Does economic growth relate to human development? If so, why the discord between different aspects of human wellbeing?
On July 30, 2011, in Kanpur, Sikandar Khan was mauled to death by a pack of stray dogs which then went on to partially eat his body. Khan, unbelievably, was lodged in the emergency ward of a government hospital. Such an occurrence would have raised a public outcry in any decent society, but such bizarre tragedies are not out of the ordinary in the second fastest growing, and the fourth largest economy in the world.
If a single feature could encapsulate India since 1991, it is this paradox: The dissonance between different aspects of human wellbeing. Thus, is it surprising that while 63 per cent of households have telephones, only 47 percent have toilets? While the concept “development” itself has become a buzzword, its meaning, like many who are subject to it, has become malnourished: It merely means economic growth and has nothing to do with human development.
But after 20 years of spectacular economic growth, India's Human Development Index — HDI (2011) — is marginally below, not China, which is far ahead, but, that of South Asia! In the health category, Nepal and Bangladesh are better than India, while Pakistan is at the same level. All (except Afghanistan) do better than India in gender equality.
Women face it more
In our perception, these nations, especially Bangladesh and Pakistan, are of course, far inferior, especially in the treatment of women. In the humorous look at stereotypes — “The World According to India” — popular across social media networks, Pakistan stands for “terrorists trained here”, and Bangladesh for “immigrants”. But as Sen and Dreze note: “Overall, India had the best social indicators in South Asia in 1990, next to Sri Lanka, but now looks second-worst, ahead of only Pakistan. “Remarkably, as they show, Bangladesh, with less than half of India's per capita income, has surpassed India in child survival, life expectancy, fertilization rates, immunization, etc. This is a telling commentary on the nation which has abandoned the poverty of 40 years of “socialism” for the supposed prosperity of unbridled capitalism.
Unless development is rescued from its equation with economic growth and expansion of markets, the present scenario will continue. A revolution in social consciousness is needed to understand the multifaceted nature of human wellbeing. To understand that development is not only the proliferation of material goods, but, is, ultimately, in Amartya Sen's famous formulation, development as freedom: “Advancing the richness of human life, rather than the richness of the economy in which human beings live, which is only a part of it.” To understand that economic growth, while very important, is not enough for the best realisation of human capabilities. After all, for example, it is not starvation — caused by economic poverty — alone that hinders human functioning but also obesity — an effect of economic prosperity (in North America, the additional burden imposed on health-care expenditure by obesity was a staggering $ 127 billion last year).
And more importantly, there are so many aspects of human life that cannot/ should not be commodified, or are beyond the ken of economic language, but are still vital to human wellbeing.
To understand development thus is to realise that vital areas of that wellbeing like health and education, the environment (crucial not only for us, humans) and many others have to be dissociated, at least substantially, from the profit motive or the market. Instead, what has happened, since the opening up of the markets, is the opposite. These have been sold to the highest bidder, and when there have been no takers, they have been left to the depredations of an avaricious and incompetent state.
That is why there are many government schools in the country which are used to house buffaloes, while five-star food is served in some private schools. That is why Sikandar Khan is eaten by dogs in a government hospital, while Americans fly to “world class” private medical facilities for a hip replacement which comes with a free tour to the Taj. And that is why 80 per cent of spending in health in our country is in the private sector, while it is above 80 per cent in the public sector in Cuba (a socialist country), and Norway (a capitalist country!).
The dissonances and paradoxes thus continue. That India is the second fastest growing economy in the world is known by every school child while the fact that India has, shockingly, the highest proportion of underweight children in the world, or that it is ranked 171 out of 175 countries in public spending on health would not be taught. This is a classic case of development sans people, or at least a majority of them.
And we move from being a market economy to what the philosopher Michel Sandel calls a market society, where markets and market values completely penetrate “spheres of life traditionally governed by nonmarket norm.” So social programs like NRHM, MGNREGA, and food security are merely “economic costs” (or bones thrown at starving dogs) which can be tampered with anytime to protect the sacred Sensex. They are not a part of an overall paradigm shift which sees the healthy and employed poor as human beings and as an end in itself.
But a shift to development as freedom is not easy as policy climate and public consciousness is stacked against it. We have influential free market voices like the economist Jagdish Bhagwati for whom HDI is a scientifically “nonsensical index.” But GDP and GNP are not! Thus, for him, economic reforms have lifted 200 million people out of poverty. But the fundamental questions that are not being asked are: Why is it that poorer nations with much poorer economic growth rates than India have done better in many aspects of the same HDI? What does it mean to be lifted out of poverty when the urban poverty line is Rs. 28 per day? And what does it say about the economic growth which has produced increasing concentration of wealth and double the levels of inequality in earnings since 1990 (India being the worst case among emerging economies)?
To move to development as freedom, and development with people, we need to abandon seeing market logic as the only logic, to realise that providing sanitation to almost 600 million Indians is not only about saving the economy $ 54 billion every year, but also about ending the horrific degradation of 13 lakh manual scavengers; the 200 children who die every hour, many due to diarrhoea, is not terrible happenstance; innovation is not only what a Steve Jobs does, but also what a Bindeshwar Pathak does, and the fact that one billion citizens will have cellphones by 2015 is not necessarily the pinnacle of Indian civilisation.
Dr. Nissim Mannathukkaren is Acting Chair, International Development Studies, Dalhousie University (email@example.com).