Listening to her mellifluent tones, it is easy to believe that states like Bihar and UP could become exemplars of how good governance can dramatically change health indicators. Over 12 years, Melinda French Gates, co-chair of the Bill and Melinda Gates Foundation has worked tirelessly to promote immunisation in India's poorest states like Bihar. The results show with a jump from 33% to 66% in immunization in Bihar. Gates tells HT about the turnaround in health strategies in India.
What are the significant changes you have seen on the health front over the years?
Immunisation rates have gone up dramatically. Infrastructure has improved, women can now access hospitals more than they could earlier thanks to motorable roads.
Is this because people have become more assertive in their demand for better governance?
Oh absolutely. Incredible health surveillance programmes are in place in Bihar and UP. I have spoken at the TedxChange meeting about the strides taken by Nitish Kumar. UP chief minister Mayawati is also taking the lead in infrastructure as a tool to improve health. But, of course, India needs to invest much more in health as China, Brazil and Russia have.
Do you see greater political commitment at the Central govt level?
PM Manmohan Singh is one person who understands the importance of vaccines and it is very much on his very crowded agenda. India is losing a huge number of babies before they are a month old. There have been super innovations in vaccines like the rotavirus one for diarrhoea.
The TedxChange meet talked of the need to educate women in better health practices. Don’t you think that men have to be involved far more in a patriarchal society like India?
Yes, often the mother is only a teenager unable to take decisions. Here, I feel that apart from the husband, the mother-in-law is also key to ensuring maternal and child health. I have found in my interactions with women in villages that mothers-in-law want to ensure their daughters-in-law don’t go through the traumas they went through in childbirth.
What is next on your agenda?
We will continue to help to address health challenges in UP, Bihar, Karnataka etc. I also want to focus on family planning. We have to think of modern contraception and not sterilisation. Injectibles could protect women. They could be tested in small pockets. Women have to be given contraceptive choices. The time is ripe now because people are demanding better contraceptive options. So I am hopeful that things are really moving forward.