📰 Births and rights: On laws on reproductive rights
Laws on reproductive rights must recognise differences in orientation, relationship choices
•A Bill that the government of the land intends to make law, cannot be exclusivist at the very outset; and at least, with the time of passage, it is imperative that it loses its biases. It cannot exclude certain categories of citizens from the benefits and rights that the law seeks to confer upon the people of the country. And, that is what the Assisted Reproductive Technology (Regulation) Bill, 2020, that was passed in the Lok Sabha on Wednesday, has done, by excluding two categories — LGBTQIA+ and single men. Undoubtedly, the time has indeed come for such a Bill; for government intervention to regulate the field of fertility treatments, and by seeking to establish a national registry and registration authority for all clinics and medical professionals in the segment, it will fill a vacuum. The Bill has provisions to protect the rights of the donors, the commissioning couple and the children born out of ART, to grant and withdraw licences for clinics and banks depending on performance factors. It proposes to make it impossible for outlaws to operate within the system and profit from it, while exploiting patients. It also plans to put an end to illegal trafficking in embryos, and mistreatment of the poor coerced by their circumstances into donating eggs or sperm.
•It is unfathomable that a Bill, so progressive by its very nature, would glaringly exclude members of the LGBTQIA+ community and single men. As citizens, these groups too have the right to exercise reproductive rights. The omission is particularly baffling considering that the legislation has made provisions for single women too, apart from a commissioning heterosexual couple. The Union Health Minister said that several recommendations made by the Parliamentary Standing Committee had been considered. Unfortunately, despite expert recommendations to include both categories, the Committee recommended ‘it would not be appropriate to allow live-in couples and same sex couples to avail the facility of ART’ citing the best interest of the child born through ART. It also recorded that ‘given [the] Indian family structure and social milieu and norms, it will not be very easy to accept a child whose parents are together but not legally married’. While the law would do well to be cognisant of the sentiments of the people, its purpose is also to nudge retrograde social norms out of their freeze-frames towards broader acceptance of differences and preferences. Legislators have also pointed out that the Surrogacy Bill intrinsically connected with the ART Bill was pending in the Rajya Sabha, and that it would only be appropriate that both Bills be considered together before they are passed. The ball is now squarely in the court of the Upper House; legislators can still set right the omissions and introduce the spirit of justice in the letter of the law.
Revisiting the UN Environment Programme’s review of China’s strategy provides useful lessons for policymakers
•Experts frame environmental concerns in technical terms — pollutants, their monitoring and penalties — whereas air pollution in cities is driven by urban form and transport infrastructure; solutions depend on the stage of development.
•The National Green Tribunal (NGT) had begun the process of taking a new look at an old problem by asking the Government to list its causes. For example, there is a report that the NGT directed the Ministry of Environment, Forest and Climate Change to modify the National Clean Air Programme (NCAP) which proposes 20%-30% reduction of air pollution by 2024. But the NCAP with its ‘collaborative and participatory approach’, monitoring, targets, emergency measures and even role for international organisations has still to make an impact.
•Just a day ago, on December 2, the Supreme Court of India asked pertinent questions: despite the compliance reports, why are the results on the ground negligible and what is the Commission for Air Quality Management in the National Capital Region doing? At a hearing where the Court gave the Centre and Delhi government 24 hours to come out with suggestions to control air pollution, the Solicitor General’s response was that the Commission’s power structure needed reworking, to which an exasperated Court asked for ‘creativity’. This exchange raises the fundamental question about the role of the Commission, what it should be doing — and not just what it has done — as it has not been responding to interdependent causes driven by complex urban problems. Urban transformation is a social process (people, services, lifestyles) rather than a physical problem (congestion, technology, regulation). Therefore, the focus of the Commission has to be on how cities are organised, which in turn requires collaboration between multiple stakeholders. The challenge is to move away from solutions that merely require coordination between discrete administrative units, and enforcement taking the matter to the courts.
Lessons from Beijing
•The UN Environment Programme’s review of Beijing’s control of air pollution provides useful lessons for policymakers. The population size of both cities, Beijing and Delhi, is comparable. Delhi also shares with Beijing, and other cities, the three stages in dealing with urban air pollution as a long-term task. It starts with end-of-pipe air pollution control gradually moving to integrated measures targeting primary pollutants (SO2, NO2, PM10, and CO), with the Government playing the main role. Later, secondary pollutants, or particulate matter leading to smog, primarily PM2.5, become the main focus for control with a regional coordination mechanism. The similarity ends there.
•The review by the UN points to a management system characterised by systematic planning, strong monitoring capacity, local standards, specific enforcement mechanism and public awareness.
•First, the key result area is a new model of network operation and quality control to provide early warning to effectively reduce the level of pollution under adverse weather conditions. In case of forecasted heavy pollution, warnings are issued at least 24 hours in advance through the media, in addition to daily air quality reports and forecasts.
•The technical system combines high-resolution satellite remote sensing and laser radar, an integrated network combining ‘air-land’ data for quality monitoring with greater analytical capacity and over 1,000 PM2.5 sensors throughout the city to accurately identify high-emission areas and periods.
Approach to urbanisation
•Second, in Beijing what really made a difference was not shutting down polluting units, restricting car ownership and travel, and improved fuel standards but the approach to urbanisation. ‘Smart cities’ such as New York, London and Beijing provide more space for public transport and mixed land use spatial planning minimising travel. The problems of Beijing and Delhi, as transit centres with no peak-hour traffic, require additional measures. Beijing’s 7th Ring Road to ease congestion is 1,000 kilometres long, and even before buildings came up, the metro link was operational.
•Beijing already has more than 550 km of metro, more than one-and-half times that of the Delhi Metro; the plans are to have 1,000 km of metro rail. The bus transport system has 30,000 low floor buses, more than eight times the number with the Delhi Transport Corporation. In China, 72% of travel is completed by public transport compared with 37% in Japan, 17% in Europe and 10% in the U.S.
Vehicle policy
•Third, when it comes to air pollution, particulate matter is the most difficult to control, leads to smog and serious health issues, and is largely caused by vehicle emissions. Traffic has been identified as a distinct and growing challenge. Systematic study on PM2.5 source apportionment in Beijing has found that local emissions constituted two-thirds of this, of which vehicle emissions were nearly half the main source. Regional transport contributes to pollution on heavily polluted days. On-road diesel vehicles formed the largest part of mobile sources, and the policy focus gradually changed from gasoline vehicle emissions to heavy-duty diesel vehicle emissions. Phasing out older vehicles made the most significant contribution. Beijing plans to have 48 lakh charging points by 2022 to push the use of electric vehicles. Delhi has nearly two times the number of registered vehicles than Beijing, increasing at a faster pace and source apportionment is still being debated.
•Fourth, innovative implementation steps were instituted in Beijing. Local regulation targeted controlling both the concentration and total emission amount leading to transforming and upgrading the industrial structure production processes and equipment. Economic incentives were tailored to the specific problem, with attractive levels of subsidies to high-polluting enterprises to close their production and differentiated fees charged according to the concentration of waste gas emissions for those who chose to remain in production. Enforcement at the municipal and State levels is coordinated, with each level having different responsibilities and a mechanism for cooperation. Municipal environmental enforcement teams do specific inspections and hotspot grid supervision based on a detailed emission inventory for each source, passing on serious cases to the State level.
•Lastly, independent evaluations review the air quality management system, conduct quantitative assessments of the pollution reduction effects in selected areas, analyse new challenges, and provide recommendations for enabling further improvement in air quality and building public support.
•The problem in the NCR is not the peculiar mix of administrative levels. It is their common approach to air pollution with cosmetic steps, unverified claims, statistical compliance and shifting responsibility which the powerful Commission has failed to override with a joint plan to modify trends.
📰 Should the state stop focusing on population control?
India has a large young population which needs access to contraception, not family planning
•According to the recently released National Family Health Survey (NFHS)-5, India’s Total Fertility Rate (TFR), which is the number of children a woman would have in the course of her life, is 2, a decrease from 2.2 in NFHS-4. Is this cause for cheer and should women be credited with stabilising the population? Poonam Muttreja and S. Irudaya Rajan discuss whether governments should stop focusing on population control, in a conversation moderated by Serena Josephine M. Edited excerpts:
India launched its National Programme for Family Planning in 1952. What are the factors that have helped the country bring down its TFR?
•Poonam Muttreja: Yes, it was good that India had an early start. But while India has the oldest family planning programme, it does not have the best or even an average programme. I’d first like to give credit to the women and their aspirations. The men have demonstrated that they are not responsible for family planning and rarely support women in family planning decisions. The decline is on expected lines. If you look at NFHS-4, women, on average, wanted 1.8 children. So, it’s just that we have a huge unmet need for family planning. It was 13% in NFHS-4. In NFHS-5, it has come down to close to 10% on average in many States. There are 16.4 million abortions every year, which I think is an under-estimate and a proxy for contraception. So, there is determination in India in spite of men not participating. Having said that, I do want to say that in the last five or six years, we’ve had new methods introduced, though we need to do a lot better on numbers and we need more temporary methods. Another reason for women having or desiring fewer children is education. It is the best contraceptive pill, and better education means women will have fewer children. There are many factors for the drop in TFR, but I’d like to give maximum credit to women. Also, fertility has come down across religious lines.
•S. Irudaya Rajan: Though I agree that the programme was managed by women because the sterilisation rate among women is extremely high compared to that of men, the fertility decline is not the end of the story but the beginning of a new era. Most policymakers and journalists think that when you achieve a fertility rate of 2.1, the population policy is over. Unfortunately, the population policy is not just a fertility control policy. We have to educate our administrators and policymakers that population policy includes not just fertility but also mortality and migration. These are the three components of population growth. This is the beginning of the work that the government has to do in terms of child nutrition, child mortality and providing employment for the youth — what we call the demographic dividend. I don’t think it is time to celebrate the NFHS-5 results.
Many view this drop in TFR as a sign of population stabilisation. Is that really so?
•S. Irudaya Rajan: I don’t think it is a sign of population stability. Kerala, for instance, has almost the same replacement level of fertility for close to 30 years now. We have not stabilised; the population is still growing. Population momentum will set in right now and continue for perhaps a few years or a decade. Only then can we talk about population stabilisation. Basically, population momentum means that the population will continue to grow and it is not going to have a negative growth rate. Kerala still has a positive growth rate and we expect a negative growth rate may be after the 2031 to 2041 Census. It will take several decades for India to reach population stabilisation. This is the first point.
•As I said earlier, this fertility decline is not going to end the story of India’s human development. Even as we discuss the low fertility rate, according to the data, 23% of women were married before 18 years. The percentage of women aged 15 to 19 years who were already mothers/pregnant at the time of survey was 6.8. However, adolescent fertility rate for women aged 15 to 19 years was 43. This is only the beginning of a new era in India’s population policy. It is very important for us to wait and do more work than what we have done so that we have healthy women, healthy children and a healthy society.
At this point in time, does India need a population control law or drastic measures such as the two-child norm proposed by Uttar Pradesh and Assam? Do you think the country should move away from coercive measures for population control, keeping in mind the lessons learned from China’s one-child policy that was scrapped a few years ago?
•Poonam Muttreja: If there’s anything in the news in the NFHS, it is that it’s taking the wind out of those who are saying India needs coercive population control measures. India needs to move away from not only the coercive measures it has, but shouldn’t even think about population control measures. Let me explain why. First, Kerala, Tamil Nadu and other States that have achieved a TFR of 2 [have done so] without coercion. Second, we are going to have a balance in India as migrants from Bihar and U.P. are already moving to the southern parts. The country will balance its population even when we reach a minus growth rate. Let there be a secular decline, which is already happening. In fact, 70% of the population is going to be fuelled by population momentum as we have a very young population. We need to provide three or four things keeping them in mind. Our population policy needs to get more spacing methods, which are long lasting. A large percentage, if you look at people’s access to family planning, depends on where you live, what your wealth quintile is and what your age is. Younger girls have the least access to family planning services and so, there are high teenage pregnancies. We need to not only increase the age of marriage but keep girls in school and university for their own empowerment and growth. If we keep focusing on coercion, we will not focus on the right things. We are barely talking about ageing. Those who are talking about coercive policies in U.P. and Assam haven’t thought about investing in ageing and improving the health systems. If we use coercive methods and use the population to create greater disharmony, if we victimise or demonise one particular population, we should remember the Emergency and the impact that forced sterilisations had. The biggest lesson from that is that we shouldn’t be talking about population control or population in a coercive manner.
•S. Irudaya Rajan: We should not do politics with fertility. We should talk about the quality of family planning services, which is pathetic. Family planning programmes have been about following the women. They have the first child, then the second. In between they probably have one abortion as there was no method [of contraception]. And then sterilisation. We should change this and propagate temporary methods [of contraception] among men and women. We need innovations in family planning programmes.
What do you think of incentives and disincentives in family planning?
•Poonam Muttreja: There is no evidence to show that linking incentives and disincentives to family planning and social schemes work globally. In India, we invest so much money in incentives for sterilisation. That’s part of the problem why women are not able to have the number of children that they wish to have. They have more children than they wish to have and go through multiple abortions, which impacts their health. Abortion-related mortality is close to 8%.
•S. Irudaya Rajan: I am against providing incentives. I think people are addicted to the two-child family. We should think of new ideas of how to promote the quality of family planning services. Historically, if you look at India’s family planning programme, we started with the ‘cafeteria approach’ where you can ask what they have and choose. Now, you will be told there is only sterilisation and not many are promoting other methods. Many couples are using abortion as a contraceptive method. This indicates that we have failed to promote temporary methods.
The use of contraceptives has improved, as per the latest NFHS, but male sterilisation continues to be low. What are the implications of the continued thrust on women with regard to family planning?
•Poonam Muttreja: Once again, NFHS-5 proves that women are taking more responsibility and men are taking less. How do we change men? There are myths about adopting contraception. I don’t believe coercion is needed, but we need more communication on behavioural change. We have to change social norms, especially among the younger population, but we don’t even have sex education. Much of our population momentum is going to come from the young. We should recognise that the overuse of female sterilisation has been adversely impacting women's health.
•S. Irudaya Rajan: We have to start educating women as well because some do not want their husbands to be sterilised. Family planning should be converted into family welfare. A family includes men and women. We should recognise this in our data collection. I think we have to do more research on women and men. We should convert that into a family affair. Probably then we will succeed.
So, if not population control, what should be the focus areas?
•Poonam Muttreja: I think there’s going to be the targeting of one minority community, which is the reason behind the population control push. As Professor Rajan said, we shouldn’t do politics in population. Given that India has a strong preference for sons and an aversion for daughters, our sex ratios will get more skewed. I don’t believe that on the whole, the population will decline faster. It will just distract us from all the good things that we are talking about doing such as expanding choice and social indicators like age at marriage.
•S. Irudaya Rajan: There are two important components. One, what we are celebrating is that in India people are living longer. Now, living longer is being celebrated because it gives you the human development index. But we are only adding years to the people, not a better quality of life for our senior citizens. Second, migration is going to play a major role in India. My estimate is that right now, 600 million people are internal migrants. But we don’t have any policy on migration. We should look at population policy beyond fertility. We should include mortality decline, quality of life in old age and create a migration policy.
What is the way ahead in terms of population control, family planning and in men taking greater responsibility in adopting sterilisation?
•Poonam Muttreja: The family planning budget is only 6% of the health budget. Within that, we spend 2.5% on temporary methods of contraception. The money spent on incentives is 60% of the budget. This can instead be used on bringing about behavioural change. We have to recognise that India is going to keep growing because of a young population. And they don’t need family planning, they need access to contraception.
📰 A white touch to a refreshed green revolution
The Amul model, of a socio-economic enterprise, has immense potential to aid India’s crop-growing farmers
•November 26, 2021 was celebrated in Anand, Gujarat as the 100th birth anniversary of Verghese Kurien, the leader of India’s ‘white revolution’, which increased the incomes and the wealth of millions of cattle-owning small farmers in India, many of them women. November 26, 2021 also marked one year from the day when thousands of crop-growing farmers, who have been the beneficiaries of the ‘green revolution’ which increased their incomes, began a non-violent protest to force the Indian government to withdraw the new laws it made to undo the policies of the green revolution. The Government’s new policies intended to double incomes of small farmers, which have been languishing while stock markets are soaring. The protesting farmers feared the new policies would enable corporations to make more profits and marginalise farmers further. The Government must now go back to the drawing board to find better ways to increase farmers’ incomes.
Revolutions, varied purposes
•The contrast between the two revolutions provides valuable insights. Their purposes were different. The purpose of the green revolution was to increase the output of agriculture to prevent shortages of food. The purpose of the white revolution was to increase the incomes of small farmers in Gujarat, not the output of milk. The green revolution was largely a technocratic enterprise driven by science and the principles of efficiency. Whereas, the white revolution was a socio-economic enterprise driven by political leaders and principles of equity. Sardar Vallabhbhai Patel and Tribhuvandas Kishibhai Patel had a vision of a cooperative movement of Gujarati farmers for increasing their incomes. Verghese Kurien recounts in his autobiography, I Too Had a Dream, how they enrolled him in their visionary enterprise and how he became a servant of the farmers for whose sake the enterprise was created, and amongst whom he lived.
•Amul has become one of India’s most loved brands, and is respected internationally too for the quality of its products and the efficiency of its management. It has successfully competed with the world’s largest corporations and their well-established brands. The fledgling, farmer-owned, Indian enterprise the two Patels sponsored had many technological problems to solve. That is why they enrolled Kurien, who had studied engineering in the United States (on a Government of India scholarship). Kurien and his engineering compatriots in the organisation were compelled to develop solutions indigenously when Indian policy makers, influenced by foreign experts, said Indians could not make it.
Equity was key
•Kurien’s accounts of the political battles he fought for ‘Make in India’, and of the ‘can-do’ spirit and innovation of Indian engineers, are inspiring. However, as he repeatedly emphasises, the enterprise achieved its outcome of empowering farmers because the governance of the enterprise to achieve equity was always kept in the foreground, with the efficiency of its production processes in the background as a means to the outcome.
•The green revolution’s aim was to increase outputs by applying scientific breakthroughs with methods of management to obtain economies through scale. It required inputs, like chemical fertilizers, to be produced on scale and at low cost. Therefore, large fertilizer factories were set up for the green revolution. And large dams and irrigation systems were also required to feed water on a large scale. Monocropping on fields was necessary to apply all appropriate inputs — seeds, fertilizer, water, etc., on scale. Focus on only one or two crops at a time enabled their outputs to be increased by avoiding diversion of land use to other “non-essential” crops. Monocropping increased the efficiency in application of inputs. Thus, farms became like large, dedicated engineering factories designed to produce large volumes efficiently. Diversity in the products and processes of large factories creates complexity. Therefore, diversity is weeded out to keep the factories well-focused on the outputs they are designed for. Similarly, in large-scale farms and plantations, any plants other than those the farm is designed to produce on scale are weeds.
On productivity
•In large, modern factories, workers are only a means for producing outputs. Workers are replaced by machines whenever possible to increase outputs more efficiently. Thus, ‘productivity’, when defined as output per worker, can be increased by eliminating workers. This may be an acceptable way to measure and increase productivity when the purpose of the enterprise is to increase profits of investors in the enterprise. It is a wrong approach to productivity when the purpose of the enterprise is to enable more workers to increase their incomes, which must be the aim of any policy to increase small farmers’ incomes.
•The need for new solutions to increase farmers’ incomes has become imperative. Moreover, fundamental changes in economics and management sciences are necessary to reverse the degradation of the planet’s natural environment that has taken place with the application of modern technological solutions and management methods for the pursuit of economic growth. IRMA, or the Institute of Rural Management Anand, which Kurien had founded to develop a new breed of manager for increasing the well-being of farmers, convened a workshop to celebrate his 100th birth anniversary to discover what can be learned from the white revolution to regreen the green one. Leaders of on-the-ground movements, who are applying the principles of cooperative management in “natural (environmentally suitable) farming” around India, assembled to distil insights for better economic policies and better management methods to increase inclusion and improve environmental sustainability.
The guidelines
•The first insight is: inclusion and equity in governance must be hardwired into the design of the enterprise. Increase in the incomes and wealth of the workers and small asset owners in the enterprise must be the purpose of the enterprise, rather than production of better returns for investors.
•The second: the ‘social’ side of the enterprise is as important as its ‘business’ side. Therefore, new metrics of performance must be used, and many ‘non-corporate’ methods of management learned and applied to strengthen its social fabric.
•The third: solutions must be ‘local systems’ solutions, rather than ‘global (or national) scale’ solutions. The resources in the local environment (including local workers) must be the principal resources of the enterprise. The enterprise must be embedded in the local community from whom it gets its environmental resources, and whose well-being it must nourish by its operations.
•The fourth: science must be practical and useable by the people on the ground rather than a science developed by experts to convince other experts. Moreover, people on the ground are often better scientists from whom scientists in universities can learn useful science.
•The fifth: sustainable transformations are brought about by a steady process of evolution, not by drastic revolution. Like strong drugs to treat specific ailments, large-scale transformations imposed from the top can have strong side-effects too. They slowly weaken the patient’s health, as the scientific managerial solutions of the green revolution have harmed the soil and water resources of northern India.
•Large-scale farming using modern scientific methods was the approach in the Soviet Union to improve agricultural outputs, as it is in the United States, and it achieved equally spectacular results. However, it wiped out peasants in the Soviet Union and has swept off small farmers in the U.S. Kurien told Premier of the USSR Aleksey Kosygin who visited him in Anand that top-down ownership of enterprises, whether by the state (in the Soviet model), or by remote investors (in the capitalist model) was the wrong solution. The essence of democratic economic governance is that an enterprise must be of the people, for the people, and governed by the people too.
