Of all the lessons that the pandemic has taught a civilisation that had become improbably confident of its beliefs, perhaps the most unsettling is that the most technologically capable nations cannot protect the lives and health of their citizens from a medieval plague. It follows that a political culture and economic system invested in the ideal of ever-increasing GDP must invest more in the health of its citizens, who power the engine of growth. Historically, India has hesitated to invest adequately in school education and health, the twin foundations of a mature society, and these sectors remained neglected even by the reforms process. Now, it appears that even the newest innovation for optimising spaces and communities for growth, the Smart Cities Mission, hasn’t understood the foundational importance of health.
The figures are appalling. Only 1.18 per cent of the 5,861 projects okayed since 2015 are for augmenting infrastructure and capability in health. In fiscal terms, they account for only 1.03 per cent of the volume invested by the Mission. Plumbing an abyssal nadir in the importance accorded to health, this is even lower than the shamefully inadequate 1.6 per cent of GDP which the states and the Centre together set aside for health in 2019-20. For comparison, the total health expenditure in the US in 2017 was 17.9 per cent of GDP, of which the state contributed over 8.5 per cent. Of the 30 municipal jurisdictions which account for 79 per cent of cases, 17 are smart cities — and, of them, only seven have invested Mission funds directly in health. Hotspots like Jaipur and Surat have no health projects at all under the Mission.
As the Mission clarifies on its website, a smart city has no absolute definition. The term originated among Western planners to describe a city which uses Internet of Things data to optimise its services. The Indian ministry of housing and urban affairs mentions this aspect in only one of the eight features it lists for a smart city. The rest focus on urban planning strategies for quality of life, such as reducing pollution and improving land use. Health is mentioned only in one point, which discusses urban identity conferred through local economic activities like making sports goods and hosiery, and providing medical facilities. Health is not acknowledged as the substrate of productivity. We can only hope that the pandemic drives the point home, and the Mission pivots to health.
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