Human Development Report

World Bank has raised its global poverty line from $1.25 a day (in Purchasing Power Parity, or PPP, terms) to $1.90 in October.

World Bank’s data shows that India had witnessed the fastest-ever decrease in the percentage of its population below the poverty line between 2009 and 2011.

India’s Human Development Index value went from 0.462 to 0.609 between 2000 and 2014.

Reasons for improvement in India’s HDI

• improved economic growth and increase in life expectancy as a result of improved health care, and
• little improvements in educational outcomes, which have been harder to achieve, especially for women
• India’s Gross National Income more than doubled over the last 15 years, from $2,522 (PPP) to $5,497 between 2000 and 2014, putting it into middle income status.This economic growth translated into better human development outcomes as well

India Health Report: Nutrition 2015 released by the Public Health Foundation of India findings

• Child undernutrition, which had been declining slowly when data were last available in 2006, has begun to fall at historically high rates; between 2006 and 2014, stunting rates for children under five declined from 48 per cent to 39 per cent, translating into 14 million fewer stunted children, and declines in wasting translated into seven million fewer wasted children. These are extraordinary achievements.

Long road to travel

The UNDP report if India’s women were their own country, they would be 30 ranks lower on the HDI than the country as a whole is now, with far worse educational outcomes dragging them down.

• Indian women are at a particular disadvantage in the workforce; the high proportion (up to 39 per cent of GDP by one estimate) of unpaid care work that falls on women alone pushes them out of the workforce, resulting in one of the world’s lowest female labour force participation rates.
• The 2015 HDR, which is based on the theme of work, highlights just how vulnerable and ill-prepared for the future the majority of the Indian workforce is, and without a social protection blanket.
• The PHFI report shows that India’s national successes mask massive inter-State variability; moreover, gender inequalities are possibly having an impact on children’s nutritional outcomes.

Coming at a time when there is a fear of social sector budget cuts, these reports show that India must build on its human development successes with better redistributive justice.

Medical Research

• private investment in medical research should not be supported.
• In the West, the drug manufacturers are not interested in cure as they want to keep people dependent on drugs. Countries in the developing world should not follow this model of capitalism

Nobel Prize in Physiology

The discovery of the drug ivermectin, a derivative of avermectin, by William Campbell of Drew University in Madison, New Jersey, and by Satoshi Ômura of Kitasato University in Tokyo, nearly eradicated river blindness and radically reduced the incidence of lymphatic filariasis.

The discovery of artemisinin by Tu Youyou of the China Academy of Chinese Medical Sciences in Beijing in the early-1970s was a decisive step in the battle against severe cases of malaria.

As in the case of many other wonder drugs, resistance to artemisinin is fast emerging. As of February 2015, artemisinin resistance has been confirmed in five countries of the Greater Mekong subregion — Cambodia, the Lao People’s Democratic Republic, Myanmar, Thailand and Vietnam.

SDGs vs MDGs

Are the SDGs any different from the MDGs?

• For one thing, only one SDG addresses health, as compared to three MDGs. On maternal and child health, the SDGs extend the MDGs, since they have largely not been met in many developing countries.
• Non-communicable diseases have been included, reflecting concern for the growing incidence of non-communicable disease even among the poor.
• Alcohol abuse and tobacco have also been targeted.

The failure of the MDGs has been blamed on a lack of adequate financing and governance failure.

The critique should look also at the way the MDGs were structured.

• First, the goals and targets were interpreted too literally, without reference to the starting point from which different countries began the journey.
• Second, the cost-effectiveness analysis focused on addressing the biological causes of disease, with little recognition of the social determinants of health. It was this biological agent that was the target of the cost-effective intervention, maybe because biological causes are easier to tackle.

India has failed to achieve — reduction in maternal mortality.

Institutional delivery was the solution chosen to achieve this goal. Strengthening health infrastructure, training manpower and incentivising women who would otherwise have given birth at home to come to an institution for their delivery have been the goals of the health system since 2005.

Reasons for failure of institutional delivery system

Poor women in rural areas face tremendous challenges in reaching an institution for delivery, despite government subsidies. There is evidence that skilled birth attendance inside the home can be just as safe. Many women find it more comfortable, less socially intimidating, and certainly less expensive. But it takes time and sustained effort to ensure the quality of care that will make it a credible choice.

This should teach us that the goals we set should be informed by the realisation that health issues cannot be seen in isolation from the social context.

RSOC Findings Report released : Stats about health

Rapid Survey on Children ( RSOC ) findings look like relatively good news. They suggest a marked improvement in many aspects of maternal and child nutrition between 2005-06 and 2013-14. But the progress is uneven — fairly rapid in some fields, slow in others.

• At first glance, the biggest change relates to safe delivery. The proportion of institutional deliveries among recent births shot up from 39 per cent in 2005-06 to 79 per cent in 2013-14, and the proportion attended by a skilled provider rose from 47 per cent to 81 per cent. At least part of this trend is likely to reflect the impact of Janani Suraksha Yojana, including cash incentives for institutional delivery.

This leap forward, however, has not been accompanied by a general breakthrough in maternal care.

• For instance, the proportion of pregnant women who had at least three antenatal checkups was not much higher in 2013-14 (63 per cent) than in 2005-06 (52 per cent).
• Similarly, the proportion who consumed Iron and Folic Acid tablets for at least 90 days was very low in both years: 23 per cent and 24 per cent respectively.
• Another area of substantial progress is vaccination. The proportion of children with a vaccination card rose from 38 per cent in 2005-06 to 84 per cent in 2013-14, and vaccination coverage rose from 59 to 79 per cent for measles, 55 to 75 per cent for DPT3, and 44 to 65 per cent for “full immunisation”. Even with these improved figures, India has some of the lowest child vaccination rates in the world, and lags far behind Bangladesh and even Nepal. As with institutional deliveries, this pattern can be plausibly attributed to recent health policy initiatives, such as the appointment of Accredited Social Health Activists (ASHAs), who are now actively involved in immunisation programmes along with Anganwadi workers and Auxiliary Nurse Midwives (ANMs).
• the proportion of undernourished children declined from 48 to 39 per cent based on height-for-age criteria and from 43 to 29 per cent based on weight-for-age criteria. This is a significant improvement over the preceding period, when child undernutrition was declining at a glacial pace. Yet, much faster progress is required if India is to overcome this colossal problem in a reasonable period of time.
• Finally, there are worrying signs of stagnation in some important fields. One of them is access to safe drinking water: 88 per cent in 2005-06 and 91 per cent in 2013-14. The shortfall from universal coverage may not look large, but considering the vital importance of safe water, it is alarming that close to 10 per cent of households are still deprived of it (the corresponding figure in Bangladesh was just 3 per cent in 2007).
• No less alarming is the slow progress of sanitation: the proportion of sample households practicing open defecation declined from 55 per cent in 2005-06 to 46 per cent in 2013-14, or barely one percentage point per year. At that rate, it will take at least another 40 years for India to eliminate open defecation.
• despite being about twice as rich as Bangladesh in terms of per-capita GDP, India lags far behind Bangladesh in terms of child vaccination rates, breastfeeding practices, incidence of open defecation, access to safe water, and related indicators.
• RSOC findings also suggest that the areas of rapid progress (example, safe delivery and vaccination) are those where serious action was initiated during the last 10 years or so. The need of the hour is to consolidate these initiatives and extend them to other domains where there is still no sign of rapid progress.