The race to unhealthy economic development? Perspectives on India

By Andrew Williamson

With India tipped to be the world’s third largest economy by 2026 and possibly overtake the United States by 2030, its rate of economic transformation will be vital for improving the  livelihoods of its citizens and accelerating poverty reduction. However, amongst the range of economic forecasts and projections, lies a number of interconnected health implications that will continue to hinder India’s economic miracle, in particular air pollution and water security. 

The relationship between health and economic growth is dynamic, complex and often underappreciated. As a vital component of human capital (as well as education), health is often viewed as integral to economic productivity, similar to labour and physical capital. Yet, India is characterised by unique social, cultural and religious factors that need to be fully considered in order to understand the role of health within the country and how these factors have influenced a slower transition to health-conscious economic growth. 

Smog in Delhi, India. Credit: Shutterstock

Air pollution

Indian cities have been a token feature within yearly polls of the world’s most polluted urban areas. Linking the air with economic development is vital due to its inherent relationship with our health, our ability to work, its impact on food supplies alongside exacerbating pre-existing inequalities and societal fragilities.  For the vast majority of pollutants, emissions are projected to increase in the coming decades. Rising emissions reflect the underlying baseline assumptions on economic growth – increase GDP and energy demand equals increased air pollutants albeit at a slower pace. In India, extreme ambient air pollution has become a yearly ‘phenomenon’ primarily commencing in the winter season yet remaining a persistent health and economic threat throughout the entirety of any given year. Statistics on increased child mortality and increased respiratory complications connected to air pollution exposure have been coupled with the detrimental impact air pollution has had and will continue to have on the nation’s GDP. Recent approximations have pointed to significant economic losses (roughly 1% of India’s overall GDP). Renewed government efforts such as the National Clean Air Programme are welcomed, yet what is required is an all-encompassing strategy that is representative of the whole of the country, and integrated into a national planning process. This will reflect an economic agenda necessary to alleviate the human toll of air pollution.

Water from tube well used for irrigating agricultural fields in a village in Andhra Pradesh. Credit: Shutterstock

Water security

India is home to 18 per cent of the global population but has only four per cent of global water resources. Per capita water availability is around 1,100 cubic (m3), well below the internationally recognised threshold for water stress at 1,700m3, and close to the threshold for water scarcity at 1,000m3 per person. Population growth and economic development has put an increasing strain on water resources. In addition, climate change is expected to bring changes in weather patterns leading to more extremes. Interestingly, India relies on water for the production of exports like agricultural produce and textiles, making it one of the world’s most water—intense economies. This is worrying given increasing levels of water scarcity; highlighted by India coming thirteenth in the world’s most water stressed countries. Examples of urban hubs such as Chennai depleting its water sources in 2019 and 80% of available ground water in India having been withdrawn, point to a water management crisis and not a simple water crisis as is commonly understood. The crises of continued depletion and contamination of groundwater supplies, coupled with inefficient water conservation, governance and usage practices have led to dire institutional projections. It is expected that by 2030, 40% of India’s population will have no access to drinking water and twenty-one of India’s major urban hubs will run out of groundwater. A multitude of compounding institutional inefficiencies, unsustainable agricultural policies and practices, as well as rapid unplanned urbanisation demonstrate poor water management and what could reasonably be viewed as a human-induced crisis. Moreover, government capacities at the local and national level are lacking in terms of water management, while current policies and incentives favour inefficient and unproductive uses of water. This is coupled with weak or absent institutions in water regulation and poor data collection and assessment. The development of sound, well-planned and implemented policies combined with tailored infrastructure investments are critical components in pursuing a two-pronged approach to securing water and sanitation services and enabling sustained economic growth.

The multitude of economic and social pathways through which health affects economic growth and the reverse causal channel by which economic prosperity promotes better health shows the complexity of this relationship. Addressing these complexities are future technological advances and institutional improvements that will promote public health and economic growth. Nevertheless, India’s economic ambitions have been politically coined on two key principles: raising economic growth and making growth more inclusive. In practice, this should entail interlinking health and economic development to accelerate India’s demographic dividend for sustainable economic growth whilst reflecting the health and wellbeing of both urban and rural populations.

Andrew works for a development think tank and has a keen interest in climate change and economic development.

The views expressed in this article are those of the author and do not necessarily represent the views of Development in Action.


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