·          Private Sector Bio-Medical Curative frameworks: This model runs on free market logic. State and private insurance is considered to be third party.
·         Statist Public Health Framework where state is responsible for full provisioning and financing with PPP (Public Private Partnership) as a concession to the reality of their existence.

The existing framework is mixture of two above stated frameworks. The aim has to be to extract the best from both the systems and form a unique system. Both the systems have components of various knowledge systems, reliance on STGs (short term goals), audits, monitoring to ensure rational practice and peoples movement as a possible moderating force.


Impact of people’s movements on health systems led to: Frontiers of Modern Medical Practice changing paradigm that limits Intervention, promotes self care, patient involvement in decision-making, greater role of psychosomatic etiologies finding from studies and revitalizing primary health care. Questions regarding choice of Stream of International Health trends, of framework conducive for people’s health have risen. The broad points of agreement emerging from the debate and dialogue are:
·         Public funding with public and private provisioning.
·         Structure of services designed for cost effective and rational services, with quality and equity.
·         Rational care to contain costs and iatrognesis.

Another important aspect to health-care system is closer availability to the patient, hence starting from home, each level provides as much care as it can and is supported by the next level. So, unnecessary services move to GP, GP to HWs and to self-care. It is important to design structure of services which are cost- effective and rational and also serves purpose of quality and equity: Community centered public services plus civil society provisioning; monitoring is the available solution that includes knowledge system democratic and integrative pluralism. The move towards integrating institutional structures, formalizing cross referral and interaction across pathies; for instance AYUSH education generating confidence in AYUSH and LHTs, its revitalization by growing herbal gardens in the sub-centre and PHC compound, focus and promotion of National University for Pluralistic Sciences- with one college for each recognized pathy, 1 institution for local health traditions, one for integrated medicine etc.

Conclusion
We live in a country where one in every four persons goes to bed hungry. Health problems in India need to be treated at very grass root level provision of basic minimum needs like roti, kapda and makaan to every individual though employment generation which provide them self esteem and dignity. Access to clean drinking water, better sanitation conditions, balance between physical work, food and leisure and emotional and social wellbeing through community structures and dignity enhancing societal conditions can take care of 50% of diseases due to unhygienic environment, hypertension etc.
Hence there is a need for: Health Impact Assessment of all development plans. Further, social and economic development planning needs to be centered on people’s health and well-being. Only a new policy milieu of social solidarity and caring is the solution.


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