An incendiary and violent jobs reservation protest by young people from the Jat community in Haryana got very close to bringing the capital of India to a standstill. Is this an ominous sign of social upheaval that looms in the horizon?
Henrik Urdal of the Harvard Kennedy School finds that globally, it is nearly all young men who fight in wars or commit violent crimes and found that a “youth bulge” made them more strife-prone. When 15-24-year-olds made up more than 35% of the adult population — as is common in developing countries — the risk of conflict was 150% higher than with a rich-country age profile.
By 2020, the average age in India will be 29 and it is set to become the world’s youngest country with 64% of its population in the working age group. With Western Europe, the United States, South Korea, Japan and even China aging, this demographic potential offers India and its growing economy an unprecedented edge that economists believe could add a significant 2% to the GDP growth rate.
However, Western Europe, the US, South Korea, Japan and China have grown rich before they have grown old. They invested in education and skills, health, empowerment and employment and ensured women joined the workforce, as they were empowered to plan their families.
India is currently enjoying a ‘demographic dividend’, which means it has a higher labour force than the population dependent on it. While this may appear a reason for blissful complacency, it must be remembered that by the latter half of the century India will have an increasingly aging population, yet the country lacks a social security net adequate for the needs of its people.
A demographic disaster also looms. This is caused by low levels of investment in education and health. Currently a majority of Indian workers — nine out of 10 — are in the informal sector, where employment is unsteady, pay is poor and social security is lacking.
Education, especially secondary education for girls, must be prioritised. The gross enrolment ratio for girls at the secondary school level is 73.7 (slightly higher than for boys) but the government cannot rest until that number is 100. The 10% cut in government allocation for the school sector means the push towards total gross enrolment just got harder. We wonder if the Union budget being presented today will take note of this.
The country must also generate large-scale employment, to ensure more women join the work force. Concurrently, access to quality higher education must be expedited; currently, 75% of graduates — by some estimates — are not considered employable.
The healthcare sector is really where India must up its game. Rates of malnutrition among India’s children are almost five times higher than China’s and twice of those in Sub-Saharan Africa. A staggering 75% of new mothers are anaemic.
Healthcare in India is so pathetic that without a seismic change the demographic dividend may not last as long as envisaged. The country has one of the lowest government expenditures on public health at a measly 1.2% of GDP. Fellow BRICS countries, China and Brazil, spend 5.5% and 9% of the GDP on healthcare, respectively. In 2015, the Indian government slashed the budgets for both the education and health sectors.
Consider some statistics: Around 700,000 unqualified doctors are practising medicine in Indian hospitals. Some 50% of Indians (and 60% of those living in rural areas) travel at least 5 km to access a healthcare centre and in rural India, 8% of primary healthcare centres do not have medical staff. Less than 15% of the population has a healthcare insurance cover. A single illness in a poor family can push it below the poverty line.
Appropriate policies, strategies and programmes need to be put into place immediately. Priority must be given to substantially lowering fertility (currently Total Fertility Rate/TFR is 2.5) and lowering maternal and child mortality. While overall, India is on track to achieving replacement level fertility of 2.1 children per woman, the TFR of 2.5 masks disparities between urban and rural areas with TFRs of 1.8 and 2.6, respectively, and regional variation between states, notably between northern states like Uttar Pradesh (TFR 3.3) where the illiteracy and poverty rates are high and more developed southern states like Kerala (TFR of 1.8), which also has the highest literacy rate in India.
As Haryana is showing, without concerted action, India could face a backlash from the growing numbers of disgruntled, unemployed or unemployable youth that will emerge as has already been witnessed in many other parts of India.
However, in a best-case scenario, if India makes healthcare the government’s central priority, it could grow at an unprecedented rate. The country would do well to start by following the example of African countries, many of which in 2001 pledged to allocate 15% of their GDP to public health. A matching investment in education and skills would be an appropriate starting point.
So India, too, must grow rich before it grows old. For that to happen, increased investments in education and health must be central to its public policy. All eyes are on the finance minister today.
Siddharth Chatterjee a former Indian Army officer and is presently UNFPA’s Representative in Kenya
Unni Karunakara is a former International President of Medecins Sans Frontieres and now a senior fellow at Yale University
The views expressed are personal