A scene from the play R/Z, written by French writer Bernard-Marie Koltes, which was staged at the NSD in New Delhi recently.

Inequality is back in from the cold, and becoming a hot issue in the development discourse around the world. Till a few years ago, those who believed that economic growth will fix most problems sparred with those who argued that economic growth was necessary but not sufficient for human development.
Now there is a growing recognition that even with human development, everyone does not develop equally. In other words, there is an absolute need to step out of the comfort zone of the “average” and make a special effort to find out what is driving the huge differences in human development outcomes between different sections of the population despite public and non-governmental action, and reach out to those falling between the cracks.
For example, take healthcare. We have a healthcare system that few would envy. What would change if we had the doctors, the nurses and the necessary medicines and equipment in place? Certainly, things would be a lot better, but the end results in health would not still be the same for everyone. Why? As Nata Menabde, the World Health Organisation’s representative to India, once told me: “Even if there is a the health system to serve everyone who needs it, the rich often have better and easier access to services than poor and vulnerable populations. This is, among other reasons, because the poor have reduced access to information and take more time to find their way to needed services within the system. Therefore, having services available to all is not enough. Extra efforts are needed to ensure that all people can benefit from them in an equitable manner.”
The point comes home forcefully as I read the United Nations Development Programme’s latest human development report. People have differential access to information, and different levels of control over their lives. Those who have the least control over their lives typically have less information are less aware of the options before them and, therefore, their human development is ultimately not what it could have been.
Which brings me to the “G” word — not Greece, but gender.
The UNDP Human Development Report 2011 places India near the bottom of its “gender inequality index” in South Asia. Only Afghanistan fares worse. Millions of women in India have better lives today than their mothers or grandmothers ever did. Many women are in positions of power and visibility These are the faces that we see. Millions more remain trapped by circumstances that offer no choices and hold out no future. India’s fertility rate makes the point. Fertility in India has been going down steadily. But the burden of contraception falls disproportionately on women even today. The other crucial factor is the age at which women marry. Despite a law criminalising it, child marriage continues in many states. Child marriage fuels early pregnancy and increases the risk of the mother and the child dying needlessly. All this is a reflection of the gross gender inequality that persists in many parts of the country.
Lamentable as the situation may be, we can also view it as a window of opportunity. The UNDP report sounds a timely alert, and reaffirms what many experts and activists have been saying. The examples cited by the report makes it clear that it is not always more money that makes the difference. Given enough political will and community mobilisation, a lot can be done even in cash-strapped places.
One example that really stands out is neighbouring Bangladesh. In Bangladesh, the fertility rate fell from 6.6 births per woman in 1975 to 2.4 in 2009, a huge drop attributed to the introduction of a major policy initiative in 1976 that emphasised population and family planning as integral to national development, according to the UNDP report.
What did Bangladesh do? It did many things — community outreach through discussions with religious leaders, teachers, NGOs, sensitisation of both men and women, focusing on reproductive health research and training and so on. One key area where Bangladesh has shown impressive progress is adolescent fertility — that is, births per 1,000 women for those in the 15-19 age group. Bangladesh’s adolescent fertility rate is 78.9, according to the UNDP report. The corresponding figure for India is 86.3. Bangladesh’s sustained investments in female education has paid off. India has hugely expanded coverage of education. But the gains have been mostly in school enrolment.
At the press conference in New Delhi where the UNDP report was released, I asked rural development minister Jairam Ramesh what he thought were some of the factors that explained Bangladesh’s relative success in tackling the fertility issue, especially among adolescents. He was characteristically outspoken: “Bangladesh has not been squeamish. It has adopted a frontal approach towards the population question.”
Political India, in sharp contrast, still sees population as a taboo subject because of its associations with the 1975-77 Emergency, when forced sterilisations were carried out. Ever since then, we talk about population in seminars and in places like the India International Centre, but no Indian politician or political party ever takes it up in a major way. There is another taboo topic: child marriage. There is a law criminalising it, but it still continues because of socio-cultural sanction among many communities, and few politicians are willing to condemn it or push for stringent action against those guilty.
Once again, different parts of the country respond to the challenges in different ways. According to the most recent National Family Health Survey (2005-2006), the all-India statistic for women in the 20-24 age bracket, who were married off by age 18, is 47.4 per cent. Women in the 15-19 age group, who were already mothers or pregnant at the time of the survey, is 16 per cent. Startling differences, however, exist in the life circumstances of women within the country: In Kerala, only 5.8 per cent of women in the 15-19 age group had already given birth or were pregnant at the time of the survey. The corresponding figure in Madhya Pradesh was 13.6 per cent. Madhya Pradesh has more child marriages than not only Kerala but also the all-India average.
Why do women who don’t have choices and control over their lives need our urgent attention? Because sustainability and equity, including gender equity, are intertwined. A more equal India, where women have more say over what they do with their bodies, and lives, can do miracles. Such an India will also help reduce environmental pressure by slowing demographic growth.

Patralekha Chatterjee writes on development issues in India and emerging economies and can be reached at patralekha.chatterjee@gmail.com