Looking ahead

Good news for India and good news for the world. India's population is expected to peak at 1.6 billion in 2048, almost 100 years after Independence in 1947. After the peak, it will steadily decline to 1.09 billion by the turn of the century in 2100, promising a significant reduction in poverty or a modicum of prosperity. The new estimate comes as a huge relief from earlier forecasts of world population hitting 11 billion in 2100, up from 7 billion just six years ago in 2014.

The latest projections for India and the world published last week in the British medical journal, The Lancet, come in a study by researchers at the University of Washington's Institute for Health Metrics and Evaluation. Pointing to trends about future labour shortages in the developed countries and their immigration needs, it also highlights the demographic dividend for countries like India with younger people entering the job market.

The population turnaround hinges upon total fertility rate (TFR) which is showing declining trends in most of the world, except in continental Africa, and less so elsewhere. For India, the TFR, the average number of children a woman has in her lifetime, is expected to decline from 2.3 in 2017 to 1.66 in 2100, which is lower than the population replacement rate of 2.1 births per woman.

India's TFR is thought to have slipped already to the replacement benchmark of 2.1 in 2019, a cause for some satisfaction but we are not out of the woods for a long while yet. The backlog accumulation of population, or rather overpopulation as some experts would describe it, is going to keep us pretty busy in our fight against poverty for a considerable number of years, probably well beyond 2100. The precarious state of India's fight against poverty has been brought home in all its ferocity as never before during the current onslaught of Coronavirus pandemic.

The cross country travels and travails of millions of internal migrants from big city centres back to their village homes hundreds of kilometres away have opened our eyes to the reality of the gap between poverty and bare survival for millions of our men, women and children.

The fight against poverty is a long one — no easy solution, no quick mantra. The escape from poverty and the road to reasonable sustenance lies through family planning which India has long talked about and even achieved somewhat by fits and starts. Family planning is a multifarious affair where no single prescription exists to meet all shortcomings.

The story of family planning in India is a long and chequered one. Sterilisation has been the chief instrument preferred by our planners over long years. Cumbersome, even painful, the method still remains unpopular as ever. There are few takers for it voluntarily. The 1970s Sanjay Gandhi drive for forced sterilisation or 'naas bandi' gave the family planning idea an everlasting setback which the country is still unable to shake off. No political party since then has ever dared to openly talk about birth control, which is the core of all family planning.

No wonder it didn't succeed. Nor could India go the China way. The one-child policy which China imposed on its people succeeded only through dictatorship and punishment, not by any willing acceptance. Facing fierce opposition, democratic India gave up the fight in favour of soft and indirect television messages like cine star Amitabh Bachchan's advertisement about the joy of holding a baby and the importance of the first 1,000 days in a child's life. No hard warnings of malnutrition or stunted children or prenatal or postnatal problems. Even a yesteryear advertisement about 'Ek ya do, bas' (one or two children, enough) was dropped after a seemingly good initiative. It was direct and could have made an impact without being imposing like the Chinese dictat. Instead, most political parties in India have chosen to maintain dead silence on the issue.

The consequences of this abrogation of duty for active promotion of population control measures are open for all to see. Poverty remains a national curse as the current migrant upheaval has exposed. In sharp contrast, China has outpaced India in its march towards prosperity. Figures released earlier this year revealed that the Chinese per capita GDP (gross domestic product or per person yearly income) crossed USD 10,000, nearly five times India's per capita or per person earnings.

Even without any Chinese style draconian population control measures, India could have achieved a lot. But retreat from the active, direct call for population control has been costly and will continue to cast its shadow for the foreseeable future.

As a reminder, India faces special challenges in two of its states, namely Uttar Pradesh and Bihar which have a visible higher total fertility rate which is much above the replacement level of 2.1. Uttar Pradesh FTR in 2018 stood at 2.9 while Bihar posted 3.2 — both too high for any sense of satisfaction. Nevertheless, both states have shown signs of progress as both states clocked 4.2 FTR in 2006. Some progress, but not enough. It's time for the national authorities to help both states out of their sluggish performance.

To make matters worse, some of our fringe leaders like Sakshi Maharaj have been peddling the idea that every Hindu woman should produce at least four children to protect Hindu religion. He issued his call at a Sant Samagam Mela in Meerut five years ago when he was Member of Parliament for Unnao. Not to be left behind in this competitive race, the Shankracharya of Badrikashram, Shri Vasudevanand Saraswati, urged every Hindu woman to give birth to ten children to maintain Hindu majority status in the country!

Only last month, a former Madhya Pradesh Congress minister, Jitu Patwari, is said to have compared five daughters being equal to one son in his tweet saying: 'Five daughters were born namely demonetisation, goods and sales tax, employment, inflation and economic slowdown while anticipating a son called development (Vikas).' He deleted the tweet when criticised by the BJP leaders who accused him of being misogynistic. Regretting his howler, Patwari later said daughters are like goddesses.

There are several crackpots in other communities too. The sad fact is that such high priests of parochial causes have not been openly reprimanded by the top political leadership.

To come to actual family planning work undertaken over the last few decades, the achievements balance sheet is pretty weak. Sterilisation has been the most talked-about method, almost exclusively confined to women. Men seem to have opted out of all family planning routes — condoms, sterilisation and all. Women seemed to have been dragooned into it by husbands, doctors who earn a fairly good target driven fee for every operation they perform in a single day at day camps organised by health officers. The bouquet of options like the pill in all its variety and injectable contraceptives are seldom offered with any persuasion. The pill which has been the most successful contraceptive in the West has negligible usage in India. Part of the reason why the pill has failed to attract enough users is the price tag, however nominal.

Primary workers ASHA (Accredited Social Health Auxiliaries), who have been the main driving agents of all family planning work in rural and semi-rural areas are often overburdened with various other chores. Nevertheless, they are still the best hope, literally and metaphorically true to their name — ASHA.

Views expressed are personal