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Opinion II
Last Updated: 03/03/2011
The Threatened Millennium Development Goals in India
Mayuri Misra

Despite official claims that India is on track to achieve the Millennium Development Goals, Mayuri Misra writes that real progress will depend on a transformation of traditional social structures and a reorientation of government policy toward public health and social justice.

Like all ambitious plans, the Millennium Development Goal has been a mixed bag: as much as it has achieved some success in its goals, it has suffered significant failure too. Many rich countries have failed to meet their promise of generous aid; the last few months have, no doubt, seen an improvement on that count but a lot still needs to be done.

The Indian government insists that its aim of meeting its MDG targets for 2015 is on track. It points out that many government-funded schemes have increased public spending in important sectors; it says that there has been a steady decline in the number of people living below the poverty line and even child and maternal mortality rates are also steadily coming under control, or, at least to the levels expected in the government’s declared plans.

As an example, India claims that its National policy to promote primary education -- The Sarva Shiksha Abhiyan -- has helped to increase enrolments in schools; and the Mahatma Gandhi National Rural Employment scheme has increased rural employment, with even the UNDP citing it as a robust social protection and employment programme which has benefitted 46 million households.

The Integrated Child Development Services, The Reproductive and Child Health Programme-2, and the National Rural Health mission have also been successful, having accrued enormous inputs in the health sector. The government asserts that deaths due to hitherto fatal diseases, such as tuberculosis and malaria, have gone down while HIV rates are still low in India. It agrees, however, that the emergence of extremely drug-resistant tuberculosis, and the high incidence of malaria in certain regions of the country, are worrying, but it insists that the Total Sanitation Campaign and the Rajiv Gandhi National Drinking Water Mission are in perfect symbiosis with crucial MDGs.

Unfortunately, the numbers don’t always reveal the true story: certain experts argue that the government’s poverty reduction claims are nothing but a well-crafted interpretation of the data, manufactured through debatable measurements and assessment. The prevalence of malnutrition, according to them, is the country’s biggest challenge, affecting more than 60% of all children below the age of five. This is clearly not in sync with the government’s claims of hunger reduction.

There are other concerns too: some experts feel that, even though there has been a reduction in maternal and child mortality, the targets for the MDGs are actually unattainable, and that pursuing more reasonable goals would be a better use of India’s vast economic and social resources.

The GDP growth of the country, predictably, indicates a booming middle class, but sadly, doesn’t reflect the massive poverty at the lower strata, or the gross inequalities in Indian society. Its bustling economy and enormous potential to create wealth has had no effect on social development; worse, it has only led to uneven increases in social and economic opportunities which have only widened the disparities between regions, castes, and even genders.

India is a patriarchal society that imposes a number of restrictions on women. Legal and constitutional reforms are needed to promote gender equality and women’s empowerment. The prevalent feudalism in the social structure also oppresses the scheduled castes and tribals in the country where we see a lower rate of health and a greater rate of poverty.

The MDG declaration was originally a visionary document seeking specific results. Therefore, measuring the country’s success through surrogate variables will not reflect real progress. Let us look at the National Rural Health Mission (NRHM) that focuses on child and maternal mortality as an example. While it outlines the latest infrastructure introduced, and talks about increased funding, greater numbers of health personnel, and valuable new initiatives, it does not explain the impact of these measures on the health of people.

While there is enough evidence to show that the mission is on track in many states, there are many others who are lagging behind too; not surprisingly, this pulls down the country’s overall achievement too.

India’s vast population, persistent inequality, ineffective delivery of public services and the lag in implementing pro–poor polices all contribute to the challenge of achieving the MDGs.

The significant disparity across regions can, to some extent, be attributed to its diversity, both in terms of geography and culture. This demands locally developed strategies based on region-specific targets, in a national context of good governance, a focus on public health, and, perhaps most importantly, a transformation of traditional social structures towards equality and justice.

A concerted effort is required to eliminate corruption too, which is a critical factor in the realization of MDGs. Clean water, sanitation, nutrition, education, housing, employment are still not top priorities despite the fact that they have a direct impact on the health of the population; the focus should be on public health approaches rather than improvements in health industries or technologies per se.

To make real progress on the MGDs, all government schemes and policies need to be audited and evaluated regularly, so that policies may be based on financial reality, rather than their presumed impact. The outputs required to meet the MDGs need to be measured too, rather than focusing on the new inputs.

Many states have not fully utilized the increased funding even or taken up the new schemes. It is the responsibility of each state to improve local governance which will, then, have a greater effect on the country’s MDGs.

Until significant reforms are made in the social structure of Indian society, and until there is real improvement in the health and economic status of the population, the progress of the MDGs shall remain threatened. The time to act is now.

Mayuri Misra is a graduate student at the University for Peace.