The Gates Foundation should not rely on government data

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Salil Tripathi

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Later this month, the Bill and Melinda Gates Foundation will give its Global Gatekeeper Award to Prime Minister Narendra Modi. The award is being given in recognition of the Swachh Bharat Abhiyan (or “Clean India mission”), which Modi launched soon after he was elected in 2014.

The Gates Foundation exists to improve public health around the world. By 2018, it had made grants totalling $50.1 billion, dwarfing other philanthropic rivals. Its endowment stands at a whopping $46.8 billion, supporting programmes in 139 countries, including the US. The foundation’s results-oriented approach, focusing on effective interventions, has raised public health standards in many parts of the world, even if some of its methods, including reliance on numerical targets to eliminate waste, corruption and inefficiency, have been controversial.

Access to toilets is crucial to sanitation and uncontroversial, but the choice of Modi has become controversial. Three Nobel laureates, Mairead Maguire (1976), Shirin Ebadi (2003), and Tawakkol Abdel-Salam Karman (2011) have called upon the foundation to rescind the award. A petition, signed by 100,000 people, also wants it to reconsider the award. Critics have pointed out the 2002 carnage in Gujarat during Modi’s chief ministership, the mob lynchings that have grown in the past five years, and the crackdown in Jammu and Kashmir after its autonomy was eroded and the state bifurcated—the impact on health and education in particular. Defending the award, the foundation told CNN: “Before the Swachh Bharat mission, over 500 million people in India did not have access to safe sanitation and, now, the majority do. There is still a long way to go, but the impacts of access to sanitation in India are already being realized.”

This is not to argue whether Swachh Bharat is a good idea—of course it is. But the Gates Foundation should know better than to rely on government statistics. Open defecation continues in areas that the government has claimed are free of it, as the Research Institute for Compassionate Economics has shown. While latrine ownership has increased, latrine usage has not, as Payal Hathi of the University of California at Berkeley and Nikhil Srivastav at the University of Texas at Austin have shown, citing possible discrepancies in government data. In some cases, this is because newly-built toilets do not have water connections. In some places, people prefer to use toilets for storage. A detailed analysis on the news website Scroll suggests that the government has made selective use of statistics. Only one in seven villages claimed to have given up open defecation had undergone two levels of verification. Besides, manual scavenging, which is a major health hazard, persists. About 180,000 households in India are still engaged in it. A 2018 estimate says there are five million manual scavengers in India. Some 88 people have died while cleaning septic tanks in India over the past three years.

None of that is surprising. Data gets manipulated, but rarely on such a large scale. Changing societal norms isn’t easy. But this Indian government tends to declare victories prematurely, which the Gates Foundation ought to know. It is, however, not changing its mind, which is its prerogative. It is a private institution, even if it operates in the public sphere. It should be noted that the foundation has had a difficult time in India recently. It has had to face questions of consent, for example, over its vaccination programme in Andhra Pradesh. The government has asserted control over an immunization project the foundation has been supporting. It wants better ties with the government. But can it ignore criticism?

Human rights are “universal, inalienable, indivisible, interdependent, and interrelated”, as laws usually state. However, governments frequently trade off some rights against others: The right to strike is suspended so that investment can create jobs. The right to speak is abrogated in the name of public safety and security. The right to protest must make way for people’s right to food, and so on.

However, rights are not mutually exclusive. That is a false binary, and the “choice” is not between, say, health and prevention from arbitrary detention. Yet, by disregarding such concerns, the Gates Foundation ends up reinforcing false binaries. It isn’t alone in doing this. There have been controversial choices in the past. Henry Kissinger has won the Nobel Peace Prize. In 1989, the United Nations honoured Indonesian dictator Suharto for his family planning policies. (Hundreds of thousands died in massacres during his 32-year rule, which ended in 1998.)

The foundation could have honoured India’s countless manual scavengers, primary health care workers, including midwives, or organizations such as the Safai Karmachari Andolan, which aims to abolish manual scavenging. That would not have been glamorous, but would have encouraged rapid deployment of automation, such as mechanised scavenging, so that workers are liberated from that undignified work. However, that would not have fetched headlines or photo opportunities. It would have improved lives, though, which presumably is the foundation’s primary purpose.

Salil Tripathi is a writer based in London. Read Salil’s previous Mint columns at www.livemint.com/saliltripathi



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