Social Scientist. v 22, no. 256-59 (Sept-Dec 1994) p. 2.


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2 SOCIAL SCIENTIST

brought into focus some of the problems of method congealed in the Report. Niraja Copal Jayal locates it in the discourse of philosophies of welfarism and the attacks mounted on the welfare state by neo" liberal critiques of the philosophy of welfare. She concludes that the WDR 1993 shows hardly any concerns for the agendas of the rights of the marginalised. Imrana Qadeer traces the shifts that have occurred over the years in India's commitment to comprehensive primary health care and the major actors that have guided these shifts. The WDjR 1993, she argues, enforces a disjunction between the various components of public health thus profoundly undermining it. Again, her paper also draws attention to some serious methodological problems with the report.

Nata Duvvury draws attention to the myriad ways in which the package of policies under the structural adjustment programme would add to burdens borne by women, contributing to accentuating gender differentials in health. In my paper, I trace the evolution and growth of the family planning programme in India, drawing attention to the factors which are deemed to contribute to its success, viz. employment and poverty, improvements in health, nutrition and infant and child survival. The experience of countries in Latin America and Africa which structurally adjusted their economies, shows that the negative impact of these policies were precisely felt in this areas. On this basis we can hypothesise that the new economic policies will further erode the already weak base for the acceptance of family planning in our country.

An understanding of issues of equity is crucial to any discussion of the WDR 1993. The notion of equity does not merely fall within the economic domain; central to it are issues of philosophy and ethics. A.K. Shiva Kumar's paper discusses these issues, arguing that there cannot, on this basis, be any wittling of India's commitment to comprehensive and free primary health care. Seeta Prabhu draws attention to the consequences of the on-going economic policies to health expenditures. State government expenditures have been particularly badly affected. She concludes that this can only aggravate pre-existing inequities in our country, as the poor are largely dependent on publicly provided health care.

Rama Baru, surveying a host of data, substantiates the last point made by Prabhu. In addition, studying the data on the 'availabilty of health care services in the private and voluntary sectors, she concludes that these cannot be expected to fill in the gaps left by the public sector subjected to cutbacks.

In any country of India's size and diversities, development of infrastructure in health is extremely crucial. Given our resources, population and morbidity and mortality profiles, there is no option but the development of indigenous capacities in the drug industry. In other words, we cannot afford not to be self-reliant. It is in this context that



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