Economy to grow 6 % ? Are we fooling ourselves !


Car sales in India slumped 25.7 percent in February, the biggest fall in more than 12 years and the fourth consecutive monthly slide, an industry body said on Monday, as sluggish economic growth continues to weigh on demand.

The industry is expected to see it first decline in annual sales in a decade as high interest rates and rising fuel costs in Asia’s third-largest economy put off buyers in a market that was once one of the world’s most promising.

Automakers sold 158,513 cars in India last month, data from the Society of Indian Automobile Manufacturers (SIAM) showed. Car sales are down 4.6 percent for the first 11 months of the fiscal year ending in March, it said.

“There is no improvement in the market sentiment. People have more or less stopped discretionary purchases,” Sugato Sen, deputy director general of SIAM told Reuters.

“This has really impacted the bottom of the pyramid, people who buy the smaller cars,” he said, referring to the slowing economy that is expected to grow 5 percent, a decade low. “That is getting reflected in the numbers.”

http://in.reuters.com/article/2013/03/11/india-autos-cars-idINDEE92A04R20130311

Our Finance Minister is now doing road shows in Hong Kong, Japan etc to attract investors ….. If the Finance Minister of India has to take to road shows, Indian economy is entering a ‘No show’ time ……

This is what i have been writing for the past one year ……..Wake up call for our ‘Learned Handicapped’ Politicians, who are disconnected from the ground realities

Rajendra Pratap Gupta

http://www.commonmansblog.com

Budget 2013-14


I am not an economist , so in case, my predictions go wrong ( so far, i have not been wrong on a single occasion ), i do have an option to take refuge in my lack of educational qualifications in the Economic theory unlike the proficient doctors of economics do at PM’s office , Planning Commission & the Finance ministry …..

My belief is that in 2013-14;

1. This Government will struggle to revive growth

2. Inflation ‘might’ ( 50 % chances ) come down a bit , as consumption story of India will go down

3. Manufacturing sector will slow down

4. Fiscal deficit will increase, and might create a balance of payments problem , or the Government will open more avenues for FDI ( or bend to the demands of the industrialists )

5. Tax collections will go down

6. Divestment target will not be met under the current situation unless some more ‘targets’ are divested

7. India might face a ‘security threat’ before the next elections

8. Investor confidence cannot be revived due to ‘Governance deficit’ and ‘Scamful’ Government at the centre .

Also, you can expect this Government to come out with injecting ‘Oxytocin’ in the economy as mentioned in my earlier blog ….. but this will be a short-term story, and will further dent the strength of the economy

Overall, not a good omen for job seekers and this nation . Hopefully, this will be the last budget for Congress

Rajendra Pratap Gupta

http://www.commonmansblog.com

Why spectrum auctions didn’t take off


A lot of debate and ‘political firing’ has been happening across party lines ( within parties as well ! ) about the wrong calculation of the loss due to spectrum auctions to the tune of Rs1.76 lac crore as computed by CAG, and a mere collection of Rs 9,407 crore this time against the expected Rs.40,000.00 crore has been quoted as the reason. This is a totally flawed argument .

On September 24th , 2012 , our telecom minister announced that, in the new telecom policy , there would be ‘One nation- free roaming’  . This implicitly  indicated that , it  would move to one circle instead of multiple circles !  Taking a cue from the new telecom policy, mobile operators have ‘smart-checked’ the government by not bidding at all for expensive circles like Delhi and Mumbai or remain contended with what they have . As most likely , with this policy of ‘One nation- free roaming’ , all operators would be national players automatically and no need to pay 10’s of thousands of crores ! And this may be the reason for poor collection during these auctions , as the policy environment has changed than what used to be during Raja’s time . You cannot play a game of hockey and apply rules of cricket and decide who wins !

Rajendra Pratap Gupta

www.commonmansblog.com

 

India – from Emerging to a Submerging economy


India – from Emerging to a Submerging economy

On 22nd March 2012 , I wrote this on my blog and also sent the same to leading public figures .I had stated dwelling  in detail about how,  ‘ Have we oversold the India story’, and this was much before the bad news starting sinking in !

Link to the blog is  https://commonmansblog.com/2012/03/ .

This blog clearly mentioned that we must be prepared for bad news in April – May – June Quarter , and we know that,  India was downgraded as an economy by the international rating agencies ( S&P & Fitch ) and many Indian banks also faced the brunt , many retailers are gasping for breath ….

This time , I have decided to write about the story of how Indian economy would  enter a dark phase if immediate steps are not taken ,and this note is not against anyone but for everyone who wants to see India doing well !  I have tried my best to put data for every statement ( Besides Almighty , everyone should believe in data !).

So now , it is time to peep in the story of how an emerging economy can become a submerging economy .

Let us look at the following data :

Sector – Industry / company Financials ( Loans / NPAs) Source / Remarks
Telecom Sector Rs. 2.00 Lac Crore debt TOI, 26th September , 2012.
Banking Sector NPAs Rs.1.37 Lac crore as of June’12 Mint , 7th September, 2012
Banking Sector According to RBI’s assessment , a fifth of all re-structured loans go   bad . According to RBI, as on March 31, banks had Rs.2.18 Lac worth of   restructured loans on its books Mint, 7th September, 2012
Banking Sector State-run banks  NPA crosses   Rs.1.23 Lac crore Mint , 23/ August/ 2012
Credit card outstanding Rs. 22150.00 Crore As on July/ 21 Ref. ET 14/9/12
Indian Government Total planned borrowing is Rs.5.71 Lac crore for FY 13, of which   Rs.2.0 Lac crore would be in the second half of the fiscal by Dec’12 As per Mint dated September 28, 2012
Banking Sector Report by Credit Suisse group AG points that exposure to 10 large   Industrial groups constitute 13 % of the entire banking system Mint, August 21, 2012.
Banking Sector As of 27th July, Indian banks had loans outstanding of   Rs.36,600.00 Crore to the mining and quarrying sector, and Rs.93,170.00 Crore   to the Telecom sector Mint, 12th September, 2012.
Power Sector As of March, 2011, the accumulated losses of the State power distribution   companies are estimated to be alone Rs.1.90 lac crore which, by now,  would have crossed  Rs.2.0 lac crore IBN Live dated 23rd, September,  2012
Air India ( NACIL) Rs.67520.00 crores in loans & dues NDTV Profit, 8th Feb, 2012
Pantaloons ( Kishore Biyani’s ) Rs.3300.00 crore ET, 14th June 2012 . After selling a portion of its   apparel business to Aditya Birla Group. Before the sell-off , the debt of   Pantaloon was about a billion dollars
Reliance ADA Group Rs.86700.00 crore  FY’12 Business Line August 26th, 2012.
GMR Rs.33600.00 croreFY’12 Business Line August 26th, 2012.
JSW Rs.40,200.00 crore FY’12 Business Line August 26th, 2012.
Jaypee Rs.45,400.00 crore FY’12 Business Line August 26th, 2012.
Lanco Rs.29,300.00 crore FY’12 Business Line August 26th, 2012.
Essar Group Rs.93,800.00 crore FY’12 Business Line August 26th, 2012.
Vedanta Rs.93,500.00 crore FY’12 Business Line August 26th, 2012.
Adani Group Rs.69500.00 crore FY’12 Business Line August 26th, 2012.
Videocon Rs.27,300.00 crore FY’12 Business Line August 26th, 2012.
GVK Rs.21,000.00 crore F’12 Business Line August 26th, 2012.
Fortis Healthcare Rs.6237.00 crore Business Line August 15th, 2012
King Fisher Airlines Rs.7500.00 crore The Hindu, July 2nd , 2012
Losses of top three oil marketing companies Rs.40,500.00 crore in April-May-June’2012 Forbes India , Sept 03, 2012
Airtel Rs.60,018 Till Q1, 2012 Business Line , Aug 3, 2012

The total debt level of  ten companies alone (Adani, Essar, GMR, GVK, JSW, Jaypee Group, Lanco, Reliance ADA, Vedanta and Videocon) has jumped 5 times in the past five years to Rs 5,39,500 crore  ( Indian Express , September 06, 2012 )

Business Line dated August 26, 2012: Credit Suisse said that the aggregate debt of the ten groups accounts for about 13 per cent of total bank loans and a whopping 98 per cent of the entire banking system net worth.

“Therefore, surprisingly now in terms of concentration risk, Indian banks rank higher than most of their Asian and BRIC counterparts,” it added.

The report said a strong loan growth of Indian banking system in past five years is increasingly being driven by a select few corporate groups.

“Given the high leverage, poor profitability and pressure from lenders, most of these debt heavy groups have initiated plans to divest some of their assets. However, given that most domestic infrastructure developers are already over-geared, demand for these assets may be limited,” Credit Suisse said.

Each of these groups alone account for 1-2 per cent of total banking system loans, the report said, while noting that all banks appear to have high exposure to the same few groups.

“With the economic slowdown and a downturn in these sectors, multiple assets of each group appear stressed and financials of these groups are stretched,” the report said.

Bank’s exposure to real estate sector ( ET dated 22nd August , 2012)

Bank Exposure to real estate FY 2011-12 ( Rs. Crore )
State Bank of India 144668.38
ICICI Bank 81421.73
Axis Bank 52730.39
Punjab National Bank 48474.59
IDBI Bank 36784.47
Bank of Baroda 22157.40
StanChart 26027.78
HDFC Bank 25020.26
Total exposure Rs. 437285.00 Crore

Despite an exposure / investment of about Rs.4.37 lac crore from banks  ,still five lac houses remain unsold ( ET, 22/ 08/2012 & TOI dated 18/ 09/ 2012. ) . So land became costly as the builders brought them with loans , houses became expensive due to builder cartels and now that houses are not getting sold , all are a part of the downturn ……..no solution is in sight except for NPA’s and its cascading affect later .

Clearly, Indian economic story lacks ‘depth’ but has been built on ‘debt’ and this is a painful bubble waiting to burst …. So a common man must have enough savings to last a few years if without a job  !

July 26, 2012 in TOI, it was reported that at least eight cases of FDI in some obscure real estate companies – each worth more than USD 100 Million – from Singapore have come under scanner , with Income tax Overseas unit (ITOU) having investigated them for alleged round tripping . Suspicion was raised when authorities detected huge FDI inflows into some little known real estate firms in India in the form of equity participation . A senior finance ministry official said they suspect these real estate firms to be front entities of some corporate houses and their black money has been routed through Singapore to acquire real estate in the country . All these FDIs coming from Singapore pertain to 2011. India received Rs.1.74 Lac crore worth of FDIs in 2011-12, of which Singapore contributed third highest at Rs.24,700.00 , after Mauritius ( Rs. 46,700.00 crore ) and the U.K ( Rs. 45,000.00 Crore).  So , now we can understand why an Indian’s politician’s family have a flat in Singapore and why Indian Government along with a few ‘parties with vested interests’ are pushing  for FDI ! Does it also not answer the question why Government opened the real estate sector to FDI in 2005 ? So that money stashed abroad can be brought back in real estate sector, and further money could be made by investing in and increasing the prices by buying land !  Does Lavasa ring a bell in your ear !

In absolute terms, bank’s bad assets have doubled in three years between 2009 and 2012  – from Rs. 68216 crore to Rs.1.37 Lac crore ( Mint 21st August , 2012).  Bad assets in coal, iron and steel , mining , construction , textiles and aviation sector have been on the rise . Bankers see stress in telecom and power sector, too.  The biggest beneficiaries of loan restructurings are large industrial houses in the manufacturing sector – 8.24 % of loans given to industries have been recast. In the services sector , the comparable figure is 3.99 % , and in agriculture loans , 1.45 %.  It is clear that the small borrowers don’t get relief  from loan servicing but the large industrial houses have gotton one ( Mint , 21, August ,2012. ). According to the same article , public sector banks have 90 % of the restructured assets , and this in my view clearly states one fact – a strong political – bureaucratic and business houses nexus to make loans and buy private jets and show companies in losses to the investors !  What right do the business houses have to question the Government on profligacy and spending when these business houses have huge debts but have their CEO’s / promoters taking home 10’s of crore in salaries plus stakes in companies and still flying private jets on borrowed money ! We know of the large business house where the debts are more than revenue but the flamboyant chairman / promoter flies on private jets ! Such company’s ( any company that has over Rs. 50 crore external debt ), boards must be restructured by the MCA (Ministry of Corporate Affairs)  and independent directors with fixed term and remuneration should be appointed by the Government , so that the loans and shareholders money is not misappropriated by such promoters in the name of expenses and privileges  !

Three more developments to be noted to give you a sense of state of affairs in the Indian economy :

Remarks
India S&P rating is BBB (Minus) . Outlook  – NegativeFitch rating is BBB (Minus ). Outlook – Negative  ( TOI, 26th June, 2012 ).
Bharti Airtel Downgraded by Goldman Sachs and other banks. ET .  10th , August , 2012
Retail Sector Fitch has downgraded the ratings to negative

Agriculture / Food crises : The US is facing a severe drought , and India has witnessed a bad spell of monsoon this year with erratic and unpredictably low rainfall . When India imports pulses and oilseeds , & the prices of these commodities is set to rise. Stock piles of the biggest crops will decline for a third year as drought parches fields across three continents , raising the food-import costs already forecast by the United Nations to reach a near record $ 1.24 trillion . Combined inventories of corn, wheat, soya beans and rice will drop 1.8% to a four year low before harvests in 2013, the US department of Agriculture ( USDA) estimates . Crops in the US, the biggest exporter, are in the worst condition since 1988, heat waves are battering European crops . Wheat production in Russia , the fourth largest exporter , will fall 20 % this year , and in Australia , output will decline 19 % and, God forbid, another year of bad spell of rain in India will spell disaster for this country . This situation warrants an emergency action ! On 9th August , 2012 on page 7 of ET, I read an appeal to the GOI by All India Starch Manufacturer’s Association regarding the crises due to non-availability of maize in the domestic market.  Even if starch manufacturers were ready to buy maize at higher prices, it was not available and adding to it was the monsoon failure   !  We are all awaiting a miracle to happen with Wal-Mart et al. But the reality is that these players have not much to contribute. We must not forget that , the supply chain structures in these companies are leaner and they work on shortest inventory, so clearly , these people will not do much for supply chain management . Also, the biggest contribution is stated to be creation of 10 million jobs in India . I wish to ask that these companies have a ROI ( Return on investment ) for each employee and so , clearly , we must see what is the cost that we are going to pay to these MNC chains for them creating 10 million jobs & the Government must come out with a white paper on this ? After all , Wal-Mart is not here in India for charity !  For sure , it would mean we paid will pay them dearly for doing what we could have done 100 times cheaper ! All FDI investments to me appear to be taking the ‘economy in debt’ to ‘sell off’ ( divestment )… We are back to what East India Company did to India but this time , it is not one company, but multiple East India Companies !

Also , a time to look at the sectorial composition of GDP 1950-51 – 2011-12 from CSO data

Agriculture Industry Services
1950-51 53.1 % 16.6 % 30.3 %
2011-12 13.9 % 27 % 59 %

In 1950, India had a population of 350 million and now it is 1210 million. During independence,  the population dependent on agriculture was 72% and now it is  54 %. But except Madhya Pradesh, where agricultural growth has increased to dramatically  , not much is visible in other states .

Infrastructure – Construction firms sector ( Mint , September 11, 2012): for a set of 87 firms with a significant presence in infrastructure , sourced from Capitaline database , these numbers show an increasing difficulty to service debts

For these firms , the interest coverage ratio (ICR), for fiscal 2012, plunged  1.9 times , the lowest in at least five years. In other words , for every Rs. 100 of interest payments, the firms earnings before interest and tax ( EBIT ) stood at Rs.1.90 . The comparable number for 2007 was almost five.

In the fiscal 2012, at least 17 firms did not earn enough to pay the interest ! The list includes some of the bigger and better known firms such as Hindustan Construction Co. Ltd, Gammon Infrastructure Projects Ltd and GMR Infrastructure Ltd. This might give us a sense of where India is headed . First we oversold the India story, and now we are gonna pay heavily for it ….. !

Emerging Economy – really ? Let’s have a look at the following figures ;

  • According to the NSSO survey( July 2011 – June 2012 ), 10 % of India lives on less than Rs.17 a day . As per the survey , half of the population in rural India was living on a per day expenditure of Rs. 34.33 , and this is after two decades of reforms in India !
  • About 8.3 % of the population is unemployed
  • 54 % of Indian families live in houses that don’t have concrete or brick roof ( Census, 2011 )
  • 47 % of the total households live in houses with mud floors ( Census , 2011 )
  • More than 800 Mn don’t have toilets at home
  • Millions of tonnes of grains are stored in the open as we have no place to store !
  • Tata shut production of passenger vehicles for two days to avoid inventory pile up due to bad economic situation
  • 1/3rd of rural Indians and 1/5th of urban Indians forego treatment due to lack of money
  • 47 % of rural Indians and 31% of urban Indians finance treatment by loans or sale of assets
  • One child dies every 16 seconds due to malnutrition , diarrhoea or pneumonia
  • All major currencies have appreciated against dollar but rupee has weakened . Even Singapore dollar is up by about 50 % compared to rupee last year

GDP & Growth without fundamentals & eventual Collapse :  This is the India’s growth story’s fate . Let me give you two glaring examples and rest you can relate for your conclude;

I have travelled to the draught prone areas, and heartland of farmer’s suicides i.e. Vidharbha region of Maharashtra .  Lanco is setting up a power plant in Wardha and has purchased land for as high as Rs. 25 lac per hectare ( as per the farmers statement ). So  , let’s look at this example where Lanco purchased 7 acre land from a farmer for Rs.1.75 crore . A farmer who was drought and debt ridden for years becomes a millionaire overnight, and buys a SUV for himself along with a rifle , gold jewelry for his wife , builds a pucca house with the money he gets , and the money is spent soon as he did not know how to plan and how much to spend and the land is also gone to Lanco ! Also, money brought in a lot of vices ( please check the number of AIDS patients in the region ! ).   This company Lanco, runs a debt of Rs. 29300.00 crore and has gone for CDR ( Corporate debt restructuring ).  The banks that gave the loan should be ready for a NPA ( Non-performing asset )! So , the farmer , the company Lanco and the bank have become a non-performing asset ….. whereas , the farmer buying a SUV, Gold etc, would have boosted the sale of vehicles , gold, wines, apparel companies temporarily , and soared the rates & increased the GDP ! So this is growth in GDP but not a sustainable one or growth without prosperity !

Let me quote another example :  Country auctioned the airwaves (spectrum), a few years ago for which the companies paid tens of thousands of crore for airwaves. The companies took loans , passed on the cost to consumers ( Co’s were not wrong as they had to get an ROI for their investors ) and finally , like Airtel with over 200 million customers, run into a debt of about Rs. 60,018.00 crore ……….So , let me consider an alternative scenario . If companies were given spectrum for a nominal administrative fee of say Rs. 500.00 crore + 50 % revenue sharing . In that case, the companies would have invested more into infrastructure and services would have been better and much cheaper , also , the Government could have made a cool Rs.80,000.00 crore every year taking the current revenue of all telecom operators to be Rs.160,000,00 crore, with probably very little debt on telecom companies and no such scams !  Today, the telecom sector has a debt of Rs. 200,000.00 crore and government barely gets anything of the total revenue of Rs.160,000.00 crore as its revenue sharing is in lower single digits .  All have lost due to myopic policies of the Government . This is what I call GDP without prosperity ,  and this is what our entire Indian economy is passing through . It has no depth but debt ! What I call as lack of strong fundamentals, for which none of the parties have shown a concrete action plan . Companies have stock valuations and we are measuring our strength on the stock market indices which are not at all in relation to our ground realities ,  and only 2 % people in our country dabble in stock markets whereas 98 % suffer the hallucinations of this economic growth and GDP which is backed by loans , subsidies and political doll outs and have become a drain on our economy  & our economy is becoming a bottomless pit ! Here I will not fail to quote  the maiden address of our former finance minister and current President of India on 15th August , 2012  ‘It is indeed a wake-up call to Indian polity that even 65 years after independence and 74 years after Bose’s observation ( Subhash Chandra Bose in 1938 had flagged at the 51st session of Indian National Congress at Haripura that country’s primary challenges were poverty , illiteracy and hunger ) , the number of poor in the country today outstrip the population of the country in 1947’

All the sovereign wealth should be leased on 50-50 % revenue sharing between the Government & the private sector companies , and never be auctioned ! There is no other sustainable model for our meeting the financing needs and auctions only give a one-time income ! This must be made a policy so that every year , Government can make decent money and invest in the infrastructure,  growth and give good governance to all Indians

Indian population a mere statistics  ? Let us take the example of the recently concluded London Olympics . China with a larger population came 2nd with 38 gold , 27 silver and 23 bronze medals and India came on 55th position amongst 79 nations with zero gold , 2 silver and 4 bronze medals ….. this is what our leaders have led us to ! With committed leadership we must have made it the top by now …..

Let us do a rough sum of Indian economy which has a GDP of approximately Rs. 100 lac crore and we still borrow about Rs. 5.2 lac crore every year, and we already have  debts of about Rs. 45 lac crore . India’s  42 % of the net annual tax revenues of Rs.7.71 lac crore goes in servicing its debt ( Rs.3.20 lac crore ). Another 25 % goes in subsidies ( Rs.1.90 lac crore ) – an annual amount that would actually be Rs.78000.00 crore higher if off-balance sheet fuel subsidies to oil marketing companies were included.  The fiscal deficit of Rs.5.19 lac crore – 5.9 % of nominal GDP – is 67 % of the net central tax revenue . This was detailed in TOI dated 19th August 2012. I had read somewhere that , 54 % of Indian’s income goes in interest payments on debts taken for decades , 30 % is the cost of running the inefficient Government & bureaucracy and 16 % for subsidies ……so I keep wondering , does India have any money at all to invest in infrastructure or for future !!!! ( Hope I am wrong in remembering these numbers and India does better ). If not , time to take action !

According to Apparel Promotion Export Council ( APEC) , an estimated 4.5 million jobs have been lost over the past 3.5 years . Do our policy makers know how an ordinary Indian would survive without a salary for even a week and what pains his family and relatives pass through him being a jobless !

If all of you witnessed the discount sales season, it was advanced and even extended to make up for the shortfall , and this must show the desperation from the companies to meet the numbers . Unfortunately , If corrective steps are not taken immediately , we will have more companies getting into CDR or closure and millions of jobs might be lost till 2015……worst is yet to come !

Let me quote a facts about why India gained political independence and what was the average age of leadership . Maulana Azad became the President of INC at the age of 35 , Bose became the President of INC at the age of 41 and Nehru became the  President of INC at the age of 40… So now we know  why we got political freedom and why we have not been able to get economic freedom ??? For a nation with more than 65 % of the population below 35 years , it is important to take care of the representation of youth to lead this country with fresh innovative ideas for a double digit growth and that too  grounds up. Though our policy makers tell us that we cannot grow at about 8 % , but the fact is that, in 2011 calendar year , 12 countries clocked more than 8 % growth and some of them like Ghana , Iraq , China , Argentina and Turkey are not exactly small . We have been capped by the ‘old school of policy makers’ and their thinking , who believe that they know all and what they do is right ! This has to go now ! We need leaders with a nose on the ground , good governance and a strong political will and rest will fall in place . Government must earn from the rich and middle class, and help upgrade the lower income class to middle class on a ‘mission mode’ basis by empowering them by providing them training , education, healthcare  and technology  .

Our country’s finance ministers have taken to ‘Populonomics’ ( Economics of populism ) , and not ‘economics’, and this has clearly shown the results to the common man . India is heading towards an economic disaster and short cuts like FDI are short lived solutions !

I can bet you that if a party rises above caste , religion ,reservation, dynasty ,  and parochial regional politics, it is sure to win the youth and come to power without taking to populism !

It is the time for the finance minister to move from being an ‘efficient tax collector’ to ‘passionate creator of wealth through innovation & entrepreneurship ’. India is the only country in the world at this time that  has ample opportunities for each problem to be solved and is a fertile basin for innovation ! If you were born as a human- being , you must be lucky, but if you are born as a human -being and that too, in India , you must be the luckiest on earth, and this describes our India today and what it can offer to the world !

All ministries must have wealth creation strategies  ! Just imagine that for the year 2012-13, India will have gross tax receipts of 1,077612 crores and expenditure of Rs.1490925 crore…. Even if we do the sell-offs , we still cannot pay off the Rs.45 lac crores of debts that India has ! Which assets will be left to sell for our next generation ( oh boy that’s too far , I must say in the next 10 years ) ,to sustain our economy ? I think then , our Government will call upon the US President and ask his farmers & companies to come and invest in Indian land and make it more productive , and that will be the final sell off of this once a great nation i.e India

I am not an economist, though , I have studied economics during my graduation ( but I must confess that I do not remember anything I studied during graduation J , and I am glad that I don’t remember anything J) All that I have written here is a common man’s perspective from the data and facts available in the public domain.  I have researched the state of economy well over five months to help our dear policy makers to do a better job and making the life of a common man better and not bitter !

I am leaving to US for two weeks on 14th October evening , and on my return, I will launch www.indiawewant.org ,and would welcome your suggestions and participation

With best wishes

Rajendra Pratap Gupta

Economy I Healthcare I Retail I Innovation         

http://commonmansblog.com

 

President of India – Dont denigrate the office of H.E.


It is sad to see that , the person who destroyed the Indian economy ( Pranab Mukherjee) is likely to become the next President of India .

We , Indians must stop treating Rashtrapati Bhawan as an ‘Old age home’ . It is time to elect a President between the age of 45-55 years in age , who can inspire the youth and old alike with his understanding , passion  & energy for taking India forward

It would be sad, if Pranab Mukherjee , a rubber stamp of congress , becomes the President of India

Rajendra

Right to Primary & Preventive Care


August 10th , 2011

Dr.Manmohan Singh

Prime Minister

Government of India

7, Race Course , New Delhi 110001

Subject: Right to Primary & Preventive Care

Dear Dr.Singh,

 

Greetings from the Disease Management Association of India – DMAI, The Population Health Improvement Alliance .

 

DMAI – The Population Health Improvement Alliance is a not-for-profit organization formed by global healthcare leaders. It is the only civil society organization in India dedicated to chronic disease management in the country, with an objective of overall population health improvement .In the past three years , DMAI has worked at both International level and within India to address the issue of India’s healthcare challenges,  with the support of  patient groups , Industry & policy makers , and wishes to put on record the continuous support DMAI has received from policy makers and the industry .

 

Your government has been behind some key initiatives like

 

Right to information Act

Right to Education

Right to Work / Employment

Right to Food

 

I wish to draw your kind attention to consider enacting, the ‘Right to Primary & Preventive care’ for all citizens of this country, before it gets too late !

 

The nation is burdened by ‘a catastrophic disaster in slow motion’, moving towards it in the form of a huge population suffering from Life threatening diseases / disorders ( LTD’s ) or Debilitating Chronic Disorders- ( DCD’s ); what is today called the NCD’s ( Non communicable diseases ) .

 

We are already facing an acute shortage of both, hard infrastructure and soft infrastructure in healthcare delivery , and with our current ‘Baby Boomers’ becoming ‘Patient Boomers’ in the next 15-25 years , we could lose our competitiveness & productivity by over 50 % . India  in 2025 , with over 1.40 Billion population and with over 600 million LTD / DCD patients

would be a burden for the human race if we fail to adopt the Right to Primary & Preventive care, as the basic right for all citizens .

 

I must also state an electoral reason to accomplish this very important act . It is not just the US that fought the last elections on issue of Healthcare reform , but back home,  Andhra Pradesh and Assam are examples of how healthcare schemes can be a deciding factor for the public to choose who will run their government and so, lets get this ‘Right to Primary & Preventive care’ implemented at the earliest possible.  My detailed note on healthcare reforms agenda available at the DMAI website ( www.dmai.org.in ) , has the details of what could be potentially done in this area . It has to be multi-sectoral and inter ministerial effort & I am sure that this act with vast social & economic implications will be the best thing to do in healthcare !

 

Also, to keep you posted , I am working on the Chronic Care Bill & the Child Health bill . If all goes as per plan , the draft of these documents will be submitted to the policy makers by end of September 2011

 

Hoping for a positive response from a responsible government on the ‘Right to Primary & Preventive care !

 

We remain at your disposal for any help / assistance that you might need on this matter of great national interest

 

Yours Sincerely

Rajendra Pratap Gupta

president@dmai.org.in

 

H.E. Ban Ki Moon, Secretary General , United Nations

H.E. Joseph Diess , President of the UN General Assembly

Hon’ble Deputy Secretary General of the UN General Assembly

Ms. Margaret Chan, Director General, WHO

Shri Ghulam Nabi Azad , Hon’ble Ministry of Health & Family Welfare, GOI

Dr.K. Srinath Reddy , President , PHFI

Dr.Syeda Hameed, Planning Commission , GOI

Sri Sudip Bandopadhyay, MOS- H&FW

Shri K.Chandramouli, Secretary , H&FW , GOI.

K.Desiraju, Additional Secretary , Government of India.

Dr.Sudhir Gupta , CMO, NCD’s. MOHFW.

Board Of Directors , Disease Management Association of India – DMAI , The Population Health Improvement Alliance .

UN Summit on Chronic Diseases in September 2011


July 11 , 2011.

Dr.Manmohan Singh

Prime Minister

Government of India

7, Race Course , New Delhi 110001

Subject: UN High-Level Summit on Non-Communicable Diseases, September 2011

Dear Dr.Singh,

In the above quoted reference , and in continuation to the letter I wrote to you on 8th June 2011; I am connecting with you on my return from the UN session on NCD’s

On 16th June 2011  , on the invitation from the United Nations, I participated  in the informal interactive civil society hearing  & delivered an address at the UN General Assembly Hall . The session was presided by the President of the UN General Assembly , Mr.Joseph Diess

My view was also quoted in the closing remarks by Sir George Alleyne , UN Special Envoy to the Caribbean .

This September, you and your fellow political leaders will have a once-in-a-generation opportunity to halt a global epidemic that is killing and disabling millions of people, impoverishing families and undermining economic progress. The United Nations High-Level Summit on Non-Communicable Diseases (NCDs) is a chance for the Government of India to play a leading global role in confronting this major threat to health, prosperity and security of all of us and future generations.

I wish to assure you of the full support of our organization for the High-Level Summit in September 2011.  We campaigned for such a Summit because the NCD epidemic has reached such proportions that it now constitutes a major risk to global prosperity, development and political stability.

Together the four major NCDs – diabetes, cancer, heart disease and chronic respiratory disease – are the world’s number one killer. It is estimated that some 35 million people die from NCDs each year, and 14 million of these deaths could be averted or delayed.

Recently , Our Hon’ble Health Minister quoted; that every ten seconds two new cases of  diabetes are reported . Further , 14 % people in Bangalore were found to be diabetic , 21 percent had  high blood pressure and 13 % had both diabetes and hypertension. DMAI had conducted the first Health Risk Assessment study in 2009 , and our findings showed that  other NCD’s pose a threat of similar magnitude . We found that 44 % males & 42 % females were Obese , 18 % males and 8 % females were suffering from Hypertension ,  21 % males and 11 % females were suffering from Diabetes , 7% males and 6 % females were suffering from respiratory ailments .

Overall average occurrence across occupations was found to be thus :

Obesity 44 % , Diabetes  20 %, Hypertension 16 % & , alarmingly 7 % of the students suffered from Hypertension

India’s biggest enemy is taking the shape of a multiple headed monster i.e. Chronic diseases .We must be proactive in keeping India prepared for victory against our biggest enemy, Non- Communicable diseases. If we win the war against chronic diseases, rest of the enemies could be easily defeated, but if we lose the war against chronic diseases, we would certainly lose the war against all other enemies

The right word for NCD’s is ‘Irreversible diseases’ or ‘debilitating chronic disorders- DCD’s’ or ‘Life threatening disorders – LTD’s ’ . As a first step, let us address the diseases with the seriousness they need  ! Let’s change the name from NCD’s to LTD’s or DCD’s. Through the same note , I call upon the UN & WHO to redefine the terminology for addressing these disorders .

Dr.Singh , I must highlight you the points of discussions that we had at this special session at the UN on chronic diseases .

President of the General Assembly emphasized the need for a global response to the challenge of non-communicable diseases (NCDs). NCD prevention and control should not be seen as competing with other development and health priorities, and solutions must be integrated with existing initiatives

The Deputy Secretary-General noted that NCDs are a threat to societal well-being, taking

their greatest toll in developing countries. This is an issue that the United Nations is taking very seriously to ensure that there is a global response to the broader social and economic impact of NCDs. Praising the work and commitment of those present at the hearing, who are at the frontline of the fight against NCDs, she encouraged them to learn from and link with those working on other key health development issues – HIV/AIDS, and maternal and child health.

The World Health Organization’s Assistant Director-General for Non communicable Diseases and Mental Health cited key evidence on the scale, distribution and impact of the global NCD epidemic. Reviewing the key achievements of the past decade, he noted the important role that civil society had played in progress of management of chronic diseases to date

The Director-General of the King Hussein Cancer Foundation, Princess Dina Mired of Jordan,

emphasized the need for everybody to be unified in their efforts to get NCDs on the global

agenda and receive the attention they deserve

The first roundtable addressed the health, social and economic scale of the NCD challenge.

There is a fundamental right to good health that is being undermined by the globalization of

NCD risk factors and an insufficient action to date. Thus, a human rights-based approach to

NCD prevention and control is warranted. The global response to NCDs needs to address the

developmental and political aspects of the drivers of the main NCDs, and this will require

collective action – no individual country will be able to deal with the problem alone. Much greater progress can, and must be made in preventing and controlling the NCD epidemic to prevent unnecessary suffering and premature deaths.

Speakers emphasized the need for urgent national and global action as NCDs are increasingly frustrating social and economic development. Some countries already suffer the ‘double burden’ of communicable and non-communicable diseases as well as under- and over nutrition, sometimes in the same household. Health systems in all countries will not be able to cope with the projected burden of NCDs and governments need to be clear that the cost of intervening is much less than the cost of inaction. The economic burden of NCDs is already substantial and will become staggering over the next two decades. Economic policy makers need to better understand that NCDs pose a significant economic threat as they can be expensive to treat, require long-term management and undermine the labour contribution to production. There is also a substantial opportunity cost as the money spent on treating preventable diseases could be spent on other priorities.

Speakers stressed that the economic impact of NCDs is felt disproportionately among the poor and many individuals and families are already tipped into poverty by these diseases; thus NCDs are also a social justice issue. This will only worsen if NCDs are not prioritized in countries’ health and development plans. Health systems strengthening must address the need for social insurance to reduce the potential for ‘catastrophic’ expenditure by individuals who suffer from an NCD.

Given the complexity of the factors driving the NCD epidemic, speakers underscored the need for a response that is ‘whole-of-government’, multi sectoral and spans the life-course.

Both prevention and control are essential, and there is much that can be done by more systematically applying existing knowledge. There are highly cost-effective population and individual interventions for the four main NCD key risk factors – tobacco use, poor diet, inadequate physical activity and harmful use of alcohol – and these should be prioritized.

Focusing on the ‘best buys’ should not be at the expense of the broader range of approaches that is needed to effectively reduce the impact of these risk factors. Speakers noted that this includes the need to consider the broader social, environmental and economic determinants of health, which strongly shape health-related choices and decisions made by communities, families and individuals. Likewise, the cultural, religious and social context should be considered in implementing effective interventions.

Many speakers highlighted the need for a response that is integrated – not competing – with existing initiatives, improving health systems for all conditions regardless of their origin.

There is great potential for synergy with existing health development priorities, including those in the MDGs. The important role of health professionals in both prevention and control was highlighted by speakers. A holistic approach is required that addresses the needs of people and doesn’t treat diseases in isolation. In this sense, other non-communicable conditions such as mental health and substance abuse and oral health disorders should be considered in the health system response to NCDs.

The leadership role of governments was highlighted, which should include a commitment to developing and implementing a national NCD action plan and committing to ‘health in all policies’. It was repeatedly emphasized that all key stakeholders need to be involved in the response, but it was noted that clarity of roles is essential to ensure that potential conflicts of interest are appropriately managed and it was proposed that frameworks be developed to assist countries to do so. It was noted that there are some industrial influences that are in conflict with not just health and social goals but also the goals of other industry and private sector actors; all stakeholders have an interest in dealing with these negative influences.

Speakers agreed on the need for ongoing and improved surveillance of NCDs, their risk factors and outcomes. This will be needed to monitor progress, guide policy decisions and research priorities, and provide information on the effectiveness of different interventions.

There was strong endorsement of the need for a clear monitoring and accountability framework as part of the global response to NCDs, with measurable indicators that countries can report against.

Finally, it was noted that success is possible, and there are many examples of significant and rapid progress in addressing NCDs. Now is the time to scale up collective action on NCDs, and the opportunity must not be lost to avoid the growing negative social and economic consequences of the NCD epidemic.

The second roundtable examined effective ways to address the NCD epidemic. Much is known about effective interventions at both the population and individual levels to both prevent and control NCDs.

These include tobacco control as set out in the Framework Convention on Tobacco Control; reducing the sugar, salt, trans-fats and saturated fats content of processed food; improved diets; increased physical activity; effective policies and programmes to reduce the harmful use of alcohol; and providing low-cost high-quality essential medicines and technologies.

For example, chapters four and five of the WHO Global Status Report on non communicable diseases 2010 summarize the ‘best buys’ in NCD prevention and control http://www.who.int/nmh/publications/ncd_report2010/en/index.html

There is little contention about the evidence for the most cost-effective interventions, and the challenge is thus primarily one of ensuring their proper implementation. It was agreed that NCDs are a societal problem, so a range of government departments and societal actors need to be involved in the response. An effective mechanism to achieve this should be a priority for every country. There is an important role for civil society and civil society should be given a formal role in both the development and implementation of each country’s response.

Speakers highlighted that premature deaths from NCDs are largely preventable, and prevention is central to a more effective NCD response at both national and global levels.

Many primary and secondary preventive interventions are highly cost-effective and there are existing tools to support their implementation, including agreed international codes, strategies and Conventions.

Full implementation of the World Health Organization Framework Convention on Tobacco Control (FCTC) was cited by many speakers as being a top priority for action, due to the domination of tobacco-related premature deaths across the NCDs – currently six million per year. The FCTC is now widely ratified by both developing and developed countries, but more can and should be done to support its full implementation in developing countries.

NCD prevention and control should be grounded in a life-course approach, given the fatal and early childhood origins of some NCDs. Children are an important focus for interventions, with the growing impact of risk factors such as obesity on children and adolescents and the opportunity afforded to reach them through schools. Likewise, women are an important target for interventions as child bearers and, frequently, as the ‘gatekeepers’ for food, physical activity and health services for families. Speakers also emphasized the importance of prevention and effective treatment across the life-course, including into older age where much of the burden or diseases falls.

Speakers agreed on the need for an effective health system, which has benefits for all areas of health, not just NCDs. Primary care is the key healthcare setting for cost-effective NCD prevention and control. An important learning from HIV/AIDS is the need for better integration of prevention and treatment services across disease areas – so-called ‘horizontal’ and ‘diagonal’ approaches. In support of this, one participant proposed ’15 by 15′ – namely that by 2015, 15% of funding in all ‘vertical’ programs should be earmarked for strengthening ‘horizontal’ health systems activities. In low-income countries, such approaches should also address the endemic NCDs that affect the so-called ‘bottom billion’, for example sickle cell anemia and rheumatic heart disease, as well as palliative care.

Speakers referred to the roles that civil society organizations can play in NCD prevention and control. There is a significant opportunity to use information and communication technologies to promote health awareness and increase empowerment of individuals and communities to reduce their exposure to NCD risk factors and supporting self care.

Many speakers emphasized that access to essential medicines and technologies for prevention and treatment of NCDs is critical. The cost of the essential medicines is low, and these should be included in readily available ‘packages’ of essential care; this will require increasing manufacturing capacity of essential drugs to ensure quick access to high quality generic pharmaceuticals. The specific need for better access to adequate pain relief, especially morphine, as part of palliative care was raised by several speakers. It was noted that late presentation is all too common in developing countries, partly because of a lack of universal social insurance, as well as lack of awareness; both need to be addressed to avoid unnecessary suffering and premature deaths. Patient and ‘survivor’ groups should be engaged in policy and implementation and can play a significant role in influencing the public, politicians and the media with their stories.

Speakers noted that governments need to set the pace for change and utilize their power to ensure appropriate regulation to achieve public health goals. This may require regulation at both national and international levels to address significant health threats such as the obesity epidemic, for example to support the effective implementation of standards on marketing of unhealthy foods to children and agreed targets for salt reduction. Children and the public should be protected from commercial marketing that encourages unhealthy actions and, exposed to educational messages in schools and in their communities that encourage healthy action. The use of social media to deliver such messages needs to be greatly expanded. The role of physical activity was raised by a number of speakers. The benefits of physical activity are wider than NCD prevention and national and local policies should create an environment that encourages and supports people to be physically active.

Regarding the resources required to prevent and control NCDs, speakers noted that the majority of funding for health comes from within countries, and States need to mobilize their own resources. Health needs to be a higher priority for government spending, and NCDs a higher priority in health spending – this is the only way that funding will be sustainable in the long term. Likewise, current spending on NCD prevention and control needs to be carefully scrutinized to ensure the best possible value for money. NCD prevention and control should also be considered in decisions about ODA for health, in particular through integration with existing health development priorities. In addition, innovative funding mechanisms will need to be explored.

Many speakers emphasized that one important source of funding for NCD prevention and control is through increasing taxation of tobacco products. Tobacco taxation is also irrefutably one of the most effective ways to decrease tobacco consumption, particularly among young people, and is fundamental to an effective tobacco control programme.

Speakers endorsed the need to build capacity and capability to address NCDs among health professionals. This will require concerted efforts to revised training curricula, dealing with ‘brain drain’ of trained professionals from low income to higher income countries, and greatly strengthening research capacity in developing countries to monitor trends and evaluate interventions.

 The final roundtable examined ways to scale up action at the global level to collectively address NCD prevention and control. The full range of stakeholders, including all those present at the debate, was identified as been essential to a more effective response. It is vital to carefully examine previous international experiences to draw out the key lessons.

The value of international instruments such as the FCTC was emphasized, and it was noted that other such instruments may be needed in the future to support effective international action.

Speakers provided specific examples of enabling mechanisms to support global cooperation, including a ‘clearing house’ function to facilitate knowledge sharing, a global forum, and bilateral and multilateral partnerships to support technology and knowledge transfer.

The need for appropriate monitoring and accountability was reiterated, noting that accountability is a national responsibility that can be supported by appropriate international monitoring.

It was acknowledged that the funding environment is currently challenging, but there is much that can be done with existing funding. At the national level, there are opportunities to generate or ‘free up’ resources, for example through taxation of tobacco, alcohol and foods high in fat or sugar, and reprioritizing spending on ineffective and expensive health care interventions. Reducing donor ‘silos’ will help to ensure that health development occurs in a much more integrated way that will benefit NCDs as well as other priority areas. There is a need to expand the donor base, and opportunities to do so through linking with other related issues such as climate change.

International federations of NGOs, private sector and other organizations have a useful role to play in promoting global cooperation. Representatives of the research-based pharmaceutical industry and the food and non-alcoholic beverage industries outlined pledges they have made to contribute to NCD prevention and control. There is potential to expand new partnerships, for example with the sporting goods industries to promote physical activity. The private sector can bring a range of capabilities to support NCD prevention and control; for example, its global reach, and experience with global brands and global marketing campaigns. With respect to NGOs, speakers identified the value of greater collaboration, which has been realized over the past two years. This has greatly enhanced their ability to mobilize resources, advocate and generate social and political momentum. This collaboration will need to be further developed to support and monitor the implementation of the outcome document that is to be adopted in September.

 Sir George Alleyne, Director Emeritus of the Pan American Health Organization,summarized many of the key points canvassed during the day’s discussions. He noted a strong degree of coherence in the day’s discussion and agreement on the need to act urgently, while acknowledging the different views within and between the different stakeholder groups on some key issues. Underscoring the need to use proven tools and the value of strong partnerships within the UN and across broader society, Sir George urged all stakeholders to work together for the global public good of reduced suffering and early deaths from NCDs. He echoed the comments of many speakers on the need to integrate NCD prevention and control with action on other key health priorities, notably HIV/AIDS and maternal and child health.

In concluding, Sir George Alleyne exhorted participants to increase their efforts to stimulate political action on NCDs. Civil Society has the resources and passion to overcome the apparent inertia and it must use its unique ability to ‘agitate’ for change. The wider public needs to be informed of the size of the problem and of the consequences of inaction. He emphasized that the High-level Meeting is an important milestone but that sustained action will be needed beyond September.

In closing, the President of the General Assembly emphasized that, as with other key health and development issues, all stakeholders need to act collectively to address the global challenge of non-communicable diseases. He noted that the global community can act decisively and effectively on important global health issues, and we must learn from these prior experiences. It is in our common interest to act now.

Thanking all those who participated in the hearing, the President noted his optimism that the  High-level Meeting and the subsequent response will make a real difference to the global NCD epidemic. This optimism had been strengthened by quality of the discussion and range of ideas canvassed during the hearing and the obvious energy and sense of purpose from all stakeholder groups.

Principal conclusions

 The key conclusions of the hearing include the following:

Countries should move urgently to prevent and control NCDs to alleviate the significant social, economic and health impact these diseases are having, which is now compromising development gains. The last decade has seen some progress at the global level in NCD prevention and control and it is clear that concerted action and leadership by governments can result in significant and rapid progress. However, efforts need to be greatly scaled up to avert unsustainable increases in the costs of treating NCDs, which no country can afford.

There is a strong consensus that NCDs are a development issue and urgently need to be afforded greater priority in national health and development plans, and a higher priority in government funding decision. NCDs also need to be incorporated into the global development agenda in ways that complement rather than compete with existing health development priorities, and innovative funding mechanisms need to be rapidly identified and implemented.

The complex drivers of NCDs require multi-stakeholder action, and countries should put in place a mechanism to engage all the sectors needed for an effective response. Governments should ‘set the pace’ of the response and must show political courage and leadership.

Addressing the key risk factors for NCDs will require involvement of government, communities, civil society, non-government organizations, academia and the private sector. It is important that potential conflicts of interest are appropriately managed so that effective action is not compromised.

NCDs disproportionately affect the poor at global and, in many cases, national levels and lead to ‘catastrophic’ expenditure that forces people below the poverty line. Universal social insurance schemes are essential to avoid this and their implementation should be a priority, with attendant benefits for health care that go beyond just NCDs.

Countries should prioritize the implementation of the most cost-effective population and individual level interventions to prevent NCDs, some of which are in fact cost saving, to ensure they are getting the best value for money from existing expenditure. These interventions should be the priority for new spending on NCD prevention and control.

A renewed commitment to full implementation of the FCTC is essential to prevent a huge burden of suffering and many millions of premature deaths among working age people.

Countries should honour their commitment not just to full implementation nationally, but to international cooperation to support low-income countries to implement the FCTC.

Countries should continue to strengthen NCD surveillance and monitoring to inform and guide NCD policy and action at both national and international levels.

The health system response to NCDs must be fully integrated with programmes that address other key health issues, to ensure that services are delivered around the needs of the people who use them. Access to high-quality and affordable essential medicines is an essential component, and the implantation of programmes to deliver them effectively in low resource settings.

The outcome document for the High-level Meeting must have clear objectives and measurable indicators, supported by a monitoring and evaluation function, to support national accountability for scaling up NCD prevention and control. Civil society organizations should play a role in independently monitoring and reporting on progress.

It is essential the Heads of State and Government attend the High-level Meeting, to ensure that there is the high-level political commitment to scale up NCD prevention and control.

Countries should consider including NGOs on their delegations to the High-level Meeting, as they can bring technical expertise, can help to mobilize political support, and will be essential actors in implementing the agreed outcomes of the High-level Meeting.

Health workers are key to an effective national response to NCDS, but many are not trained to prevent, detect and manage NCDs. Training curricula should be reviewed to ensure that health workers receive relevant training in both NCD prevention and control.

Governments should look to tobacco taxation as a key way of raising revenue to prevent and control NCDs – in addition, this is a highly effective way to reduce smoking rates, particularly among young people.

DMAI – The Population Health Improvement Alliance asks you to attend the UN Summit and in person and make this a high priority for the Ministry of Health & Family Welfare . We are also calling for the establishment of a NCDs partnership to lead multi- sectoral and coordinated action, and a UN Decade of Action on NCDs to implement the commitments governments will make at the UN Summit in New York

DMAI – The Population Health Improvement Alliance would be pleased to provide your office with any further information in preparation for the UN Summit.

NCDs have the power to affect us all. Increasingly NCD’s strike people in younger age groups, including children, threatening international economic progress. But we are not powerless.

We have achievable cost-effective solutions. We need political leadership now to make them a reality. Please be a champion for NCDs by attending the UN Summit in September and safeguard the health and prosperity of future generations in India

We sincerely hope that the country will take leadership and set an example for the world on how to manage chronic diseases through early interventions

DMAI – The Population Health Improvement Alliance Recommends that:

Indian government establishes an NGO-Private Healthcare Players – Government  Alliance . An  India NCDs Alliance , linked to WHO, to coordinate follow up action with member states, other UN and multilateral agencies, foundations, NGOs and private sector

  • We must look at enacting a Chronic Care bill 2011 in the parliament in the winter session that addresses this biggest healthcare challenge (NCD’s) .
  • Create a high level committee for creating an actionable plan for identification , enrolment and treatment of chronically ill populations or move them under a primary prevention plan for people at the risk of chronic diseases . This plan should be implemented on ground before end of this year
  • As written in my comprehensive healthcare reforms document  in 2009, we must set up a CDR ( Central Disease Registry ). Details available at www.dmai.org.in .
  • Come out with protocols for the treatment of chronic diseases
  • Come out with mandatory guidelines for work force wellness
  • Enforce child health guidelines in all primary schools & dietary guidelines . Please refer DMAI’s note on Healthy Foods & An Appeal at www.dmai.org.in for details
  • Include general & basic information on nutrition and physical activity in school curriculum from class VI onwards . Have a compulsory paper on health & Wellness for  class 10th exam for all educational boards in India
  • Adopt an open minded and outcome driven approach of roping in private healthcare players to improve preventive care & treatment of identified populations
  • Include preventive checks and health clubs ( Gyms & Yoga ) under tax benefits
  • Levy additional premium on insurance policies for smokers to dissuade them from smoking
  • Launch a nationwide campaign for creating awareness on avoiding and managing chronic diseases
  • Encourage and implement the use of mHealth for timely access & affordability

 Post my return from UN session , I had discussions with leading pharmaceutical companies as to how to get their support and involvement in this major pan India efforts. All the

Companies  I have talked to are willing to work with the government on the way  to address the issue of chronic diseases . I believe that we must involve the companies in our outreach efforts and form a long term partnership with the pharmaceutical companies

Finally , I must state that success will depend on the development of strategic partnerships, ensuring there are explicit and measurable targets, and governments providing the necessary political leadership. I would be grateful for your consideration of the following in order to ensure a successful Summit in September:

  • Support the strong participation of civil society in the Summit. We request that civil society representatives be included in the official government delegation to the Summit.
  • Invest in the consultation process leading up to the Summit to ensure that the meeting produces an outcomes document with strong recommendations and a concrete plan of international action, as outlined in the NCD Alliance 10 Outcomes Document Priorities. This should include:
  • Language on the NCD Alliance’s 10 Priority Outcomes, based on previously agreed upon language.
  • Acknowledgement of the health, social and economic burden of NCDs in the world, particularly in low- and middle-income countries.
  • An increase in international development funds and technical assistance to NCD prevention and control, including support for international instruments such as the Framework Convention on Tobacco control.
  • Measures that address the availability and affordability of quality medicines and technologies to ensure that people living with NCDs can access life-saving treatments.
  • Agreement to global accountability monitoring, reporting, and follow-up mechanisms.

DMAI – The Population Health Improvement Alliance is a not-for-profit organization formed by global healthcare leaders , and the only civil society organization in India dedicated to the management of chronic disease management in India .  In the past three years , DMAI has worked at both International level and within India to address the issue of chronic diseases with the support of  patient groups , Industry & policy makers , and wishes to put on record the continuous support DMAI has received from policy makers and the industry . We wish to expand this association further to address the issue of NCD’s together in form of a ‘PPPP’ – Profitable Private public partnerships .  I personally believe , that if the first “P” – Profit is missing from PPP We would just be restricted to pilot stage. We should not shy from adding the additional  “P” – Profits , so that the industry is incentivized to align its goals to government, and work together in a sustainable and profitable manner with performance that is measurable and with positive outcomes 

I think without profit , government cannot demand performance ; and without performance, private players should not expect profit . So profit has a pivotal role in the success of PPPP

To show our support for this summit , we have put the sub-theme ‘Management of Chronic Diseases using technology’ at the International Telemedicine Congress (www.telemedicon11.com ) that I am chairing from 11-13 November 2011 at Mumbai, India.

We would very much appreciate the opportunity to share perspectives on the meeting with you or one of your colleagues. At your earliest convenience, please let me know your availability in the coming weeks.

We look forward to your personal participation with a team of civil society organizations at the High-Level UN Summit in September, & I am sure that your thoughts will be really helpful for the summit and will set an example for others to follow . We wish you and the UN a successful summit .

Yours sincerely,

Rajendra Pratap Gupta

President & Member of the Board

Disease Management Association of India

Member – Healthcare , QCI. Government of India

P.N. : Details of the work done by DMAI in managing chronic diseases is available at the website www.dmai.org.in

Encl: Message at the UN delivered on 16th June 2011.

CC:

H.E. Ban Ki Moon, Secretary General , United Nations

H.E. Joseph Diess , President of the UN General Assembly

Hon’ble Deputy Secretary General of the UN General Assembly

Ms. Margaret Chan, Director General, WHO

Shri Ghulam Nabi Azad , Hon’ble Ministry of Health & Family Welfare, GOI

Dr.K. Srinath Reddy , President , PHFI

Minister of State for Health & Family Welfare , GOI

Dr.Syeda Hameed, Planning Commission , GOI

Shri K.Chandramouli, Secretary , H&FW , GOI

Board Of Directors , Disease Management Association of India – DMAI , The Population Health Improvement Alliance .

Address of the President of DMAI – The Population Health Improvement Alliance at the UN on 16th June 2011

Venue : UN General Assembly Hall , United Nations , New York.

Chaired by Mr. Joseph Deiss , President of the UN General Assembly .

Dear Friends ,

I am honored to be here , &  have few key points  for the special high level, two-day session that UN will convene in September 2011 for addressing the issue of chronic diseases.

I appreciate the point that UN session talks about local issues across regions . I would further suggest the United Nations that , if we want the governments to act on its recommendations , we must go beyond local i.e. get micro . My experience in public policy makes me believe that governments do appreciate and act on recommendations that are local but also focus on micro issues .

We have mega goals but  our actions have to be micro and we must suggest inputs that are local and at  micro level,  for execution.

Also, let us  accept the fact that for this generation , we are late, and we have already missed the bus . What I would not like is, that our next generation sits in the same UN General Assembly hall after 40 years , and discusses the same issues related to chronic diseases , and says that ‘our earlier generation behaved irresponsibly and did nothing for us ! ’. So the time has come for us to distinguish the ‘Urgent’ & ‘Important’ . Urgent is that we must fix the issues related to the chronic diseases now , but it is more Important  that we plan to build a healthier next generation . So my expectation from the UN is,  that  there will be a dedicated session related to Child health at the UN General Assembly in September .

Also that,  the technology is becoming all-pervasive and we must use this UN session to promote the use of  mHealth to address the issue of chronic diseases . I am expecting that the UN general assembly will dedicate a session to mHealth, and how it can help in the delivery of care for chronic diseases.

Lastly , I would like to run a quick survey on ABCDE of  Chronic Diseases / Healthcare . Where,  A stands for – Asthma/ Arthritis , B stands for Blood Pressure , C stands for CVD / Cancer , D stands for Diabetes & E stands for Epilepsy / Elderly patients ( as 84 % of all the elderly patients are on one or more medications)

If anyone of you or your immediate family members have any of these ABCDE , please raise hands .

The response is unbelievable ! I have made a point . It is not about the 5 or 10 % prevalence rate of chronic diseases. We have just now had the visual proof of the prevalence of chronic diseases , and it is much higher than the figures that we read often .

It’s time to act now .

Thank you.

Rajendra Pratap Gupta

Recording of the speech is available at www.un.org/webcasts

Post Pone FDI in retail for another five years


Prime Minister Dr. Singh,

Yesterday , I attended the meeting of CAIT ( Confederation of all India Traders ), I felt really bad seeing the plight of the traders, and the hell they would be subjected to , should FDI be allowed in India at this point .

Over the last few months, you have rallied all associated departments and ministries to build a case for FDI in retail. I feel sad that you & your government have ignored the fact , that FDI in retail at this juncture will put a big question mark on the means of livelihoods of over a Crore traders in the country .

I have seen that you / your government has been saying that inflation will come down as Wal-Mart , Carrefour , Tesco’s of the world come to India ( Wal-Mart has already come in few years ago ! ).

Prime Minister , remember, that Inflation has not come down despite Wal-Mart being in India . Your government’s logic that supply chain will get strengthened and prices will fall is fallacious . FDI in retail is a wrong justification for strengthening the supply chain , as FDI in supply chain is already allowed, and a lot of wholesalers are already around and more can come in without needing FDI – Why are you fooling around Manmohan ji ? How low will you stoop now to push to agenda of foreigners !!

Even those who are operating Cash & Carry business , are issuing cards to individuals to buy from them, thereby , stabbing the small retailers . Shut down Cash & Carry immediately after a proper investigation . I go to Sam’s Club in the US ( For your information , Sam’s Club is Wal-Mart’s Cash & Carry Venture in the US). Anyone can buy a card for USD 40 and start buying from Sam’s Club. I have gone twice with my friends to Sam’s club and brought goods from the store , my friends are not retailers , but Indian professionals working in the US . So when these retailers do the same in India , what will we do ???

Your government has failed to understand the cause of inflation , and firstly , you said that recession caused inflation ; then recession got over but inflation did not come down. Then you said that irregular and deficient rainfalls are the cause of inflation. Last year , we had good rains and inflation still did not come down. Realizing that there was no answer with your US educated ( read brain washed ) consultants ( Rajan ,Montek, Kaushik & Sam ) , your government said that inflation was due to high growth and it would continue . Study our next door neighbor – China . They have had high growth with less than 5 % inflation !! All your predictions have failed !!

Also remember dear economist, that ‘inflation is reversible but FDI is not’ . What I mean to say is that , when BJP comes to power, it will bring down inflation , but if you permit FDI ( As your government is hell bent on it ) , we will not be able to reverse FDI . So think before -hand !! Don’t jump like the nuclear deal & do another fiasco !!

Sonia Ji is shouting aloud on NAC podium for poor people on one side, and on the other side , both of you have already done a deal with major international retailers , and are hell bent on cracking the back bone of small retailers by allowing FDI

Government has a flawed policy with regards to FDI, as you are saying that you will allow FDI in top 35 towns to start with. This goes contrary to strengthening the supply chain. If you really want to strengthen the supply chain then please ask this big giants to start retail in ‘C’ class towns and then come to B & A class towns !!

Your statement that farmers will get better value because of FDI in retail : Wal-Mart’s of the world are known for extracting even the ‘blood’ of suppliers !! Their labor policy record needs to be closely examined , and how many times they have been fined !

Also, Wal-Mart is failure in Japan ( social dumping & doubts about its quality ) , Korea ( Wal– Mart failed to understand local customers) , Brazil ( Lack of understanding about local culture ) & Germany ( due to cultural insensitivity ) .

I am producing an excerpt from a report

‘Walmartization does not travel well’ Clearly, neither Wal-Mart’s business concept nor its social dumping – the so-called Walmartization – work in developed economies with a social dimension. Many consumers shun the Bentonville giant and prefer to do their shopping in stores where they know that workers are treated correctly and with dignity. There is also more and more uneasiness and suspicion about many of the products sold. Squeezing the last drop from suppliers can hardly promote safety and quality. There is also a growing aversion against buying, consuming and using products which could well have been made under inhuman conditions. That the tide is fast turning against Wal-Mart at home has not gone unnoticed abroad. Consumers start to know that the retail giant denies its American workers their fundamental rights, and many of them vote with their legs, going to other stores if they have a choice. The poor business results in Germany, Korea and Japan should be taken seriously in Bentonville

Another report : This article appears in the November 21, 2003 issue of Executive Intelligence Review. Wal-Mart Collapses U.S. Cities and Towns by Richard Freeman

During the last 20 years, Wal-Mart has moved into communities and destroyed them, wiping out stores, slashing the tax base, and turning downtown areas into ghost-towns. This is accomplished through Wal-Mart’s policy of paying workers below subsistence wages, and importing goods that have been produced under slave-labor conditions overseas. Often, communities will even give Wal-Mart tax incentives, for the right to be destroyed. Wal-Mart both reflects, and is, a major driving force for America’s deadly implementation of the Imperial Rome model. Unable to produce physical goods to sustain its own existence, the United States, like Rome, sucks in imported goods from around the world, using, in this case, a dollar that is over-valued by 50-60%. America has been transformed from a producer to a consumer society.

I believe that Wal-Mart destroyed American Economy and now it is here to kill ours !! Also, since we know that Wal-Mart is a failure in four countries , please produce a report on those four countries .

Also, let us examine that how many small mom & pop stores have shut down with the advent of Wal-Mart in the United States ? Similar study we must do in China .

Let me also tell you why Biyani’s & Ambani’s of the world are wanting FDI ?

Let me ask these retailers one question ? If the retail trade is so good and profitable , why they have the problem in raising money , investing and growing their business – why do they need foreign investment ? The talk that these MNC retailers bring latest technology is also misleading , as Indian retailers are working in a different environment and all foreign CEO’s have been an utter failure so far in India . You can see the example of Reliance Retail ; How many CEO’s have been brought from outside India in the last four years ? I understand that recently a new CEO was hired from Wal-Mart China !! These traders are actually looking at exiting the business by selling their business to these multinationals to make a quick buck !! That’s the real reason they need FDI .

Once FDI comes , farmers will cry for a good deal and Wal-Mart would never give them a fair deal . On one side , farmers are forced to sell land and other side whatever is left with land & cultivation , they would be forced to sell to these MNC chains at a wafer thin margin .

Congress is a killer party for the poor !! Prime Minister Singh , where is your plan to upgrade the current Kirana stores ? Why are you not excited with their welfare . Give them FDI ( Finance from domestic institutions ) , and provide them training .

I call upon Shri Nitin Gadkari , President BJP to stand behind these standalone Kirana store and oppose FDI . We should post pone FDI for another five years and then revisit the issue. A massive peaceful agitation is called for to stop FDI in Retail for the next five years .

Mail is marked to Montek, Raj Jain of Wal-Mart , CAIT and all leading retailers & political parties in India

A Common Man

Rajendra Pratap Gupta

http://www.rajendragupta.wordpress.com

Nehru Gene , Congress & Faulty Policies – Let’s move on or else suffer more !!


March – April meant a lot of travel and meetings for myself , but the most interesting part were a few conversations that I will never forget !!

Whenever I am travelling to places within India and abroad , I make sure that I interact with people and ask them how much they know of our great country and what they feel about it . I am always proud to be born in this great country . May be , this drives me to find some answers to questions that need not be stated here !!

One conversation I had was  with a senior columnist in Kashmir during my visit last month . While we were talking , the issue of partition came up ( this topic is close to my heart as my mother was born and brought up in Lahore , now in Pakistan ) .

This columnist had an interesting point : He mentioned that due to the insatiable lust for power in Nehru , India got divided . His belief was that, Jinnah was at his fag-end due to cancer  , if only Nehru would have waited for one more year ( It is not good to have a wish that one dies of cancer but…)  , we could have saved ourselves from partition . The columnist went on to add , how could India leave Khyber pass and partition India and give away the pass to Pakistan ;The only way to reach Europe ?? I do not know geography so much , but he had an interesting point !

Other discussion I had was with my cab driver on the way from Washington DCA airport to the hotel . I figured out that the driver seemed to be from our part of the world , So I asked him where he belonged to ? I was right , he was from Pakistan but settled in the US for over 28 years !! While we kept talking about our countries before Partition and the sad story of strained relations now . He shared some very interesting information of why India got partitioned ? 

According to this cabbie . India had the maximum number of Muslims , and Nehru & Congress party knew very well that,  if India remained united , the vote of Muslims would swing to Indian Muslim League and not come to congress , so Nehru used his proximity with Edwina Mountbatten and planted the thought of partition in Jinnah. Well, I never thought of this angle !! Further this cabbie informed that, if you see the history of Jinnah a few years before freedom , he was never in favor of a partition . It was a congress and Nehru’s game plan and they never wanted to share a few states with IML ( Indian Muslim League ), which would have garnered power in some states, as some states had Muslims in majority , and Hindu’s & Muslims lived in complete harmony .

I completely empathise with this cabbie . I can only state that my mother’s family stayed in Lahore and Karachi , and I have seen my grandfather writing letters in Urdu , it never was an issue . It was planted by congress and today both nations are paying a price for the naked & insatiable lust of Nehru & his congress for grabbing power in 1947 .

The amount of money both these nations have spent on armed forces and conflict would have made this region developed in just 25 -30 years after freedom . But what we got was freedom for Nehru family to rule this nation and not for India !! Now we can well understand why Gandhi ji was in Calcutta during Independence and not with Nehru !! Gandhi ji died at the right time. Had he been alive , he would have revolted against Nehru .

AICC should have been dissolved after independence : Gandhi ji was never in favor of AICC continuing after freedom , In fact , he made a suggestion that since the objective of the congress were achieved by getting freedom from the British , it must be dissolved . But we know that Nehru had a different plan and India continues to ruin under this party !!

One of the interesting viewpoints I can share is from LKY ( Lew Kuan Yew , Father of Modern Singapore ). He has openly criticized Nehru for aping the central planning of the Soviet Union . LKY went on add that Nehru was a good writer & poet but not a great leader for India . Nehru kept promoting the non-aligned movement for the developing world but strongly sided with the soviet Union ( that is , he said one thing and did just the opposite , this is what I call the ‘Nehru Gene’ , which by the way is a legacy of the Gandhi family and its congress ) , and in the end, Nehru  caused more harm to India than any other leader ! Nehru had a great opportunity to change the course of the nation immediately after freedom as he had a free hand and people believed in him , but he missed the opportunity .

Indians know that Nehru was the one who took Kashmir to United Nations , he was the one who promoted industries and not SME’s & agriculture ! Nehru guided India towards a disaster with his short-sighted policies ‘Nehru gene’ still rules the Gandhi family and the congress, and it is time to let this party be out of power for at least two terms so that the country can be brought back on track

Rajendra Pratap Gupta

http://www.rajendragupta.wordpress.com