Biharis Processing Outsourcing (BPO)

Kumari Chitra/ Patna

Win-win strategy: To tap manpower potential, entrepreneurs have set up about 70 BPOs in rural Bihar.

Biharis are an enterprising and hardworking people. Lack of opportunities back home has forced them to migrate and work in all kinds of situations, including in hostile terrains. To fulfil their dreams and aspirations, educated youths have to venture out of state. But the situation is slowly changing for the good.

A few entrepreneurs have set out to tap the huge human resource potential of the state by starting business processing outsourcing (BPO) units in hinterlands. Their argument is that if a Bihari youth can excel in BPO firm in Bangalore or Gurgaon for that matter, he can very well excel back home too. What is needed is skill development opportunities.

The advantages are many for this business model. The BPO get cheap manpower while the employee gets a job near his home. RK Paswan, an intermediate of science student, had only heard about computers a few years ago. He now sits in front of an LCD monitor surfing Internet, tweet his mind and chat with his friends. During breaks, he will go to his home to taste delicacies prepared by his mother.

Students of over 150 villages of Madhubani, Darbhanga and Samastipur, Motihari and Betiah need not have go now to neighbouring towns to get computer education. Knowledge and daily utility kiosks are at their doorsteps.

Rahika village of Madhubani is a great case in point to village BPOs' tagline that believes "towns are now being set among villages". Right from get eyesight check to seeking insurance cover from leading companies, villagers can buy mobile phones, recharge coupons, herbal beauty products, solar lamps, lever torches and even micro education loan up to R15,000 at these kiosks.

Saurath village of Madhubani has got the state's first-ever rural BPO that works as a nodal unit for all kiosks.

Over 5,000 students including rural girls have got diploma in cyber gateway programme (6 month) and advanced nine-month diploma in software programme at these kiosks. Several of them have now moved out of their villages to get jobs in Bihar towns and also in New Delhi, Mumbai and Kolkata. Drishtee organizes employment fairs at regular intervals.

Quiver Infoservices Limited under Drishtee Development and Communications Limited (DDCL), a public limited company, has been bringing about knowledge revolution in Mithila villages. They started the mission of "connecting village to village" in 2004 from a single kiosk at Saurath and have now taken it to 35 kiosks and 75 village resource centres (VRC) and rural retail points centres (RRPC). VRCs provide English speaking courses, insurances and market products. RRPCs have only insurance and market products.

Besides Madhubani, Quiver Infoservices Limited has been operating 20 kiosks at Munger, Samastipur, Vaishali, Sitamarhi and Muzaffarpur.

Satyan Mishra, a Delhi School of Economics pass-out, has been instrumental behind the idea. Drishtee Foundation has over 8,000kiosks at Bihar, Assam, UP, Haryana and Northeastern states.

Rural BPO manager KK Jha, who has worked as an IT advisor with UNDP in Darwin, Australia, said: "I am immensely satisfied with working with a village BPO. It is like a homecoming with a great mission of connecting India". Kamlesh's associate Shishir Jha has also left a Jhansi job for the BPO near his hearth and home.

Kamlesh said convincing people about technology had been a big problem. "We had to change mindsets of people before enlightening them. I still remember how our first batch of computer students would spread gutkha covers all around. But they learnt to keep it clean soon".

Kiosks have directly and indirectly employed over 300 youths, some of them earning between Rs 3,000 and Rs 7,000. BPO, however, can employ only 20 people. BPO runs on diesel-run generator. All kiosks get Internet services through V-SAT.

The BPO does data entry for companies and also engages in translation, typing, cut and paste job and all-bound insurance services and control all kiosks. These kiosks have been getting big public response at Satghara, Bijalpura, Simri, Basaith, Gurmaha and Rahika panchayats of Madhubani and Rajaura in Darbhanga.

Murhaddi panchayat kiosk operator Chandrashekhar is so enthused about villagers' response that he had now procedures four computers and a laptop for them. He has also employed two staffers at his kiosk. Gurmaha panchayat Narendra Kumar Lal is so busy in far off villages that his mobile phone mostly says 'unreachable".

Need to depoliticise suicides in countryside

Sankar Ray/Kolkata

The politicisation destroys the spirit of being in unison to combat any farm crisis

The spat between the West Bengal Governor Mayankote Kelath Narayanan and the chief minister Mamata Banerjee on farmer suicides in the state is no more a hush-hush affair. An intrepid fighter-turned-CM refuses to call these suicides as committed by farmers excepting one. She has termed this as a concocted matter, used by the Opposition — meaning the Communist Party of India (CPI-M) - to malign her newly formed government under the All India Trinamool Congress (AITC) of which she is the chairperson. She has pulled up the Indian National Congress (INC), ally of AITC in the state ministry. But Narayanan, formerly a very senior IPS officer and ex-National Security Advisor to the Prime Minister in a stark contrast to the CM's denial on the same day said that "farmers' suicides were taking place and some of the peasants were debt ridden". In other words, the head of state smells a threat to food security unlike the state's chief administrator.

Politicisation of suicide is not desirable as politicization aggravates the bad blood and destroys the spirit of being in unison to combat any crisis. Let's forget political entities like the CPI(M), AICP, INC, Communist Party of India (CPI) and instead go straight into the contentious and thorny issue. Rephrasing famous lines of a very well-known poet of Bengali literature, Kazi Nazrul Islam who wrote that when a boat capsizes, one should not ask whether the drowning man is a Hindu or Muslim, one might write " Why ask he is farmer or non-farmer?/ Ask why do those who kill themselves?". Those - already 24 in less than eight months - were rural people.

Similarly, it's mischievous to try to drive a tendentious point home that these suicides take place after the change of government. This again is a political point which needs to be de-politicised first. Politicisation always misleads common and innocent people. Nor is there any point in booing and hooting against the Opposition saying that over 1000 residents of tea estates in north Bengal - mostly tea estate workers - died of hunger, some having committed suicide in less than ten years during the previous regime. If suicides in tea estates are pitted against recent suicides in muffasil areas - mostly in the district of Burdwan , one of the largest granaries on the state, it will end it fruitless blame game only.

Social issues have a much greater primacy than political ones, although these are primarily social phenomena which politicians try to cash in on for short-term gains. Farmer suicide as a phenomenon is nothing new in India. But over 95 per cent of peasant suicides until 2010 were by those who raised cash crops and failed to get remunerative prices. The Center for Human Rights and Global Justice (CHRGJ) at New York University School of Law, set up in 2002, brought out a major study- Every Thirty Minutes Farmer Suicides, Human Rights and Agrarian Crisis in India - states at the outset that during the last 16 years, ended 2009, there happened "the largest wave of recorded suicides in human history". Indirectly, the statement is a spanner aimed at the neo-liberal financial reform, imposed by the two largest international financial institutions, World Bank and International Monetary Fund. Moreover, the caption states, it's an agrarian crisis, not agricultural. In other words, the fault lines relate to land tenure or lopsided production relations in agriculture.

The CHRGI study makes no bones of the reality that "a great number of those affected are cash crop farmers, and cotton farmers in particular. In 2009 alone, the most recent year for which official figures are available, 17,638 farmers committed suicide-that's one farmer every 30 minutes.". But actual self-assassinations might have been more, the study points out. "While striking on their own, these figures considerably underestimate the actual number of farmer suicides taking place. Women, for example, are often excluded from farmer suicide statistics because most do not have title to land-a common prerequisite for being recognized as a farmer in official statistics and programs", it observed (Italics added).

The CHRGI expresses concern about violations of human rights of Indian farmers and of the estimated 1.5 million surviving family members, afflicted by the farmer suicide crisis to date. "Millions more continue to face the very problems that have driven so many to take their lives. The Report seeks to amplify the many voices calling on the Indian government to act now to put an end to this unmitigated disaster. Farmers in the western state of Maharashtra, for example, now address their suicide notes to the President and Prime Minister, in the hopes that their deaths may force the Indian government to remedy the conditions that have led so many farmers to take their own lives.

Ramchandra Raut, who committed suicide in 2010, even went to the trouble of purchasing expensive official stamp paper and-in laying out the reasons for his despair to this official audience-cited two years of successive crop failure and harassment by bank employees attempting to recover his loans."

Undeniably, those peasants and their dependants "are among the victims of India's longstanding agrarian crisis. Economic reforms and the opening of Indian agriculture to the global market over the past two decades have increased costs, while reducing yields and profits for many farmers, to the point of great financial and emotional distress. As a result, smallholder farmers are often trapped in a cycle of debt.

During a bad year, money from the sale of the cotton crop might not cover even the initial cost of the inputs, let alone suffice to pay the usurious interest on loans or provide adequate food or necessities for the family.

Often the only way out is to take on more loans and buy more inputs, which in turn can lead to even greater debt. Indebtedness is a major and proximate cause of farmer suicides in India. Many farmers, ironically, take their lives by injecting the very pesticide they went into debt to purchase."

Even if there was a single suicide in West Bengal - taking Mamata Banerjee's point for granted - and ignore the means of livelihood of other self-killers, a serious issue crops up. The farmer killed himself for not getting remunerative price of paddy, not cash crop.

Not even 30 per cent of targeted procurement of 200,000 tonnes could be reached even after a month after the deadline. This has not happened in any other state so far.

Is agriculture as a profession under threat? What will the apologists of free market say about this.

Sarpanchs get power push

Kumari Chitra/ Patna

To edge out Naxal influence, Bihar government gives more power to sarpanches

Outlawed CPI (Maoist) now may well have to think twice before thinking of holding janadalat to provide instance justice, at times by killing the accused. For sarpanch has started exercising his real powers from this month. Though Bihar Panchayati Raj Act, 2006 has provided these powers, they were seldom exercised with police often taking up cases which a sarpanch was supposed to do.

It was just about practical implementation to lend power punch to sarpanch and at the same time give out message to Red brigade to be careful and remember -- only legitimate court is that of a sarpanch.

The political vacuum after Maoists spread its tentacles with least resistance in at least 20 of 38 Bihar districts may well be filled by a strong sarpanch. And no one should try to mess with sarpanch as even a minor scuffle with him/ her would mean a DSP or SP monitoring the case and thus, giving sarpanch a sense if reassurance to do his duty.

But this has been happening only from this month - six years after the implementation of the Act. No one had bothered to check till recently that a sarpanch can play a big role in justice delivery at local level.

But until last month, moving around any corner of Bihar will make one hear only of mukhiya and mukhiya pati. It simply meant while a woman became mukhiya after Nitish Kumar government gave 50 per cent reservation to woman in panchayats since 2006, it was often husbands of these mukhiyas who wielded big financial powers after implementation of the Act.

In any case, tt just tells one about mukhiya's powers exercised directly or by proxy. Sarpanchs somehow felt left behind with work to hold kahhari one of twice a week to sort out petty village disputes.

Worse still, very few villagers preferred to go near a sarpanch and rather preferred "more influential" mukhiyaji to sort out disputes.

But this is not what Bihar Panchayati Raj Act, 2006, provided for. It has given a whole lot of power to sarpanch as well. But no one bothered to read between the Act to empower sarpanch for last six years.

Finally, it was Bihar Director General of Police Abhyanand, who tasked some senior police officers to read the Act carefully and find out what is there for a sarpanch, hence taken non-seriously. Even the state election commission was surprised to find that number of contestants for mukhiyas' posts were almost triple the number of ones contesting for sarpanchs' posts in 2011 panchayat election.

The DGP's team came out with the extract of the Act that said that a sarpanch has powers to take action under at least 25 IPC sections relating to rioting to creating nuisance after drinking to land disputes.

Sample these IPC sections and see what a sarpanch can do to stop piles of petty cases coming to police stations with a single page verdict, that can be challenged only in a district court. A sarpanch also has right to impose fine up to Rs 1,000 for an offence. He can hear and dispose off cases under IPC Sections of 142 (unlawful assembly), 143 and 145 (punishment provisions for unlawful assembly), 147 (punishment for rioting), 151 (continuing of assembly of five or more persons), 153 (provoke rioting), 160 (punishment for disturbing public peace by fighting), 172 (absconding summons), 174 (disobeying a public servant order), 178 (refusing oath by public servant), 179 (refusing to answer public servant), 269 (negligence causing infectious diseases, 277 (fouling water of public reservoir), 283 (obstructing navigation), 285 (fire safety negligence), 286 (negligence with respect to explosive substance), 289 (animal safety negligence), 290 (punishment for nuisance in public), 294 (obscene acts), 294 (A) (keeping lottery office), 332 (stopping public servant from doing his duty), 334 (hurting on provocation), 336 (engendering others life), 341 (punishment for wrongful restraint), 352 (punishment for assault), 356 (assaulting while committing theft), 367 (kidnapping for slavery), 374 (unlawful compulsory labour), 403 (misappropriation of property), 426 (punishment for mischief), 428 (mischief by maiming or killing animals), 430 (wrongful water diversion), 447 (punishment for criminal trespass), 448 (house trespass punishment), 502 (sale of printed substance carrying defamatory matters), 504 (insult with intent to provoke breach of peace), and 510 (misconduct in public in drunken state).

Any decision of Gram Kachahari can be challenged before full bench of Gram Kachahari within 30 days. Later, it can be challenged in district court concerned. A judicial secretary is being appointed in every panchayat to keep records. Under IPC provisions, a police station in-charge has to inform Gram Kachahari about any offence that should be taken up by sarpanch.

Sarpanchs can take up cases such as house or criminal trespass to disobedience to public servant to causing nuisance after drinking to rioting. The biggest aspect of sarpanch power is to resolve land disputes, which often burden any police station and at times, pave way for corruption.

Bihar Director General of Police (DGP) Abhyanand said: "We hope sarpanchs come forward to know their powers. All police stations have been asked not to take up cases coming under sarpanchs' domain".

Of the new school

Meet VR Prasanna, CEO of Sikshana Foundation. A young and enthusiastic social entrepreneur, he gave up a cushiony IT job in the US to make a difference in the education sector in India. Today, under his stewardship, Sikshana Foundation has reached out to over 600 government schools in the states of Karnataka, Andhra Pradesh and Gujarat. The schools adopted by Sikshana have shown remarkable academic improvement. Students and teachers alike are serious about education as opposed to the typical substandard government schools. All this was made possible with timely professional support via sustainable models adopted by Siskshana. The participatory approach involving the local community has paid off rich dividends in these schools. Prasanna shares his views on social entrepreneurship with Poornima Kandi.

How did Sikshana happen?

In 2005, I co-founded Pragathi with a few like-minded individuals in Austin, Texas, USA, with a goal of funding deserving NGOs in India. Sikshana came on my radar as part of Pragathi when we were looking for a project in education that could be scaled up for a larger impact. Sikshana started by Ramamurthy and a few of his friends right from the outset was designed to scale, replicate and exit eventually, which was attractive to me. The more I got to know about the intervention the greater I saw an opportunity to get in and make a difference on a large scale very quickly. It is amazing that within a short span of 4years we are able to impact over 75,000 children.

What made you interested in education sector? Tell us about your foray into development sector?

In my opinion education is a great leveller and is a sure way to move up the social ladder. Primary and secondary education are the most critical sectors, which need urgent intervention as various reports every year reveal dismal state of learning levels in children. My area of focus in education has been particularly on public school system, where over 80% of the children in this country are enrolled in such schools for quality education. After 17 years in USA, I decided to relocate to India, to work in a different area. Development sector was not new to me since I was involved with it in various forms, from the outside though. I had decided to take a very business-like approach and wanted to run the organisation more like a commercial enterprise. I gradually realized that you need to be more than just that. The customers or beneficiaries of our work will suffer if we fail to deliver because their aspirations would have raised and they are with us because they don't have a choice. So failure is simply not an option here.

What motivated you take up social entrepreneurship?

My grandfather lived a socially conscious life and watching him over the years made me sensitive of the environment I lived in. I have worked as an entrepreneur while I was in the US and was the Founder CEO of Softrends, Inc. As an entrepreneur in the for-profit sector I was doing my bit via non-profits. During this time I noticed that many non-profits put charity as the main purpose of the organization and this positioned planning, efficiency and professionalism in the backseat. I felt that instead of wishing a change in this sector why not attempt a change.

What according to you is a good model for development, which can work in the Indian context?

India is a unique in many ways but two things stand out for me, one is lack of standards in almost everything and the other being the diversity. Most of the major programs which have failed have one thing in common, a top-down approach. The need is to create a model, which allows decentralized system. This will take care of local needs and aspirations besides enabling outer structure which ensures meeting the overall goal of the program.

Do you think there is a need for government to bring out a policy for incentivising entrepreneurs for such ventures that have larger impact in terms of economic/social empowerment?

In my opinion the government has done an amazing amount of good work especially in the primary and secondary education. They have limitations when it comes to areas of innovation or experimentation. However, there has been some attempt to involve private entities in this area but it is not well defined. I see a need for a clear transparent policy, which will enable the social enterprise to run pilot programs and once proven the government should fund the enterprise to scale up. The initiative can then be made a part of the government programs. We see successful Private Public Partnership models in mega projects and I would like them to look at partnering with micro social enterprises which thrives on decentralization. The best approach would be to empower the local government to execute the partnership.

What do you think of the recent developments where lot of young Indians are taking up social entrepreneurship as a career? Your advice for budding social entrepreneurs.

I am glad to note that there is a talk of career in development sector which was unheard of a few years ago. What was typically looked as an end of career choice started to attract mid career deflectors like me and I now see many of them taking it up as first choice. This industry needs new ideas to deliver social impact and infusion of youth bodes well. One must have a lot of passion and a bit of compassion to be in this sector. One must not ignore the sacrifice made to enter this sector. Make sure that you compensate by accounting for personal growth and the larger impact one makes through this.

Are there dos and don'ts for such ventures unlike commercial activities where profits, dividends for shareholders are the only way to go?

In fact I do not see it any different from commercial activity except that profit / dividend mean a quantified social impact in addition to a sustainable or zero monetary gain.

Commercial ventures will die out when it is inefficient or when the customer rejects it purely from the standpoint of not meeting their needs. Here the customer is more forgiving since the intent is good, which means we internally have to push ourselves in measuring the impact and get better in what we do.

It's hellish for girls here

Sopan Correspondent/ New Delhi

Fresh UN-DESA shows India is the most dangerous place to be a baby girl

India has to cut a very sorry figure if one goes by the newly released United Nations Department of Economic and Social Affairs (UN-DESA). According to the data, India is the most dangerous place in the world to be a baby girl.

According to data, an Indian girl child aged 1-5 years is 75% more likely to die than an Indian boy, making this the worst gender differential in child mortality for any country in the world.

Infant (0-1 years) and child (1-5 years) mortality are declining in India and across the world, though not as fast as was hoped in India. Simultaneously, most of the world is experiencing a faster fall in female infant and child mortality than in male, on account of well established biological factors which make girls better survivors of early infancy given equal access to resources. The world's two most populous countries, however, buck this trend.

The UN-DESA data for 150 countries over 40 years shows that India and China are the only two countries in the world where female infant mortality is higher than male infant mortality in the 2000s. In China, there are 76 male infant deaths for every 100 female infant deaths compared with 122 male infant deaths for every 100 female infant deaths in the developing world as a whole.

The released data has found that India has a better infant mortality sex ratio than China, with 97 male infant deaths for every 100 female, but this is still not in tune with the global trend, or with its neighbours Sri Lanka (125) or Pakistan (120).

When it comes to the child mortality sex ratio, however, India is far and away the world's worst. In the 2000s, there were 56 male child deaths for every 100 female, compared with 111 in the developing world. This ratio has got progressively worse since the 1970s in

India, even as Pakistan, Sri Lanka, Egypt and Iraq improved.

The UN report is clear that high girl child mortality is explained by socio-cultural values. So strong is the biological advantage for girls in early childhood that higher mortality among girls should be seen as "a powerful warning that differential treatment or access to resources is putting girls at a disadvantage", the report says.

"Higher female mortality from age 1 onwards clearly indicated sustained discrimination," says P Arokiasamy, professor of development studies at Mumbai's International Institute for Population Studies, who has studied gender differentials in child mortality in India.

"Such neglect and discrimination can be in three areas: food and nutrition, healthcare and emotional wellbeing. Of these, neglect of the healthcare of the girl child is the most direct determinant of mortality," says Arokisamy. Studies have shown that health-related neglect may involve waiting longer before taking a sick girl to a doctor than a sick boy, and is also reflected in lower rates of immunization for girls than boys.

Moreover, since the outrage over India's poor child sex ratio came out of census data for children aged 0-6 years, the UN data on child mortality indicates that a campaign against female foeticide alone is not a complete solution. "Pre-natal and post-natal discrimination are complementarily contributing to gender imbalance," agrees Dr Arokiasamy. While pre-natal discrimination in the form of sex-selective abortions is more common among better educated upper income households, post-natal discrimination or neglect is more common among poorer, less educated rural households, he adds.

State of the nation

Sangita Jha/ New Delhi

Economic disparity among different states is widening

India has seen over two decades of high economic growth. The time span is enough to do some reality check to see if the high economic growth is translating into overall wellbeing of people or not and more particularly if the poor are able to break out of the poverty cycle or not.

However, various studies point out to one common thing, that the poor are getting poorer and rich are getting richer. This clearly is a sad commentary on a socialist country with strong commitment for welfare of the poor.

The most overriding concern of economists is that the economic disparity among various states is getting further skewed. It's being clearly pointed out that a large number of poor in the backward states are not able to reap the benefits of the economic growth. While there had been inequality among various states, it's now clearly emerging that the better off states are doing well in improving lots of the poor than the poor states. This is despite the fact that the Centre factors in poverty in states while designing its various schemes and also fund allocation in the form of Central support.

The Associated Chambers of Commerce and Industry of India (Assocham) by collating various data and analysis has come to the conclusion that inequalities continue to rise among various states even after two decades of economic liberalization, broadly implying that poor people are getting poorer and rich are getting richer.

The Assocham based its analysis on average household monthly per capita consumption expenditure (MPCE) at current prices, which was deflated by consumer price index, to arrive at a measure of change in real economic well being of people across regions and classes. The study does confirm that growth rate of both average per capita expenditure and resultant demand increased during 2004-05 and 2009-10.

But the flip side of the India's growth story was the fact that while the average per capita consumption expenditure remained unchanged for the poorest 20 per cent people, the average household income of the richest 20 per cent increased by 7.7 per cent. So, the study suggests that the inequality is clearly deepening further.

The Assocham found that on an average, a rural household in the richest 20 per cent category spent more than 258 per cent of what a household of similar size falling in the poorest 20 per cent category spent in 2004-05. This difference further increased to 286 per cent in 2009-10, the study revealed.

Worrying aspect as pointed out in the study was that while the size of consumer markets expanded at a healthy rate of 7.9 per cent, economic inequality further widened over these five years. Also, market size of richer average household monthly per capita consumption expenditure (MPCE) classes too increased at a relatively faster pace.

More particularly the study on the basis of statistically analyzing the data came to the conclusion that income inequalities increased in Jammu and Kashmir by 7.37 per cent, Madhya Pradesh, including Chhattisgarh, by 4.96 per cent and Bihar, including Jharkhand, by 4.9 per cent. Here it is worth mentioning that Jharkhand and Chhattisgarh are facing worst crisis in the form of the leftwing extremism, popularly Naxal menace, for quite a long time, with the proponent of violent means having established their footholds among the poor tribals.

The study further revealed that some of the state did better by reducing inequalities, which was by 5.75 per cent in Orissa, 3.85 per cent in Maharashtra, 2.36 per cent in Haryana and West Bengal. The industry body also noted in its study that Rajasthan, Karnataka, northeastern states and union territories too have seen some fall in the degree of income inequalities.

The study recommended "along with higher economic growth, more efforts need to be made to make it more inclusive", while stressing that reducing income inequalities is necessary for accelerating economic and human development. It also sought from the state governments to play a major role in developing social sectors and critical infrastructure.

National Advisory Council (NAC) member NC Saxena is also of the view that the absolute number of poor has gone up in the last two decades. It's also a well known fact that China, Indonesia and other South-east Asian nations have done much better than India in reducing the absolute number of poor, while riding on decades of high economic growth.

Saxena points out one critical aspect of public distribution, which invariably favors rich states. He says that the Department of Food and Public Distribution has been following the poverty head count ratios of 1993-94 and foodgrain is allocated to states based on this number plus 10 per cent to account for the transient poor. "In addition, some states such as Tamil Nadu, Andhra, Delhi, the North-east states also received quota for the APL, which was not given to the poorer states on the ground that they did not lift it in the past when the market price was low. This policy favours the well-off states and punishes the poorer states," added Saxena.

There is also a well accepted fact that the incidence of poverty is acute in poor states than the richer ones. The poor states also face another crisis in the form that more poor people are left out of the process to include them in the BPL list so that they can benefit from the welfare schemes. In fact, the officials of the ministry of rural development agree to the fact that the incidence of exclusion of deserving poor from the BPL list is very high in the poor states.

In fact, the findings of the study of ASSOCHAM is supported by fact that Bihar has as high as 25 per cent poor who have no BPL cards, which is 22 per cent in the case of Jharkhand, 24 per cent in Chhattisgarh and 30 per cent in Madhya Pradesh. Almost half of the poor people in the poor states find themselves deprived of the benefits of the welfare schemes of the Central and state governments.

"These must be presumably the most poor tribal groups, women headed households, and people living in remote hamlets where administration does not reach. Thus, the people most deserving of government help are deprived of such assistance. On the other hand, almost 60 per cent of the BPL or Antyodaya cards have been given to households belonging to the non-poor category," Saxena noted in a representation to the Planning Commission, while seeking launching of a drive to weed out errors of exclusion and inclusion.

The interesting aspect of the way the Central government and Planning Commission deal with the allocation of resources to deal with poverty and the resultant cap which they impose on number of poor for each state. In fact, Planning Commission has not fixed a uniform cap of 37.2 per cent for every State. The estimate of poverty differs from state to state from a high of 57 per cent for Orissa to 9 per cent for Nagaland and 13 per cent for Delhi. However, the percentage fixed for each State does amount to a de-facto cap for that state as far as central allocation in some schemes and subsidies are concerned, such as Old Age Pension, Total Sanitation Campaign, Public Distribution System, etc.

Some states have issued more BPL cards than warranted by Planning Commission poverty estimates, and that the Central government has not placed any restrictions to this so long as the concerned state makes its own provision for the additional subsidy and food grain requirement. This enables rich states likes Tamil Nadu, Haryana, Maharashtra to do much better than the states of Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh in improving the lots of the poor due to better resources at their disposal.

However, the poor states do not have the wherewithal to pump in additional financial resources to improve the overall conditions of the poor.

Drunk with poverty

Vinod Kumar/ Jhabua

Though slow, efforts are on to wean away tribals of Madhya Prades from alcoholism

Chendu, a tribal from Alirajpur in Jhabua district, beat his wife to death. Reason? She asked him to stop drinking. In the same block, another young man killed his brother with an arrow when the latter tried to extract toddy from the palm trees owned by him.

Often the reasons for murders or fatal assaults here are as mundane as someone's hen entering the neighbour's territory or someone's refusal to lend a 'bidi' (leaf rolled cigarette) to a friend. In all these crimes, either the killer or the victim or both are high on alcohol.

Alcoholism is taking a heavy toll on the socio-economic life of the tribal population. According to an official from the department of tribal development, the age-old problem of excessive drinking in tribal areas is affecting the new generation too.

"One can see teenagers brewing 'arrack' (local brew) in front of their houses. There is lack of conscious effort from the community to prevent youngsters from becoming hard-core addicts," he said.

This reflects on the literacy rate and high dropout percentage in the district, the highest in the state.

"The attendance in schools also comes down especially during October to March when toddy tapping starts in certain regions of the district. Several students show up for classes drunk while others sneak off for a nip or two of toddy from the nearby palm groves," said Sanjay Solanki, a teacher.

Efforts are underway to counter alcoholism among tribals, though the progress is not very encouraging. Since alcoholism is also associated with starvation and unemployment, the district administration tried an innovative method to make use of toddy to generate gainful employment.

The project started in November 2004 in Bhavari village in Alirajpur. "We gave training to one Bhim Singh and his family, who owned 10 toddy palms, to make palm gur (sugar) out of toddy," said Rajkumar Pathak, the district collector of Jhabua.

The logic of the administration was - a family with 10 toddy palms involved in making gur can earn up to Rs.16,000 a season, while through sale of toddy it can earn only less than half that amount.

The officials in the district administration thought that since gur making was more profitable, more and more tribals would change over from the toddy business. "This would not only improve their financial situation but also reduce the number of crimes in the area," said Pathak.

However, this did not happen. Although Bhim Singh is very happy with his newfound enterprise, there are not many takers for it among his community.

The district administration has managed to convince only three more families to pursue gur-making. One reason for the failure of this project was the tribals' love for toddy. "No one wants to leave toddy," said Shankar of Khedut.

But many people feel that if effective marketing strategies were in place the new enterprise could have done better. In states like Orissa and Karnataka, it is catching up well.

Despite the setback in the gur-making project, the district administration has not lost hope. It is encouraging tribals to sell fresh, unfermented toddy for making 'neera', a health drink. Unfermented toddy is very sweet and healthy. But fermented toddy contains 50-60 percent alcohol, making it a highly intoxicating beverage.

"We are working on this project. Our effort is to encourage more and more people to sell toddy for making neera so that there is a shortage of toddy for making alcohol," said Pathak. The administration has approached the Khadi and Village Industries Commission (KVIC) for processing and marketing neera.

Sources in KVIC say that it is working on the proposal. With suitable technological intervention as prescribed by the Pune-based National Chemical Laboratory, neera's shelf life can be enhanced to six months.

"Neera contains a number of minerals and salts; acids like ascorbic acid, nicotinic acid and riboflavin; proteins and vitamin C. It has less calorific value, apart from being sweet and delicious. It can give mineral water a run for its money," said A.K. Sharan of KVIC.

According to Sharan, neera can enhance the income of a farmer. One palm tree yields four litres of toddy a day. So if a farmer has 100 trees it would become 400 litres. The same could be sold at the rate of Rs.10 a litre, amounting to Rs.600,000 for the season lasting five months.

Although it makes a lot of economic sense, weaning away the tribals from the toddy business is an onerous task. "It all depends on the commitment on the part of the administration. If the government really wants to counter alcoholism then it should stop promoting foreign liquor also," said Shankar.

Alcoholism is linked to high incidences of crime in the district. According to the state crime records bureau, in 2005 there were 124 murders in the district -- the highest among all districts in the state.

"In more than 50 percent cases, alcohol was a factor," said Avinash Sharma, the assistant superintendent of police, Jhabua. "Tribals are very simple people. But once they consume alcohol they get violent even on trivial issues and use fatal weapons against each other."

The crime rates are very high in certain blocks, especially Alirajpur and Jobat. Toddy palms are found in abundance in these blocks.

A survey by the Adivasi Sewa Shikshan Samiti in 2004 revealed that 10 percent of the tribal population in the district could be termed "heavy drinkers". About 80 percent of the addicts in the district are below poverty line.

"An average tribal family spends between 60-70 percent of its income on alcohol. It was found that if a person is a 'desi' (local) liquor addict, he spends a minimum of Rs.400 a month on it. But for a person addicted to foreign liquor, his bills touch up to Rs.3,000-3,500 a month," said Benedict Damor, secretary of the samiti. Even poor families spend huge amounts - to the tune of Rs.25,000-30,000 on alcohol alone during marriages.

The alcohol industry is the only flourishing business in this district. In 2007, the contract for the sale of liquor in Jhabua district was auctioned at Rs.100 million.

For Jhabua, where 47 percent of the population is below the poverty line and 85 percent is tribal, this is a huge sum. The officials in the excise department say the turnover from the sale would be anywhere between three to four times this amount. Besides, toddy and desi liquor (almost like a cottage industry) are available freely and cheaply.

However, Benedict Damor, who campaigned extensively against alcoholism, feels that prohibition is not a solution to this problem.

"Alcohol is an integral part of tribal culture. But consuming alcohol as part of rituals or festivities is different from alcoholism. Alcoholism is linked to illiteracy, impoverishment and many other factors. But there should be a concerted effort from within the community to do away with such evils and to return to our roots," he said.

It's true, fake drugs flooding markets

Sangita Jha/New Delhi

You can contest the figures rolled out by pharma lobby, but that doesn't mean the scare is baseless. Spurt in crackdown shows spurious drug industry is growing.

While the government is of the view that the spurious drug size is as low as 0.04 per cent, spate of arrests made by police in various parts of the country tell a different story. Also, there is a section which is of the view that spurious drug scare is being exaggerated by the lobby of the multi-national companies.

Notwithstanding difference of opinion in the government and the pharma community, there appears a clear case that a large number of patients across the country are being taken for a ride. What is worse is that someone having bought a counterfeit electronic product may just rue the fact that he has been fleeced of his hard earned money, the victims of spurious drugs in some instances may pay with his life as well. So, there is no difference of opinion that spurious drugs can kill.

The Central government on the basis of a study conducted by the Ministry of health which had a sample size of 6000 chemists across the country maintains that the spurious drug size in the country is as low as 0.04 per cent. However, the industry experts peg it to be anywhere between 10 per cent to 30 per cent. Clearly, the range is quite wide and one can take liberty to come to his conclusion, that the actual spurious drug size could be anywhere between the government and industry's estimates.

Critics of the health ministry's findings question if the chemists would keep the spurious drugs on the shelf at their shops to invite the censure. The sample of the study conducted by the ministry of health was on the basis of random shopping of medicines done at 6,000 chemists. The critics do have a point that an organised racket of spurious drugs could have a modus operandi to escape the ambit of the study of the health ministry.

Delhi and the National Capital Territory Region (NCR) are considered the conduit for the distribution of the spurious drugs across the country. A number of arrests by the police in the national capital have revealed that the manufacturing base of spurious drugs is spread from the western Uttar Pradesh to the neighbouring areas of Haryana, Punjab and Himachal Pradesh. In fact, the Minister of state for home affairs Mullappally Ramachandran had informed the Parliament in a written answer that 10 people were arrested in 2011 for involvement in the production and distribution of spurious drugs in Delhi, while two cases of spurious drugs production and distribution racket were registered in the national capital last year. He had stated that there were five such cases in 2010 and six cases in 2009, while in 2008 there was just one case.

Mr Ramachandran's statement in the Lok Sabha does point to one clear indicator, that cases of spurious drugs being registered by the police are on the rise. And also that there could be a bigger network of those involved in the manufacture and distribution of spurious drugs evading the eyes of the police.

The industry on the other hand is of the view that the low estimate of the government of spurious drugs could also be due to the definition of counterfeit. In fact, Tapan Ray, director general, Organization of Pharmaceutical Producers of India (OPPI), had earlier stated "anything that is not genuine is counterfeit". Section 17 of Drugs and Cosmetics act 1940 specifies that spurious, adulterated and misbranded are counterfeits. Regulators do not agree on definition of counterfeits.

Many pharmaceutical companies manufacture drugs at third party facilities. When the pharma companies squeeze margins, third party manufacturers resorts to diverting additional production to market without original manufacturer name and selling at lower price because of lack of marketing costs. These are called legal counterfeits by the pharma experts.

However, Mr Ray had suggested three-pronged approach to fight against spurious drugs by way of legal enforcement, consumer awareness and deterrent to seller, and technology to differentiate between genuine and fake.

India has put in place a strong legal safeguard against menace of spurious drugs. The ministry of health and family welfare has notified and implemented the "Drugs and Cosmetics (Amendment) Act, 2008", significantly increasing the penalty for manufacture of spurious or adulterated drugs. The amended Act enhances the penalty for manufacture of spurious drugs to a minimum imprisonment of 10 years, which may extend to a life term, and a minimum fine of Rs 10 lakh or three times the value of the drugs confiscated, whichever is higher. And it makes the offence non-bailable in some cases.

While the legal mechanism has been put in place, the industry is of the view that the government should encourage whistleblowers along with enough safeguards to ensure that those indulging the trade of manufacture of spurious drugs are apprehended with no loss of time.

A glance at the number of arrests made by Delhi police in the last year may alarm of the people at large of the extent of the spurious drugs' reach. For example, police raids carried out at central Delhi's medical wholesale market, Bhagirath Place, and subsequently also in Agra on June 3 and June 6 respectively yielded spurious drugs worth Rs 8 lakh drugs worth Rs 34 lakh. The police later said that a total of 115 different kinds of drugs were being sold without any licence by this gang. Racketeers may have stamped the spurious medicines with the names of different government agencies to authenticate them so that people will assume that these medicines are genuine and purchase them, DCP (crime) Ashok Chand, who had led the raiding team, had said.

Worst part was that almost the entire lot recovered from Agra turned out to be expired drugs. They were pushed into north Indian markets after recycling. Worse, a senior official of a pharmaceutical company, who accompanied the raiding party, told the police that 45 ampoules of seized 'Susten 100' injections, used by pregnant women, were also spurious. Other medicines included those meant to cure heart ailment and diabetes.

In another catch, the police busted a spurious drugs manufacturing unit in Uttar Pradesh and stumbled upon fake drugs worth more than Rs 1 crore. Following interrogation of those arrested, the police seized huge quantity of reputed antibiotics and pain-killers worth more than Rs 1.37 crores. The police later said that following tip-off they nabbed 92 boxes of Voveran. Among the seized items were 26 lakh spurious tablets of diclofenac sodium, 14,000 spurious Voveran tablets, 600 empty boxes of Voveran, 25 empty boxes of Nor TZ, one strip packing machine, a tablet printing machine, two dye rollers, 11 rubber stamps and 4,500 Novartis stickers among other things. Delhi police officials maintain that there exists network of racketeers which ship the spurious drugs from the northern parts to as far as West Bengal, Orissa and Bihar.

The spurious drugs not only threaten the prospects of an industry worth Rs 75,000 crore by revenue but at the same time put the lives of a large number of patients at risk. Therefore, the government and the industry need to join hands in finding a solution to the menace by giving top priority to the safety of the patients.

Spurious medicine scare: Are they faking it?

KM Gopakumar/New Delhi

Although spurious medicines are in circulation, the threat is not as serious as it is made out by big multi-national pharma companies

Initiatives to address the issue of spurious medicine/counterfeit medicine at national and international level is a classic case of propaganda based law and policy making without concrete evidence. It is a fact that the problem of medicine with compromised quality, safety and efficacy (QSE) can endanger the life of patients. No one is denying the circulation of medicines with compromised QSE. However, the dispute is with regard to the scare mongering and the absence of evidence to show the prevalence of the problem. There is an attempt to see it in binary medicines with QSE and medicines with compromised QSE. This approach would lead to hushing up the real issues i.e. availability of affordable medicines with QSE and may help to further the commercial interest by enhancing intellectual property (IP) enforcement standards especially those related to the trademark and patents. Naturally, pharmaceutical multi-national corporations (MNCs), the first beneficiary, are the vociferous campaigner as well as supporter of the campaign to "combat counterfeit " medicines. This aggressive campaign if translated into law and policy may hamper availability of affordable medicines with QSE.

It is important to have a nuanced approach to the issue. The circulation of medicines with compromised QSE is not a black and white story. Manufacturing and distribution of medicine is one of the most regulated industries primarily due to the public health implications including the safety of the patients. All activities starting from manufacture to distribution are regulated through licensing. Licensing requirements are imposed on all actors starting form manufacturer, wholesale dealer and retail chemists. Further, guidelines in the form of good manufacturing, distribution and quality checking practices are in place to regulate procurement of raw material, transportation and storage of finished formulations. Anyone indulging in any activities viz. manufacturing or distribution of medicines without licence is treated as an offence under many national laws, including Drugs and Cosmetic Act.

As a result, there can be two scenarios: First, production and distribution of medicines with compromised QSE by license holders. Second, production and distribution of medicines with compromised QSE. The second situation is already a criminal offence. The first scenario is more complicated and need nuanced approach because QSR of medicine can be compromised in many ways.

QSE can get compromised manufacturing, distribution and storage stage. For instance, QSE of a medicine produced with all quality standards as per the good manufacturing practises may get compromised due to poor transporting and storage facilities. Similarly, QSE may get compromised due to poor quality of raw materials used or due to technical problems in the manufacturing process. QSE can also get compromised without following the good manufacturing practices or poor quality packaging materials. At times QSE is affected due to poor label information, including false information on dosage. For instance, a label information states the dosage of tablet as 50 mg but the actual does is either below or above than 50 mg. Even QSE may be affected even at the hand of patient's hand in the absence of proper storage instructions. The worst case of medicines with compromised QSE is the production and distribution of medicines without any active pharmaceutical ingredients (API) or inadequate API. This should be dealt with stringently without any margin of appreciation. Hence, medicine manufacturer alone cannot be held liable. Each situation demands special particular law and policy intervention and proper incentive and disincentive need to be built in the regulatory system. Therefore, it is not proper to dump all such medicines as counterfeit or spurious products.

Most of the regulatory system requires the manufacturer to provide such information on the label to enable trace and track the origin of medicine. Now, many new technologies are available for track and trace mechanism. However, most of the new technologies are patented and therefore costly to use. Therefore, it is important to use cost effective technologies to ensure affordability.

In policy circles, terms like substandard, spurious, falsely labelled, falsified and counterfeit are used to refer medicines with compromised QSE. One can also find terms like fake medicine, fraudulent medicine. Technically speaking all these terminologies are different and cannot be used interchangeably.

The hidden agenda

The MNC campaign does not follow the above mentioned nuanced approach and just conveys the message that "combating counterfeit medicines" because counterfeit drugs kill. (Spurious medicines in the Indian context). Some of the brochures convey the following messages: Counterfeits have harmful effects on patients' health and can kill; Counterfeits frustrate efforts to deal with high burdens of disease; Counterfeits undermine health care systems; Increased international collaboration is essential to defeat counterfeiting; Combating counterfeiters requires acting at the same time on legislation, regulations, enforcement, technology and communication strategies.

The trap is lies in the word 'counterfeit', which is legally associated with the criminal infringement of trademark. There are two types of infringement of trademarks viz. civil and criminal. A criminal trademark infringement occurs when someone uses a trademark (literal copying of trademark) without the permission of the trademark owner. For instance, someone uses the brand name "Crocin" to sell paracetomol without the permission of the owner of the trademark i.e Glaxo SmithKline Beecham. This is treated as criminal infringement of trademark. However, if someone uses the brand name 'Procin" instead of "Crocin" then it may amount to a civil infringement of trademark but not a criminal offence. The only remedy in that case for Glaxo is to file civil suit and obtain an order against the use of the word "Procin". By projecting counterfeit medicine as a threat to public health, which is essentially an intellectual property issue, MNCs want to use Drug Regulatory Authorities to enforce intellectual property enforcement. In order to achieve this objective MNCs are conflating the QSE issues of medicines with the IP enforcement and advocating for a set of law and policy changes, which would strengthen the IP enforcement.

The hidden agenda behind 'combat counterfeit' campaign at the international level is the enhancement of IP enforcement standards. After the conclusion of the TRIPS Agreement, which obligated all WTO Member States with a few different transitions periods to least developed countries (LDCs) to accept common minimum standard for IP protection and enforcement standards. Immediately, after the conclusion of the TRIPS Agreement MNCs and developed countries together pushing for TRIPS Plus IP protection and enforcement standards through various forums, including Free Trade Agreements ( FTA). The objective of the TRIPS Plus is to close the policy space available on intellectual properties due to the flexibilities in the TRIPS Agreement. Unlike the earlier initiatives, the new ones, especially IP protection and enforcement, are pushed through unilateral, bilateral, plurilateral and multilateral level. At the multilateral level, various multilateral organisations were used to set up multi-stakeholder platforms on IP enforcement viz. WCO (SECURE), WHO (IMPACT), INTERPOL (IP Crime Unit) etc. WHO's IP enforcement platform known as International Medical Products Anti-Counterfeit Task Force (IMPACT) deserves the special mention. This was launched in 2006. G8 Declaration of 2007 states that "Trade in pirated and counterfeit goods threatens health, safety and security of consumers worldwide, particularly in poorer countries. In this regard we welcome work on the WHO initiative to implement the International Medicinal Products Anti-Counterfeit Task Force (IMPACT)." Thus G8 declaration makes it clear that IMPACT is an initiative to enforce IP. The multi-stake holder platform was launched even without the approval WHO governing bodies. Now, the WHO Member States are engaged in a discussion to address the QSE concerns related to medicines and the disengagement of WHO form IMPACT as well as the dropping of the word counterfeit to refer toe QSE of medicine. The upcoming World Health Assembly is to approve Member State mechanism to examine the QSE and access issues of medicine. Raising concerns on WHO's involvement on counterfeit medicines 52 civil society organisations (CSOs) wrote to WHO in November on these issues.

Another important issue related to counterfeit/spurious medicine initiative is the lack of evidence. According to Prof. Kevin Outtersson and Ryan Smith, not only that the evidence for counterfeit drugs is anecdotal rather than empirical but that the only comprehensive collection point for global data on counterfeiting is the Pharmaceutical Security Institute (PSI)-a trade organisation created by the security directors of 14 global drug companies that does not make data available to the public". Thus, there is no independently verifiable data available globally to determine the degree of prevalence of counterfeit/spurious problem. According to humanitarian group Doctors Without Borders, substandard medicines represent far larger risk to public health than spurious medicine. Further, WHO data does not make any difference between substandard, spurious or counterfeit. Therefore, policy makers are not informed the real nature of each problem. As a result, it blocks a nuanced law and policy reforms. MNCs make use of this situation to push their agenda.

Another important problem is that counterfeit/spurious medicine camping mainly focus on stringent and law and its enforcement along with complementary use of technologies to track and trace. There are many technologies existing, including radio frequency technologies to track the final user. Many of these technologies protected under and therefore use of these technologies is not easy and impacts the price of medicines. Similarly many solutions advocated by the MNCs campaigners would result in the high cost of medicine and squeeze generic industry. Therefore the measures on QSE need to be evidence based and should not increase the cost of medicines.

It is not strange that the campaign is not looking at the high price of and unethical promotion of medicines, which are identified as one of the important reasons for the circulation of medicines by fly by night operators.

In India too, the picture is not different from the global context. The campaign on spurious drugs started with a few reports in 2003 citing a WHO study, which WHO later denies even the existence of such a study. According to the alleged WHO study, 35% of global counterfeit medicine produced in India and nearly 20% of medicines available in the domestic market is spurious. In response to the press reports, the Health Ministry appointed a committee under the Chairmanship of then Director General RA Mashelkar to examine the quantity of spurious medicines and strengthening of drug regulation. The Committee recommended capital punishment for those who produce spurious medicines. However, the Government reduced the capital punishment to life imprisonment and amended Drugs and Cosmetic Act accordingly.

Of late, a new partnership has been formed in India which is known as Partnership for Safe Medicine. This new partnership is listed as the India chapter of for Partnership for Safe Medicine USA, a partnership sponsored by pharmaceutical MNCs. Partnership for Safe Medicine USA lists Pharmaceutical Research and Manufactures Association of America (Ph RMA) and Pharmaceutical Security Institute (PSI) as its partners. Further, two board of directors are from industry, one belongs to Pharmaceutical Security Institute, one is the global policy head of Merck & Co and one is from PhRMA.

The way forward

There is a need for a cautious approach and both the government and civil society organisations should not be carried away by the MNC propaganda. Law and policy makers should go beyond headlines and really look at the nature of QSE compromise and make appropriate classification of medicines instead of branding them as spurious or counterfeit. First, the policy response should focus a public health approach to address the genuine public health concerns emerging out of medicines with compromised QSE. Second, the thrust of the policy response should ensure availability of affordable medicines with QSE. Third, strengthen the monitoring capacity of drug regulatory authorities at the central and state level including their coordination action. Four, use the low cost information technology tools to increase the track and trace capabilities’ of regulatory agencies including their capability to recall medicines of compromised QSE. Fifth, increase the consumer awareness through appropriate communication and education strategy. Private actors should not be allowed to carry out such consumer education due to the potential conflict of interest.

(The author is Member, National Working Group on Patent Laws.)