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An Uncertain Glory: India and its Contradictions Hardcover – Illustrated, August 11, 2013
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Why India's problems won't be solved by rapid economic growth alone
When India became independent in 1947 after two centuries of colonial rule, it immediately adopted a firmly democratic political system, with multiple parties, freedom of speech, and extensive political rights. The famines of the British era disappeared, and steady economic growth replaced the economic stagnation of the Raj. The growth of the Indian economy quickened further over the last three decades and became the second fastest among large economies. Despite a recent dip, it is still one of the highest in the world.
Maintaining rapid as well as environmentally sustainable growth remains an important and achievable goal for India. In An Uncertain Glory, two of India's leading economists argue that the country's main problems lie in the lack of attention paid to the essential needs of the people, especially of the poor, and often of women. There have been major failures both to foster participatory growth and to make good use of the public resources generated by economic growth to enhance people's living conditions. There is also a continued inadequacy of social services such as schooling and medical care as well as of physical services such as safe water, electricity, drainage, transportation, and sanitation. In the long run, even the feasibility of high economic growth is threatened by the underdevelopment of social and physical infrastructure and the neglect of human capabilities, in contrast with the Asian approach of simultaneous pursuit of economic growth and human development, as pioneered by Japan, South Korea, and China.
In a democratic system, which India has great reason to value, addressing these failures requires not only significant policy rethinking by the government, but also a clearer public understanding of the abysmal extent of social and economic deprivations in the country. The deep inequalities in Indian society tend to constrict public discussion, confining it largely to the lives and concerns of the relatively affluent. Drèze and Sen present a powerful analysis of these deprivations and inequalities as well as the possibility of change through democratic practice.
- Print length448 pages
- LanguageEnglish
- PublisherPrinceton University Press
- Publication dateAugust 11, 2013
- Dimensions6.47 x 1.29 x 9.38 inches
- ISBN-100691160791
- ISBN-13978-0691160795
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Editorial Reviews
Review
"It's an urgent, passionate, political work that makes the case that India cannot move forward without investing significantly--as every other major industrialized country has already done--in public services. . . . This book is . . . a heartfelt plea to rethink what progress in a poor country ought to look like."---Jyoti Thottam, New York Times Book Review
"Sen and Drèze carefully explain such issues as health care, education, corruption, lack of accountability, growing inequality, and their suppression in India's elite-dominated public space. . . . Sen and Drèze also reveal how democracy in its simplest manifestation, the scramble for votes, can drive successful implementation of welfare programs such as the Public Distribution System."---Pankaj Mishra, New York Review of Books
"After three decades of trawling the data compiled by central and state governments, Indian nongovernmental organizations, and international bodies, these longtime collaborators know--possibly better than any other commentators--how Indian governments since the 1980s have failed the vast majority of Indians, especially in health care, education, poverty reduction, and the justice system."---Andrew Robinson, Science
"[A]n excellent but unsettling new book." ― The Economist
"[E]legant and restrained prose, and with an array of fresh examples."---Ramachandra Guha, Financial Times
"Sen and Dreze are right to draw attention to the limits of India's success and how much remains to be done. They are exemplary scholars, and everything they say is worth careful study."---Clive Crook, Bloomberg News
"Economists Dreze and Nobel laureate Sen compellingly argue that Indian policy makers have ignored the basic needs of people, especially those of the poor and women." ― Choice
"An Uncertain Glory is an excellent, highly readable, and exceptionally meaningful book."---S. Prakash Sethi, Business Ethics Quarterly
Review
"This important book provides a comprehensive and probing analysis of the Indian economy and its enormous potential. What makes this such an engaging book is that it is a deeply sympathetic and, for that very reason, a deeply critical evaluation of contemporary India. The book's combination of economics, politics, history, and law makes it a fascinating read."―Kaushik Basu, chief economist of the World Bank
From the Inside Flap
"India is a great success story of economic growth and poverty decline, but it remains the home of global poverty, and half of its children are profoundly malnourished. This paradox of poverty and plenty poses one of the great intellectual and moral challenges of the day. We can ask for no better guides to it than a philosopher and an activist, both distinguished economists, and both with unparalleled knowledge of India's glories and its shames."--Angus Deaton, author ofThe Great Escape: Health, Wealth, and the Origins of Inequality
"This important book provides a comprehensive and probing analysis of the Indian economy and its enormous potential. What makes this such an engaging book is that it is a deeply sympathetic and, for that very reason, a deeply critical evaluation of contemporary India. The book's combination of economics, politics, history, and law makes it a fascinating read."--Kaushik Basu, chief economist of the World Bank
From the Back Cover
"India is a great success story of economic growth and poverty decline, but it remains the home of global poverty, and half of its children are profoundly malnourished. This paradox of poverty and plenty poses one of the great intellectual and moral challenges of the day. We can ask for no better guides to it than a philosopher and an activist, both distinguished economists, and both with unparalleled knowledge of India's glories and its shames."--Angus Deaton, author ofThe Great Escape: Health, Wealth, and the Origins of Inequality
"This important book provides a comprehensive and probing analysis of the Indian economy and its enormous potential. What makes this such an engaging book is that it is a deeply sympathetic and, for that very reason, a deeply critical evaluation of contemporary India. The book's combination of economics, politics, history, and law makes it a fascinating read."--Kaushik Basu, chief economist of the World Bank
About the Author
Excerpt. © Reprinted by permission. All rights reserved.
An Uncertain Glory
India and Its Contradictions
By JEAN DRÈZE, AMARTYA SENPRINCETON UNIVERSITY PRESS
Copyright © 2013 Jean Drèze and Amartya SenAll rights reserved.
ISBN: 978-0-691-16079-5
Contents
Preface....................................................................vii1 A New India?.............................................................12 Integrating Growth and Development.......................................173 India in comparative Perspective.........................................454 Accountability and Corruption............................................815 The Centrality of Education..............................................1076 India's Health Care Crisis...............................................1437 Poverty and Social Support...............................................1828 The Grip of Inequality...................................................2139 Democracy, Inequality and Public Reasoning...............................24310 The Need for Impatience.................................................276Statistical Appendix.......................................................289Table A.1: Economic and Social Indicators in India and Selected AsianCountries, 2011............................................................292Table A.2: India in Comparative Perspective, 2011..........................296Table A.3: Selected Indicators for Major Indian States.....................298Table A.4: Selected Indicators for the North-Eastern States................330Table A.5: Time Trends.....................................................332Notes......................................................................337References.................................................................373Indexes....................................................................413
CHAPTER 1
A New India?
'O, how this spring of love resembleth/The uncertain glory of anApril day,' says Proteus in The Two Gentlemen of Verona. The recentachievements of modern, democratic India are not inconsiderable,and have been widely recognized across the globe over the last decadeor more. India's record in pioneering democratic governance in thenon-Western world is a widely acknowledged accomplishment, as isits basic success in maintaining a secular state, despite the challengesarising from its thoroughly multi-religious population and the hugelyproblematic history of violence around the ending days of the Raj. Tothis can be added the achievement of rapid economic growth in thelast decade, when India became the second fastest-growing largeeconomy in the world.
And yet – despite these great achievements – if the much talked-aboutglory of today's India is deeply uncertain, it is not because anunblemished sunny day stands in danger of being ruined by a freshlyarriving shower, as was feared by Proteus of Verona. The uncertaintyarises, rather, from the fact that together with the sunshine, there aredark clouds and drenching showers already on the scene. It is importantand urgent that we try to evaluate both the achievements and thefailures that characterize India today. To what extent have India's oldproblems been eradicated? What remains to be done? And are therenew problems that India has to address?
In historical perspective, the accomplishments are large indeed,especially in light of what the country was at the time of independencein 1947. India emerged then from an oppressive colonial rule,enforced by dogged imperial rulers; there was little devolution of realpower until the British actually left, and it was not unnatural at thattime to doubt India's capacity to run a functioning democracy. Asecond challenge was to avoid the danger of chaos and conflict, oreven a violent break-up of the country. There is a long history – stretchingover thousands of years – of cultural affinities across India,and the struggle for independence generated a great deal of popularunity. And yet the diversities and divisions within India – of many languages,religions, ethnicities – gave sceptics good reason to worry aboutthe possible break-up of the country in the absence of authoritarianrule. More immediately, the chaotic partitioning of pre-independentIndia into two countries – India and Pakistan – gave justified cause foranxiety about whether further violent splintering might occur.
Supplementing and in some ways overshadowing all these concerns,the poverty of India was perhaps the most well-known factabout the country – with little children in Europe and America beingasked by their parents not to leave food on their plates because of themoral necessity to 'think of the starving Indians'. And indeed, in 1943,just four years before colonial rule ended, India did actually have agigantic famine in which between 2 and 3 million people died.
India had not always been a symbol of poverty and hunger – farfrom it – and we shall turn, in the next chapter, to the question of howthe country became so poor. What is not in doubt is that the economyof British India was remarkably stagnant, and that living conditionsaround the time of independence were appalling for a large proportionof the Indian population, and not just in famine years.
ACHIEVEMENTS AND OPPORTUNITIES
Despite that grim beginning, newly independent India rapidly wenton to have a cluster of significant political and economic successes. Itsbold decision to go straight from centuries of colonial rule to resolutelydemocratic government, without a pause, has proved to besound and sustainable. In India as in other democratic countriesaround the world, democracy in the full sense of the term (that of'government of the people, by the people, for the people') has notbeen achieved, and there remain many gaps to fill in Indian democracy.1 Nevertheless, after more than sixty years of largely successfuldemocratic governance, India has earned its status as a leading democraticcountry. The army has not moved to take over civilian affairs ashas happened in many newly independent countries in the world – notleast in South Asia. The country has also shown quite powerfullyhow democracy can flourish despite a multitude of languages, religionsand ethnicities. There are, it must be noted, confined departuresfrom democratic norms, for example in the use of military powerordered by the civilian government at the centre to quell discontentat the periphery (on which more later), and there is need for changethere – and not just on the periphery. But taking everything together,there are good reasons for seeing a major accomplishment in thebroad success of secular democracy in India. Also, the relativelyhealthy state – overall – of democratic institutions in the country providessignificant opportunities for reasoned solutions to the problemsthat remain as well as for further extending the reach and quality ofdemocratic practice.
On the economic front, even though the growth of the Indian economywas quite slow – about 3.5 per cent annually – for several decadesafter independence, this slow growth was nevertheless a very largestep forward compared with the near-zero growth (and at times eveneconomic decline) that occurred in the colonial days. This prolongedeconomic stagnation ended as soon as the country became independent.However, to reverse a zero-growth performance can hardly beadequate, and there is much to discuss about the real as well as imaginedreasons for the forces that held India back for decades afterindependence. Happily, things have changed in that respect as wellover the recent decades, and India has now been able to establish anew position as one of the fastest-growing economies in the world.Table 1.1 presents a summary picture of the growth of the grossdomestic product (GDP), from the colonial time to now.
There has been some slackening of the growth rate of the Indianeconomy very recently – partly related to the global slump (there hasbeen a similar slowing in China as well, though from a higher base).India is still – even with its diminished growth rate below 6 per cent peryear – one of the fastest-growing economies in the world. While that bitof reality check is useful, it is also important to consider the policychanges that could make India's growth performance perk up more.The country's growth potential remains strong and robust and it can bea major source of strength for India – particularly if the fruits of economicgrowth are well utilized for the advancement of human lives andthe development of human freedom and capabilities (a subject on whichthere will be much to say as the book proceeds). We shall take up the'growth story of India' more fully in the next chapter.
After two hundred years of colonial domination, combined withalmost total economic stagnation, the economy seems well set to remedythe country's notorious and unenviable condition of poverty. The factthat there has also been, at the same time, maintenance and consolidationof democracy in one of the poorest countries in the world, makesIndia's achievements particularly noteworthy. India has also establisheditself as an innovative centre of some significant departures in the worldeconomy, not just in the application of information technology andrelated activities, but also – no less significantly – as the great supplier ofinexpensive but reliable modern medicine for the poor of the world. Asthe New York Times put it in a recent editorial, since 'India is the world'slargest supplier of generic medicines', in the pharmaceutical field, 'itspolicies potentially affect billions of people around the world'.
Along with economic progress, there has also been significant socialchange. Life expectancy in India today (about 66 years) is more thantwice what it was in 1951 (32 years); infant mortality is about onefourth of what it used to be (44 per thousand live births today asopposed to 180 or so in 1951); and the female literacy rate has goneup from 9 per cent to 65 per cent. There have certainly been majorimprovements in the miserable levels of social indicators that prevailedat the time of India's independence (see Table 1.2). All this isin contrast with the predictions of doom, gloom and famine that wereoften made about India in the 1950s and 1960s. It is also a substantialpolitical achievement that many of the leaders of democratic politicshave tended to come from neglected groups – women, minorities anddisadvantaged castes. As we will discuss, enormous inequalitiesremain, and many divisions have not diminished at all, but the factthat some significant changes have occurred even in the political arenaof hierarchy must be a reason to believe that more – much more – shouldbe possible. B. R. Ambedkar, the champion of the socially andeconomically discriminated (who did not shy away from challengingthe Indian nationalist leaders for their absence of engagement with'economic and social democracy'), insisted that we have reason topursue, rather than lose faith in, the power to 'educate, agitate andorganize'. Since India's political democracy allows plenty of roomfor that engagement, its absence or its timidity cannot be blamed onany prohibition imposed by 'the system'.
In this context we have reason to rejoice in the massive expansionof a free media that has taken place since independence. We shallargue, as the book progresses, that there are nevertheless huge failingsof the Indian media, but these limitations do not arise from governmentalcensorship nor from the absence of a sufficiently large networkof print or oral or visual journalism. India can be proud of its hugecirculation of newspapers (the largest in the world), and a vast andlively stream of radio and television coverage, presenting – amongother things – many different analyses of ongoing politics (many ofthem round the clock). This is surely something of a triumph of democraticopportunity – at one level – that adds much force to the workingof other democratic institutions, including free, multi-party elections.
The failings of the media, which we will discuss presently, concerna lack of serious involvement in the diagnosis of significant injusticesand inefficiencies in the economic and social lives of people; and alsothe absence of high-quality journalism, with some honourable exceptions,about what could enhance the deprived and constrained lives ofmany – often most – people in the country, even as the media presentsa glittering picture of the privileged and the successful. There is surelya need for political and social change here, which we will discuss (particularlyin Chapters 7–9). By enriching the content of the coverageand analyses of news, the Indian media could certainly be turned intoa major asset in the pursuit of justice, equity, and efficiency in democraticIndia.
AN UNFINISHED AGENDA
The record of India's achievements is not easy to dismiss, but is thatthe whole story? An agreeable picture of a country in a rapid marchforward towards development with justice would definitely not be acomprehensive, or even a balanced, account of what has been actuallyhappening: indeed far from it. There are many major shortcomingsand breakdowns – some of them gigantic – even though privilegedgroups, and especially the celebratory media, are often inclined tooverlook them. We also have to recognize with clarity that theneglect – or minimizing – of these problems in public reasoning istremendously costly, since democratic rectification depends cruciallyon public understanding and widespread discussion of the seriousproblems that have to be addressed.
Since India's recent record of fast economic growth is often celebrated,with good reason, it is extremely important to point to thefact that the societal reach of economic progress in India has beenremarkably limited. It is not only that the income distribution hasbeen getting more unequal in recent years (a characteristic that Indiashares with China), but also that the rapid rise in real wages in Chinafrom which the working classes have benefited greatly is not matchedat all by India's relatively stagnant real wages. No less importantly,the public revenue generated by rapid economic growth has not beenused to expand the social and physical infrastructure in a determinedand well-planned way (in this India is left far behind by China). Thereis also a continued lack of essential social services (from schoolingand health care to the provision of safe water and drainage) for ahuge part of the population. As we will presently discuss, while Indiahas been overtaking other countries in the progress of its real income,it has been overtaken in terms of social indicators by many of thesecountries, even within the region of South Asia itself (we go intothis question more fully in Chapter 3, 'India in ComparativePerspective').
To point to just one contrast, even though India has significantlycaught up with China in terms of GDP growth, its progress has beenvery much slower than China's in indicators such as longevity, literacy,child undernourishment and maternal mortality. In South Asiaitself, the much poorer economy of Bangladesh has caught up withand overtaken India in terms of many social indicators (including lifeexpectancy, immunization of children, infant mortality, child undernourishmentand girls' schooling). Even Nepal has been catching up,to the extent that it now has many social indicators similar to India's,in spite of its per capita GDP being just about one third. Whereastwenty years ago India generally had the second-best social indicatorsamong the six South Asian countries (India, Pakistan, Bangladesh, SriLanka, Nepal and Bhutan), it now looks second worst (ahead only ofproblem-ridden Pakistan). India has been climbing up the ladder ofper capita income while slipping down the slope of social indicators.
Given the objectives of development and equity that India championedas it fought for independence, there is surely a huge failure here.It is not only that the new income generated by economic growth hasbeen very unequally shared, but also that the resources newly createdhave not been utilized adequately to relieve the gigantic social deprivationsof the underdogs of society. Democratic pressures, as we willdiscuss in later chapters, have gone in other directions rather thanrectifying the major injustices that characterize contemporary India.There is work to be done both in making good use of the fruits ofeconomic growth to enhance the living conditions of the people andin reducing the massive inequalities that characterize India's economyand society. Maintaining – and if possible increasing – the pace of economicgrowth will have to be only one part of a larger – muchlarger – commitment.
POWER AND INFRASTRUCTURE
If the continuation of huge disparities in the lives of Indians from differentbackgrounds is one large problem on which much more publicdiscussion – and political engagement – are needed, a far-reachingfailure in governance and organization is surely another. Indians facethis problem, in one form or another, every day, even if global awarenessof the extent of this systemic failure comes only intermittently, aswhen on 30–31 July 2012 a power blackout temporarily obliteratedelectricity from half of the country, wreaking havoc with the lives of600 million people. Intolerable organizational chaos joined handswith terrible inequality: a third of those 600 million never have anyelectricity anyway (an illustration of the inequality that characterizesmodern India), whereas two-thirds lost power without any warning(an example of the country's disorganization).
(Continues...)Excerpted from An Uncertain Glory by JEAN DRÈZE, AMARTYA SEN. Copyright © 2013 Jean Drèze and Amartya Sen. Excerpted by permission of PRINCETON UNIVERSITY PRESS.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
Product details
- Publisher : Princeton University Press; Illustrated edition (August 11, 2013)
- Language : English
- Hardcover : 448 pages
- ISBN-10 : 0691160791
- ISBN-13 : 978-0691160795
- Item Weight : 1.67 pounds
- Dimensions : 6.47 x 1.29 x 9.38 inches
- Best Sellers Rank: #2,194,975 in Books (See Top 100 in Books)
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About the authors

Amartya Sen is Professor of Economics and Professor of Philosophy at Harvard. He was Master of Trinity College, Cambridge, from 1998 to 2004, and won the Nobel Prize for Economics in 1998. His many celebrated books including Development as Freedom (1999), The Argumentative Indian (2005), Identity and Violence: The Illusion of Destiny (2007), and The Idea of Justice (2010), have been translated into more than 40 languages. In 2012 he received the National Humanities Medal from President Obama and in 2020 he was awarded the Peace Prize of the German Book Trade by President Steinmeier.

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An Uncertain Glory is a look at India from the bottom up and from the lens of development economics. The authors use a large data set to show that despite its strong GDP growth India is a country that has many population segments which suffer poverty on par with that of sub-sahara africa. India is not a uniformly developed country, states like Kerala and Tamil Nadu having far superior literacy and developmental states versus states like Bihar. The authors do comparative studies on where India stacks up globally on things like child immunization, literacy, life expectancy etc and show the results show huge disparity within the country. They look at corruption and accountability and find them to be rampant and absent respectively. They look at education and discuss how absenteeism of teachers is at record levels and the solution is not based off higher salaries but a much needed revamped organization. They discuss the total failure of the health system and the state spending at levels that are unforgivably low. They look at poverty and social support mechanisms and discuss how they are largely absent though they make a point to advocate the National Rural Employment Guarantee Act. They discuss the intrinsic class structure as a function of the caste system as well as inequality of the sexes and these have created a background of terrible inequality in India. The authors also argue throughout the book about the benefits of democracy and how development and democracy are not at crossroads but that democracy facilitates more consensual growth strategies. They do however feel that India's democracy and the media that pushes where agendas are focused is in the grips of the minority and the debate is held hostage to the issues that are more important to specific minorities.
The authors believe India has made some achievements but that despite its economic growth its growth in the median lags the growth of the mean. India needs to focus on the basic provisions it provides so that the biggest asset India has, its human capital, will be included as well as drive India's development. This book is helpful in looking at India from the bottom up. The authors are careful to show how far India is lacking other countries in the provision of basic services. How to fix it is ambiguous but the authors give several directions and articulate the biggest headwinds which remain institutional. Having an accountable government is at the source of being able to reform and the authors feel India's government is lacking in accountability. The authors make a strong case for the need of a more inclusive growth strategy and the current policy faikures that India faces are shown extensively in this work. At the same time creating an institutional arrangement that allows for more inclusive growth is not sufficient as a goal right now. India also needs a hospitable business environment- as India needs foreign capital to fund parts of this stage of its development. Policy makers need to focus on improving the lives of its citizens but simultaneously realize that an improving investment climate and improving taxable income sources allows for budgetary adjustments to be made with much greater ease.
You can't read this book and not change. You can't read this book and not work towards remedying the pitiful situation in which our fellow human beings live and toil.
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Social indicators not only lag countries of India's GDP per capita level, but are simply abysmal. Here's an example: outside of sub-Saharan Africa, India is the sixteenth poorest country per capita. The authors turn the stats on their head by defining those sixteen countries as India's peer group. Among them, to be clear, India is the richest. Regardless, there are barely any measures, from life expectancy at birth, to child immunization, to access to a toilet (55% of Indians have to defecate outdoors, if you must ask) where India can hold its head up high compared with earthly paradises such as Vietnam, Moldova, Uzbekistan and Laos, not to mention how backward it's made to look by much poorer Bangladesh and three times poorer Nepal.
Moreover, India seems to be rapidly falling behind. The authors rank India, Bangladesh, Bhutan, Nepal, Pakistan and Sri Lanka on 12 measures, including per capita GDP, life expectancy, infant mortality rate, under-5 mortality rate, etc. and compare 1990 figures with 2011. India's average rank has only improved on a single measure (it has gone from fourth to third in GDP per capita) and has regressed or stagnated across the 11 remaining measures.
The numbers themselves make you cry:
43% of children are underweight
26% are never immunized for measles
26% of young women (15-24) can't read
It gets worse than that. India is far from uniform. There are states that look almost like the rest of the world, such as Kerala (human development index 0.97) and states that don't bear looking at. In Bihar, female literacy is 37%, a mere 44% of children can pass a simple reading test, 84.8 out of 1,000 children under 5 will die before they reach that age, in part because only 32.8% are fully immunized, and more than half the population is below India's unfathomably low poverty line.
What's to be done?
Education is a good starting place. At the time of India's liberation from the British, very few could read. The literacy rate was 18%, quite unbelievably. So the task was momentous, but India did not prove up to it. Much poorer Nepal (adult literacy rate 9% in 1960, versus 28% in India) has caught up, for example, with a 60% adult literacy score in 2011 versus 63% for India. Even today, some 20% of kids in India never attend school and in many of the schools (12% to be precise) there's only one teacher. He is a state employee and earns on average three times more than their parents, but often as much as six times. Half the teaching hours go wasted on average due to 20% teacher absenteeism and 33% student absenteeism. And in a study quoted by the authors, half the schools visited by an inspector did not have a head teacher at the time of the visit.
The authors blame Gandhi and Nehru, who allegedly believed it was more important for the youth to learn a craft than to acquire an official education. Whatever the case might be, those leaders have not been in power for decades and there's something that needs to be done. The authors note that there is enormous divergence between states. Therefore, studying what the states have done that have the good results ought to be an excellent starting point. No surprises, then, those are the states where the government has taken seriously the task of educating the young. Places like Tamil Nadu and Himachal Pradesh. The authors have nothing against private education, but follow basic economic theory, which states that for goods with high positive externalities and high incidence of market failure, there is a strong case to be made for government intervention. Other important contributions come from the hot meal that both nudges pupils to attend and helps them concentrate, on top of forcing pupils of all backgrounds to mix and offering work to the women who prepare it. Standardized evaluation, famous for all its sundry drawbacks, is in the authors' opinion entirely appropriate for the current state of Indian education.
Healthcare is another important issue that needs to be addressed. The current healthcare situation is a crisis. The authors don't mince words here. They lay the blame squarely on the American-style private healthcare system. India only spends 1.2% of GDP on healthcare, less than half the percentage China spends, for example. In numbers, 39 dollars per citizen per annum. This evidently does not go a long way. 74% of preschool kids in India suffer from anaemia, 61% from Vitamin A deficiency. 46% are more than 2 standard deviations lighter in weight than they ought to be. The list goes on. When it comes to healthcare, the authors are downright categorical as to where the answer lies: with the much-maligned Integrated Child Development Services and equally maligned Primary Health Centres. Yes, they often deserve all the criticism they get, and more. However, the statistics could not be more clear: where these services are taken seriously by the state, the standards of healthcare are head and shoulders above the rest of the land. Getting these two already existing programs to work should take first precedence. However, this will entail a fight against the business interests of private medicine. Should these interests prevail, the authors believe that it will be a one-way street to an American style health system which (uniquely for this book, which is jam-packed with data) they reject pretty much in principle as inappropriate for this stage in India's development.
Poverty, Inequality (across class, caste and gender) and corruption are the three other big problems the authors identify. Again, they mostly see the state as the first line of attack on all these fronts (for example through the monthly distribution of the 35kg of rice to poor families), but their arguments are more nuanced and subtle here than for healthcare and education. They don't see how things can change overnight, but they observe very happily that attitudes are changing. Practices that used to be normal are now frowned up.
The book sometimes drifts into philosophy, which I found fascinating. Consider, for example, how democracy served India better than dictatorship served China in the fifties and sixties. Mao let millions starve during the Great Leap Forward. This was impossible to do in democratic India. These days, on the other hand, China's more efficient dictatorship can be credited with delivering its subjects from poverty, bringing them education and assuring them healthcare, while India's democracy has spawned corruption and to a great extent failed its citizens.
The authors choose to emphasize two further issues above all.
First, progress relative to the survival of girls versus boys is being reversed. Depending on how hot it is in a country, babies conceived are anywhere between 900 girls for 1000 boys and 960 girls for 1000 boys. Girls are better survivors, so at birth they're typically doing better. Call it 940 girls per 1000 boys on average. By age 6 in older days when medicine was not advanced, the numbers would totally even out. Not in India. Girls suffer at every step of the way. More so in the upper classes, too. And more so today than ten years ago. In 2011 there's 914 girls age 6 for every 1000 boys in India, down from 927 in 2001. While the poor states are improving (so Punjab has improved from 798 to 846, which represents great improvement) in West Bengal (where you'll find Kolkata) the presumed use of selective abortion among the rich has brought the number down from 960 to 950. The authors struggle to propose a solution to this awful problem.
Second, and equally disturbing, none of the topics discussed above seem to be part of the public discourse. While India enjoys a genuinely free press, which the authors are proud of and, indeed, celebrate, it is very uncomfortable discussing the problems that afflict the vast majority of Indian citizens. The authors believe that the top echelons of society live in a parallel world where the plight of the poor majority is a taboo that never gets discussed. As with every argument they make in the book, they provide the full set of statistics
The result is that the wherewithal of the state is wasted on subsidies to the lower strata among the affluent. Subsidized fuel for their automobiles, subsidized fertilizer etc.
So the book has three purposes:
1. To air in public all the issues that never get discussed
2. To suggest that the newly found GDP growth is an opportunity that needs to be harnessed
3. To expose that the tax take from this newly created GDP needs to be funnelled from the state to those who really need it.
Contrary to what other reviews here seem to suggest, I believe it succeeds at all three levels.
India could easily afford to remove this shameful blight but elite groups have put their own interests above everything else and politicians have colluded.
This is a brilliant book by brilliant authors. It leaves an uneasy sense that the situation could easily persist and there is nothing anyone outside India can do about it. Dreze and Sen call for intense public debate and much more willingness to challenge vested interests. But where is this new dynamism to come from? Why should the situation change simply because it is morally repugnant?
Although this is a weighty academic work it has a message for anyone connected with India, although most of all for Indian people because they alone can bring about a solution. It is an issue of priorities within a democracy.
They discuss at great length, and with copious charts and tables, exactly why India's economic revolution seems to be stalling.
In the end, they say, it's down to not spending the money on education and medical support on the 80% of the population who are rural and poor but using the taxes to prop up the middle class and a corrupt political system.
It's an interesting way of saying, in a very long winded way, what Gandhi said 70 years ago: "The future of India lies in the villages".








