INFRASTRUCTURE DEVELOPMENT IN HEALTH CARE 113 the "rolling back"' of many gains of the previous decades in the areas of realth and education. As a result of the adjustment policies, at the behest of the Bank, many of these countries had drastically reduced resource allocation in these areas. The danger signals from these countries were, for example, echoed by the UNICEF in the following manner: "For the first time in the modem era, a subcontinent is sliding back into poverty. The number of families in sub-Saharan Africa who are unable to meet their most basic needs have doubled in a decade. The proportion of children who are malnourished has risen."1 UNICEF went further in squarely blaming such conditions on the debt burden imposed by the Bank's policies on these countries, noting : "The total inhumanity of what is now happening is reflected in the single fact that even the small proportion of interest which Africa does manage to pay is absorbing a quarter of all its export earnings and costing the continent, each year, more than its total spending on the health and education of its people."2 It commented further: "Great change is in the air as the 1990s begin. And great change is needed if a century of unprecedented progress is not to end in a decade of decline and despair for half the nations of the world. In many countries poverty, child malnutrition and ill-health are advancing again after decades of steady retreat. And although the reasons are many and complex, overshadowing all is the fact that the governments of the developing world as a whole have now reached the point of devoting half of their total annual expenditures to the maintenance of the military and the servicing of debt.'^ The WDR 1993 essentially accepts its complicity in the process of this slide back. It notes: "Because cuts in government spending are usually central to an adjustment program, health spending is likely to be reduced. In many countries early cuts were indiscriminate and failed to preserve those elements of the health system with the strongest long term benefits for health .''(Emphasis added) Having accepted that its adjustment policies were responsible for rather unpleasant fallouts in many countries, the Bank found it necessary to suggest certain remedial measures. These measures, had to be of the kind which did not fundamentally endanger the Bank's adjustment policies in these countries, but which at the same time could initiate some sort of "disaster management". The Bank hence advocates a "safety net" for the poorest, who bear the brunt of the these policies most acutely. The WDJR 1993 is essentially a prescription for setting in motion the erection of this safety net. The nature of the safety net the Bank wants in position is not de^rmined by any altruistic concerns for the victims of its adjustment policies in developing countries. Rather, they are an extension of the very same concerns which led the Bank to push for the adjustment policies in the first place. Let us see how, in more concrete terms, the kind of thrust these policies would have in a country like India. In the