Indian Gov’t on Collision Course With Civil Society


Police accost women protesting against the Kudankulam nuclear plant in India. Credit: K. S. Harikrishnan/IPS.Police accost women protesting against the Kudankulam nuclear plant in India. Credit: K. S. Harikrishnan/IPS.

NEW DELHI, May 23 2013 (IPS) – For years India’s pro-liberalisation, Congress party-led coalition government chafed at civil society groups getting in the way of grand plans to boost growth through the setting up of mega nuclear power parks, opening up the vast mineral-rich tribal lands to foreign investment and selling off public assets.

Now, at the end of its tether, the Interior Ministry has cracked the whip on hundreds of non-governmental organisations engaged in activities that “prejudicially affect the public interest.”

 

“…The government is trying to promote globalisation while cracking down on the globalisation of dissent.” — Achin Vanaik

On Apr. 30 several NGOs were informed that the bank accounts through which they receive foreign funding had been frozen. 

“It is shocking what the government has done – but not surprising given the increasingly authoritarian, undemocratic and repressive measures being directed…against anyone who is seen to challenge or disagree with their positions and decisions,” Lalita Ramdas, anti-nuclear campaigner and board chair of Greenpeace International, told IPS.

Ramdas said NGOs concerned with nuclear power, human rights, environment and ecology – areas where corporate and industrial interests were likely to be questioned – appeared to be particular targets of the government order.

Among the worst affected is the Indian Social Action Forum (INSAF), a network of more than 700 NGOs that is currently challenging, in the Supreme Court, the government’s restrictions on foreign funding reaching groups that engage in activities that can be described as “political” in nature.

In its court petition INSAF described itself as an organisation that believes that “the fundamental rights enshrined in the Constitution of India need to be safeguarded against blatant and rampant violations by the State and private corporations.”

INSAF said it has “actively campaigned against land grabs by corporations, ecological disaster by mining companies, water privatisation, genetically modified foods, hazardous nuclear power (and) anti-people policies of international financial institutions like the World Bank and Asian Development Bank.”

INSAF declared in court that it “firmly believes in a secular and peaceful social order and opposes communalism and the targeted attacks on the lives and rights of people including religious minorities, and regularly organises campaigns, workshops, conventions, fact-findings, people’s tribunals, solidarity actions for people’s movements and educational publications.”

“With that kind of a profile we were expecting this crackdown,” Anil Chaudhary, coordinator of INSAF, told IPS. “Still, the government could have waited for the Supreme Court verdict.”

“At this rate,” he said, “organisations working against discrimination of women and (advocating) for their empowerment through participation in local bodies could be termed “political”, as (well as) organisations working for farmers’ rights.

“The same arbitrariness can be applied to green NGOs trying to protect the environment against mindless industrialisation.”

Chaudhary thinks it unfair that NGOs critical of government policies are being singled out. “Instead of selectively freezing the funding of groups under INSAF, the government should order a blanket ban on all foreign funding.”

Among INSAF’s many campaigns is an intiative to bring international financial institutions like the World Bank under legislative scrutiny for their activities in India.

It cannot have escaped the government’s attention that INSAF’s campaigns have run parallel to powerful movements for transparency and clean governance led by social activist-turned-politician Arvind Kejriwal, founder of the Aam Admi Party (Common Man’s Party) that plans to contest general elections due in 2014.

 

Kejriwal, whose social activity led to the passage of the 2005 Right to Information Act, has also been closely associated with transparency campaigns led by Anna Hazare, who mounted a Gandhian-style fast against corruption in April 2011 that rallied over 100,000 ordinary people.

Street protests demanding good governance have since been a thorn in the side of the government.  When they peaked in December 2012, following the gang rape of a young woman in a bus in the national capital, police took to beating protestors.

The government, starting with Prime Minister Manmohan Singh, has also been frustrated by NGOs’ efforts to stall work on a string of mega nuclear parks along peninsular India’s long coastline, especially at Jaitapur in Maharashtra, Mithi Virdi in Gujarat and Kudankulam in Tamil Nadu.

In February, the government froze the accounts of two leading Tamil Nadu-based NGOs allegedly associated with the protests at the site of the Kudankulam plant, signalling a new and tough stance against civil society groups fighting the displacement of farmers and fishermen by mega development projects.

The two NGOs, the Tuticorin Diocesan Association and the Tamil Nadu Social Service Society, received four million and eight million dollars respectively over a five-year period that ended in 2011, according to declarations they made to the government.

With strong backing from the Church, the groups continue to operate despite the freeze on their assets.

During the same five-year period a total of about 22,000 NGOs across India received roughly two billion dollars in foreign contributions, going by government records.

Unexpected protests have surfaced from among the Congress party’s partners in the ruling United Progressive Alliance (UPA). Devi Prasad Tripathi, general secretary of the Nationalist Congress Party and member of parliament, reminded Interior Minister Sushil Kumar Shinde that the UPA is “committed to protecting and promoting secular, democratic and progressive forces in the country.”

“Effectively, the government is trying to promote globalisation while cracking down on the globalisation of dissent,” commented Achin Vanaik, professor of political science at the Delhi University.

The government’s move stands in stark contrast to promises made not two years ago at the Fourth High Level Forum on Aid and Development Effectiveness in Busan, South Korea, where 159 governments and member organisations honoured the vital role played by the non-profit sector by pledging to foster an “empowering” climate for civil society.

In his most recent report to the United Nations General Assembly, Maina Kiai, special rapporteur on the right to freedom of peaceful assembly and of association, noted with grave concern that India has repressed “peaceful protestors advocating economic, social and cultural rights, such as…local residents denouncing the health impact of nuclear power plants.

 

Socioeconomic Inequality in Disability – A Multi Country Study


 

A Multicountry Study Using the World Health Survey.
disability-discrimination1

 

Ahmad R. Hosseinpoor, Alana Officer, Emese Verdes, Nenad Kostanjsek, and Somnath Chatterji are with the World Health Organization, Geneva,Switzerland. Jennifer A. Stewart Williams is with the University of NewcastleNewcastle, New South Wales, Australia. Jeny Gautam is with Dianella Community Health, Melbourne, Victoria, Australia. Aleksandra Posarac is with the World Bank, Washington, DC.

 

“……We compared national prevalence and wealth-related inequality in disability across a large number of countries from all income groups.

Methods. Data on 218737 respondents participating in the World Health Survey 2002–2004 were analyzed.
A composite disability score (0–100) identified respondents who experienced significant disability in physical, mental, and social functioning irrespective of their underlying health condition. Disabled persons had disability composite scores above 40. Wealth was evaluated using an index of economic status in households based on ownership of selected assets. Socioeconomic inequalities were measured using the slope index of inequality and the relative index of inequality.

Results.
Median age-standardized disability prevalence was higher in the low- and lower middle-income countries. In all the study countries, disability was more prevalent in the poorest than in the richest wealth quintiles. Pro-rich inequality was statistically significant in 43 of 49 countries, with disability prevalence higher among populations with lower wealth. Median relative inequality was higher in the high- and upper middle-income countries.

Conclusions.
Integrating equity components into the monitoring of disability trends would help ensure that interventions reach and benefit populations with greatest need. …”

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(Am J Public Health. Published online ahead of print May 16, 2013: e1–e9. doi:10.2105/AJPH.2012.301115)

#India – Why Salwa Judum was held Unconstitutional by Supreme Court


 

Excerpts from

NANDINI SUNDAR & ORS.
VERSUS
STATE OF CHATTISGARH

 

What is ominous, and forebodes grave danger to the security
and unity of this nation, the welfare of all of our people,
and the sanctity of our constitutional vision and goals, is
that the State is drawing the wrong conclusions, as pointed
out by the Expert Group of the Planning Commission cited
earlier. Instead of locating the problem in the socioeconomic matrix,

and the sense of disempowerment wrought by

the false developmental paradigm without a human face, the
powers that be in India are instead propagating the view
that this obsession with economic growth is our only path,
and that the costs borne by the poor and the deprived,
disproportionately, are necessary costs. Amit Bhaduri, a
noted economist, has observed:
“If we are to look a little beyond our middle class noses,
beyond the world painted by mainstream media, the picture is
less comforting, less assuring…. Once you step outside the
charmed circle of a privileged minority expounding on the
virtues of globalization, liberalization and privatization,
things appear less certain…. According to the estimate of the
Ministry of Home Affairs, some 120 to 160 out of a total of 607
1 Ajay K. Mehra, supra note 114
districts are “Naxal infested”. Supported by a disgruntled and
dispossessed peasantry, the movement has spread to nearly onefourth of Indian territory. And yet, all that this government
does is not to face the causes of the rage and despair that
nurture such movements; instead it considers it a menace, a lawand-order problem…. that is to be rooted out by the violence of
the state, and congratulates itself when it uses violence
effectively to crush the resistance of the angry poor…. For the
sake of higher growth, the poor in growing numbers will be left
out in the cold, undernourished, unskilled and illiterate,
totally defenceless against the ruthless logic of a global
market…. [T]his is not merely an iniquitous process. High growth
brought about in this manner does not simply ignore the question
of income distribution, its reality is far worse. It threatens
the poor with a kind of brutal violence in the name of
development, a sort of ‘developmental terrorism’, violence
perpetrated on the poor in the name of development by the state
primarily in the interest of corporate aristocracy, approved by
the IMF and the World Bank, and a self-serving political class….
Academics and media persons have joined the political chorus of
presenting the developmental terrorism as a sign of progress, an
inevitable cost of development. The conventional wisdom of our
time is that, There Is No Alternative…. And yet this so widely
agreed upon model of development is fatally flawed. It has
already been rejected and will be rejected again by the growing
strength of our democratic polity, and by direct resistance of
the poor threatened with ‘developmental terrorism”.
15.As if the above were not bad enough, another dangerous
strand of governmental action seems to have been evolved
out of the darkness that has begun to envelope our policy
makers, with increasing blindness to constitutional wisdom
and values. On the one hand the State subsidises the
private sector, giving it tax break after tax break, while
simultaneously citing lack of revenues as the primary
reason for not fulfilling its obligations to provide
adequate cover to the poor through social welfare measures.
On the other hand, the State seeks to arm the youngsters
amongst the poor with guns to combat the anger, and unrest,
amongst the poor.
16.Tax breaks for the rich, and guns for the youngsters
amongst poor, so that they keep fighting amongst15
themselves, seems to be the new mantra from the mandarins
of security and high economic policy of the State. This,
apparently, is to be the grand vision for the development
of a nation that has constituted itself as a sovereign,
secular, socialist and democratic republic. Consequently,
questions necessarily arise as to whether the policy
makers, and the powers that be, are in any measure being
guided by constitutional vision, values, and limitations
that charge the State with the positive obligation of
ensuring the dignity of all citizens.
17.What the mandarins of high policies forget is that a
society is not a forest where one could combat an
accidental forest fire by starting a counter forest fire
that is allegedly controlled. Human beings are not
individual blades of dry grass. As conscious beings, they
exercise a free will. Armed, the very same groups can turn,
and often have turned, against other citizens, and the
State itself. Recent history is littered with examples of
the dangers of armed vigilante groups that operate under
the veneer of State patronage or support.
18.Such misguided policies, albeit vehemently and muscularly
asserted by some policy makers, are necessarily contrary to
the vision and imperatives of our constitution which
demands that the power vested in the State, by the people,
be only used for the welfare of the people – all the
people, both rich and the poor -, thereby assuring
conditions of human dignity within the ambit of fraternity
amongst groups of them. Neither Article 14, nor Article 21,
can even remotely be conceived as being so bereft of
substance as to be immune from such policies. They are
necessarily tarnished, and violated in a primordial sense
by such policies. The creation of such a miasmic16
environment of dehumanization of youngsters of the deprived
segments of our population, in which guns are given to them
rather than books, to stand as guards for the rapine,
plunder and loot in our forests, would be to lay the road
to national destruction. It is necessary to note here that
this Court had to intercede and order the Government of
Chattisgarh to get the security forces to vacate the
schools and hostels that they had occupied; and even after
such orders, many schools and hostels still remain in the
possession and occupancy of the security forces. Such is
the degree of degeneration of life, and society. Facts
speak for themselves.
19.Analyzing the causes for failure of many nation-states, in
recent decades, Robert I. Rotberg, a professor of the
Kennedy School, Harvard University, posits the view that
“[N]ation- states exist to provide a decentralized method
of delivering political (public) goods to persons living
within designated parameters (borders)…. They organize and
channel the interests of their people, often but not
exclusively in furtherance of national goals and values.”
Amongst the purposes that nation-states serve, that are
normatively expected by citizenries, are included the task
of buffering or manipulation of “external forces and
influences,” and mediation between “constraints and
challenges” of the external and international forces and
the dynamics of “internal economic, political, and social
realities.” In particular he notes:
“States succeed or fail across all or some of these dimensions.
But it is according to their performance – according to the
levels of their effective delivery of the most crucial political
goods – that strong states may be distinguished from weak ones,
and weak states from failed or collapsed states…. There is a
hierarchy of political goods. None is as crucial as the supply
of security, especially human security. Individuals alone,
almost exclusively in special or particular circumstances, can
attempt to secure themselves. Or groups of individuals can band17
together to organize and purchase goods or services that
maximize their sense of security. Traditionally, and usually,
however, individuals and groups cannot easily or effectively
substitute private security for the full spectrum of public
security. The state’s prime function is to provide that
political good of security – to prevent cross-border invasions
and infiltrations, to eliminate domestic threats to or attacks
upon the national order and social structure… and to stabilize
citizens to resolve their disputes with the state and with their
fellow human inhabitants without recourse to arms or other forms
of physical coercion.”1
20.The primary task of the State is the provision of security
to all its citizens, without violating human dignity. This
would necessarily imply the undertaking of tasks that would
prevent the emergence of great dissatisfaction, and
disaffection, on account of the manner and mode of
extraction, and distribution, of natural resources and
organization of social action, its benefits and costs. Our
Directive Principles of State Policy explicitly recognize
this. Our Constitution posits that unless we secure for our
citizens conditions of social, economic and political
justice for all who live in India, we would not have
achieved human dignity for our citizens, nor would we be in
a position to promote fraternity amongst groups of them.
Policies that run counter to that essential truth are
necessarily destructive of national unity and integrity. To
pursue socio-economic policies that cause vast disaffection
amongst the poor, creating conditions of violent politics
is a proscribed feature of our Constitution. To arrive at
such a situation, in actuality on account of such policies,
and then claim that there are not enough resources to
tackle the resulting socio-political unrest, and violence,
within the framework of constitutional values amounts to an
abdication of constitutional responsibilities. To claim
that resource crunch prevents the State from developing
1 “The Failure and Collapse of Nation-States – BREAKDOWN, PREVENTION AND FAILURE” in
“WHEN STATES FAIL: CAUSES AND CONSEQUENCES” Robert I. Rotberg, Ed., Princeton
University Press (2004).18
appropriate capacity in ensuring security for its citizens
through well trained formal police and security forces that
are capable of working within the constitutional framework
would be an abandonment of a primordial function of the
State. To pursue policies whereby guns are distributed
amongst barely literate youth amongst the poor to control
the disaffection in such segments of the population would
be tantamount to sowing of suicide pills that could divide
and destroy society. Our youngsters are our most precious
resource, to be nurtured for a better tomorrow. Given the
endemic inequalities in our country, and the fact that we
are increasingly, in a demographic sense, a young
population, such a policy can necessarily be expected to
lead to national disaster.
21. Our constitution is most certainly not a “pact for national
suicide.”1 In the least, its vision does enable us, as
constitutional adjudicators to recognize, and prevent, the
emergence, and the institutionalization, of a policing
paradigm, the end point of which can only mean that the
entire nation, in short order, might have to gasp: “The
horror! The horror!”

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Gujarat and The Illusion of Development


By – Shipra Nigam at kafila.org

MAY 23, 2013

This Guest post by SHIPRA NIGAM is a review of a volume of essays edited by Atul Sood Poverty Amidst Prosperity: Essays on the Trajectory of Development in Gujarat (Aakar Books 2013).

gujarat-farmers_507544e

Thousands of farmers protested in March this year in Ahmedabad against the state’sindustrialization policies

This volume of essays is the outcome of a detailed study by a team of contributing research scholars led by Atul Sood. This timely evaluation provides an insight into many crucial questions: What are the constituent elements of Gujarat’s growth story? To what extent can the successful features of Gujarat’s growth story be attributed to the political regime fashioned by Narendra Modi? Is it possible to replicate even this limited success story at the national level – as Modi’s starry eyed upper and middle class following would like to believe? More significantly: what are the implications of Gujarat’s Development Model in terms of its sustainability and its desirability? What happens when we assess this development through a set of comprehensive   measures, judge its implication for the average citizen’s material wellbeing, and see what it means for the political and economic rights of citizens?

The study proceeds through a meticulous examination of existing official data sources on investment, infrastructure, agriculture, manufacturing , employment, poverty , inequality, education and health expenditures and a set of other indicators of development.  These are then used to explain various developmental outcomes in the state in relation to national averages and the performance of other states which have also experienced high growth rates recently, such as Maharashtra, Haryana and Tamilnadu. Atul Sood’s cogently argued and insightful introduction brings together the different strands of the study, weaving the detailed findings into a coherent narrative. The picture that emerges interrogates both the normative implications of the ‘Gujarat development model’, and offers a powerful critique of its actual performance even judged in terms of its own self projections.

Unsurprisingly there is little that is new in Gujarat’s developmental model.  Its market led growth operates within the new-liberal paradigm that has for some decades been touted by the IMF, World Bank and inc as the panacea for all ills in developing countries. It is a frame that has been widely contested, critiqued and discredited for its abysmal failure in bringing in sustainable, equitable and participatory growth within the developing world. In fact, the paradigm has been held responsible for inducing and aggravating the enormous difficulties faced by many of the developing countries.  As the analysis in the book confirms, the ‘Gujarat Development Model’ is nothing more than a fervent adaptation and implementation of this chosen path favoured by the Indian state itself since the mid-1980s.  Hence, along with the imminent candidature of Narendra Modi as BJP’s prime ministerial nominee, the celebration of this developmental model by India Inc assumes omnious significance .

An Investment Fatigue?

The initial chapters by Ruchika Rani, Santosh Kumar Das, Pankaj Vashist and Gaurav Arya explore various aspects of Gujarat’s  GDP growth, investment flows and infrastructure development. While  Gujarat’s average  GDP growth rates in the past decade are higher than the national average and slightly above those of other high performing states, the gap has been narrowing overtime, which also coincides with an ‘investment fatigue’ that has set in recently. Since Gujarat’s infrastructure is not markedly different from other industrially competitive states, the substantial difference in investment levels is frequently attributed to the ‘investor friendly governance structure’. For instance, the biannual ‘Vibrant Gujarat Global Investors Summit’ is often highlighted as an example of the state’s proactive role in promoting investment. However its success seems to be waning in recent years. Out of the total MOU’s signed under these successive summits, the share of projects implemented and under implementation have continuously declined from about 73 % in 2003 to 13% in 2011. Moreover, the state’s share in investment intentions in terms of IEMs ( Industrial Entrepreneur Memorandum), letters of intent (LOIs )and Direct Investment Licences (DILs) has declined from early 20’s in percentage in  2005 to less than 10 % in 2011.  A slowdown in overall investment climate, saturation of best investment opportunities and a more realistic assessment of the ‘efficiency’ of the state administration – are all posited by Sood as the possible explanations behind this decline in both investment and output growth in the most recent years. So the sustainability of even the much vaunted higher growth rates and investment flows has increasingly become suspect. To put it another way: the investors are also suspicious of the sustainability of returns.

Whose developmental vision is it anyway?

Far more damning is what the book reveals about the growth story itself.  It shows how the state renounces any responsibility of ensuring growth with equity when it relies entirely on the play of the market forces and on private investors to meet its development needs. As Sood points out, In Gujarat this has entailed that the investor is no longer just the source for resources but the one who determines the priorities of  development and this has had serious consequences for the sustainability and distributive justice of the entire growth process. The path of growth, its trajectory, is not defined by the state, or any planning body of economists; it is decided by investors, financial institutions, and corporate firms. The book shows how the economy of Gujrat has been given over to the corporates. They invest in it and they also sing all the praises of the development model.                                  

37% of the total investment in Gujarat in the last two and a half decades has been in infrastructure development. The state’s infrastructure development strategy involves two basic components: 1)promoting private intergrated investment to develop ports, rail, road and power sectors and 2) developing large enclaves for industrial and service sector growth as ‘greenfield sites’ with world class infrastructure.  In all cases this is sought to be done through massive concessions, rebates, subsidies and even direct handing over of financial control over revenues to attract the private sector.  These include initiatives like the Investor Support Systems (ISS), the Public Private partnership (PPP) model, establishment of Special Economic Zones (SEZs) and Special Investment Regions (SIRs) to create ‘world class infrastructure’  and several mega projects (units with minimal investment of 1000 crores in core industrial sectors and 5000 crores in infrastructure projects). The 2009 industrial policy of the Gujarat state locates these initiatives within a larger central government framework to create Delhi-Mumbai Industrial Corridor (DMIC), utilizing its coastal proximity and geographical location within this project.  The DMIC plan itself is full of references to setting up industrial areas and infrastructure in Greenfield sites at Dhar, Pune, Alwar, Surat, Rewari and Muzzafarnagar and is integral to Gujarat’s own infrastructure and development strategy.

So what’s the big problem over here? – the same as with all such green field projects which instead of strengthening infrastructure where it is needed , prefer to establish development  enclaves  neglecting existing human habitations, with serious implications for equity and huge environmental and human costs. For instance, the DMIC plan on groundwater indicates that Gujarat would have to allocate water for industrial uses by diverting water away from irrigation and domestic purposes. Further, the plan envisages migration figures of 94 million workers by 2039. But nowhere in its sweeping grandeur does the plan state how the consequent multiplication of urban demand for scarce water and other resources would be met, how would the water be distributed and who would pay the price ? But the answers are not difficult to guess.

In implementing this development strategy Gujarat has sought private investment across the board. Key sectors – traditionally held to be the preserve of the state – such as ports, roads, rail and power have been handed over to corporate capital. This has meant, inevitably, that the government has abdicated all decision making powers, as well as functional and financial control over such projects. Nowhere else in the country has this abdication of responsibility been so total, nowhere else has the state given over the economy so entirely to the corporates and private investors. For instance, the BOOT (Build Own Operate Transfer) policy initiative for port development involves royalty holidays instead of revenue sharing, permission to investors to adjust royalty against capital costs, freedom to developers to collect charges and tolls, land acquisition for private investors, 30 year window to make profits, special arrangements of forward linkages to private consortiums and SIRs and so on. The policy   restricts  the role of government to minimum and allows complete operational and tariff freedom to the investor. Not surprisingly, Gujarat leads the country in terms of private investment flows in projects implemented and underway for port development. Private initiative is similarly promoted in case of development of roads and railways under the PPP mode. Most of the investment in expanding the communication networks has gone into  improving access of new ports, SEZ’s and SIR’s falling in rural areas, with most connectivity gains from the vantage point of human habitations coming from Central funds (under PGSY). Similarly the upgrading of 630 km of rail tracks from narrow gauge to broad gauge has also meant improved rail connectivity to ports.

Again in the case of the power sector, huge concessions in terms of tariff and transfer of operational control to private sector through legislative changes has resulted in substantive private investments in power plants and a 34% increase in overall power generation. But this has been achieved largely through an increase in the capacity of private captive power plants for industrial use. The power tariff structure also favors commercial and industrial use over agriculture when compared with national averages. Thus, as Sood points out:

“Road and rail expansion is less focused on increasing access of human settlements  but more about improving and strengthening access to SEZ’s and minor ports… In addition the private investment in infrastructure is dovetailed and integrated with the industrial corridor, which in itself is suspect in terms of gains it will bring to the local people and its implications for groundwater in water scarce regions… Gujarat seems to have internalized the two falsehoods mentioned earlier, to turn to private sector for addressing infrastructure and second to give preference to ‘Greenfield sites’ rather than address the aggregative challenges of infrastructure inadequacy.”

Of Corporate Agriculture, Landgrabs and Capital Intensive Manufacturing

And rife in this story is the speculation in land fuelled by legislative changes brought about ostensibly to promote infrastructural and agricultural development. Sucharita Sen and Chinmoyee Malik’s chapters map the increasing emphasis on corporatization of agriculture which has made agriculture a highly profitable activity with an average growth two-and-a-half times faster than the national average. Improved market access, technological dissemination, infrastructure development and a filip from the growth in other areas, have all contributed to this growth. However its distributive effects largely depend on land ownership and land use patterns and small farmer participation in high growth crops.  It also comes with crop specific and area specific challenges thrown in by a growth driven by privatization and liberalization of agricultural procurement, pricing and marketisation policies. There has been a shift in cropping patterns away from food to non-food and high value crops in terms of acreage, output and value. Data on land allocation and farmer participation reveals that cotton cultivation and high value crops have benefited large farmers disproportionately. If we look at farmer groups by land size, in Gujrat, the number of households of the smallest farmer group has increased, but not the acreage they control, while the largest farmer groups have gained in acreage, indicating worsening inequalities. This is contrary to the trend at the all-India level. The position of STs and SCs has also deteriorated overall except in case of SCs in the highest income size class leading to a rise in intra-caste inequalities within the latter. While incidence of landlessness has reduced overall (though starting from a much higher initial base as compared to national averages), it has increased in tribal areas ( in particular in Panchmalal, Dahod and Dang regions ). These also happen to be the most underdeveloped regions in the state lying largely outside the loop of the recent agricultural growth.

These changes could be indicative of worse times ahead given the recent modifications and amendments in land legislation. The rise in overall profitability of agriculture comes with a shift in land policy from ideas of ‘ Land to the tiller’ (a legacy of the post-independence era uptil the days of the KHAM alliance) to those of ‘land de-regulation and liberalization’ over the past two decades. As has been widely documented, even the earlier phase of land reform policies (land ceilings, surplus distribution etc) had come in Gujarat with measures like a complete ban on tenancy which led to the middle peasantry benefitting at the cost of lower peasantry and dalit farmers. Progressive measures over time, such as the Jinabhai Darji Commision suggestions through a KHAM alliance initiative in the early 1980s, never took off in the state. Now, with rapid upward mobility of the same peasantry in this story of privatization and liberalisation, the stakes in land have risen and legislative changes relating to land use which began under BJP-Janata alliance reflect the changing power dynamics and new ground realities (this includes the lifting of the 8-kms ban on land purchase and allowing non-local, non-farming groups to enter the rural land market). These have been brought in under the pressure of the rich farmer/agro-industrialist lobbies – who wanted speculative gains from land markets in the Narmada Valley Projects’ proposed command area – and the demands of builder lobbies for land for non-agricultural purposes. The policy shifts were consolidated and further strengthened under Modi’s regime by 2005. Legislative measures under his regime also facilitated the transfer of village commons and wastelands for private use, displacing marginalized communities who lost their de facto and de jure rights over pastoral lands. As sociologist M. Levein points out, the idea of Greenfield sites combined with the privatization of land within the SEZs, has together been responsible everywhere for ‘a thinly guised land grab for urbanization by the private sector’. Nowhere has this been more manifest than in the case of Gujarat.

If we turn to the experience of industrialization we have another story of skewed development. As the chapter by Sangeeta Ghosh brings out, manufacturing also witnessed high growth rates in Gujarat. In recent decades, the share of manufacturing within the Gross State Domestic Product (GSDP), has been higher in Gujarat when compared to national averages as well as other high performing states. Yet at the same time, if we look at employment, the picture is the reverse. In Gujarat the share of the manufacturing sector within total employment is below the national average and has been declining rapidly overtime. Growth has been highly capital intensive in nature and concentrated in some sectors, incomes and regions. It favours the more developed regions and has weak backward and forward linkages between the unorganized and the organized sectors. There has been a shift away from the employment generating textile sector to refined petroleum, petrochemicals, chemical, metal and fabricated products marked by very high capital intensities.  This shrinks opportunities for ancillarization and sub-contracting and has also raised serious concerns about its environmental impact. Significantly, this growth trajectory links well with the infrastructure story in several ways. For instance, the need for proximity of well developed ports helps in the case of petroleum and chemical industries given their high import content, and surplus power generation the state fosters comes in handy for  the highly energy intensive metal related industries.

So the story of corporatization of agriculture and the growth of selective capital intensive manufacturing completes the loop of Gujarat’s recent growth experience. Along with the tale of ports, roads, rail and power, this turns out to be a fable ‘of the private investor, by the private investor and for the private investor’. What about the average citizen then? And where do the workers, the underclass, the poor, the tribals and other minority groups figure in this haven for investors?

On Jobless Growth, Widening Inequalities and Social Exclusion

As it turns out, their story is integral to understanding the missing pieces of this puzzle.  To begin with, the chapter by Ruchika Rani and Kalaiyarasan map the stagnant and socially discriminatory employment conditions that persist in this period of high output growth.  There has been a significant mismatch between sources of income and employment leading to low employment elasticities of output and ‘jobless growth’. Employment growth in manufacturing and services turned negative in the last 5 years. Whatever growth in employment occurred in the last decade was largely in the category of casual- and self-employment indicative of rising informalisation. There were sharp regional differences in employment outcomes with rural Gujarat experiencing negative growth rates in the last five years.  Employment was also unevenly spread across social groups and minorities. Upper caste hindus and a small proportion of SCs had a proportionately large share in regular employment within manufacturing and services, with most of the rise for SCs in services being in casual employment. Meanwhile OBC’s, Muslims , other minorities experienced a shift towards traditional sectors when growth was located in modern capitalist structure, indicating a stagnation and even a worsening of their employment conditions. The share of STs in Industrial employment had risen in the earlier decade, but it declined rapidly in the last five years. This decline was absorbed by the agricultural sector at a time when growth was shifting to the Industrial sector, indicating possibly ‘distress migration’ to agriculture.

Where measures of income, poverty and inequality are concerned, despite its spectacular growth, Gujarat’s performance has been average as compared to national averages and it lags behind competing states like Tamilnadu, Maharashtra and Haryana on different counts. Certain features stand out in the chapter by Nidhi Mittal who maps the changes in average per capita consumption expenditure, and calculates the Gini coefficient and headcount ratios for Gujarat. First, the earlier decade 1993 to 2004-05 compared better than the last five years of the decade ending 2010, and these were the years when Narendra Modi’s  ‘growth and development’ agenda was unleashed fully. Second, urban inequality has risen much more at a time when most of the rise in growth rates and per capita expenditure is located in urban areas.  This implies opposing trends in terms of rise in consumption levels and rise in inequalities of income in areas of high growth, questioning the dynamics of the recent growth process itself.

This assumes further significance given the increasing gap in average consumption levels between Hindus and Muslims over 2005-10 in urban areas. Also while urban poverty levels for Muslims stagnated, those for Hindus declined by around 4 percentage points. Again, while per capita expenditure grew by 2.5 % p.a in the last five years, the increase for STs was a mere 0.14%, with an exponential widening of gap in growth rates of per capita income levels between STs and the rest. In urban areas poverty has increased for both SCs and STs while rural poverty has declined.  However the extent of poverty for STs in rural areas is still two-and-a-half times higher as compared to others . While overall poverty for SCs as a group has declined and they seemed to have gained more than STs, intra group inequalities within SCs have again risen substantially.

Privatising Health and Education the Gujarat Way

Change in the quality of life is always indicative of the nature of economic development. Nowhere is this reflected more clearly than in the case of improvements in health and education, as brought out in the chapters by Sourindra Ghosh and Sandeep Sharma. As Sood points out , these estimates are significant in their ability to  capture the influence of a wide array of factors such as quality of food and water, the quality of housing and clothing, ability to earn livelihoods, household decision making, social and health outcomes in any population group. Not surprisingly, in keeping with the larger development vision, the roots of Gujarat’s experience lie in an unswerving faith on the private sector even in these areas where today even ardent advocates of free markets would tread with care.  Accordingly, the share of expenditure in development, health and education in total NSDP has been falling continuously over the past decades. This is also reflected in lower access to and utilization of government services and a move towards private service providers with rising per capita health and education expenditures.

In terms of aggregate health parameters – such as Infant Mortality Rates (IMRs), male and female life expectancy, vaccination and antenatal care –  Gujarat has experienced very average performances vis-a-vis national estimates. In most cases it compares unfavorably with other high growth states such as Tamilnadu, Haryana, Maharashtra over the past decade despite leading them in terms of growth in per capita GDP. What is worrying is that it lags behind even national averages in IMRs and under-five mortality, as well as in the mortality rates for women and people in rural areas. This obviously affects poorer sections disproportionately and social disparity in health has had a more regressive impact on health indicators for the marginalized, in particular the STs.

Again where education is concerned, average figures do not tell the full story. The figures for average literacy levels in Gujarat are higher than the national average.  But its ranking in terms of literacy levels has deteriorated between 1999-00 and 20007-08, and fewer children in the age group of  6-14 attend school in Gujarat than the numbers suggested by the national average.  For the same age groups – i.e  for above primary and secondary school education –  the access of women, SCs, STs, Muslims and other minorities is again lower than the national averages, and markedly behind those of comparable states. While Gujarat has experienced higher rates of decline in share of state expenditure on education than national averages, the proportion of people dependent on government aided and government and local bodies run institutions is higher or the same, much more so in rural areas, indicating that the far costlier private-sector-run institutions were unable to substitute the educational needs of people at large. This brings out a clear mismatch in government’s policy to rely on and encourage unaided private sector in education and the people’s capacity to afford the same.

Economics of Growth and the Political Culture of authoritarianism

So what does the Gujarat Model have to offer to the people of Gujarat and the country at large ? To begin with, Gujarat’s success story is crucially linked to its history, its people’s entrepreneurial skills, its farmers, its globally recognized and gifted artisans and the legacy of a social reform and cooperative movement which wove together many of these strengths within its social fabric. This history along with a favorable geographical location provided a strong base for the recent growth experience in terms of human capital, social infrastructure and natural advantages. On its own terms, it remains questionable if even this limited success achieved could be replicated or extended as a ‘growth model’, and whether the policy assumption ‘one size fits all’ can offer solutions to problems of the rest of India, with its regional specificities, and the diversity of the historical growth trajectories which exist elsewhere. This is something Modi’s urban middle-class following seems blissfully unaware of in its mooting for the ‘new messiah’ of development on the horizon.  Especially at a time when even the future trajectory of this story itself is in serious doubt, given that most recent estimates suggest a petering out of existing growth rates and the setting in of an investment inertia.

More significantly, as Sood points out, even this limited success story is questionable in terms of its desirability for Gujarat’s own development trajectory. The painstaking analysis in the book reveals how the regime of governance unleashed in the last decade has at its heart an unabashed dependence on the private sector, and state support and policies prioritizing growth in infrastructure and investment aimed at strengthening the requirements and profitability of the private investor. The developmental model has meant neglect of human habitations and needs of ordinary citizens in improving access through rail, ports, road for Industry, SIRs, SEZ’s; promotion of selective and capital intensive manufacturing  growth; jobless growth and falling share of wages in total income; corporatization of agriculture, neglect of small farmer and privatization of village commons; legislative changes in land-use norms reinforcing speculation in land; neglect of public policy and expenditure and a misplaced dependence on private initiative to even address inadequacies in social infrastructure. All of which is manifest in deeply exclusionary social and economic outcomes as reflected in extensive environmental degradation, widening regional disparities, neglect of the rural sector and increased marginalization of workers, women, STs, Muslims and minorities in social and economic outcomes within the state. The book then offers us a damning indictment of this path to development.

As Atul Sood concludes, the roots of these uneven outcomes lie in the ‘ neoliberal framework’ within which  this  development  trajectory itself is located, which ‘inherently negates the possibility of a level playing field.’    However, while the social and economic manifestations brought out in this study are the classic hallmarks of the ‘market led’ path to development , they have been renewed in the last decade in Gujarat with a zeal stamped all over by Narendra Modi’s authoritarian style of governance itself. In crucial ways it  represents a fundamental shift away from Gujarat’s own history of Gandhian humanism, liberal welfare programmes and democratic social engineering of the KHAM ( an experimental alliance between Kshatriyas, Harijans, Adivasis and Muslims in the 1980s) days.

It might be illustrative to conclude with a reference to the mention of industrial unrest in Sood’s introduction over here. Where workers are concerned, the state witnessed not merely jobless growth but also the lowest share of wage income in total income, one of the highest use of contract workers in organized manufacturing and rising trends of casualisation of workforce.  Not surprisingly, Gujarat topped the list as the  ‘worst state’ for labour unrest in the Economic Survey 2011, witnessing the maximum incidences of strikes, lockouts and other forms of unrest on various financial and disciplinary grounds (wage and allowances, bonus, personnel, discipline and violence) at a time when these were actually declining in the rest of the country. At the same time, investors and industrialists from  all over, be it Maruti or Tata, are vying with each other to shift their production  plants and activities to designated sites within Gujarat. Under such circumstances, an investment boom and Industry’s soaring confidence in Modi government’s ability to control any undue disturbance by establishing the ‘rule of law’ is indicative of the crucial link between the ‘Gujarat Development Model’ and, what some might see, as the totalitarian roots of Modi’s governance regime.

Parita Mukta has traced the genesis of this rule of law in Gujarat right from the times of resistance to development projects like Narmada Valley Project. She brings out how this acquired a distinct flavour with the invocation of the river goddess to reinforce the visions of grandeur and prosperity for the rich farmers and industrialists of the state in the preachings of RSS idealogues (“Worshipping Inequalities-Pro-Narmada Dam Movement” Economic and Political Weekly October 13, 1990)

During Narendra Modi’s regime, it has all come together as never before in a self fulfilling prophecy of an effective, pro- corporate, investor-friendly governance build on consolidating a ‘political culture of authoritarianism’, a ‘brash pride to demonstrate, brute force’, and a belief in  ‘worshipping inequalities’. This package is marketed to us via powerful media and advertising giants like APCO worldwide which counts dictators and global Investment firms as its clients. See for example Aditya Nigam on Spin Doctors and the Modi Make-over, and Binoy Prabhakar on how an American Lobbying Company markets Modi.

Gujarat’s development experience thus suggests the deep authoritarianism that made specific aspects of the recent growth experience possible is not so delinked from its fascist manifestations in spectacular forms of violence against religious minorities, scheduled castes and tribes and lower castes that the state has witnessed in its recent past.

Shipra Nigam is a Consultant Economist with Research and Information Systems (RIS) for Developing Countries

Biometrics programs for the developing world could put data in the wrong hands #Aadhaar #UID


Privacy for the Other 5 Billion

Western-backed biometrics programs for the developing world could put data in the wrong hands.

By  and 

Posted Friday, May 17, 2013, at 11:51 AM

An Indian villager looks at an iris scanner during the data collecting process for a pilot project of The Unique Identification Authority of India (UIDAI) in the village of Chellur, some 145kms north-west of Bangalore on April 22, 2010.

An Indian villager looks at an iris scanner for a pilot project of the Unique Identification Authority of India, or UIDAI, in the village of Chellur, northwest of Bangalore, on April 22, 2010.Photo by Dibyangshu Sarkar/AFP/Getty Images

Move over, mobile phones. There’s a new technological fix for poverty: biometric identification. Speaking at the World Bank on April 24, Nandan Nilekani, director of India’s universal identification scheme, promised that the project will be “transformational.” It “uses the most sophisticated technology … to solve the most basic of development challenges.” The massive ambition, known as Aadhaar, aims to capture fingerprints, photographs, and iris scans of 1.2 billion residents, with the assumption that a national identification program will be a key ingredient to “empower poor and underprivileged residents.” The World Bank’s president, Jim Yong Kim, effusively summed up the promise as “just stunning.”

Although few can match Nilekani’s grand scale, Aadhaar is but one example of the development sector’s growing fascination with technologies for registering, identifying, and monitoring citizens. Systems that would be controversial—if not outright rejected—in the West because of the threat they pose to civil liberties are being implemented in many developing countries, often with the support of Western donors. The twin goals of development and security are being used to justify a bewildering array of initiatives, including British-funded biometric voting technology in Sierra Leone, U.N. surveillance drones in the Democratic Republic of the Congo, and biometric border controls in Ghana supported by the World Bank.

This vigorous adoption of technologies for collecting, processing, tracking, profiling, and managing personal data—in short, surveillance technologies—risks centralizing an increasing amount of power in the hands of government authorities, often in places where democratic safeguards and civil society watchdogs are limited. While these initiatives may be justified in certain cases, rarely are they subject to a rigorous assessment of their effects on civil liberties or political dissent. On the contrary, they often seek to exploit the lack of scrutiny: Nilekani recommended in another recent speech that biometric proponents work “quickly and quietly” before opposition can form. The sensitivity of the information gathered in aid programs is not lost on intelligence agencies: Pulitzer Prize-winning journalist Mark Mazzetti recently revealed that the Pentagon funded a food aid program in Somalia for the express purpose of gathering details on the local population. Even legitimate aid programs now maintain massive databases of personal information, from household names and locations to biometric information.

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Humanitarian organizations, development funders, and governments have a responsibility to critically assess these new forms of surveillance, consult widely, and implement safeguards such as data protection, judicial oversight, and the highest levels of security. In much of the world, these sorts of precautions are sorely lacking: For example, despite the success of information technology in Africa, only 10 countries on the continent have some form of data protection law on the books (and even those rarely have the capacity or will to enforce them).

Kenya is a good example of how these programs can go wrong. In the country’s recent election, a costly biometric voting scheme flopped, adding widespread uncertainty to an already fragile situation. The problems were manifold, from biometric scanners that couldn’t recognize thumbprints to batteries that failed and servers that crashed. As journalist Michela Wrong put it, “almost none of it worked.” With limited resources, why support expensive and often ineffective technologies like biometric voting when traditional systems often suffice? While biometrics could help clean up electoral rolls, they may very well serve to obfuscate the electoral process, as information is passed through proprietary applications and technologies, closed to public scrutiny and audit.

But the worries in Kenya extend beyond technological failure. Like many low-income countries, Kenya has historically lacked a robust program of birth registration, making public health work notoriously difficult. It also stymies the provision of education services and cash transfers to vulnerable populations. To rectify this, the Kenyan state has sought to enroll all adults in a biometric national identification scheme that aims to interoperate with various other databases, including the tax authority, financial institutions, and social security programs. According to the director of this Integrated Population Registration System, George Anyango, the government now has “the 360 degree view of any citizen above the age of 18 years.” The Orwellian language is particularly worrisome given Kenya’s lack of data protection requirements and history of political factionalism, including the ethnic violence in the aftermath of the 2007 election that resulted in the death of more than 1,000 Kenyans.

The Aadhaar project in India—a country with a history of ethnic unrest and social segregation, widespread political and bureaucratic corruption, and with no effective legislative protection of privacy—should raise similar, magnified fears. Furthermore, it’s doubtful the program could help bring about the social equality it promises. Proponents of these state registration schemes argue that a lack of ID is a key reason why the poor remain marginalized, but they risk misdiagnosing the symptom for the cause. The poor are marginalized not simply because they lack an ID, but rather because of a complex history of discriminatory political, economic, and social structures. In some cases a biometric identity scheme may alter those, but only if coupled with broader, more difficult reforms.

One of Aadhaar’s biggest promises is the opportunity to open bank accounts (which require identification). Yet, poor, marginalized Indians, even with an ID, find formal banks to be unfriendly and difficult to join. For example, the anthropologist Ursula Rao foundthat the homeless in India—even after registering for Aadhaar—were blocked from banking, most frequently for lack of proper addresses, but more fundamentally because, as she notes, biometric identification “cannot establish trust, teach the logic of banking, or provide incentives for investing in the formal economy.” Bank managers remain suspicious and exclusionary, even if an identity project is inclusive. Without broader reforms—including rules for who may or may not access identity details—novel identification infrastructures will become tools of age-old discrimination.

Another, more practical drawback is that biometric technology is particularly ill-suited for individuals who have spent years in manual labor, working in tough conditions where their fingerprints wear down or they may even lose full fingers or limbs. Even with small authentication error rates—say, the 1.7 percent that recent estimates from Aadhaar suggest—the number of failures in a population the size of India’s can be enormous. Aadhaar has already enrolled 240 million people, with plans to reach all residents. You do the math.

The growth of these systems is due in part to the lack of public education and consultation, as well as the paucity of technical expertise to advise on the risks and pitfalls of surveillance technologies. But certainly the international donors and humanitarian organizations that support these initiatives have a responsibility to critically assess and build in safeguards for these technologies. Given the enormity of the challenge facing these organizations, it is perhaps easy not to prioritize issues like privacy and security of personal data, but the same arguments were once made against gender considerations and environmental protections in development. Aid programs that involve databases of personal information—especially of those most vulnerable and marginalized—must adopt stringent policies and practices relating to the collection, use, and sharing of that data. Best practices should include privacy impact assessments and consider the scope for “privacy by design” methodologies.

As the rhetoric around Aadhaar makes clear, the promise of a quick technical solution to intractable social problems is alive and well. However, it is time to recognize that human development involves the protection of civil liberties and individual freedoms, and not blindly rush into the creation of surveillance states in the name of development and poverty alleviation. Donors and aid organizations need to remember that the other 5 billion deserve privacy, too.

 

SOURCE- slate.ocm

#India- World Bank team faces protests in Odisha #Posco


By Express News Service – BHUBANESWAR

11th April 2013 09:05 AM IE

The protest against World Bank, which has been holding a series of consultations on environmental and safeguard policies across the country, continued in the State with people’s organisations staging a demonstration in front of a city hotel where its team is staying, here on Wednesday.

The organisations targeted the World Bank’s latest round of consultations for review of its environmental and social safeguard policies to which representatives of the State Government, corporate sector and NGOs are invited. The protestors were critical of the Bank’s impact on the State which led to proliferation of the private sector by illegally closing the PSUs in various public sectors such as education and health.

“The World Bank Group claims that it has lent around $26 billion to India between 2009 and 2013. However, this is spent through different anti-community policies, programmes and projects and have helped the corporate sectors only. Poverty has increased during this period,” said Sivaram of CPI(ML), who was leading the protests. The protestors said thousands of people have been displaced from their homes and were forced to live cattle’s life due to induced displacement and migration. The Bank’s programmes on environment have ruined the environment of Odisha while unnecessary loan for forestry sector development has put a burden on the State in terms of debt.

Lok Shakti Abhijan president Prafulla Samantra said the demonstration was part of the series of protests against the World Bank whose officials had to face the same fate by the activists on April 5 at New Delhi and April 8 at Bangalore.

The protesters slammed the NGOs saying that many profit-oriented organisations in the State are hand-in-glove with the World Bank projects and are engaged in many anti-community activities. These NGOs are also equally responsible and accountable to the people of the State, they said. Members of CPI (ML), Odisha Chasa Parivesh Surakhya Parishad, Lok Shakti Abhijan, Posco Pratirodha Sangram Samiti and Krushaka Samukhya were among others who participated.

 

Private health providers are NOT more efficient, accountable or medically effective #healthcare


POSTED BY ANNA MARRIOTT ON MAR 28TH, 2013 globalhealthcheck.com
 
 

In 2009 Oxfam published “Blind Optimism: Challenging the Myths about Private Health Care in Poor Countries,” to help redress what we saw as an international health discourse increasingly dominated by unchallenged private sector advocates.  Some of those same advocates accused Oxfam of being purposefully selective with the evidence.

The health team at Oxfam were therefore very pleased to see the recent publication of a thorough and balanced independent appraisal of peer-reviewed evidence on this topic in PloS Medicine. The study supports many (not all) of our conclusions about both the public and private sector.

In their research Basu et al. assess the comparative performance of the private and public sectors in health across a range of health system performance areas. They are clear that comparative evidence is often lacking and that distinctions between what is public and private are often difficult (for example when public facilities act more like commercial operators by charging fees). With these limitations acknowledged, the authors’ own conclusion states:

‘Studies evaluated in this systematic review do not support the claim that the private sector is usually more efficient, accountable, or medically effective than the public sector; however, the public sector appears frequently to lack timeliness and hospitality towards patients’.   

Like Oxfam, the authors of this comparative study make special note of the World Bank as an influential advocate of public-private partnerships in health, but one whose claims are often unsubstantiated by their own data. The authors raise concerns about a conflict of interest for the World Bank that may undermine the validity of their research and analysis on this topic.

Some highlights from the paper are listed below (though I recommend reading this important article in full – especially for interesting country examples):

Access and responsiveness

  • A significant proportion of services in some developing countries are provided by the private sector but figures vary enormously by country and by income level. When informal or unlicensed providers are excluded, the public sector provided the majority of care in 19 out of 22 low- and middle-income countries for which World Bank data is available.  
  • Studies that measured utilization by income levels tended to find the private sector predominately serves the more affluent. In Colombo, Sri Lanka, where a universal public health service exists, the private sector provided 72% of childhood immunisations for the wealthiest, but only 3% for the poorest.
  • Waiting times are consistently reported to be shorter in private facilities and a number of studies found better hospitality, cleanliness and courtesy and availability of staff in the private sector.

Quality

  • Available studies find diagnostic accuracy, adherence to medical management standards and prescription practices are worse in the private sector.
  • Prescribing subtherapeutic doses, failure to provide oral rehydration salts, and prescribing of unnecessary antibiotics were more likely in the private sector, although there were exceptions.
  • Higher rates of potentially unnecessary procedures, particularly C-sections, were reported at private facilities. In South Africa for example, 62% of women delivering in the private sector had C-sections, compared with 18% in the public sector.
  • Two country studies found a lack of drug availability and service provision at public facilities, while surveys of patients’ perceptions on care quality in the public and private sector provided mixed results.

Patient outcomes

  • Public sector provision was associated with higher rates of treatment success for tuberculosis and HIV as well as vaccination. In South Korea for example, TB treatment success rates were 52% in private and 80% in public clinics. Similar figures were found for HIV treatment in Botswana.

Accountability, transparency and regulation

  • While national statistics collected from public sector clinics vary considerably in quality, private healthcare systems tended to lack published data on outcomes altogether. Public-private partnerships also lacked data.
  • Several reports observed significant public spending being used to regulate the private sector in order to improve patient care quality, and with limited effectiveness.

Fairness and equity

  • Financial barriers to care exist in the public and private sector.
  • Private sector services tend to cater for higher income groups with studies showing exclusion and discrimination against poorer patients and women.
  • Several studies suggested the process of privatizing existing public services increased inequalities in the distribution of services.
  • Private contracting and social franchises showed potential for reaching impoverished groups, though findings are tentative because comparisons to the public sector are unavailable.

Efficiency

  • Contrary to prevailing assumptions, the private sector appeared to have lower efficiency than the public sector, resulting from higher drug costs, perverse incentives for unnecessary testing and treatment, greater risks of complications, and weak regulation.
  • The evidence is mixed (and often weak) on the cost of contracting to private providers – increasing expenditure in some countries whilst reducing it in others.

Other important findings

  • Rather than adding resources, several studies reported that growth of the private healthcare sector, whether independently or via public-private partnerships, directly reduced public funds and staff available for public provision.

And on the World Bank….

  • The World Bank has made strong claims that investing in public-private partnerships will improve efficiency and effectiveness in the health sector, yet several of its publications revealed that these assertions were either unsupported by data or the data was not provided in sufficient detail to pass minimal inclusion criteria for this review’.
  • Despite the lack of data about private sector performance, recent initiatives by the World Bank’s International Finance Committee (IFC) are underwriting the expansion of private sector services among low- and middle-income countries. For example in sub-Saharan Africa, the IFC has created a private equity fund to make 30 long-term investments in private health companies. These conflicts of interest pose a potential threat to the validity of World Bank-sponsored studies and raise the need for independent scrutiny.

The evidence from this study shows that while public health systems are often weak and under-resourced they still deliver better quality of care, more equitably and with greater efficiency than the private sector.  The study highlights the tendencies of private providers to serve higher socio-economic groups, have higher risk of low-quality care, create perverse incentives for unnecessary testing and treatment, and suffer from weak regulation. It also suggests there are a number of ways public health systems can do better.  They must be more responsive to patients and more accountable to citizens, improve systems for distributing essential inputs like medicines, and address financial barriers to accessing care (such as formal and informal fees).

These are legitimate challenges that deserve thoughtful attention and action, but they should not be used as evidence of the superiority of private sector approaches. Instead, the policy response to these findings should be very clear: far more effort and resources must be mobilized to maximize the clear advantages of public health systems, rather than further starving them of the resources and support they need to deliver equitable and quality health care for all.

 

Call for endorsements – Our planet is not for sale! ADB Quit India! Quit Asia! #mustshare


 Peoples Front against IFIs

We, peoples’ movements, mass organisations, struggle groups, trade unions, communityorganisations and many others from India and the Asia-Pacific region, call for a protestagainst the 46th Annual Board of Governors’ Meeting (AGM) of the Asian DevelopmentBank (ADB) in Greater Noida, Delhi during May 2-5, 2013. The AGM will make decisionson key development issues for the Asia-Pacific region, that will affect all of us now and inthe future. India, which is touted as ‘the emerging power in the region’ and in the ADB, ishosting the AGM for the third time to showcase and endorse a ‘development throughempowerment’ model put forth by the ADB. In fact, over the years, the Indian ruling classhas been working hand in glove with the ADB in a mutually beneficial complicity at theexpense of hundreds of millions of poor, marginalised and other toiling sections of thesociety.The ADB has earned the notorious title of actually being an “
 Anti-human DestructiveBank
,” whose devastating acts are not limited to India, but are evident across the Asia-Pacific region and also at the global level in collusion with the World Bank, InternationalMonetary Fund (IMF) and other institutions of global capitalism. Likewise, our protest andresistance is not limited to the ADB but extends to all International Financial Institutions(IFIs) whose primary missions are to appropriate and commodify the natural, human andsocial wealth of the planet, and force nations into indebtedness and political subordination. A self-acclaimed “development” financial institution, the ADB claims to combat poverty inthe region. But its poverty reduction strategy is merely a masquerade for prescribing adoomed model of rapid economic growth powered by the privatisation, commodificationand financialisation of natural resources and basic needs like water, power, education, etc.Under the guise of “good governance,” the ADB supports profit-mongering, un-accountableand non-transparent private sectors. The Long-Term Strategy Framework (Strategy 2020)of the Bank is a recipe for the transfer of wealth, means and capacities from the poor andmiddle classes to the wealthy, upper classes. Using grand slogans such as ‘inclusivegrowth’, ‘environmental sustainability’ and ‘regional integration’, the Strategy 2020 focuseson private sector development and explicitly advocates private sector participation in ADBand borrower operations. In 2011, the Bank spent nearly $6 billion as private sector finance. Not surprisingly, in India the number of billionaires rose from 2 with a combinedworth of $2 billion in the mid-1990s, to 46 in 2012 with a total net worth of $176 billion!With nearly $22 billion in annual financial investment for nearly 350 projects (loans, grants,equity investments and Technical Assistance) in Asia-Pacific, governments have given the ADB a mandate to direct the development path for the region. Under the pretext of addressing environmental and climate crises and alleviating poverty, the ADB continues todisplace and alienate large numbers of people from their lands, homes, water sources andforests, and violates their rights to livelihood, ctizenship and participation in decisionmaking.
Join hands against the ADB AGM
While it is our governments who borrow, the onus of debt repayment falls on the publicexchequer and the people of the country, and is transferred to subsequent generationsand the environment. Debt repayment depletes scarce foreign exchange reserves, andredirects national revenues away from spending on essential public goods such as
education, health, housing, water, sanitation, electricity and job-creation towards servicingan upward spiralling illegitimate debt.The struggles, movements and campaigns against ADB funded projects in West Bengal,Chhattisgarh, Odisha, Tamil Nadu, Kerala, Karnataka, Gujarat, Maharashtra, Jharkhand,J&K, Himachal Pradesh, and the North Eastern States take this opportunity to expose the ADB’s collusion with the Indian Government to enable the concentration of wealth,resources and capacities in the hands of the economic-political elites. People led byvibrant struggles in these states to halt nuclear power, land and water grabbing, forcedevictions, anti-people laws, farmers suicides and environmental destruction send out thisappeal to challenge the asymmetrical, ill-designed and anti-people developmentprescriptions of the ADB.The 2013 ADB AGM in Delhi offers a much-needed opportunity for us to come together toexpose the destructive developmental model promoted by the ADB and our governments.We invite all of you to join us in voicing our opposition to institutions like the ADB, whichmutilate our democratic institutions, perpetrate untold violence on our societies and foster continuing marginalization and pauperization of our peoples.
ADB QUIT INDIA! QUIT ASIA!
PEOPLES FRONT against IFIsENDORSED BY
(27March’13)
:
India
: Adivasi Moolvasi Astitva Raksha Manch (Jharkhand), All India Forum of Forest Movements (AIFFM), All India Union of Forest Working people ( AIUFWP/NFFPFW), ANBALAYAM – Pondicherry , Andhra PradeshMuslim Organization, Bongiyo Paromparik Kaaru O Bastra Shilpi Sangho (West Bengal), Behavioural Science Centre (Ahmedabad), Bharat Jan Vigyan Jatha, Bharatiya Kisan Union (BKU), CASA-ACT, CitizensForum for Mangalore Development, GM-Free Bihar Movement, Haldia Dock Complex Contractors Shramik Union, Himalaya Niti Abhiyan, India FDI Watch, Indian Social Action Forum (INSAF), Indianoil PetronasContractors Shramik Union, Janpahal, Kabani – the other direction,Kisan Manch, Kisan Sangharsh Samiti,KSMTF – Kerala Fishworkers Forum, Manthan Adhyayan Kendra, Mines, minerals & People (MmP), Nadi Ghati Morcha, National Fishworkers Forum, National Hawkers Federation, New Socialist Alternative(CWI-India), Paschim Banga Khet Majoor Samity, Posco Pratirodh Sangram Samiti (PPSS), Radical Socialist,River basin Friends, South Asia Network on Dams, Rivers & People – SANDRP, Sundarban Banadhikar Sangram Committee, Tamil Solidarity & others
 Asia/International
: Alternatives Asia, Asia Europe Peoples Forum, Asia-Pacific Movement on Debt & Development (JubileeSouth), CADTM International Network, Europe Solidaire Sans Frontières (ESSF, France), FOCUS on theGlobal South, Migrant Forum in Asia (MFA), Socialist Alternative (Australia)
 Asian Countries
:
Bangladesh
; EQUITYBD, Humanitywatch, Initiative for Right View – IRV, Nabodhara, Online KnowledgeSociety, Participatory Research Action Network-PRAN, VOICE
Indonesia
: Solidaritas Perempuan
Nepal
: All Nepal Peasants’ Federation (ANPFA), All Nepal Women’s association (ANWA), Forum for theProtection of Public Interest
Pakistan
: Awami Workers Party, Pakistan Fisherfolk Forum, Umeedenao Citizen Community Board
Philippines
: AMA- Aniban ng mga Manggagawa sa Agrikultura (Union of Agricultural Workers)
Sri Lanka
: Centre for Environmental Justice/Friends of the Earth, Federation of Media Employees Trade Unions
SEND ENDORSEMENTS – email: willyindia@gmail.com

 

Hugo Chávez: Death of a socialist


6 March 2013 , By Arvind Sivaramakrishnan, The Hindu

In this October 9, 2012 photo, backdropped by a portrait of
independence hero Simon Bolivar, Venezuela‘s President Hugo Chavez
talks during a press conference at the Miraflores palace in Caracas.
Hugo Rafael Chávez Frias, President of Venezuela, who died on March 5,
2013 at the age of 58, was a defining figure in Latin American
politics for fifteen years, becoming almost synonymous with the
popular tide that has elected and reelected left and centre-left
governments across the continent in that time.
Mr. Chávez combined courage with immense conviction. Born to
schoolteacher parents in Sabaneta in 1954, he qualified in military
arts and sciences at the National Military Academy, became an officer
in a paratrooper unit, and started his political career in the early
1980s by founding a secret organisation, the Revolutionary Bolivarian
Movement, which took its name from the Latin American independence
leader Simón Bolivar. His first big move was an attempted military
coup in 1992, for which he was imprisoned for two years before being
pardoned.
Yet ordinary people’s suffering under austerity measures led Mr.
Chávez’s fellow officers to try again, in November 1992; they failed.
Mr. Chávez, however, renamed his group the Movement of the Fifth
Republic, which later merged with other groups to form the United
Socialist Party of Venezuela (PSUV), and won the 1998 presidential
election on a socialist manifesto, promising millions relief from a
system which had put oil wealth into luxurious lives for the rich and
profits for the oil corporations.
Mr. Chávez removed corrupt military officers and started a national
reform programme. Venezuela, according to the United States Department
of Energy and a former CIA oil expert, has the world’s largest oil
reserves at 1.36 trillion barrels, and the new president promptly
nationalised the main oil company, Petróleos de Venezuela (PDVSA),
putting the profits into very effective social programmes. Carles
Mutaner, Joan Benach, and Maria Paez Victor note in CounterPunch that
between 2000 and 2010 social spending increased by 61 per cent or $772
billion; the country has the region’s lowest level of inequality, with
a reduction in its Gini coefficient of 54 per cent. Poverty is down
from 71 per cent in 1996 to 21 now, and extreme poverty is down from
40 per cent to 7.3. The programmes, or Misiones, have reached 20
million people, and 2.1 million have received senior citizens’
pensions, a sevenfold increase under Mr. Chávez.
The country has also cut food imports from 90 per cent to 30 per cent
of its consumption, and has reduced child malnutrition from 7.7 per
cent in 1990 to 5 today; infant mortality has declined from 25/1000 to
13 in the same period, and the country now has 58 doctors per 10,000
people (as against 18 in 1996). As many as 96 per cent of the
population now have access to clean water, and with school attendance
at 85 per cent, one in three Venezuelans is enrolled in free education
up to and including university.
Oil royalties help. A 2001 law cut foreign companies’ share of the
sale price from 84 to 70 per cent, and they now pay royalties of 16.6
per cent on Orinoco basin heavy crude; they used to pay 1 per cent.
Exxon and Conoco Philips rejected these terms, as Deepak Bhojwani says
in the Economic and Political Weekly (December 22, 2012), and were
expelled, but Chevron stayed.
Mr. Chávez of course infuriated the mainly white elites, some of whom
talked of him in racist terms, as well as the United States government
and press, both of which have consistently vilified him in language
bordering on the delusional. The State Department greeted the 2002
coup against Mr. Chávez by expressing solidarity with the Venezuelan
people and looking forward to “working with all democratic forces in
Venezuela.” The statement also said Mr. Chávez had dismissed the
Vice—President and Cabinet. In fact it was the coup figurehead, Pedro
Carmona Estanga, who, according to the Notable Names Database NNDB,
dissolved the national assembly, disbanded the supreme court, closed
the attorney—general’s and comptroller’s offices, and repealed 48
redistributive laws meant to help the poor.
Yet huge public support for Mr. Chávez meant the regime collapsed
within days. The President was reinstated, but the then U.S. National
Security Adviser Condoleezza Rice hectored him to “respect the
constitution”, and Greg Palast points out in The Progressive that in
2006 the Bush administration’s National Security Strategy called him a
demagogue out to undermine democracy and destabilise Venezuela.
The U.S. press dutifully played its part. In September 2012, the
WorldNet columnist Drew Zahn called Mr. Chávez a “socialist dictator”,
when the President was about to win a fourth successive election. All
those elections were of far greater probity than the respective U.S.
presidential elections of 2000 and 2004; this time Mr. Chávez won by
11 percentage points on a turnout of 80 per cent. Other U.S. media
bodies have spread partial truths about the Caracas government, saying
it bloats the public sector and lets the budget deficit spiral. In
fact, as Mark Weisbrot notes in the Guardian, 18.4 per cent of
Venezuela’s work force is in the public sector, in contrast to
Norway’s 29 per cent, and its 2012 budget deficit, projected at 51.3
per cent of GDP, is lower than the European Union average of 82.5 per
cent; inflation has declined too, from 27 per cent in 2010 to 19 per
cent now. Weisbrot also points out that the New York Times — which
welcomed the coup — has taken 14 years, longer even than other
American media outfits, to publish any arguments for Mr. Chávez.
Carles Mutaner and colleagues comment that U.S. analysts ask what
Venezuela will do when the oil runs out, but do not ask that about
other oil exporters like Saudi Arabia and Canada; neither do critics
note that the country’s interest payments are only about 3 per cent of
export earnings.
One of Washington’s problems is that, as Greg Palast recognises, Mr.
Chávez kept oil revenues within Latin America; unlike Saudi Arabia,
which buys U.S. treasury bills and other assets, Venezuela at one
point withdrew $20 billion from the U.S. Federal Reserve, and since
2007 has aided other Latin American countries with $36 billion, most
of which has been repaid back. In effect, this supplants the
International Monetary Fund (IMF) and possibly also its neoliberal
fellow—crusader the World Bank. Even more unpalatably for Washington,
Chávismo is now a clear political programme towards a Bolivarian
Revolution, which Palast calls a close replica of Franklin Roosevelt’s
New Deal, with progressive income tax, public works, social security,
and cheap electricity. For Bolivarians, such things are rights; they
are even reminiscent of T.H. Marshall’s view that they are integral to
substantive citizenship. Worst of all for U.S. regional hegemony, Mr.
Chávez himself said Venezuela is no longer an oil colony, that it has
regained its oil sovereignty, and that he wanted to replace the IMF
with an International Humanitarian Bank based on cooperation; Uruguay
already pays for Venezuelan oil with cows. Mr. Chávez wished the IMF
and the World Bank would “disappear”, and his passionate concern for
Latin American countries’ sovereignty made him a decisive figure in
the 2011 creation of the Community of Latin American and Caribbean
States (Celac).
Mr. Chávez could be ruthless; in 2010 a military court sentenced his
former key ally Raúl Isaias Baduel to just under eight years for
embezzlement after a long—delayed trial, and Baduel is now banned from
future political office, almost certainly because he criticised
constitutional reforms which would allow a president more than two
terms. Mr. Chávez was, however, no doctrinaire leader. Although a
Christian, he criticised clerical collusion with the ancien régime,
and did not accept the Church’s authority in politics. He also thought
seriously about political economy. Bhojwani notes that he favoured a
form of 21st century socialism partly derived from the work of Heinz
Dieterich Steffan. For Mr. Chávez, ethics, morality, cooperativism,
and associationism make for strong public economic activity and in
turn protects the equality which is essential to liberty; it even
includes a respect for private property.
The Venezuelan electorate have repeatedly endorsed this; in the
December 2012 gubernatorial elections — the first ones in 14 years in
which Mr. Chávez himself did not campaign — Mr. Chávez allies won 20
out of 23 states. After the President’s win in October, Argentina’s
President Cristina Fernández de Kirchner had sent him a message
saying, “Your victory is also ours.” Billions, and not only poor
people, around the world would agree: Tu victoria es también la
nuestra.

Press Release- Campaign for Affordable Trastuzumab


The Department of Pharmaceuticals, Ministry of Commerce has just released a report by a committee set up to examine the issue of price negotiations for patented drugs.  Comments are being invited from stakeholders.

 

The Campaign for Access to Affordable Trastuzumab is shocked that the Department of Pharmaceuticals is even considering the option of negotiating with multinational pharma companies for price discounts.

We note with concern that this report comes at a time when the Ministry of Health is actively exploring options such as compulsory licensing for bringing down prices of life-saving patented drugs through allowing market competition by generics and biosimilars. Trastuzumab is one of the drugs being considered for compulsory licensing.

This ill-timed move by the Department of Pharmaceuticals will benefit none other than big pharma companies whose patents on life-saving drugs are the main barrier in access to health for millions of Indians.

Global experience shows clearly that measures such as negotiated price reductions and “managed competition” through voluntary licenses (which usually incorporate stringent conditions to protect the interests of the originator company) do not result in any significant expansion of access, since prices continue to remain beyond the reach of most citizens.

A case in point is Brazil, which tried to use price negotiations with multi-national pharmaceutical companies to bring down the price of patented HIV drugs. As a result, the price of Efiverenz (Merck) came down to  USD760 per person per year in 2003.  In contrast, when Efiverenz was brought under compulsory license in 2007, the price came down to USD170 per person per year – less than one fourth the negotiated price.

 

Similarly, a World Bank supported process of negotiated price decreases in Central America and the Caribbean in 2002 brought prices of HIV drugs down to USD 1100-1600 per patient per year. In contrast, 10 Latin American countries independently adopted an open competition-based model involving both generic manufacturers and originator companies, resulting in prices coming down from USD 5000 to USD 400 per patient per year.

 

The Government of Thailand, which began issuing compulsory licences in 2007, considered and dropped the option of negotiated price reductions, noting that “Prior negotiation with the patent holders is not an effective measure and only delays the improvement in access to
patented essential medicines and puts more lives in less healthy or
even dangerous situations.”

 

India plays a key role as a supplier of affordable medicines to other countries in the global south. Unlike negotiated prices, which apart from being unacceptably high would apply only in India, compulsory licensing of a drug like Trastuzumab would benefit millions of people across the developing world through global marketing of cheap generic versions.

 

The Campaign for Affordable Trastuzumab urges the Government of India to follow through on the strong political will it has shown by initiating the process of compulsory licensing for Trastuzumab. With 25,000 new cases of HER2+ breast cancer being recorded every year with most patients being young women, there is no time to waste. We look forward to a speedy notification and an accelerated process to bring biosimilars of Trastuzumab into the market.

 

We call on our policy-makers to ensure that big pharma companies do not continue to hold our health hostage to their greed for profits.

For further information, contact <kmenonsen@gmail.com> and <shailly.gupta@gmail.com>

 

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