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NOT LONG ago, Delhi and Beijing competed with each other for the infamous tag of being the world’s most polluted city. Beijing beat Delhi hands down till the mid-noughties. Then things changed. While air quality in Beijing began to improve steadily, pollution levels in Delhi kept rising. In 2017, the yearly average concentration of PM 2.5 (particulate matter with a size of 2.5 microns or less) in Beijing was less than half that of Delhi. The number of “very unhealthy” days (when the pollution levels were very high) in Delhi was also four times that of Beijing. So, how has Beijing succeeded in reducing pollution while we continue to struggle?


When the great smog hit central, northern and eastern China government to launch a comprehensive action plan to tackle air pollution. It was based on a regional approach and identified key polluted regions such as Beijing-Tianjin-Hebei for time-bound action. It set specific pollution reduction targets and defined “10 measures” to guide the development of regional action plans. Based on these 10 measures, China’s Ministry of Environmental Protection issued implementation rules for Beijing-Tianjin-Hebei region and surrounding area. Accordingly, Beijing’s government formulated action plans that included specific targets such as restricting the total number of vehicles in Beijing to six million by the end of 2017, reducing coal consumption by 80 per cent by 2020 and meeting annual average PM 2.5 concentration of micro-grams per cubic meter (µg/m3) by 2017.


Beijing is implementing these measures quite seriously. For instance, in 2017, the quota for new vehicles was fixed at 150,000 cars, with 60,000 allotted only to fuel-efficient cars. In 2018, this quota was reduced to 100,000 annually. Similarly, in 2017, coal consumption reduced to 11 million tonnes as Beijing closed all its big coal-fired power stations. Beijing has enforced stringent norms to control industrial pollution. In 2016, Beijing’s environmental watchdog imposed fines totaling US $21.8 million (`150 crore). Beijing has also undertaken a massive greening programme. Du-ring the past five years, about 4,022 hectares of urban green space has been created.


To effectively reduce Beijing’s air pollution, the surrounding provinces such as Tianjin, Hebei, Shandong, Shanxi and Inner Mongolia coordinated and implemented a joint action plan. The combination of Beijing’s own Action Plan and those of its surrounding regions has paid off. In 2017, Beijing recorded 226 blue sky days (good air quality), compared to just 176 in 2013. In the Beijing-Tianjin-Hebei region, PM 2.5 levels decreased by ab-out 30 per cent between 2013 and 2017. This has helped Beijing meet the PM 2.5 target it had set for itself in 2013.


So what lessons can Delhi learn from Beijing? Let me list the five key ones. First, a regional action plan and regional coordination mechanism involving Delhi and its adjoining states must be put in place. Second, the region needs time-bound targets to reduce pollution levels; without targets, action plans are me-aningless. Third, the action plan should be an integrated one involving all pollutants and all key polluting sources. Fourth, concerted action rather than incremental change is the key to reduce pollution levels quickly. Lastly, without strict enforcement, all these measures will fail. The bottom line is that Delhi faces the same challenges as Beijing did a few years ago. What we lack is political willingness and public anger to force the government to take hard action.

THE PACE of India’s emissions standard roadmap for cleaner vehicles and fuels has quickened. The country has already drawn accolade for skipping the stage V emissions standards to leapfrog from Bharat Stage IV (RSIV) to Bharat Stage VI (BSVI) in 2020–advancing by five years from the original proposal. But two new developments this year make this trajectory even more unique. One, BSVI fuel has been introduced in Delhi in advance to battle its deadly smog, and, two, the automobile industry has not been allowed extra time to phase-in or to sell unsold older BSIV vehicles after BSVI kicks in on April 1, 2020. India, a rapidly motorizing economy, facing a big technology lag, has finally chosen disruptive strategies.


Though this change was resisted by the auto industry, public health interest has prevailed. The spirit and principle behind the decisions is clear from the Supreme Court ruling of October 24: “Even a day’s delay in enforcing BSVI norms is going to harm the health of the people that cannot be compensated in the marginal extra profits that the manufacturers might make. “The ruling is categorical: “If there is a conflict between health and wealth, obviously, health will have to be given precedence… The larger public interest has to outweigh the much smaller pecuniary interest of the industry.” These developments, however, have aroused a certain curiosity about the benefits of these early moves.


Fuelling change with clean fuels

How will Delhi gain from the early introduction of BSVI fuels without BSVI vehicles? Even though the maximum emissions benefits are expected from combined introduction of BSVI fuels and vehicles, the on-road vehicles will also gain from clean fuels. According to the United States Environmental Protection Agency (USEPA), particulate matter increases linearly with sulphur content of the fuel. Drastic reduction in fuel sulphur to 10 ppm can reduce particulate emissions from the on-road fleet. High fuel sulphur increases sulphur dioxide emissions–a harmful ingredient of smog, that also forms sulphate particles. In the oxygen-rich diesel exhaust, sulphur dioxide can oxidize to form hazardous sulphate particles and ultra-fine particles.


Clean fuel improves the performance of the emissions control system and cuts emissions from on-road vehicles. Petrol vehicles also benefit as low sulphur improves efficiency of catalysts. USEPA estimates show that if petrol sulphur drops from 30 ppm to 10 ppm NOx and carbon monoxide emissions from on-road vehicles can reduce by 8 per cent each and volatile organic compounds by 3 per cent. Clean fuel will also reduce engine wear and corrosion.


BSVI fuel opens up the opportunity to retrofit existing vehicles with advanced emissions control systems and early introduction of BSVI vehicles in Delhi. Many companies are ready with BSVI models, but these vehicles must not be “misfuelled” with sulphur-rich fuels. Their systems, once affected, can recover to some extent if the use of near-zero sulphur fuels is restored, but recovery takes time due to sulphate storage on the catalyst. To ensure steady and expanded uptake of BSVI fuel and to prevent “misfuelling”, the price of BSVI fuels in Delhi must remain lower than the price of BSVI fuels in the National Capital Region.


Impact of leapfrogging

The big change is awaited with the introduction of BSVI vehicles in 2020. This is a critical step, given the risk of dieselization in India. The gap between emission limits for petrol and diesel cars will narrow substantially. Particulate limit for different segments of diesel cars will be 82-93 per cent lower than the BSVI level. NOx emissions limit will be 68 per cent lower. Similarly, particulate limits for heavy duty vehicles will be 50-67 per cent lower than BSVI level. For the first time India will introduce particle number count in exhaust emissions to ensure that auto companies use the most effective diesel particulate filter, which can have over 95 per cent efficiency in controlling particulate matter with 10 ppm sulphur fuel.


To make these technologies work during the life of the vehicle and to prevent emissions frauds like the Volkswagen scandal and dieselgate in Europe (see ‘Faux Wagon’, Down To Earth, 15-31 October 2015), India has adopted real world driving emissions testing using portable emissions measurement system (PEMS) for vehicle certification. But its actual application for certification has been delayed for both light duty and heavy duty vehicles till 2023. Until then only data will be collected. One of the reasons why heavy duty vehicles in Europe could avoid dieselgate debacle (unlike the cars) is because of early adoption of both real world PEMS testing and in-service conformity requirement (testing of emissions in real world when vehicles are in use). India will have to go one step further to introduce these systems and make the results public for scrutiny and compliance.


BSVI regulations have also improved other technical parameters needed to improve overall on-road emissions performance. For instance, specifications for on-board diagnostic system that records details of vehicle performance for monitoring are more stringent. The durability requirement of emissions control systems has been specified for a minimum distance range as 160,000 km, which is much higher than the current requirement.


Clearly the Indian automobile industry will have to walk the extra mile, like China has, to clean up toxic emissions. China has even bettered the Euro VI standards by adding tougher requirements than Europe. The mantra of the BSVI regulations has to be stringent compliance. Only this can make a real difference.










SINCE THE revolutionary invention of plastic in the 1950s, this “wonder product” has become a part of everyday existence as it is cheap, durable and lightweight. The global production of plastics has increased exponentially from 2.3 million tonnes in 1950 to 335 million tonnes in 2006. It is expected to triple by 2050. In India too, plastic use has grown by leaps and bounds. As per the 2013 estimate of the Central Pollution Control Board (CPCB), Indians throw out 15,342 tonnes of plastic waste every day, of which about 60 per cent is recycled, mostly by the informal sector. But single-use plastics like cups, plates and polybags, also referred to as disposable plastics, cannot be recycled. Hence, these are not good for the environment. However, a fascinating initiative developed by Rajagopalan Vasudevan, a chemistry professor at the Thiagarajar College of Engineering in Madurai, Tamil Nadu shows single-use plastics can be used for road construction. This and many other positive initiatives make Beat Plastic PollutionGood News from India an interesting read.


There are also other positive case studies in the book. For instance, discarded PET bottles are lighting up the lives of slum dwellers in Bengaluru through an initiative called Liter of Light. Under this, informal waste workers, especially women, are instrumental in addressing the plastic challenge. Another inspiring story is that of the Pune Municipal Corporation’s SWACH model is based on the recovery of fees from users and provision of infrastructure and management support by the municipality. An initiative in Gururgram named Alag Karo, Har Din Teen Bin (segregate in three bins every day) has witnessed the coming together of the municipal corporation, private partners and the civil society, with the aim to establish segregation at source and develop capacities of waste collector to ensure high recycling rate.


Besides the case studies, the book deals with the status of the plastic industry in the country and its challenges. It also captures various interventions taken up by the Union government to tackle the plastic menace under the Swachh Bharat Abhiyan and the Plastic Waste Management (Amendment) Rules, 2018. These include segregation of waste at source and the implementation of extended producer responsibility.


Evolution of plastics

Another book, Plastics in Life and Environment, highlights the evolution and journey of plastic, its diversification and how it became a part of our everyday existence. It also deals with the need to beat plastic pollution and tries to provide solutions especially for single-use plastics. Its main attraction is the comic strip, which tells the story of plastics in an engaging manner. However, the book also highlights how plastic is bad economics simply because more than 90 per cent of all plastics use oil as feedstock. It currently stands at 6 per cent of the total oil consumption and will use 20 per cent by 2050. In the end, the solution lies in a circular economy. The linear input-profit-output economy cannot resolve the plastic problem.



Missing links

Although both the books offer interesting perspectives, a detailed discussions on policy framework has been ignored in them. Beat Plastic PollutionGood News from India, misses out discussion on the status of implementation in the country and why it is still lax on the ground. It also fails to say why non-segregation of waste at source is still the biggest hurdle to plastic recycling and waste management in India. Similarly, Plastics in Life and Environment lays emphasis on the history of plastic whereas more focus emphasis on the history of plastic whereas more focus should have been given to the circular economy.


However, the books are highly recommended for all stakeholders, who want to gain knowledge on the evolution of plastic, its usage, management challenges and the best practices aimed at reduction. Those interested in knowing about plastics can download the books from the website of the Ministry of Environment, Forest and Climate Change for free. They were released on the occasion of the World Environment Day on June 5 this year.










THERE ARE many ways in which the canny developed nations have sought to use intellectual property (IP) laws to impose huge burdens on poor nations over and above what is mandated by the World Trade Organization requirements known as the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). Developed countries try to impose higher standards of IP protection, or TRIPS plus, in bilateral and regional trade agreements and their impact is primarily felt in the health sector. Such requirements are intended to protect the profits of multinational pharma firms by preventing the entry of generic versions of a patented product that are infinitely less expensive.


TRIPS plus can consist of various measures and one such is patent linkage (PL). this is the practice of linking marketing approval for a drug to the patent status of the originator drug in order to prevent marketing approval of generic drugs until after the expiry of patents covering the drug. What it means is that companies seeking marketing approval have to prove to the Drug Controller General that the pharma product for which they are applying is not protected by a valid patent. This kind of law forces drug regulatory authorities to ensure that there is no patent on drugs that they approve. India does not allow PL. The rationale for this was established in 2008 when the court dismissed a petition by the German drug giant Bayer objecting to the grant of marketing approval for Cipla’s generic version of its drug Sorefanib.


That has not stopped major trade partners from trying to sneak in PL demands in the free trade agreements they are negotiation with India. While India has so far been steadfast in its refusal to accept TRIPS plus requirements there is no saying what the government will do under pressure. There is, it seems, a way out of the problem: India’s Commerce Ministry officials should keep the text of the trade agreements ambiguous. This would allow low and middle income countries (LMICS) to exploit the “constructive ambiguities” in the text of the trade treaty to mitigate the impact of PL        mechanisms and keep the generic drugs flowing.


So says the just published report “Moderating medicines: Lessons from variations in South Korea, Australia, Canada and the US” which makes no bones about what the inclusion of such a provision entails. The report, published in the journal Globolization and Health says: “Patent linkage has been shown to have a detrimental effect on access to medicines, by delaying generic market entry and allowing the high prices of originator medicines to remain unrestrained by generic competition.” The report is based on a study of how PL mechanisms have been implemented in the three countries with which the US has trade pacts and gives examples of how “constructive ambiguities” can be exploited by LMICS to mitigate the worst effects of this require-ment in future agreements.


It also warns of ways in which PL might also “impede the use of compulsory licensing, despite being a recognized flexibility within TRIPS”      . To prevent this risk, the report urges LMICS to put in place domestic legislation that ensure essential exemptions to PL.


Is the commerce Ministry paying attention?

























WE WERE visiting Maitama, a posh neighbourhood in Nigeria’s capital city of Abuja. Our taxi driver, who was douling as a guide, suddenly pointed towards an automobile workshop where technicians were busy repairing and refurbishing used and worn-out cars. This is where one can buy a car of any model or brand available elsewhere in the world for just one-fourth of the rate, he said with excitement.


On the face of it, the deal offered by the workshop seemed lucrative and reasonable. But what such deals really hold hit us quite hard during our next halt in Lagos, another populous city of Nigeria. As we moved bumper to bumper on a gridlocked street, we were engulfed with choking fumes from smoke-belching vehicles all around us. We experienced similar snarling traffic and chocking vehicle fumes throughout our journey in several African cities including Nairobi, Addis Ababa, Dare Salam and many more. This also brought back memories of similar experiences on the streets of South Asian cities such as Dhaka in Bangladesh.


Importing old and polluting vehicles, some of which are unfit for the road, is how the low-and middle-income countries are embracing automobiles. The ill-effects of this thriving international used car trade are overshadowed by the glitz of the new vehicles across the world that are constantly adding to the already inflated global fleet of 2 billion. “The market for used cars exists because developed countries want their industry to thrive and ensure market for used cars to promote uptake of new cars. And developing countries want access to affordable cars,” says Muitungu Mwai, principal compliance and monitoring officer and in-charge of air quality section at Kenya’s National Environment Management Authority.


The scale of dumping from the rich countries to the poor is overwhelming. Back in 2014, it was estimated that globally about 40 million vehicles a year approach their end-of-life, which is 4 per cent of the total global automobile ownership. A lot of these get traded to low-and middle-income countries. This number is expected to explode as the global automobile fleet is slated to double by 2050 on the back of growing economy and aspirations for four-wheelers, estimates the International Energy Agency.


A 2014 World Bank estimate shows that the vehicle ownership rate in Africa, though much lower than the world average, is rapidly increasing across cities. In Kenya’s capital city Nairobi, car fleet has doubled in the past six years. While Addis Ababa saw a 6.6 per cent increase in its car fleet in 2015 alone, Lagos is expected to see an 80 per cent increase in vehicle numbers from the current level in the near future. Sadly, this meteoric increase in car fleets in most African and South Asian cities is fuelled by old imported vehicles. According to the Deloittee Africa Automotive Report 2016, as much as 90 per cent of the new sales in Nigeria in 2015 were second-hand vehicles. In Ethiopia and Kenya, the share of second-hand vehicles in 2015 was 85 and 80 per cent, respectively. The countries of Africa and Asia are thus becoming scrapyards of the world.

The worst polluters

Besides congesting the roads, the old vehicles also emit enormous pollution on roads, posing serious health concerns. Already, the “State of Global Air 2018”, has shown that North Africa has the highest concentration of population weighted annual average particulate matter; Nigeria is in the lead. Several cities of Africa are violating the World Health Organization (WHO) guidelines by several times. South Asian cities have some of the worst air pollution episodes.


Vehicles are responsible for one of the greatest exposure to toxic emissions. A 2015 study by non-profit International Council on Clean Transportation (ICCT) has projected that the high emitters, which include old cars, can become the largest contributor of particulate matter emissions globally by 2020 especially from Asia, Africa and Latin America. As new vehicles become substantially cleaner the older fleet becomes disproportionately responsible for high emissions. Old vehicles have outdated power train technologies that are high on fuel consumption and carbon dioxide (CO2) emissions. There are concerns around the safety of old cars. Efosa Peter Osawe, a safety engineering officer with Nigeria’s Federal Road Safety Corps, says their analysis has found that most road accidents involve old and used imported cars.


How clunkers flow?

Even though the global trade in used vehicle is substantial, the international trade data is not maintained separately for old and used vehicles. The International Trade Organization shows that African countries import vehicles from over 17 high-income countries spread across continents. Of them, Germany, Japan, the       US and South Korea are responsible for the lion’s share of the fleet. In South Asia, vehicles largely flow within the contiguous regions of Asia with the biggest exporters being Japan, China and India.


Vehicles change several hands even within the domestic markets of exporting countries. Consulting firm Ricardo-AEAT estimated in 2015 that in the European Union (EU), 94 per cent of the cars have a second life, 87 per cent have a third life and about 27 per cent have a fourth life. Experts say that vehicles that are less than four years old and have substantial economic life left may be traded, but in practice, vehicles that are nearing their end-of-life or are damaged are also sent to low-income countries.


Why this dumping?

It is a no brainer that poorer the country higher is the average age of vehicles. The average age of a car is less than eight years in developed countries, whereas it is 12-17 years in Africa and South Asia. Owing to strict regulations in developed countries, says a 2017 United Nations Environment Programme (UNEP) background paper on used vehicles, second-hand vehicles have poor domestic value in developed countries, and as a result, are exported to countries with lax regulations. For example, in Japan, after a vehicle turns three years old, it must get an inspection every two years under its fitness programme, which is expensive. So, many vehicle owners in Japan sell vehicles after five or seven years of usage and most of these second-hand vehicles find their way into low-income countries.


Disposable fleet of older vehicles will continue to increase as stricter regulations are adopted in high-income countries including end of life regulations, low emissions zone programmes, diesel car bans, and stricter emissions inspection programmes. What makes this dumping easy is the fact that in most African and South Asian countries, emission standards for vehicles and fuel quality are lax. While 11 countries in South and East Africa have adopted cleaner 50 parts per million (PPM) sulphur fuels, the rest are still using from 500 PPM to upto 10,000 PPM sulphur fuel. Without the requisite fuel quality, the region cannot improve emissions standards for import of used vehicles.


There are even anecdotal evidences of yards in Japan, Europe and West Asia where advanced emissions-control systems are removed from the vehicles before exporting them to Africa. In contrast, in South Asia, vehicle importing countries like Nepal. Bhutan, Bangladesh and Sri Lanka, have adopted cleaner Euro II and Euro III standards for vehicles and they largely source vehicles from within Asia where exporting countries like Japan have progressed considerably, while India and China have also improved their emissions standards. This has helped the region to improve the overall stock.













ITS TRYING times for both the government and people. Despite appeals, fines, a Supreme Court order and a Central government scheme that offers stubble management machines at subsidized rates, crop residue burning continues across Punjab and Haryana, choking Delhi and enveloping the entire northern India with dense toxic smog. In fact, instances of stubble burning are also increasing in parts of central and southern India (see ‘Fields on fire’, Down To Earth, 16-31 May, 2017). Farmers say they set fire to the farmland after harvest as it is cheaper than clearing the crop residue manually or by using machines. The practice is rampant across rice-growing belts as paddy straw is neither considered a suitable fuel nor cattle feed.


Now three graduates from the Indian Institute of Technology, New Delhi, have developed a machine that can incentivise farmers to uproot stubble. The machine, developed by Ankur Kumar, Kanika Prajatat and Pracheer Dutta, converts the hardy straw of paddy into a fibrous raw material that can be used by pulp moulding factories to prepare disposable cutlery. Paddy straw is rich in silica, which slows down its rate of degradation. “Our machine uses an eco-friendly chemical that can strip the straw of silica, making it supple and usable,” says Kumar. He refuses to divulge details of the chemical, saying their start-up Kriya Lab is still in the experimental stage. However, they claim the machine can covert one tonne of paddy straw into 500 kg of pulp, which can then be sold at `45 per kg.


A back-of-the-envelope calculation shows that farmers can earn about `5,000 by selling the pulp made from an acre (0.4 ha) of straw. The trio are confident the machine can be used to stat commercially viable ventures as following government restrictions and bans on the ubiquitous plastic, there is a growing demand for eco-friendly cutlery and packaging materials, particularly the ones made from biomass waste.


Riding on bagasse and millets

The growing market for sustainable home goods in India had caught the attention of Rhea Singhal, a young graduate in pharmacology, when she relocated to Delhi from the UK after her stint as a senior sales executive at pharmaceutical major Pfizer.


“India does not have a culture of waste management. Plastic is cheap and therefore the most used material for disposable cutlery. So in 2009, when I started Ecoware, my aim was to also challenge people’s mindset and plastic’s monopoly,” says Singhal, whose start-up uses farm waste to prepare disposable tableware. With 27 distributors across the country, Ecoware’s annual turnover has now touched about `10 crore.


In Mumbai, PAPPCO Greenware manufactures disposable tableware using a variety of biomass waste, which include sugarcane bagasse, bamboo fibre and wheat straw. “We source the raw materials from across India as well as from Thailand,” says Abhishek Agarwal, founder of PAPPCO Greeware. “Within the country, our products are regularly bought by food chains and restaurants like Burger King, Starbucks, McDonald’s and five star hotels like Marriott and Hilton. We also export our products to Dubai, Portugal, Sri Lanka and parts of West Africa,” he says, adding that the company has grown 10 folds since it was established seven years ago.


Taking the concept of eco-friendly cutlery to another level, Hyderabad-based Bakeys Foods Private Limed sells “edible cutlery”. “We make our cutlery with dough made from a mixture of sorghum, rice and wheat flours, kneaded with hot water and baked in moulds,” says Narayana Peesapaty, a former researcher with the International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), who started the company in 2010. “We make spoons of three varieties–savoury, sweet and plain,” he adds. Bakeys’ website claims the company plans to expand its product portfolio by introducing edible forks, soup, dessert and yogurt spoons and even crockery.


But not everybody is getting carried away by the concept. “Eco-friendly glass costs upwards of `10 while I can buy a plastic one just for `2,” says Akankshya Padhi, a college student in Delhi. “Though I am against plastic pollution, the cost of green products is prohibitive for students who operate on a meager budget of less than `100 per day,” she says. Singhal admits that the immediate cost of eco-friendly disposable cutlery is higher when compared with plastic. But people must consider the health and environmental benefits of such products while buying them, she says.


A change is in the air, and it’s only a matter of time before eco-friendly cutleries stop being the alter-native and become the default choice instead. The trend became evident in June this year when Maharashtra enforced a ban on plastic. Soon, food delivery companies Swiggy and Zom-ato added an option to their database which allows users to refuse disposable plastic cutlery. Swiggy has, in fact, launched an initiative that connects restaurants with makers of eco materials. As a major impetus to the change, the Indian Railway Catering and Tourism Corporation has embarked on a project to replace its plastic cutlery with cups and plates made of biodegradable material in all premium trains.

















ON OCTOBER 25, 120 UN member countries signed the Astana Declaration, vowing to strengthen primary healthcare and achieve universal health coverage by 2030. This is the second time the world took this pledge. In 1978, 134 nations signed the Alma-Ata Declaration with the same pledge. The reason behind the need for reaffirmation is clear–the world has failed to meet the targets set 40 years ago. Though Alma-Ata was signed to ensure health for all, its progress was uneven, with several countries missing out on several indicators set under the declaration. While the Americas, Europe and Western Pacific countries performed well, according to papers presented at the Astana conference, South Asia and Africa lagged.


The reason, as the 2006 World Health Report indicates, was the needs-based shortages in primary healthcare, which was the highest in sub-Saharan Africa (SSA). The report identified 57 countries, mostly in SSA, that had less than 23 health professionals, including doctors, nurses and mid-wives, per 10,000 people. As a result, 80 per cent of basic maternal and child health services could not be provided and the world failed to meet one of the main thrusts of Alma-Ata, which was reproductive health. Shortage of funds also affected the progress of this indicator. A poll conducted among the participants at Astana revealed that 59 per cent of the countries spend only 19 per cent of their national health budget on sexual, reproductive, maternal, new-born, child and adolescent healthcare. The positive feedback of the poll was that in 29 per cent countries, 60 to 69 per cent of women opt for institutional delivery.


Missing the mark

David Sanders, professor emeritus and founder director of the School of Public Health at the University of the Western Cape in South Africa, cites a fundamental problem in the approach to this global pledge. “It has been mediocre because of political and economic reasons. This is because of the lack of a new economic order to address inequities, which determine access to nutrition, safe drinking water and sanitation. These, in turn, reflect on the health of a population. As adequate policies were not framed to address these issues, Alma-Ata could not be implemented,” Sanders says. He also criticized its implementation. “The way many countries implemented it is also very problematic. Governments are using public money to rope in the private sector in the name of insurance,” Sanders adds.


K Srinath Reddy, head of New Delhi-based non-profit Public Health Foundation of India attributes the failure of Alma-Ata to donor-driven agenda. “These focused on specific health issues, forcing recipient nations to abandon their commitment to the Alma-Ata on overall comprehensive primary healthcare,” he says.


Down To Earth’s analysis of three indicators (see infographs) agreed upon at Alma-Ata also shows poor performance. Though globally, almost 80 per cent of live births occurred with the assistance of skilled health personnel between 2012 and 2017, disparities exist within regions. For instance, in more than 18 African countries, children were born without the presence of skilled attendants in 35 per cent of cases while only Guatemala in the Americas recorded this. Regarding health spending, the governments of 22 countries in Europe spend 5 per cent of their GDP on health. While South East Asia spent 3.5 per cent in 2015, the East Mediterranean region spends just 1.6 per cent of the global health spending for 8.7 per cent of the world’s population. Some countries have performed well in all the six World Health Organization regions. “In South East Asia, Sri Lanka and Thailand; in Eastern Medite-rranean, Iran and Qatar; and, in the Americas, Canada, Brazil and several Caribbean countries have done well,” says Reddy.


Looking forward

Though Astana is a step forward, a statement released by the Peoples’ Health Movement, an international non-profit based in South Africa, shows it is still lacking n several fronts. It says that Astana views primary healthcare as just a corner-stone for Universal Health Coverage even though it is a much broader concept. Though the Astana Declaration recognizes the risk factors for premature deaths and non-communicable diseases and attributes them to both human-made and natural causes, nowhere does it recognize the economic and political reasons responsible for these.


A report, The Astana Declaration: the future of primary health care? Published in The Lancet on October 20, 2018 says, “As populations age, and multimorbidity becomes the norm, the role of primary health-care workers becomes ever more important,” it concludes by saying that leadership after the Astana pledge is essential to rejuvenate all the aspects of primary healthcare.
























INDIA IS riding high on the agricultural success story it has written over the past few years. Record-breaking food-grain production was registered in seven years in the past decade. From 217 million tonnes in 2006-07, the country’s production jumped to 275.11 million tonnes in 2016-17. Three years of drought, in 2009, 2014 and 2015, did not really bring production down. The government proudly concluded that the country was not only self-sufficient, but had enough to export.


It was, therefore, disturbing that the country had recorded a very high number of famer suicides and an equally high number of farmer protests in the past two decades. Between 1991 and 2011, over 14 million financially stressed farmers quit farming.


Those who had been on an express agricultural drive, were misled into believing that their efforts were futile as the country’s production was surplus. There was price crash in the foodgrain market which forced them to sell food at throwaway prices, or just let them rot.


The fact that farmers were dumping their produce helped the government build its narrative on self-sufficiency and surplus agricultural production. Media reports and experts advocated for export of foodgrains and for setting up of more processing units to manage surplus foodgrain. India also proudly claims to be a net exporting country. This means, it exports more than it imports.


Government claims trashed

Data shows that the country barely has enough to feed its own people, let alone be self-sufficient or a net exporter. The country is home to 270 million hungry people, the highest in the world. India stands 97th in Oxfam’s Food Availability Index, and 103rd in the 2018 Global Hunger Index.


A country can be called self-sufficient only when it produces enough to meet its domestic needs. The Food Agriculture Organization has created three levels of self-sufficiency–below 80 per cent, indicating food deficit; between 80 and 120 per cent, indicating self-sufficiency; and, above 120 per cent, meaning surplus. India shows self-sufficiency, and joins the second group which includes China, the United Republic of Tanzania and Bolivia.


Government’s own data shows that the country is not self-sufficient. Ramesh Chand, ember of NITI Aayog, predicted a demand of 257.70 million tonnes in 2016-17. Chand was part of a working group of the Union Ministry of Agriculture which gave a detailed report on the demand and supply balance from 2012 to 2017. The government could claim to have surplus production if it produced more than that. The country produced 275.11 million tonnes more than the assessed demand, not enough to meet the demand during drought.



Export in times of hunger

Let’s analyse the government’s claim of being a net exporting country in agricultural produce. The country exported 20.4 million tonnes of agricultural produce in 2015-16, and 22.3 million tonnes in 2017-18. It imported 8.1 million tonnes in 2015-16 and 9.4 million tonnes in 2017-18, shows the agriculture ministry data. On the face of it everything seems time, but the country has been importing food grains on a large scale. Foodgrain imports indicate how insufficient the country is in staple food production. In 2015-16, foodgrains accounted for 79 per cent of the imported agricultural produce; the figure was 78 per cent the following year.


Large-scale import of wheat in 2016 is often attributed to drought years. But there has been large-scale import of edible oil and pulses as well in the past two decades.


Several parts of the country are still starved of rice, wheat and pulses. “Our tag of a net exporting country would be lost if the government decides to feed all its hungry people,” says Devinder Shanna, an agriculture policy analyst. Food availability per person has remained stagnant for the past many decades (see ‘Food availability stagnant’ p18). The Economic Survey 2018 annual report states that the net availability of foodgrains is 487 grams per person per day. Way back in 1961, the per capita availability of foodgrains was 468.7 grams, while in 1971 it was 468.8 grams. This dipped to 454.8 grams in 1981. Net availability did increase to 510 grams per person per day in 1991, but could never rise above that.


In 1991, the per capita foodgrain availability per annum was 186.2 kg and 177.7 kg in 2016. Between 1903 and 1908, the net availability of foodgrains was 177.3 kg. These historically low figures are reminders of the times of British rule in India that witnessed similar food availability.


In contrast, in 2015, China’s foodgrain availability per capita was 450 kg, 200 kg in Bangladesh and more than 1,100 kg in US.


Nutritionally starved

As food accessibility did not improve over the years, untraditional intake remained disappointing. In 2011-12, there was 30 per cent gap in the actual and the recommended dietary energy intake of people living in rural India. That year, the gap was 20 per cent in urban areas.


The gap exists despite the country’s per capita income having increased almost 1,400 times times–from `6,270 in 1991 to `93,293 in 2016. But the purchasing power of people has reduced, says Arun Kumar, who teaches economics at the Jawaharlala Nehru University (JNU). This is because of the absence of investments in the unorganized and the agriculture sectors. “In the last two decades, only 10 per cent of the country’s investment as in the agriculture sector despite 50 per cent of the rural workforce engaged in agriculture,” he adds.


Between 1993-94 and 2011-12, the mean calorie intake increased among the low income group. However, there was decline in the calorie intake among the rich households According to Chand, the increase in calorie consumption among the poor denotes improved access to food. He attributes the decline in calorie intake among the rich to changing food habits and increase in health consciousness.


“The government and a majority of the academia attribute undernourishment to diversification of the basket of consumption. That’s not true,” says Utsa Patnaik, professor emeritus, JNU. The decline in foodgrain absorption is due to the continuous decline in people’s purchasing power, she says.


Praduman Kumar, retired economics professor, the Indian Agricultural Research Institute, New Delhi cereals to severe under-nourishment. “Three-fourths of the nutrition comes from cereals and pulses. The decline in cereal consumption did not adequately compensate the increase in consumption of horticultural and livestock products,” he says. In the face of nutritional deficiency and hunger, it is worrisome that the country’s focus has shifted from farming to imports.













JUST THREE months after she was moved to her new home, officials have decided to put Sundari behind bars,. A tigress from Madhya Pradesh’s Bandhavgarh Tiger Reserve, Sundari was shifted to Satkosia Tiger Reserve (STR) in Odisha to boost the reserve’s tiger population. Within two months of being trans-located, she made her first human kill. In the month that followed she killed one more person and injured four.

On July 26, Sundari arrived at her new home under India’s first interstate tiger translocation project. But the way the project was handled shows gross mismanagement on part of the Odisha Forest and Environment Department. “Officials did not inform us about her presence in the area,” complains Rama Pradhan of Kumuri village inside STR. “We got to know about Sundari from media reports only after she made her first kill on September 12,” he adds.

The process of tiger translocation is governed by the “Protocol for Tiger Re-introduction”, framed by the National Tiger Conservation Authority (NTCA), a body to manage and conserve tigers, under the Union Ministry of Environment, Forest and Climate Change (MOEF&CC). NTCA adopted the protocol from the International Union for Conservation of Nature (IUCN) guidelines for the same. The protocol emphasizes on the acceptance o the translocation by the local community. It states that a team of experts from the Wildlife Institute of India (WII), forest department of the state, a qualified veterinarian and a qualified wildlife biologist should evaluate the socioeconomic impact of the translocation on the people in the area. “A thorough assessment of attitudes of local people to the proposed project is necessary to ensure long term protection of the reintroduced population, especially if the cause of species’ decline was due to human factors (e.g. overhunting, over-collection, loss or alteration of habitat). The programme should be fully under-stood, accepted and supported by local communities,” the protocol states.

The Odisha forest department did not follow this protocol while trans-locating Sundari to STR. Suvendu Behera, assistant conservator of forest, STR, and one of the officials responsible for the translocation, is not even aware that the department needs to undertake a socio-economic evaluation. “We did not undertake such a study because there is no provision for it in the process. We did talk to a few people in the peripheral villages such as Tulka, Bhuska and Raiguda, and they were fine with the translocation,” he told Down To Earth (DTE). However, his senior, Sudarshan Panda, the state’s additional principal chief conservator of forests, maintains that the protocol was followed in STR. “All its aspects were carefully examined, not just by the forest department, but by NRCA, WII, MOEF&CC and the Madhya Pradesh government,” Panda told DTE. Behera, however, acknowledges that people have been protesting against the translocation after it happened.

A day after Sundari made her first kill in Hathibada village of Angul district, pro-testers set the Hathibada forest guest house on fire and destroyed two vehicles. The forest department estimates that the protest resulted I damage of property worth `50 lakh.
Fumbled approach
Sundari was shifted after the Odisha forest department asked NTCA for three pairs of Royal Bengal Tigers in September 2016. As per an estimate by the department, there were just two tigers in STR in 2016, down from 12 in 2007, when STR was declared a protected area. NTCA gave the approval in October 2017.

“Translocation of tigers is justified only if, one, there is sufficient data to show that adequate prey density exists; two, tigers are either absent or well below carrying capacity densities as shown by data; three, there is no chance of wild tigers colonising the area naturally with adequate protection; four, the introduced tiger is not captive bred but is caught in the wild and is capable of hunting prey; and five, the introduced animals are radio-collared and tracked so that they can be shot or recaptured the moment there is problem,” says K Ullas Karanth, director, Centre for Wildlife Studies, a non-profit based in Bengaluru. “I am not aware of all details of this case, but it looks like only the fourth condition was met (in STR),” he adds.

STR is unique in many ways. As per a Right To Information reply received by Angul-based non-profit People for Animals in 2017, of all the 80 tiger reserves in the country, STR has the highest number of habitations–116 villages inside the protected area. The Scheduled Tribes and Other Traditional Forest Dwellers (Re-cognition of Forest Rights) Act, 2006, or FRA, says that rights of forest-dwelling communities must be settled before declaring a forest a protected area. But NTCA declared Satkosia a tiger reserve without settling any rights.

While on one hand, STR has a large human population, on the other, it has a low prey base. “The prey base in STR is much lower than other reserves and it does not even have enough levelled areas for tigers to chase preys,” says Biswajit Mohanty, former member of Odisha State Board for Wildlife.

On October 29, the forest and environment minister of Odisha, Bijayshree Routray, declared that Sundari will be sent to the Nandankanan Zoological Park in Bhubaneswar. A team of forest department officials and WII scientists has been trying to capture her since then. “The tigress is roaming in bushy areas, making it difficult to administer the tranquilliser. Therefore it has taken us so long,” Ramaswamy P, divisional forest officer of Satkosia wildlife division told DTE. But this does not answer why Sundari was shifted without adequate preparation. While Bandhavgarh has lost a tigress, Satkosia has not gained one.