Public spending on education and health is still insufficient to meet the needs of the entire population. The quality of the services offered is often still inadequate. There are also shortcomings in the country's infrastructure. A large proportion of the population have no or only inadequate access to basic services like water and sanitation, decent housing, waste disposal and transport. For example, about 30 per cent of India's people do not have their own toilet.
India's population has almost doubled over a period of 40 years. About a quarter of Indians are younger than 15 and nearly 45 per cent are younger than 25 years of age. This demographic development offers huge opportunities for economic growth and increased incomes – but only if India manages to actually make use of this potential by providing more education and more employment.
Right now almost 90 per cent of workers are employed in the informal sector, which means that they are not able to get occupational health insurance or any kind of wage compensation when they fall ill. Only a very small percentage of them are able to afford treatment by doctors outside the at times patchy basic health services provided by the public health system. There is also a lack of high-quality vocational training programmes that are accessible for all population groups and also have social recognition.
The COVID-19 pandemic has had major impacts on India's economy and its public health system. The economic and social consequences of the pandemic have hit the poorer, uneducated segments of the population particularly hard. In particular, many day labourers fell back into extreme poverty as a result of the pandemic, as they were no longer able to find work in the urban informal sector, which meant that some of them returned to their home villages, thus increasing the pressure on available resources there.
In the poorer states and in metropolitan areas, health facilities were stretched to full capacity and in spring 2022 some were on the brink of collapse.
The BMZ assisted India in dealing with the crisis. One focus of this support was on the northern part of the country, which is characterised by higher incidence of poverty and weak infrastructure. Food aid assistance alone reached at least 320 million people. Additional resources were provided for social protection, the procurement of medical equipment, and training for medical personnel. Germany also assisted India in distributing COVID-19 vaccines.