During the COVID-19 pandemic, those living in poverty are among the most vulnerable. In India, where “the proportion of employed population below $1.90 purchasing power parity a day in 2019 is 10.7 percent” according to the Asian Development Bank, it is an issue that must be addressed.
Earlier this month, the World Bank warned that the pandemic could add as many as 150 million people worldwide to those living in extreme poverty. In a press release, the organisation said “the COVID-19 pandemic is estimated to push an additional 88 million to 115 million people into extreme poverty this year, with the total rising to as many as 150 million by 2021, depending on the severity of the economic contraction. Extreme poverty, defined as living on less than $1.90 a day, is likely to affect between 9.1 percent and 9.4 percent of the world’s population in 2020.”
India, to its credit, has made substantial progress in tackling poverty in recent decades. Its meteoric economic growth and social programmes have entailed fewer people living in impoverished circumstances. Last year, it was reported that over the span of a decade, 271 million Indians escaped poverty. Nonetheless, 23 percent of 1.3 billion people remained impoverished.
Poverty is not merely a lack of money. It is a lack of access to basic needs, such as food, water, adequate sanitation, shelter, and health. In these areas, India faces a number of uphill climbs.
In the case of food, India is home to one-quarter of the world’s undernourished peoples. In last year’s Global Hunger Index, India slipped in the rankings. It placed 102nd out of 117 countries, with a score of 30.3 out of 100 – lower than the score for the south Asia region as a whole and lower than neighbouring countries including Bangladesh and Pakistan. India is generally considered to be behind global targets as they pertain to malnutrition and, without considerable effort, is not expected to reach World Health Organization (WHO) targets in addressing its nutrition indicators by 2025.
In the case of shelter, tens of millions live in slums and approximately four million people are homeless in India. This is despite the fact that 44 Indians escape poverty every minute.
In the case of water, availability is on the decline. As previously reported by Health Issues India, “India is home to around eighteen percent of the global population — with numbers set to increase in the coming years. Despite such a vast population, India only has access to around four percent of global freshwater resources. Meanwhile, India’s per capita water availability is on the decline…water demand is projected to surpass the supply in the near future.
“Groundwater reserves are on the decline, resulting in common usage of polluted water supplies, especially by India’s most economically deprived…due to inadequate and unsafe water supply and unimproved sanitation, about 200,000 people, mostly children, die in India every year.”
Sanitation is an area where the incumbent Union Government under the leadership of the Bharatiya Janata Party (BJP)-led National Democratic Alliance and Prime Minister Narendra Modi has won international acclaim. Yet the progress made – while substantial – is incomplete. While considerable reductions in open defecation and increased access to toilets and latrines are undoubtedly positive strides, work remains. As previously reported by Health Issues India
“Ensuring adequate water supply to homes and latrines, enforcement of sanitation protocols in facilities such as hospitals and schools, behavioural change efforts to end open defecation among practitioners, and improving waste management in the country are among the steps needed to effect broader improvements to India’s sanitation indicators and, consequently, its nutritional status.”
Finally, there is health – a field which acts as a massive impediment to poverty eradication. COVID-19 has only underscored this.
Government spending on healthcare in India has long been viewed as inadequate. Union Minister of Health and Family Welfare Dr Harsh Vardhan last year acknowledged as much, calling for an increase. He called on state and union territory (UT) governments to spend a minimum of eight percent of their total budgets on health, stating “collective increase in healthcare spending by the states/UTs to meet the goals of healthcare spending of National Health Policy 2017, which is 2.5 percent of GDP, by 2025.”
This year’s Union Budget saw, as Health Issues India reported at the time, “a Rs 69,000 crore budget for the health sector for the 2020-21 period. This marks an increase compared to last year’s Union Budget, which saw Rs 62,659.12 crore allocated in what Health Issues India described at the time as “a marginal hike” and “far below the industry expectations of increasing spending levels to 2.5 percent of the GDP [gross domestic product] to slowly move towards global average of four percent of the GDP — an increase that has previously been promised by the government on numerous occasions and which the Modi government plans to enact by 2025.”
Nonetheless, spending levels on public health remain inadequate – and the pandemic has thrust this into the very centre of the dialogue. According to the latest “Commitment to Reducing Inequality Index 2020” published by Oxfam, India’s health budget is the fourth-lowest in the world. This, Oxfam said, “may have affected how far people were shielded from the COVID-19 outbreak.” It reports excoriatingly pointed out how “just half of [India’s] population have access to even the most essential health services.”
Government spending on health is relevant as it pertains to poverty. As my colleague Nicholas Parry wrote last year, “private healthcare spending — that being the difference between public health expenditure and the total health expenditure of the state — exceeds that of public spending, often by a considerable margin…recent evidence suggests that, despite increased prevalence of health insurance, out-of-pocket expenditure continues to rise. Data from 2014 suggested around 65.6 percent of healthcare expenditure was out-of-pocket. More recent reports suggest a figure closer to eighty percent.”
Poverty eradication is a lofty goal. For a country like India, it is a challenging one. But it is a moral and societal imperative. The issues outlined above – shelter, sanitation, health, food, and water – are areas where the Government is working. Initiatives such as Ayushman Bharat, Swachh Bharat Abhiyan, Janata Dal, and Eat Right India are just a few examples. But more work must be done. Today we highlight the need for poverty eradication. Every country – including and, perhaps, especially India – ought to take the time to reflect.