EDITORIAL : THE HINDU, INDIA

Speeding up government

The Electronic Service Delivery Bill, 2011, which aims at delivering all public services to citizens in the electronic mode, is a welcome piece of legislation. By eliminating paperwork on a massive scale, the new measure can cut the red tape and corruption that notoriously plague governance in the country. The draft Bill published by the Ministry of Information Technology at its website is similar to the Right to Information Act, 2005 in that it incorporates a complaints mechanism and prescribes penalties for failure to comply with the provisions. Importantly, it sets a five-year deadline for all public services to make the online transition, with a further concession of three years in some cases. What people can expect in the new dispensation is electronic submission of forms and applications, issue or grant of any licence, permit, certificate, sanction or approval, and receipt or payment of money. No time must be lost in enacting the law, given India's poor record of delivery of citizen services. Moreover, services now facing severe bottlenecks, such as passports, should be prioritised for electronic processing. The draft provisions make it incumbent on the central and State governments to publish a list within six months of the date of enactment, and they would do well to pick the worst-performing departments for inclusion first.

India badly needs a major initiative on electronic service delivery and e-governance. That it has done little to use Information and Communications Technology to help citizens is evident from its 119th rank among 192 countries in the United Nations E-Government Development Index 2010. Although there is no standardised measure of e-governance, the indicators used by the U.N. — online service availability, telecom infrastructure, and human capital — suggest that India is below the world average for the composite index. This underscores the need to get the electronic service delivery law in place urgently and to enforce it seriously. The experience with the RTI Act indicates that public support for modernisation will overwhelm any resistance from vested interests. What must be noted, however, is the continued failure of many government departments to disclose information pro-actively on the Internet, as laid down under the RTI Act. Successful e-government requires that citizens get maximum information, and are able to conduct online transactions and participate in decision-making. All this calls for wide access to online services in the form of kiosks and special centres. Rising India must make progress on each of these metrics, if it hopes to leave its colonial baggage of red tape behind.

Threat from chronic diseases

Cardiovascular diseases, diabetes, cancers, and chronic respiratory diseases account for 63 per cent (36 million) of all deaths globally. This is the finding of the World Health Organisation's global status report on non-communicable diseases (NCDs) for 2008, and the situation is unlikely to be very different today. The picture also runs counter to the general perception that such deaths are largely restricted to developed countries. In truth, nearly 80 per cent of deaths from NCDs occur in low- and middle-income countries (if Africa is kept out of the picture). Of the four chronic diseases, cardiovascular diseases and diabetes are responsible for 80 per cent of all deaths. High blood pressure turns out to be the biggest risk factor for cardiovascular diseases. It caused an estimated 7.5 million deaths round the world. In India, according to estimates by the Public Health Foundation of India, about two million people die every year from cardiovascular diseases caused directly by high blood pressure. The rate of prevalence of high blood pressure is 24-30 per cent in urban areas and 12-14 per cent in rural areas. But the percentage of people aware of their condition is only 30 per cent in cities/towns and 10-12 per cent in villages. Shockingly, just about 10-12 per cent of those who have high blood pressure in urban areas and a mere 4-5 per cent in rural areas have it adequately controlled for their risks.

The New England Journal of Medicine reported last year that India would lose $237 billion over the next decade owing to non-communicable diseases. Prevention and control of these diseases is achievable, provided the government uses a little imagination to implement some effective low-cost population-wide interventions. Finland reduced the cardiovascular diseases mortality rate by 75 per cent, and Japan achieved a 70 per cent drop in strokes by mandating a reduction in salt content of packaged foods. Many countries have introduced chilling pictorial warnings on cigarette packets and are rotating them annually in keeping with WHO guidelines. But India has taken a retrograde step. Three years after introducing pictorial warnings in India, the warnings continue to be as ineffective as ever. The government recently decided to rotate the pictorial warnings every two years and allow the manufacturers to have the final say in the choice of pictures! As every physician knows, physical inactivity, alcohol consumption, tobacco use, and unhealthy diets figure high in the list of causative factors for NCDs. If individuals can be faulted for not adopting healthier lifestyles, the failure of the government to spread awareness is inexcusable.