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India’s poor performance on social indicators such as health and education compared to other countries, at similar levels of development, is well known. But there is reason to be optimistic, says Girindre Beeharry, India Director of the Bill and Melinda Gates Foundation. In an interview with Ishan Bakshi, Beeharry speaks on key issues that India faces in the areas of health, education and agricultural productivity.
Do you expect India’s performance on health indictors to improve in the coming years?
India has made huge progress in many areas. On the health front, India in 1990 was losing 3.3 million kids under age 5 every year to childhood diseases. That number has been brought down to 1.3-1.4 million. It’s still too high and we can make progress.
There is enormous energy in tackling the balance of what constitutes under-5 mortality. The focus on neonatal health and tackling aggressively childhood diseases like diarrhea, pneumonia. There is much more attention to the value of vaccines to prevent diseases.
India launched, middle of last year, four new vaccines which are yet to be introduced programmatically, which will put all these things together in addition to the massive push we are seeing right now on sanitation which hopefully will translate into a significant dent on the causes of childhood mortality. This gives us a sense that India is poised for continued acceleration and progress that it has seen in the last 15 years.
There are many who are critical of the public health care system in India. What are your views? Do you envision a greater role for the private sector?
The public health system has room for greater efficiency and we are working with the system in UP and Bihar to see how can we make the system that exists today work better. How do we ensure that the capacities are there, the performance management of public health care system is there? So there is an element of continuing efficiency gains in the public sector.
It’s also true that the private sector has a huge role to play. There are few things that the government is uniquely poised to do. These tend to be issues of public goods. For those areas where the government has been doing well we need to continue to accelerate efficiency gains there.
On the other side, there is this huge body of health sector that is private and where people are going to the private sector as the first point for care. How do we bring the existing capabilities of the private sector much more to bare on issues of public health interest. I think government has a key role to play but it will have to leverage the private sector capabilities.
Even though access to education has expanded, quality remains a concern. Your thoughts?
We have seen massive increase in enrolment but that has not along with an improvement in quality of education, instruction and learning. There is a learning crisis that effects India and there are ways in which we are hopeful that this learning crisis can be overcome. There is a revolution around how education is being provided now and how the traditional model of classroom teaching is being abandoned quite fast with technology, where you can take world-class classes on line. There is a huge potential in terms of what the information revolution is doing in terms of access, open access in terms of high level of education and how this could affect learning outcomes in India.
Agricultural productivity continues to remain low. How do we tackle this issue?
In parts of India where you have low productivity of agriculture, how do you augment productivity significantly through technology advancements? Most of Bihar, Uttar Pradesh and Orissa are rain fed. So you are depending on rain conditions for crop productivity and one year you can have a flood, one year drought and this impacts rice productivity. So what we have done in partnership with others is to develop a strain of the rice grown in northern India but that is bred for resistance to stress. Stress in this case means either drought, flooding or salinity. Right now in Orissa and Bihar, a few million farmers have adopted this strain of the rice. When flooding happens, the normal variety of rice dies and the one that has been bred for resisting survives the floods. Those kinds of stuff have huge potential for accelerating productivity in areas that have been bypassed by the green revolution.
