114 SOCIAL SCIENTIST schema 'of seeking out markets in the third world, India occupies an almost unique position. The "middle class" consumer market in the country is estimated to cater to a population of around 100 million—i.e. larger or comparable to the total market in the largest countries in Europe and about 40 per cent the size of the entire domestic market of the United States. There is thus a special interest in "prising" open the Indian market for various global players to exploit. In order to nurture this market, it is also necessary to increase extraction of surplus value from the 800 million who do not constitute a part of this potential market. This is precisely what is sought to be achieved through the structural adjustment policies that have been initiated in the country. The instruments adopted include fiscal austerity measures designed to cut government spending and subsidies in social sectors, reduction in direct taxes, increase in administered prices, deregulation of the labour market, etc. In other words, policies designed, on the one hand, to increase the paying capacity of the target population in the potential market and, on the other hand, to keep the rest of the populace at a level of mere subsistence. However, the signals emanating from the countries that had taken up structural adjustment programmes in the eighties were disturbing for the Bank. Disturbing not because of its actual effects, but because the effects threatened to totally disrupt the stability of these countries, and thereby of their markets. The safety net formula was hence required to bring back a semblance of stability in these countries, and had to be extended to countries now going in for structural adjustment, so as not to repeat the past experience. The safety net formula can thus be also seen as a partial strategic retreat of the earlier World Bank prescription of total withdrawal of the state from all social and infrastructure sectors. While the Bank continues to pursue its policies geared towards private takeover of other infrastructure sectors like power, telecommunications, etc., in the area of health and education it has had to make certain concessions to the logic of state support. However such concessions are grudgingly advanced, and in fact are responsible for the large variety of inconsistencies contained in the WDR. The attempt is to formulate a package which involves minimum state involvement, as the intent is not to make provisions for comprehensive health care. That would require, in the words of the Alma Ata Declaration of 1978: All governments should, formulate national policies, strategies and plans of action to launch and sustain primary health care as part of a comprehensive national health system and in co ordination with other sectors. To this end, it will be necessary to exercise political will, to mobilise the country's resources and to use available external resources rationally.4