“Demonetisation, one fine morning, came just like a missile where there were reports coming in of hardship and suffering, though it’s not quite clear yet where the missile has landed.”

Mumbai: Underlining India’s poor healthcare record, economist and Nobel Laureate Amartya Sen said the country’s continuing backwardness in providing good healthcare to its people is a striking failure.

“People greet each other with ‘salute’, which literally means good health. By saluting each other, we wish each other good health, not more wealth, not more happiness. Just in that perspective India, cannot get a salutation right now. India’s performance stands not at the top of the world league, but at the bottom,” Mr. Sen, who has been conferred with the Bharat Ratna, said.

Speaking at the Tata Memorial Centre’s platinum jubilee conference in the city, he emphasised on having a wholesome approach towards healthcare that covers nutrition, sanitation and social equity. Mr. Sen also took the opportunity to fire another broadside at the Central government for its demonetisation move. “Demonetisation, one fine morning, came just like a missile where there were reports coming in of hardship and suffering, though it’s not quite clear yet where the missile has landed.”

Mr. Sen, who teaches at Thomas W. Lamont and Harvard universities, said a poorer country like Bangladesh has caught up with and surpassed India in many social indicators including life expectancy, immunisation, infant mortality, child undernourishment, girls’ schooling and sanitary facilities such as having family toilets. “India generally had the second best social indicators among the six South Asian countries including India, Pakistan, Nepal, Bangladesh, Bhutan and Sri Lanka. Second only behind Sri Lanka. It now looks second worst, ahead of one country: Pakistan.”

He also said health-related issues are being poorly covered in media and politics, a conclusion he arrived at after studying the edit pages of leading newspapers between January and June 2000 and not finding a single article on the topic. “We repeated the exercise again in 2012, this time scrutinising more than 5,000 articles published in the editorial pages. Even though there was an improvement from 2000, only 1% of editorial matter was dedicated to health.”

This trend, he said, was particularly frightening as the second half of 2012 was a crucial phase for healthcare policy, where there was a real prospect of health becoming a priority in the 12th five-year plan. “Health was not a subject during the elections of 2014 as well. The subject was not raised by either the party that won or the party that lost. Or the communist party or any other party. Why this total deficit of public discussion on the subject?”

Healthcare, he said, should include social determinants of health like nutrition, sanitation and social equity, and should either be seen as incomplete as a concept in serving health, or be broadly defined. “For example, when you look for clean water, you are doing something for healthcare.”

Turning to the problem of increased privatisation and asymmetrical information on health. “When we combine quackery with crookery, we have alarming results,” Mr. Sen said, giving the example of an incident in Jharkhand, where malaria patients were treated by putting them on saline drip. The patients, he said, felt better.