Is sustainable growth rate of Gross Domestic Product (GDP) intertwined with public health, human capital and human development, or each one of these deserves to be seen and analyzed in isolation? Or, is there a discord between India’s GDP growth rate, and various published indices of its public health, human capital and human development?
This important issue, which has various facets and dimensions, such as, social, economic, education and health, needs to be debated widely. However, in this article, I shall try to address this question only from the public health perspective.
It is a generally accepted fact that GDP growth rate, at any given point of time, is just one of the primary indicators, and not the sole indicator, to gauge the real health of any country’s economic ground realities. Nevertheless, considering its time-tested importance, one can well understand why India’s key focus is now primarily on boosting the rate of GDP growth of the nation.
To translate this core objective into reality, the Government in power, almost single-mindedly and quite commendably, is actively engaged in various well publicized campaigns, such as, ‘Make in India’, several basic infrastructure developments, and attracting more Foreign Direst Investments (FDI) into the country.
High GDP growth and the general well-being of a nation:
The above initiatives are indeed praiseworthy. However, according to experts’ reports, though GDP growth presents a good first approximation of economic well being of a country for international comparisons, it ignores many basic and critical factors of the general well-being of a nation.
For that reason, there is a need to deliberate whether the pursuit of achieving a sustainable high GDP growth of India is in sync with a commensurate improvement in the indices of human development and human capital, where health stands out as one of the most critical common factors.
Some key parameters to assess the ground reality:
To properly assess the ground reality of the general well being of a country, such as India, at least, the following important parameters should be looked at together, and not in isolation:
- GDP growth: It’s a rate at which a nation’s Gross Domestic product (GDP) changes/grows from one year to another.
- Human Development Index (HDI): It is a tool developed by the United Nations to measure and rank countries’ levels of social and economic development based on the health of people, their level of education attainment and standard of living.
- Human Capital Index (HCI): It measures countries’ ability to nurture, develop and deploy talent for economic growth. One of the most significant parameters, that is effective in human capital performance, is the role of individual health, and its related indices in enhancing the economic level of a country, besides the investment in individuals’ education. Among health features of a society, high life expectancy, low death rate in children, healthy nutrition, degree of medical advancements, the costs that the government or the family incur for the health sector and low-cost services before birth, are considered most important.
It is worth noting, both in HDI and HCI, public health stands out as one of the most critical common factors.
A discord in India:
Keeping this in perspective, in my view, a huge discord does exist in India between HDI, HCI and the GDP growth.
High GDP growth:
All Government initiatives backed by favorable international prices of, especially, crude oil and commodities have enabled India to record the highest GDP growth of around 7.5% in 2015, as against estimated 0.5% of Brazil, -3.8% of Russia, 6.8% of China and around 1% of South Africa among the BRICS countries, in the same period.
However, according to the World Economic Forum (WEF), India has the lowest per capita GDP of US$ 5,238 among the other members of the bloc and is also lagging behind the other BRICS economies in terms of quality of life.
It is a different matter though, many experts, including a prominent member of the ruling party, are not quite convinced with India’s high GDP growth numbers.
Low Human Development Index (HDI):
According to the 2015 Human Development Index (HDI) report, recently released by the United Nations Development Program (UNDP), India occupies 130th position among 188 countries.
Among BRICS nations, Russia ranks 50, Brazil 75, China 90, South Africa 116. While among India’s neighboring countries, Sri Lanka occupies rank 73, China 90, Bhutan 132, Bangladesh 142, Nepal 145, Pakistan 147 and Afghanistan 171.
Low Human Capital Index (HCI):
According to the 2015 HCI report released by Geneva based World Economic Forum (WEF) earlier this month, India occupies105th rank out of the total 130 countries included in the index.
Among the BRICS countries, India ranks at the bottom, as against Russia’s 28th, China’s 71st, Brazil’s 83rd and South Africa’s 88th. Among the neighboring countries, even Bangladesh, Bhutan and Sri Lanka are also placed higher on the index, besides China.
Public health is the common denominator:
As I said before, for all the three – GDP growth, HDI and HCI, the health of the population is the common denominator, which no nation can possibly afford to ignore for a sustainable and high rate of GDP growth.
An article titled, “Health and the economy: A vital relationship”, published in the ‘OECD Observer’ also underscored that health care performance is strongly dependent on the economy, but also on the health systems themselves. This link should not be underestimated.
Such expert recommendations, by all means, create a high priority situation, which needs to be addressed with commensurate well thought-out policy measures, backed by adequate budgetary support.
India is still a laggard in public health standards:
Leave aside the developing nation or BRICS countries, even some much smaller neighboring nations continue performing far better on some critical health indicators than India.
In fact, the World Bank health indicators’ data show that even Bangladesh, Nepal and Vietnam, with much lesser per capita GDP are ahead of India in several key health indicators, as shown in the following table:
| Some Key Indicators | India | Bangladesh | Nepal | Vietnam | |
| GDP Per capita(PPP) (Constant at 2011 US$) 2014 | 5445 | 2981 | 2261 | 5370 | |
| Life Expectancy At Birth (Female) 2013 | 68 | 71 | 70 | 80 | |
| Survival to Age 65 (% of Cohort) 2013 | 63 | 72 | 69 | 72 | |
| Public Health Expenditure (% of GDP) 2013 | 1.3 | 1.3 | 2.6 | 2.5 | |
| Infant Female Mortality Rate/1000 of Live Birth 2015 | 38 | 28 | 27 | 15 | |
| Mortality Rate (Under 5 year of Live Births) 2015 | 48 | 38 | 36 | 22 | |
| Maternal Mortality Ratio (per 1000 Live Births) 2013 | 190 | 170 | 190 | 49 | |
| Rural Population With Improved Access to Sanitation Facilities (%) 2015 | 29 | 62 | 44 | 70 | |
| Vitamin A Supplementation Coverage Rate (% of Children 6-59 months) 2013 | 53 | 97 | 99 | 98 | |
| Immunization DPT (% of Children 12-23 month) 2014 | 83 | 95 | 92 | 95 | |
| (Source: Live Mint, October 28,2015) | |||||
Similarly, another 2011 study published in the ‘The Lancet’ reported that Out of Pocket expenditure on health in India is the highest, as compared to its much smaller neighbors, as follows:
| Country | Out of Pocket expenditure on health (%) |
| Maldives | 14 |
| Bhutan | 29 |
| Sri Lanka | 53 |
| India | 78 |
Intriguingly, this overall dismal public health situation continues to remain unchanged even today, despite well hyped high GDP growth rate of India.
Conclusion:
For a sustainable and high economic growth, if public health also becomes one of the top priority areas of the country, it would get reflected in India’s commensurate higher ranking in both HDI and HCI, as well, highlighting the general well-being of the nation.
Thus, just a single minded valiant chase in pursuit of registering high GDP growth, in isolation, may not necessarily mean significantly more job creation, and attaining world-class public health standards in India.
To ensure all-round well being of the general population of India, a well integrated and comprehensive strategic roadmap, with public health included in it, I reckon, would prove to be more meaningful.
This approach would also help resolve the prevailing discord between high GDP growth, low Human Development Index (HDI) and low Human Capital Index (HCI), where public health clearly emerges as the common denominator.
By: Tapan J. Ray
Disclaimer: The views/opinions expressed in this article are entirely my own, written in my individual and personal capacity. I do not represent any other person or organization for this opinion.