“Today is the tomorrow that we were so concerned about yesterday”, thus goes a saying . And there are many concerns our sixty-year young country faces — separatism or secessionism, politically-organized militant communalism, economic and social deprivation of the poor, strained centre-state relationships and many more. Rural India is in ruins; urban India in unhappiness. The Republic has to reinvent itself bringing about paradigm shifts in the values that governs it.

Once food-insecure, India is now a growth story drawing global whistles. The country’s growth is satisfactory and impressive but only in parts, marked by regional imbalances and disparities. And, a considerable portion of the country lives below the poverty line.

We celebrate Republic Day every year with fireworks, salute to the tiranga, distribution of awards, parade, display of military might and so on. While doing so with pomp and circumstance, we need to ask ourselves: have we lived up to the ideals enshrined in the Constitution?

India’s governance is lacklustre and the government’s cavalier attitude towards various matters stokes people’s fear about the future. We have all the rules, regulations and mechanisms in place. What is woefully lacking is implementation. We need to defeat divisive forces and get rid of socio-economic disparities. We also need to act tough on corruption and criminalization of politics that sap the vitality of our democratic institutions. Inclusive growth must keep lifting living standards. So, we cannot delay labour reforms, modernization of agriculture, trimming of unwanted subsidies as well as building better infrastructure to sustain growth. The government needs to become an enabler not a patron.

The CPM patriarch Jyothi Basu who ruled West Bengal as its Chief Minister for 23 years is no more. He died of illness last month; his demise is a great loss to the Community Party of India (M) and the Indian political scene.

That health care sector continues to be neglected is no longer debatable. Gaining access to affordable and accessible care will remain a dream to us , it seems. Worldwide, over 3 billion people live in cities and towns. By 2030, six out of 10 people will be city-dwellers, rising to seven out of ten by 2050, WHO studies show. Urbanization is here to stay. It is an irreversible trend. ‘Urbanization and Health’ is the theme of this year’s World Health Day. Urbanization faces many challenges related to water, environment, violence, injury, non-communicable diseases, alcoholism, tobacco and substance abuse etc.

In India, urban growth has been exponential over the last few decades. While the rural population has doubled, the urban numbers have grown fourfold. According to United Nations, the number will swell to 576 million by 2030. “Urban chaos is becoming a way of life. Our cities and towns are not an acceptable face of a rapidly-modernizing and developing economy, said Dr Manmohan Singh, our Prime Minister recently (The New Indian Express, 7 September 2009).

Like rural health, urban health is a huge challenge. Towards providing affordable and quality care to the 28 crore people living in urban slums of 429 cities and towns, the government designed in 2008 the National Urban Health Mission on the lines of the NRHM launched three years ago. The news aroused lots of expectation in people. Though there was delay in launching it, people remained expectant. And now, the news that it will be launched only post 2012 comes as a rude shock to all. The Health Ministry needs time to sharpen the execution plan and to get the strategy right, newspaper reports say. Whether it only hangs fire or gets shelved for now, only time will tell. We can only wait and hope. Paucity of funds is the reason for keeping it in mothballs till 2012, detractors say. Let us hope the government doesn’t abandon it!

This issue of the magazine is on the National Urban Health Mission. Contributors are Dr Bimal Kanta Nayak, Mr D John, Mr S J Chander, Dr N Devadasan, Dr S Ram Murthy, Mr Denny John, Namita Bakshi, and WHO.

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