Indore bags the cleanest city award for the seventh year in a row. A look at its strategy.
Shailaja Chandra Published : Jan 13, 2024 17:18 IST – 10 MINS READIndore was not always clean. It scaled up from the 149th position on the Clean City Index in 2014 to 25th in 2016 and finally bagged the 1st position in 2017. | Photo Credit: By Special Arrangement
Most Indian cities are known for urban filth and the defiance of civic rules. In this scenario, for six years in a row, one city, Indore, has won the first position among hundreds of aspiring municipalities. I studied dozens of publications and newspaper stories that described Indore’s Solid Wate Management (SWM), but not one explained how the municipal staff and citizens were compelled to listen. What worked?
In Delhi—where I live—municipal officials shrugged off Indore’s achievement, saying it was possible because the population was not even a fifth of Delhi’s. I was not convinced. Late last year, a chance visit to Indore allowed me to see things for myself. I asked Harshika Singh, the Municipal Commissioner of Indore, to let me visit a few sites and see for myself how things worked. Before flying out of Delhi, I got a call from an official in the Indore Municipal Corporation (IMC). Shraddha Tomar, the Corporation’s SWM expert, gave me the chronology of Indore’s fight for cleanliness.
As a former bureaucrat, I am hardwired to doubt rosy stories. I also recalled what Raghuram Rajan, the erstwhile Governor of the Reserve Bank of India, had written about Indore in his book, The Third Pillar: “People treated Indore as a vast public garbage dump…. Stray animals—dogs, cows, goats, and pigs—roamed freely, eating the garbage, and adding their excrement to the mix. Some poor people, who did not have access to toilets, defecated in the open, in vacant fields or on public drains….” the economist had bemoaned.
Shraddha told me that before 2015, only 30 per cent of the employees came to work and protests and PILs were common. Everything changed only after the election of the new Mayor-in-Council, Malini Gaud, followed by the posting of a new Municipal Commissioner, Manish Singh. Both came on the heels of the newly launched Swachh Bharat Mission. “While the mayor handled the anti-reform backlash, Manoj Singh coordinated the cleanliness drive. The two made a great team,” Shraddha said.
Since it is unusual for a bureaucrat to be remembered years after his transfer, it spurred me to locate Manish Singh. He said something that stuck in my mind: “Madam, all city sanitation work must start by 5 am and get completed by 7 am. I used to be on the road every day at 4 am, rain or shine, summer, or winter. Once the Commissioner is himself there, no engineer, officer or support staff will remain absent. The message travels down the line,” he explained.
Major milestones
Indore was not always clean. It scaled up from the 149th position on the Clean City Index in 2014 to 25th in 2016 and finally bagged the 1st position in 2017. Since then, no one has beaten it, although this year Surat tied for first place.
In reply to a questionnaire, IMC sent detailed responses. Historically, according to the response, the years 2015 to 2016 were spent mapping each of Indore’s 86 city wards to plan the collecting, transporting, segregating, and recycling of over 1000 tons of municipal waste that is generated daily across the city. It was only after mapping and calculating the capability of different vehicles to travel door-to-door and manoeuvre the narrowest of streets that a fleet of 800 mini-tippers, dumpers, compactors, containerized tippers, hook loaders and even CNG rickshaws was ordered.
Indore’s 19 administrative zones have been entrusted to four NGOs and presently some 600 volunteers cover specific beats, on foot. | Photo Credit: By Special Arrangement
The next four years were spent on awareness building, using four NGOs to sensitise the communities residing in a cluster of wards. An “Indore 311” helpline app was launched to promote communication with the public. A bio-CNG plant and a dry waste processing plant were commissioned—both as public-private ventures. The CNG generated by the 18000 capacity wet-waste plant was purchased by the IMC at concessional rates and is used to run 150 city buses a day.
Interestingly, given the high voltage fights over stray animals that are playing out in several cities, IMC approved a no-stray-animal policy without a fuss and has stood by it. In my visits around Indore, by car or on foot, I have not seen a single stray animal on the roads or markets.
Bioremediation of legacy waste and the phasing out of single-use plastic are two important initiatives started by several Municipal Corporations, whether ordered by the National Green Tribunal or under public pressure. In Delhi, while 58 trommels are trying to reduce the size of three landfills at Bhalaswa, Ghazipur, and Okhla, and indeed ~100 lakh metric tonnes have been bio-mined by now, nearly twice that volume has still to be removed. In just one colony of Delhi where I live, there are six dhalaos (huge brick structures) for some 12,000 households.
At these dhalaos, stacks of garbage await packaging and dispatch to the waste-to-energy plants. In contrast, Indore has no landfill (except for inerts), and there are no garbage dumps or dhalaos anywhere in the city, leave alone inside residential colonies. Every scrap is reused or priced for sale or recycling.
Circular economy in waste
An important feature is that Indore’s circular economy makes trading in waste remunerative. But how did Indore’s citizens accept IMC’s six-bin waste segregation instruction? The logic was explained by Captain Sunpreet (former army officer) who works in one of Indore’s four NGOs. “Unsegregated, it is just trash, but once it is segregated it becomes gold! You don’t need to spend a penny. Investors will line up to establish waste processing facilities but only if you can give them segregated waste,” he said.
At the dry segregation facility in Indore, there is a huge overhead board listing 72 different items and their sale prices fixed by the Corporation. | Photo Credit: By Special Arrangement
At a ward-level segregation facility, operating discreetly under a flyover, Capt. Sunpreet said: “The money lies in resale and recycling waste, which is why we prescribe so many containers.” One bin is for wet waste, a second for paper, a third for plastics, a fourth for domestic hazardous material (like tablets or chemicals), a fifth for sanitary waste (menstrual waste, condoms, syringes, diapers, and cotton), and the sixth bin is for electronics like TVs, laptops, printers, and their components. “100 per cent of the waste is collected by the municipal staff—not by outsourced agencies, as in Delhi,” he explained.
At the dry segregation facility, there is a huge overhead board listing 72 different items and their sale prices fixed by the Corporation. While the wet waste is sent for composting or for producing gas to the bio-CNG facility, the money earned from the sale of rubber, plastic soles, bulbs, toothbrushes, cardboard, metal, glass, and paper goes into the municipal coffers and is ploughed back into keeping the city clean.
Policy on user charges
Indore generates enough funds from the sale of waste but also from property tax, user charges, Extended Producer Responsibility (EPR) credits, carbon credits, premiums, fees, fines, and organic fertilizer to manage city cleaning from its earnings. In this, it is far ahead of all other cities, even the runners-up. The monthly fee for collecting segregated household garbage ranges from Rs.60 to Rs.150 per household and everyone pays.
The biggest difference between Indore and other cities is that Indore recycles and sells whatever can be salvaged and makes it financially remunerative. In most other cities—including Delhi—the wet and dry household waste even if it is handed over in two bags, is sorted out by individual garbage collectors (who are not Corporation staff) and they extract what can be salvaged. But thereafter, the entire garbage is again remixed in the dhalaos before it is baled up and dispatched to the waste-to-energy plants. This mixing up is wasteful.
In Indore, the household wet waste goes to the bio-CNG plant for conversion into gas while all else is sold by the Corporation itself.
The biggest difference between Indore and other cities is that the wet and dry household waste of every household is sorted by the garbage collectors to extract what can be salvaged. Then the entire garbage is remixed by the garbage collector before it is baled up and dispatched to the waste-to-energy plants. | Photo Credit: By Special Arrangement
IMC generates around 120 tonnes of organic manure per day, of which 30 per cent is used and 70 per cent is sold. The sale proceeds offset the cost of running the bio-CNG wet waste processing plant. In addition, the sludge that accumulates after sewage treatment is dried by radiation technology and sold for organic cultivation and landscaping. I could not find any other city that trades in manure so systematically and on such a big scale.
NGOs as good cops
Among all forms of pollution, including air, water, or noise pollution, solid waste tops the list in magnitude and visibility. Unlike vehicular or industrial emissions, residue burning, construction dust, or water pollution caused by mixture of sewage or industrial effluent in drainage water, the management of solid waste is the most difficult. Because one has to deal with individual householders, who dislike sermons. Early on, IMC engaged NGOs to carry out public awareness campaigns. Currently, four NGOs (Basix, Divine, Feedback, and HMS) are responsible for handholding citizens. They conduct training and demonstration programmes across neighbourhoods and even individual households. They also teach best practices to the IMC staff. The Corporation slaps fines on recalcitrant households while the NGO approach is soft, explaining how composting and segregation can be done at home.
Indore’s 19 administrative zones have been entrusted to four NGOs and presently some 600 volunteers cover specific beats, on foot. Their performance is judged on four yardsticks: adequacy of training given to the households, percentage of waste segregated at source and recycled by the ward, reduction in per capita waste generated, and citizen satisfaction. The IMC relies on the before-after pictures uploaded by citizens on the 311 app. Some other cities have begun using the NGO strategy to sensitize the public.
IMC is among the few cities earning Carbon and EPR Credits (for plastic waste) and is extending consultancy support to 30 urban local bodies, including on how carbon credits can be earned. A slew of cities both in India and abroad have availed the consultancy, which includes Ahmedabad, Surat, Pune, Navi Mumbai, Mysuru, Chandigarh, Vijayawada, and Rajahmundry in India, and Colombo (Sri Lanka), Dhaka (Bangladesh), Kathmandu (Nepal), Kigali (Rwanda), Dar es Salaam (Tanzania), and Accra (Ghana).
In most cities, ragpickers play an important link in the waste segregation cycle, but are marginalised by society. By fortifying them with safety training, identity cards, uniforms, and badges and deploying them at the garbage transfer stations and wet waste processing units, Indore has given these near social outcasts official status and dignity.
No one is above the law
The Solid Waste Management Rules 2016 and the Environment Protection Act 1986 give legislative powers to all municipal corporations to levy spot fines but, apprehensive about public backlash, few cities have increased the outdated fines. In Indore, the powers for fining range from Rs.100-5000 for a Chief Sanitary Inspector, Rs.50,000 for a Health Officer, and up to Rs.1,00,000 for the Additional Commissioner of the Corporation.
The Chappan Dukane (56 shops) area in Indore is a charming city meeting point, where 6ft × 6ft stalls sell delicious vegetarian snacks and tandoori chai in a no squelch, no dust, no flies environment. | Photo Credit: By Special Arrangement
CCTV cameras and door-to-door inspections verify whether the six-bin segregation is being followed. Around 6,000 spot fines a year were once imposed but, with constant oversight, this number has halved. IMC says the judiciary and the police too with constant oversight are more supportive of their waste management initiatives.
Did Indori culture help?
Like all visitors to Indore, I visited the Chappan Dukane (56 shops) area, a charming city meeting point, where 6ft × 6ft stalls sell delicious vegetarian snacks and tandoori chai in a no squelch, no dust, no flies environment. A few old-timers in the market association spoke of the Indori culture in which respect for the administration is a notable element.
Commissioner Harshika Singh said, “Ahilyabai Holkar is even today remembered as a just and benevolent ruler of Indore. Her legacy of good administration resonates with citizens. They gladly donate bricks, cement, and other commodities to get their requests for minor municipal repairs expedited.”
The writer was formerly Secretary in the Ministry of Health and former Chief Secretary, Delhi.
The story of the political decentralisation of Delhi started in the 1980s, when the central government set up a commission, headed by Justice Sarkaria, to examine the balance of power and suggest changes within the framework of the Constitution of India. (Express File Photo)
As a child of the 50s, I watched Delhi develop from a quiet enclave of tree-lined roads and white-washed bungalows into the world’s second most populated city. Never in my wildest dreams could I imagine how much the city’s populationwould grow and how politics would shape its destiny.
A little history is fitting. When the States Reorganisation Act was passed in 1956, Delhi was classified as a Union territory to be governed by a Chief Commissioner (CC) appointed by the President. The capital was administered until 1992 by bureaucrats reporting to the chief commissioner and then to the Lieutenant Governor, under the watchful eye of the North Block — this includes the Emergency years and the period when it witnessed the anti-Sikh riots.
From the once peaceful colonies in New Delhi, housing mostly government servants and refugees from Pakistan, to Old Delhi’s Civil Lines, Chandni Chowk and Subzi Mandi — home to the original “Delhiwallahs,” — the city has expanded beyond recognition. Today, it is Asia’s fastest-growing city and the largest wholesale market for fruit, vegetables, and spices. For decades, it has been a magnet for education, trade, and commerce. With the highest per capita income in the country, it presents a constant lure for in-migration. And, politics is in its DNA.
In the 80s and 90s, elections to the Lok Sabha and Municipal Corporation were largely fought with the upper castes voting for BJP and the OBCs and Dalits voting for the Congress. This continued right up to 1998 when Chief Minister Sheila Dikshit, while assiduously nursing the city’s poor, also saw the potential of Delhi’s organised middle class. Educated and highly opinionated, they were undependable as voters, calling the exercise “pointless”. It was Dikshit’s citizen-government partnership, Bhagidari, which gave this constituency of some 10 million people relevance. The campaign gave her three consecutive electoral victoriesuntil 2014 when the new Aam Aadmi Party pulled the rug. That bears telling.
From the mid-90s, vast tracts of agricultural land were being stealthily acquired and built up without undergoing land-use change. Thousands of unauthorised tenements sprang up in areas that were once fields of grains and plots of vegetables. Today, seven million people inhabit some 1,079 colonies.
Without town planning, roads, drainage or sewerage, such habitations present problems. The Delhi High Court once remarked, “Peter should not be robbed to pay Paul” — a reference to honest taxpayers being deprived at the cost of those who broke the law. Today, almost a third of Delhi lives in such colonies.
Two decades ago, while still in his NGO activist avatar, Arvind Kejriwal used the Delhi Right to Information Act 2001 to expose corruption, play advocate for the slum dwellers and demand piped water for unauthorised colonies. Though his new party was rewarded handsomely in the 2015 and 2020 assembly elections, the colonies continued to be “unauthorised.” In 2021, the BJP passed a Parliamentary Act “regularising” all unauthorised colonies. How these inhabitants see their future will decide how they vote in the Delhi assembly elections in 2025.
The story of the political decentralisation of Delhi started in the 1980s, when the central government set up a commission, headed by Justice Sarkaria, to examine the balance of power and suggest changes within the framework of the Constitution of India. The commission submitted its report in 1988, but it was PM Narasimha Rao who ensured that the 69th constitutional amendment was passed. This gave legislative and political representation to Delhi. The new Article 239AA empowered the Union Territory of Delhi to function virtually as a full-fledged state with three exceptions — on matters relating to land, police, and public order.
The history of the passage of the constitutional amendment becomes relevant today. The original draft had Clause 7(a) and (b). At the time of tabling, in 1991, sub-clause 7 (b) was deleted because it would have required ratification by half the state legislatures and, therefore, delayed the establishment of a legislative assembly for Delhi. Only when the 70th Constitutional (Amendment) was tabled in 1992, did Clause 7(b) get inserted. Clause 7, therefore, reads:
“(a) Parliament may, by law, make provisions for giving effect to, or supplementing provisions contained in the foregoing clauses and for all matter incidental or consequential thereto.
(b) Any such law as is referred to in sub-clause (a) shall not be deemed to be an amendment of this Constitution for the purposes of article 368 notwithstanding that it contains any provision which amends or has the effect of amending this Constitution.”
The Centre used Clause 7(b) to bring in an Ordinance on May 19. It probably inferred that the Ordinance’s provisions would not tantamount to an amendment of the Constitution. Today, Clause 7 holds the key.
Thirty-one years after the 69th constitutional amendmentwas passed and became law, on May 11 this year, a five-judge Constitutional Bench interpreted a yet unresolved part of Article 239AA. The judgment gave the elected Delhi government control over services — officer’s postings, transfers, and disciplinary matters. Chief Justice D Y Chandrachud, who headed the bench, said “If a democratically elected government is not given the power to control the officers, the principle of accountability will be redundant… If the officers stop reporting to the ministers or do not abide by their directions, the principle of collective responsibility is affected.”
The euphoria of the AAP cadres after the SC’s verdict was, however, short-lived. The Ordinance promulgated on May 19 scythed through the apex court’s decision by using Clause 7(b). It stripped the Delhi government of control over its officers. The Ordinance is expected to become law soon.
The moot point is not of morality but the application of Clause 7(a) and (b). On a simple reading, it looks like the Centre has an advantage. But until the issue is settled by the court, the question remains: How far is the Ordinance supplemental or incidental to Article 239AA of the Constitution? That is the issue another bench of the SC will now have to decide.
The writer is a former Health Secretary and former Chief Secretary of Delhi
The writer is a former Health Secretary and former Chief Secretary of Delhi
File photo of Chief Minister Arvind Kejriwal | ANI
Saturday morning’s newspapers and Whatsapp groups were incredulous that an Ordinance had been issued late Friday night, stymieing the effect of the 11 May Supreme Court order on Delhi, removing the restraint on controlling officers and in effect making them accountable to the AAP ministers. Phones buzzed. Morning walkers stood in groups voicing their concerns. The observations were similar: “How can the central government bring a law and negate what a five-judge Constitutional bench has interpreted?” “Will this not amount to contempt?”
Indeed, the Supreme Court had observed that exclusion of the officers from the political executive would disable the government from implementing government policies and programmes and had given authority over services to the elected government. But has that order been belied by the Ordinance? No. A bare reading of the Ordinance shows that it is seemingly laying down the processes by which postings, transfers and disciplinary action against officials and allied matters would be administered. It has not tinkered with the judgment in any way.
What has the Centre’s Ordinance done?
It looks as though an iron fist has been used to vanquish the beleaguered CM. If he had harboured hopes of controlling services(officers), he has instead been rendered functus officio – unable to function without the agreement of the Chief Secretary and the Home Secretary – the other two members of National Capital Civil Service Authority – who can together even negate what the CM desires be done. The CM now has the choice of going back to the Supreme Court or of operating within the process prescribed by the Ordinance. He has already opted for the former.
What does the Ordinance provide?
Starting with the All -India services (Indian Administrative Service and Indian Forest Service officers,) DANICS officers (akin to the state civil services) and including all other services working under the Delhi government, the broad process to be followed in making postings, transfers and dealing with vigilance matters has been prescribed. Nowhere has the Ordinance prevented or deterred an officer posted in any department (of which there are over one hundred) to stop assisting in the formulation of policies and programmes or, once these are approved, to stop their implementation.
The Ordinance also does not question the principle of aid and advice. Ergo, it is unlikely that the courts will treat it as contumacious or requiring immediate interference from a judicial standpoint.
While the general belief in the few hours that I have listened to conversations is that the Ordinance is a ham-handed effort to contain Kejriwal and his growing popularity, evinced by the MCD election victory, the Apex Court’s rejection of the nominated aldermen stratagem and more recently the delay in appointing the DERC Chairman, the justification given in the preamble to the Ordinance is that the Capital is the seat of the President, Parliament, the Supreme Court, and various constitutional functionaries, foreign missions and international agencies. Besides, the city is visited by national and international dignitaries.
Therefore, to quote the Ordinance, it is in national interest to maintain “the highest possible standards of administration and governance of the national capital ” and, thereby forestall (my words) “any event in the capital which can affect not only the residents, the country or have the potential of putting the national reputation, image, credibility and prestige at stake in the international global spectrum.”
The underdog and the law
Notwithstanding the foregoing apprehensions,the sympathies of the common man continue to be with Kejriwal. “Usse kaam nahi karne dete,” is the oft-repeated refrain among guards, drivers and domestics who reside in a nearby slum and an urban village where I stay. But whatever people might feel, it does not mean that the central government lacked the authority or locus to issue the ordinance. Two Articles in the Constitution enable this without a doubt. Subsections 3 and 7 of Article 239 AA of the Constitution, through which the Government of Delhi was born, stipulate that Parliament may, by law, make provisions for giving effect to, or to supplement the provisions contained in clauses of Article 239 AA and for all matters incidental or consequential thereto. And that includes item 41 in the State list, which refers to Services. The legislative competence is undeniably available and has already been used in the past, for example, by setting up the NCT of Delhi Act in 1991 and amending it in 2015.
Further, Article 73 of the Constitution states that “the executive power of the central government shall extend to matters on which Parliament has the power to make laws.” This includes the Centre’s executive authority over the union territories. Delhi being a union territory (albeit with legislature), comes under Article 73 of the Constitution.
What can the CM do?
Given this, what can the Kejriwal government do to make “obstructionist officers face the music”, as was announced hours after the judgment came? As matters stand, very little.
In such a situation, I cannot but recall the years that I spent in the Delhi government. It was not a charmed existence and as Chief Secretary I was regularly upbraided both by the then Lieutenant Governor and by the Chief Minister for showing deference of partiality to one or the other. But despite the wrangling, there was a shared conviction that Delhi must develop, young people should get access to the best education and citizens must have good health services and a decent quality of life. To achieve those ends, political differences that surfaced time and again took second place in the interest of Delhi. Things have changed radically since then. Outfoxing the elected government on the one hand and heaping calumny on the Central Government on the other, have become a recurring theme day after day, with vituperation only increasing.
And the Delhi citizen (and voter), while he watches the ping-pong match, is a canny fellow who cares more about paying less – at times even zero – for electricity, water, and sewage treatment, than he cares about the ongoing Delhi power imbroglio.
To sum up, promulgating the Ordinance has been a dexterous way of side-lining the effect of the Supreme Court judgement without referring to it. Reviled as the officers may be, no government can perform without a bureaucracy. Good officers are essential to implement political assurances. And if the positioning and control of the officials are determined by an Authority whose majority members are seen to owe allegiance somewhere else, getting one’s way may not be easy for the political executive of GNCT of Delhi. We live in interesting times.
The author was formerly Chief Secretary, Delhi and Secretary, Government of India. She Tweets @over2shailaja. Views are personal.
Updated: May 12, 2023 11:23 IST AAP rose from the India Against Corruption movement and the CM and his band of ministers looked on officers as being part of the problem. Some called them corrupt. Others humiliated them in meetings, and the stories of what went inside the House committees are legendary some say they were even threats of arrest and jail. The Anti-corruption Bureau (ACB) was reported to have been unleashed on officers.
As Chief Justice of India D Y Chandrachud read out a unanimous judgment, treating Delhi on par with full-fledged states (except for three entries in the State List), and giving control over the civil servants to the elected government, memories of what has been going on since 2015 flashed before one’s eyes. The need for the Lieutenant-Governor (L-G) to abide by the aid and advice of the Council of Ministers on all matters except police, land and law and order was settled by the Supreme Court in its 2018 judgment. However, it had left the question of control over services (officers) undecided. This was addressed subsequently but had to go to a still bigger bench because of dissent.
Finally, we have today a decision which may or may not be followed in letter and spirit but will nonetheless be almost impossible to overturn.
Citizens of Delhi have become accustomed to watching a periodic tug of war between Chief Minister Arvind Kejriwal and the political executive and each of the three L-Gs — starting with Najeeb Jung, followed by Anil Baijal and now, the incumbent, V K Saxena. The conflict came to a head in 2021, when the central government brought an amendment to the Government of National Capital Territory of Delhi Act, 1991, giving supremacy to the L-G over the elected government. It made it incumbent on the elected government to refer almost everything to the L-G and stopped the Delhi Assembly from framing rules, setting up committees or conducting inquiries. This amendment to the NCTD Act was passed as a supplement to the constitutional provision under Article 239 AA and most retired law officers said then, that it was questionable whether Parliament could bypass the constitutional provisions and give more powers to the central government. Whether the Supreme Court has referred to the NCT supplementary amendment Act is not clear right now but by observing that the “L-G’s powers do not empower him to interfere with the legislative powers of the Delhi assembly and the elected government”, it does not uphold the amendment.
While dwelling on the question of services, the apex court observed that “if administrative services are excluded from the legislative and executive domains, the ministers would be excluded from controlling the civil servants who are to implement the executive decisions”. In effect, the verdict makes it incumbent on officers to report to the chief minister and his council of ministers.
One might well ask why the subject of officers and whom they report to should take up the time of a series of benches of the Supreme Court. The IAS cadre referred to as AGMUT is an acronym to encompass the governments they are required to serve — apart from Delhi, the states of Goa, Arunachal Pradesh, Mizoram and the union territories of Chandigarh, Andaman and Nicobar Islands, Puducherry, Daman, Diu and Dadra & Nagar Haveli, Lakshadweep and additionally, now, the union territories of Jammu & Kashmir and Ladakh after these were formed in 2019. The services of an AGMUT cadre officer are placed at the disposal of any of the constituent states or union territories by the Union Ministry of Home Affairs. By and large, officers report either to the chief minister or the L-G or the administrator as the case may be. Except for a few aberrations, the officers report that they are treated with respect and consideration and their advice is listened to.
But in the last seven years, Delhi changed this status quo. Officers had grown accustomed to administering a population of some 20 million ranging from the tony areas of Lutyens Delhi and high-end private colonies to massive urban conglomerations like Dwarka and Rohini and a population of some seven million living in unauthorised colonies. Another million live in urban villages and two million in slums. This posed enormous challenges, the likes of which major state governments, though having a larger area and larger populations, do not face in the same way. The challenges of supplying electricity and water, constructing and maintaining flyovers and roads, and managing the interface with the Delhi Development Authority for land, and the Delhi Police for public order (when both organisations report to the Centre through the L-G) are not easy. Unlike Mumbai, which is administered by a single state government, there are multiple bosses in Delhi and the stakes are always high. The media too has all the time for Delhi.
Until 2015, things were manageable. Whatever disagreements and clashes took place remained within the Secretariat and L-G’s office, mostly unknown to the media or citizens. But the Aam Aadmi Party’s chief minister and ministers did not come with long political and administrative acumen and were not versed in the diplomatic ways in which power games are played. Until 2015, the CMs all knew how to get officers to give ideas and implement the decisions as their own.
AAP rose from the India Against Corruption movement and the CM and his band of ministers looked on officers as part of the problem. Some called them corrupt. Others humiliated them in meetings, and the stories of what went inside the House committees are legendary — some say there were even threats of arrest and jail. The Anti-Corruption Bureau (ACB) was reported to have been unleashed on officers. Until then, the ACB was an unheard-of organisation in the Delhi government — small, inept, and mostly irrelevant — happy nabbing low-level employees caught red-handed accepting bribes. To go after senior officers was monstrous, say the officers.
When AAP took over, they made their suspicion and loathing of the bureaucracy clear. Time will tell who will do what, when and how. For now, there is no doubt that the interpretation given by the apex court is legal and cannot be belied. But if officers are required to perform and exhibit zeal to get things done, they must be given freedom, trust and respect. That will beget more loyalty and better performance than efforts to harangue them publicly.
The writer is a former Health Secretary and former Chief Secretary of Delhi
The AAP-BJP slugfest repeatedly thwarting mayoral election, begs reflection because citizens deserve better.
Shailaja Chandra Published: 14 Feb 2023, 7:47 PM IST
So accustomed have Delhi’s citizens become to the never-ending saga of the Municipal Corporation of Delhi (MCD) elections, that even the fourth attempt to hold the Mayoral election on 16 February has evoked scant interest. This article highlights why it should matter hugely. Because on it depends the basic environmental quality that citizens are entitled to receive. A few milestones will define the context.
The elections to the three MCDs were due in April 2022. In May last year, through a Parliamentary Amendment of the Municipal Corporation Act 1957, the North, East, and South Delhi Corporations were unified into a single corporation. Through this amendment, the Corporation returned to its original structure which had been in existence for 54 years before it was reversed in 2012.
Why Trifurcation of MCD Was a Bad Idea
The trifurcation was unjustified on merits. I was not working in the Delhi government when this happened and have frequently wondered what the rationale was. By the end of the nineties, DMC had already been compressed and the new independent entities had established decentralised systems to provide citizens’ services.
To give some examples, in 1997, the Delhi Electric Supply Undertaking, (DESU) which was then a part of the Delhi Municipal Corporation, had been brought under the Delhi government by creating the Delhi Vidyut Board (DVB). Following that in 1998, the Water Supply & Sewage Disposal Undertaking (WSSDU), also under MCD, was replaced by an independent organisation ‘Delhi Jal Board’ which too established its local offices.
An independent Fire Services Department which was under the DMC, was brought under the Delhi government. The Delhi Municipal Corporation Act was amended in 2003 categorising and pegging property tax rates. The property tax structure was streamlined as property returns could now be self-assessed and filed online.
With so much devolution, the need for trifurcation of DMC seemed unconvincing. Incidentally, in the Brihanmumbai Municipal Corporation(BMC), water supply, sewage, and an autonomous body for bus transport continue to be under the BMC. Setting up three corporations for Delhi was unnecessary and it also created an artificial divide which resulted in laying resources thinly, inequitably, and worse, providing alibis for non-performance.
Fortunately, the re-unification came after the DMC Amendment Bill became law in May 2022. Once the delimitation exercise commenced and was completed, elections for the single corporation were eventually held on 4 December.
Where Matters Stand
The results of 250 contested seats were announced on 8 December. AAP won a simple majority with 134 seats and the BJP followed with 104 seats. With that, it was assumed that the new Mayor would be elected by mid-December to be followed by elections to the Standing Committee and the Zonal committees.
The Standing Committee is an all-important body which has the functional power to decide priorities, accord financial approvals, and prescribe processes to execute its decisions. The absence of a Standing committee means that a participatory form of planning, budgeting, and the approval of new projects remains indeterminate and lacks political voice.
The election of the Standing Committee members has been delayed because it needs to be overseen by the Mayor whose own election has been the flashpoint over the last more than six weeks.
The Mayoral election has been repeatedly thwarted due to the slugfest which took place repeatedly between the BJP and AAP councillors on the 6th, 24 January, and 6 February 2023. The AAP’s nominee for Mayor Shelly Oberoi then agitated before the Supreme Court which was to be heard on 13 January.
Due to paucity of time, the hearing has been postponed to Friday ie 17 February. But the Chief Justice is reported to have observed that prima facie nominated members (aldermen appointed by the LG) cannot vote in the Mayoral election.
My bare reading of Chapter II Section 3 of the DMC Act 1957, still shows the following provision which has not been amended— “Provided that the persons nominated under this sub-clause shall not have the right to vote in the meetings of the Corporation.”
The Apex Court’s final ruling will decide this on 17th February.
How Much Do Municipal Services Impact Citizens?
In scores of ways, municipal services affect citizens more than big-ticket policies and programs. The upkeep of the city roads, drains, municipal schools, public health, and sanitation all need good municipal governance. 96% of Delhi is under DMC and only 6% is under the New Delhi Municipal Council and the Delhi Cantonment Board.
With the regularisation of unauthorised colonies carrying a population of 7 million, DMC is already grappling with over 1000 unplanned habitations which had sprung up over decades, devoid of even essential requirements like drains, roads, or sanitation. That has impacted the organised part of Delhi where every road that is less than 60 feet wide comes under the municipal corporation’s jurisdiction.
While more than 250 roads are selected to be upgraded in preparation for the G20 Summit, the repair of inner roads has received little attention. No pavement is free of rubble or rubbish giving pedestrians a tough time even as unlicensed vendors colonise public spaces.
Almost 700 stormwater drains spread over some 500 kilometers, are all owned by the DMC, but they carry little stormwater and a lot of rubbish. Umpteen orders from the National Green Tribunal have exhorted municipal officials to stop garbage and construction waste being chucked into the drains. One of the excuses has been the absence of magistrates who can fine the polluters!
Nearer home citizens have still to be persuaded or enabled to segregate household waste—if the altitude of the garbage-filled hill stations at Gazipur, Okhla, and Bhalaswa are ever to be lowered. Stray animals constantly cause innumerable problems to pedestrians and motorists. Construction dust and mosquito breeding cause huge health hazards, making the city unlivable for several months of the year.
Political support and leadership are key to fulfilling municipal functions needing behavioral change. But to start with every initiative needs budgets, award of contracts, oversight, and accountability. With no elected municipal government in sight, even two months after the election results, it has repressed the citizen’s right to hold elected representatives accountable.
Resident Welfare Associations Need a Voice in MCD
Delhi has some 2500 Resident Welfare Associations (RWAs)which, despite possessing no statutory authority or public funds have become the last mile link between the Corporation and resident groups. I have found several RWAS approaching the Municipal Councillors to intercede on a slew of local matters like street lights, pruning trees, maintaining colony parks, and remodeling putrid garbage dhalaos and stinking urinals.
The RWAs have had no bridge to a public representative for over 10 months now and have been dependent on the priority individual officials attach to such grievances.
Need To Fulfill Constitutional Obligations and Put a Halt to More Political Wrangling
Under the 74th Constitutional amendment, the states are obligated to hold elections to enable the process of urban local governance to function. The corporation has run without an elected body since May 2022.
This situation is at variance with the express requirements of the Constitution which mandates that urban local bodies must govern civic affairs through elected representatives.
No more time should be lost to make the elected body functional again. Delhi’s citizens deserve more than to only watch disagreements and turmoil day after day. It is the duty of those in charge to find constitutional ways to harmonise, not accelerate differences.Why should the election of a mayor or standing committee members need the Apex court’s intervention? The time for politics is over. Please get down to work!
(Shailaja Chandra (IAS retd) has over 45 years of experience in public administration focusing on governance, health management, population stabilisation and women’s empowerment. She was Secretary in the Ministry of Health and later Chief Secretary, Delhi. She tweets at @over2shailaja. This is an opinion piece and the views expressed are the author’s own.The Quintneither endorses nor is responsible for them.)
(At The Quint, we are answerable only to our audience. Play an active role in shaping our journalism by becoming a member. Because the truth is worth it.)
In a forward-looking legislation, small consumers can achieve little on own, often pitted against corporate lawyers.
Shailaja Chandra Published: 17 Jan 2023, 2:54 PM IST
This is about the recent news that a consumer court had issued warrants for imprisoning the CEO of the Greater Noida Industrial Development Authority (GNIDA) leading to one month’s imprisonment.
The CEO is Ritu Maheshwari—an IAS officer of 2003 batch. She comes with formidable administrative experience of having worked as a District Magistrate in Uttar Pradesh , four times over—indeed a rare achievement for any woman officer and more so in UP.
She has been the CEO of NOIDA for some years and was given additional of GNIDA three months ago. I found the sensational headlines about her arrest and imprisonment bizarre. The consumer courts are not known to ordinarily use the powers of contempt. Something must have gone horribly wrong. Intrigued, I decided to check the website where fortunately all documents are available.
What Unfolded in the 18-Year-Old Case?
The ongoing case has had a chequered history from 2005 until 2023 and is a veritable case study of how protracted litigation (in this case for over 18 years – and still continuing,) takes place. Without touching on the merits of the case, the basic facts bear repetition- because on these rest my concerns and conclusions.
In 2001 an applicant was denied an industrial plot by GNIDA. He approached the district consumer forum in 2005 and got relief in 2006. This order was contested by GNIDA before the State Commission and in 2007 the commission ordered that the applicant be refunded his application money of Rs 20,000 along with interest. This was done.
Four years later the complainant went in appeal to the National Commission. The most important operational part of the National Commission’s order of 2014 was to direct that “a plot of 500 m² to 2500 m² be allotted to the applicant after giving due consideration to the project report and other documents for the purpose of examining and coming to a decision on the allotment of an industrial plot.”
While GNIDA had promptly made a provisional allotment as directed by the National Commission, the Authority kept requesting the complainant to deposit 10% advance along with a Detailed Project Report (DPR)-an essential requirement for allotment of an industrial plot. The then CEO reported that thereby, he had complied with the National Forum’s order by making provisional allotment, but also lamented inability to proceed further in the absence of any response from the applicant.
The district forum then directed the complainant to file the DPR; only thereafter some documents were filed which GNIDA found deficient on several aspects.This too was reported to the district consumer forum. But meanwhile the applicant filed for execution of the decree. This litigation went on for another five years from 2017-2022 with some 40 hearings and no outcomes .
On 7 January 2023 however, the executing court threatened to issue warrants against the CEO leading to imprisonment to come into effect in 15 days if the orders were not complied with. There the matter rests.
Consumer Court Process Should Be Consumer-Friendly
There are three things which I found worrisome about the case. First, the consumer courts were set up by an Act of Parliament in 1986, intended to check unfair practices in trading goods and deficiencies in service.
Unlike the judicial process, consumer courts can accept a direct application from a consumer, can hear the applicants without the assistance of a lawyer and the fees are nominal. The cases are expected to be disposed of in a “consumer-friendly” manner. Some say like summary proceedings.
The unfortunate reality is that the beneficiaries of a forward-looking legislation—the small consumers can achieve very little on their own, often pitted against corporate lawyers who have no brief or stake in concluding any consumer case.
This calls into question whether not just the consumer, but even the responding managements should not both be required to argue their own cases under the Consumer Act? Since consumers are generally individuals, the disposal of their complaints ought to be as consumer- friendly and uncomplicated as possible.
What Media Sensationalism Does to the Credibility of Authorities
The second worry is that the NOIDA CEO Ritu Maheshwari reportedly assumed additional charge of GNIDA only in October 2022. Was it fair for her name to be flashed with the headline, “Greater Noida Authority CEO Ritu Maheshwari sentenced to one month in jail,” when no warrants and much less a sentence has been pronounced ? Was it professional to brandish the officer’s name in the local media without checking the actual wording of the order ?
I do not worry about Ms Maheshwari’s personal reputation as fortunately, even today, an officer’s professional stature is decided by proficiency and commitment. The civil service’s grapevine never gets the reputations of officers wrong— (whatever decision-makers may decide to do with this feedback.) But without question, the sensational media reportage would have shaken the reputation of GNIDA and NOIDA Authority too, where Ms Maheshwari continues to be CEO.
Together, the two organisations must be dealing with tens of thousands of applications for residential, commercial, and industrial allotments. Can the public repose faith in an organisation where the CEO is reported to have been imprisoned for defiance of court orders? Such headlines create doubts not just on the organisation’s bona fides but on the state government’s trustworthiness.
Power of Contempt Is a Potent Weapon
The third worry is that the power of contempt remains a threat which officers fear far more than adverse observations made by auditors or vigilance watchdogs. Contempt of court can indeed land any contemner into jail. That is why when the danger of committing contempt is shared with political bosses, they invariably respect the sense of fear conveyed by officers.
To give an example, it was the threat of officers being jailed that forced the then CM of Delhi, the late Ms Sheila Dikshit to agree to implement the phasing out of diesel buses and hasten the switchover to CNG— a direction from the Apex court which had been parried for four years. But the power of contempt should normally not be used without first questioning whether the defiance was deliberate or was aimed at undermining the authority and dignity of the Court.
As things stand today, GNIDA has gone in appeal praying that the coercive portion of the order dated 7 January 2023 may be set aside and its compliance may be taken on record. No one can say how long the next part of this litigation might take.
(Shailaja Chandra (IAS retd) has over 45 years of experience in public administration focusing on governance, health management, population stabilisation and women’s empowerment. She was Secretary in the Ministry of Health and later Chief Secretary, Delhi. She tweets at @over2shailaja. This is an opinion piece and the views expressed are the author’s own.The Quintneither endorses nor is responsible for them.)
I dream of an India more open-minded and egalitarian, where the walls of caste and class have broken down, writes Shailaja Chandra.
Written by Shailaja Chandra Updated: November 23, 2022 8:47:25 am
My first vision is to secure freedom from casteism — something that has not happened in 75 years.
When India celebrates one hundred years since Independence, I may not be around. But no one can stop me from dreaming about an India that, by then, should become more egalitarian and more open-minded. It is that vision that permeates my thoughts today. While there will always be a need for improved health and education, better infrastructure and connectivity, growth in global competitiveness, and improvement in the quality of life, these are, in their very nature incremental. The way we are going, all these things will improve sooner than later. I would like instead to use this opportunity to dream and strike where it hurts. To me, four things stand out as most important.
First, to have a country free of caste — where being a Brahmin, a Kshatriya, a Bania, an OBC, a Dalit or a tribal does not matter. Second, to see those responsible for governing and protecting citizens made much more accountable — not so much by the law and the courts, as much as by citizens. By voters being able to distinguish between good governance and pretence. Third, to bridge the class divide in a country where paymasters and workers, no matter how skilled or how loyal, are underpaid, kept at arm’s length, and notoriously underpaid. I share my thoughts on making it happen.
My first vision is to secure freedom from casteism — something that has not happened in 75 years. The Scheduled Castes and Tribes listed in the Constitution have over 1,000 castes identified as once having faced deprivation, oppression, and social isolation. Over 740 tribes, who have distinct cultures and live in geographical isolation, are similarly protected. These groups constitute around 22 per cent of the population and have been receiving the benefit of laws, reservation, and a slew of social and economic benefits to overcome past and ongoing discrimination. Notwithstanding their finding political voice and reservation in government services, these efforts have been effective only in small proportions — those who were better placed initially, through access to education or their own initiative, continue to benefit. Affirmative action has not addressed the root causes of the continuing predicament of these groups.
So, while not even suggesting changing the Constitution, has the time come to identify deprivation differently? I would like to see an India where we identify deprivation not just by the caste name being included in the state lists by nativity, but by identifying families among these very groups where not even one woman in the family has studied beyond Class 8 or is a wage earner in the labour force. These signs of deprivation have many longer-term effects on the wellbeing of the family and on children’s health and education. We need to have a census of such women among the Scheduled Castes and Tribes and work towards educating and equipping them with one test of success — have they passed a minimum of a Class 10 examination and joined the labour market? Lower caste women bear discrimination of caste and gender. Empirical evidence suggests that money in the hands of mothers (as opposed to their husbands) benefits children. With fertility declining, the goalposts should be changed because India is the only country where women’s labour force participation seems to be declining.
Second, among the middle classes, I would like to see a breakdown of the walls that separate community and caste. Let more inter-caste marriages bloom and let the diversity of cultures create a band of young Indians who do not need to go to caste-based sites to select a partner. Young people’s education should equip them to understand and welcome multi-culturist attitudes to eating, dressing, speech and social mixing. Only then will the social cohesion that India receives high marks for internationally, percolate into the aspirant middle classes by choice.
Third, I would like to see young Indians participating in a thinking way in the way elections are fought and votes cast. The middle class is not small. A third of India can by most accounts be considered middle class. These people are educated, mobile and have opinions. But they do not care to vote. They do not know who their local councillor or MLA or MP is. Where then is the question of holding these “public representatives “accountable? If every adult middle-class man or woman decided to find out more about their political candidates, demanded to know what candidates and elected representatives have been doing or will do for them and force them to debate on issues that matter, it would shame those who simply ride the wave of a party. I would like the media to be assertive, not choosing their targets. In the UK, ministers are forced to resign over unethical conduct or immoral behaviour. By the time, the Indian Republic is 100, our citizens must gather voice to question, debate, discuss and kick out those who only sit as cheerleaders for their political party.
Finally, I would like to see a classless society which exists in India but which we have never taken note of. On a posting to Manipur in 1971, I was unaccustomed to seeing the baby minder (ayah) sleeping on my bed, the baby alongside. Likewise, my office peon came straight into our drawing room and occupied the sofa. The Manipuris, whether they are Meities from the Imphal Valley or tribals from the hills, live in a classless society. In Mizoram, those cooking and serving the food for a party, eat at the same table — not in some corner at the back of the house! We see our children living outside India coughing up hundreds of dollars for a plumber’s visit and offering tea while we do not even offer cold water!
My thoughts are big and small. Twenty-five years is a long time to make this happen!
The writer is a former secretary in the Ministry of Health. This article is part of an ongoing series, which began on August 15, by women who have made a mark, across sectors
Shailaja Chandra writes: Many expectations for the health sector remain unfulfilled
Written by Shailaja Chandra | Updated: February 5, 2022 9:39:12 am
A hospital staff waits beside the body of a person suspected to have died after Covid-related complications at Civil Hospital, Asarwa. (Express Photo: Nirmal Harindran)
There were many expectations of the Union budget for the health sector. The big-ticket items — the digitally managed health ecosystem and provisions for mental health — veer away from the prevalent systems. They rely on the power of technology to bypass the need to undertake physical visits to doctors, carry prescriptions and wait in queues. The digital experience could be a game-changer, but only if the facility, doctors, patients, and systems work in tandem.
When it comes to Covid vaccinations, the digital platform has been a runaway success, primarily because the COWIN platform was simple and slick, and the citizen could choose between public and private facilities. Online medical consultations have started in metros and people are setting up appointments with doctors easily. But the management of hospital beds across the country is a different story. Of the 19 lakh beds in India, 62 per cent are in the private sector. Nearly 95 per cent of them are operated by small hospitals or nursing homes — the first port of call for most citizens seeking medical care. The setting up of a National Digital Ecosystem which “will maintain digital registries of health providers and health facilities,” is welcome, but one must be clear whether it will encompass both the public and private health sector and include smaller hospitals and nursing homes. And, what about consent, compliance and cost?
The other big-ticket announcement relates to the mental health sector. It serves one purpose straightaway- making society aware that such conditions can afflict anyone, but the disease can be treated, and patients should not be stigmatized. With IIT Bangalore and the National institute of Mental Health and Neurosciences (NIMHANS) in the driver’s seat, we can expect professionalism and results
The other big-ticket announcement relates to the mental health sector. It serves one purpose straightaway — making society aware that such conditions can afflict anyone, but the disease can be treated, and patients should not be stigmatised. With IIT Bangalore and the National Institute of Mental Health and Neurosciences (NIMHANS) in the driver’s seat, we can expect professionalism and results. But the budget speech did not mention if the mental health strategy will focus on all psychological problems or only those that have arisen in the wake of Covid. Many mental health conditions encompass disorders that are not amenable to teleconsultation.
While the budget has provided some financial leg up to the National Health Mission and more to the Pradhan Mantri Swasthya Suraksha Yojana (under which AIIMS-type of hospitals and government medical colleges are being established or upgraded) these are programmes that have been in progress since 2005. Four announcements were expected but did not come.
First, the need to substantially raise the overall budgetary contribution to the health sector. It is currently pegged at 1.8 per cent of the GDP and the push in the budget appears very small.
Second, during the pandemic the unorganised middle class was caught without adequate (or even any) health insurance. After excluding insurance coverage for the organised sector (both government and private), and those covered by Ayushman Bharat and state-level health security schemes, a whopping 26 crore people had no health insurance when the pandemic started. They found hospitalisation costs staggering. One of the biggest expectations from the budget was that the lower end of the “missing middle” would get some handholding.
Third, there was an expectation that Ayushman Bharat would be expanded to cover the outpatient costs faced by the poor. The Economic Survey has recognised that such expenditure is huge.
Fourth, there was a need to address the crisis of non-communicable diseases — hypertension, diabetes, and cardiovascular diseases largely caused by unhealthy lifestyles. During Covid, people with comorbidities constituted the largest segment that succumbed. Fiscal measures, incentives, and disincentives have reduced the incidences related to lethal consequences of smoking. A repetition of the prevention of smoking story was called for.
The health sector outlay leaves many expectations unfulfilled. People I spoke to said “not everything needs to be announced in the budget.” We live in hope.
This column first appeared in the print edition on February 5, 2022 under the title ‘Not so healthy’. The writer is a former secretary in the Ministry of Health.
By Shailaja Chandra, ET CONTRIBUTORS Last Updated: Jan 31, 2022, 06:54 AM IST
Delhi tops the obesity list with 41% of women and 38% of men being found overweight in the latest survey.
Comorbidities have been the leading cause of hospitalisation and deaths during the three waves of the pandemic. Doctors around the world are reported to have found 48% of the patients who passed away after treatment, to have had underlying comorbidities. Out of the 48%, more than 30% were diagnosed with hypertension, 19% with diabetes and close to 8% with cardiovascular conditions. In India, all doctors are agreed that hypertension, diabetes, and cardiovascular diseases have been the three leading comorbidities that delayed, even hampered recovery.
While the forthcoming budget will hopefully address gaps to ramp up hospitals, train healthcare workers and detect new mutants, much more is called for at the level of the general population. Unless people help themselves, the best hospital care will never suffice. As more and more Indians exhibit the major underlying factors that accelerate serious medical conditions, policies must aim to reverse this trend.
The State of The Nation’s Health, a joint publication of the Indian Council of Medical Research, the Public Health Foundation of India and the Institute for Health Metrics and Evaluation, USA, had in 2016 shown state by state how hypertension, diabetes and cardio-vascular diseases had been growing from 1990 to 2016. The burden of noncommunicable diseases (NCDs), far from plateauing or decreasing, had spiralled from 30% of the total disease burden in 1990 to 55% in 2016. Unhealthy diet, high blood pressure, high blood sugar, high cholesterol and being overweight were found to be the main contributors to ischemic heart disease, stroke, and diabetes.
We now have the benefit of the survey results from the National Family Health Survey -5 released in December 2021 and are able to compare the changes that have taken place since NFHS-4 released in 2015-16. Both surveys show the extent to which the growth of NCDs have soared across the country; save for a few exceptions, obesity levels have grown across the board.
Delhi tops the obesity list with 41% of women and 38% of men being found overweight in the latest survey.
Among women, the states of Punjab, Tamil Nadu, Kerala, Andhra Pradesh, Haryana, Himachal Pradesh, Telangana, Karnataka, Uttarakhand 30- 40 % are obese. In the next group fall states with an obesity percentage between 20- 30 % which include Maharashtra, Odisha, West Bengal, Gujarat, and Uttar Pradesh.
Among men, curiously in all the South Indian states of Tamil Nadu, Kerala, Telengana, Andhra Pradesh and Karnataka, along with Punjab and Himachal Pradesh display between 30-40 % obesity. In the next group which includes Haryana, Uttarakhand, Maharashtra, Odisha, and Gujarat 20-30% of the men were found obese.
Synopsis
While the forthcoming budget will hopefully address gaps to ramp up hospitals, train healthcare workers and detect new mutants, much more is called for at the level of the general population. Unless people help themselves, the best hospital care will never suffice.
Obesity significantly increases the risk of diabetes, high blood pressure, and heart disease. An obese person’s risk of a heart attack is three times greater than that of a person with a healthy weight. Research has suggested that people who are obese are up to 80 times more likely to develop type II diabetes. These data call for major efforts to control the impact of lifestyle -related diseases before the situation becomes irretrievable. In the last 22 months patients with these comorbidities required high end hospitalisation which was neither universally accessible nor inexpensive.
Over the years fiscal measures and public policies have successfully weaned lakhs of Indians away from smoking – the leading cause of cancer. It is time to announce comparable policy measures to counter the two main drivers of life -style diseases- wrong eating and sedentary routines. In the interest of citizen’s health, the budget is the right time to make some far-reaching announcements.
What can be done? The first strategy must focus on reducing the volume and improving the quality of fats and oils. Second, the marketing of unhealthy processed foods must be controlled by increasing taxes, mandating colour coding for highly calorific items, and removing agricultural subsidies given to producers of oils having high saturated fatty acids. Third, farmers need to be incentivised to grow more millets. Manufacturers must be given time limits to progressively reduce saturated fat, salt, and sugar in processed foods. Moving towards the elimination of trans fats (hydrogenated oils) used in fast food joints and by street vendors need standards, oversight, and enforcement.
When cities like Toronto mandate that every slice of pizza display the calorie content, and New York restaurants carry the calorific content along with the price of a single portion, we must build public awareness even at the cost of unpopularity. The states should also be directed to introduce healthy policies and provide dietary counselling in schools. Obesity in children has already increased.
A responsible government must heed what its own agencies have repeatedly demonstrated. If public health really matters!
(The writer is a former Secretary in the Health Ministry and Chief Secretary, Delhi)
over2shailaja 