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This is twice in a row that someone else has tagged me ahead of the Arch-Tagger. Someone ought to tell her that she’s slipping

A week has gone by since I was tagged by the good doctor with the highly distractible goat-llama-accordion-loving mind and I’m still doubtful if it is an honour or otherwise to be tagged by him (and to be the first on his list of tagees). Is it just payback?

The minute I saw my name on his list I knew this was going to be hard work.

It’s taken me a week of number-crunching to come up with this. Please don’t expect me to live up to the high budgetary standards set by Rob.

I had to write it down to figure out how big a number $456 Billion is.

$456,000,000,000

Converted into Indian Rupees (denoted as ‘INR’ or the more familiar ‘Rs.’ henceforth in this post) it becomes an even larger number (conversion rate US$1 = INR 41).

Rs. 18,696,000,000,000.

That is 18.7 Trillion Rupees or to use the more familiar Indian numbering system, it is approximately 18 lakh and 70 thousand crore rupees (Rs. 18,69,600,00,00,000).

Now I’m going to assume that by some means, the entire sum earmarked for the Occupation and Utter Devastation of Normal Life in Iraq is handed over to the Indian Government.

Let us also assume that in a burst of social conscience, the Indian Government decides to give the money to the people.

Based on the current estimated population of India (from the CIA’s World Factbook, no less), if this money was equally divided,
every person in India would get approximately Rs. 16,550.

Which is roughly equivalent to the monthly salary¹ of a doctor with five years experience in the various Directorates of the Tamil Nadu government’s Health & Family Welfare Department (an Assistant Professor in the Directorate of Medical Education or an Assistant Civil Surgeon in the Directorates of Medical & Rural Health Services or Public Health & Preventive Medicine). As an aside, I just realised after visiting the government website how similar this looks to the erstwhile Soviet Union’s style of governmental organization. See this to find the similarities

If the government chooses to give the money to the approximately half a million doctors in our country instead, each of us would get about Rs. 3.75 crore (approximately US$ 910,000). So we could hope to be near our high-earning brothers (& sisters - I don’t want to be called sexist) in America.

But if our government decided to keep all the money (which is more likely), then India would jump six places in the List of Countries by GDP (International Monetary Fund) to be placed eighth - ahead of Canada.

Maybe not six places. I had forgotten about the ‘commission’ that our ruling classes would extract. Assuming a commission of 10% for the politicians and 10% for the bureaucrats, we would be left with $1.25 trillion, which would bring us down to 9th place - between Canada and Spain.

What happens to the commission?

The 10% to the politicians would break up in such a fashion.

Based on the assumption that only politicians in power would get a share and the approximate number of our electoral college (4896 according to this newspaper article) each of the members of the state legislatures and the two houses of Parliament would get about 374 crore rupees (approximately US$ 91.2 million per politician).

Not bad at all.

Since I have no idea how many bureaucrats there are in India, and what permutations and combinations one would have to do to calculate their individual shares, I will not attempt a break up.

That was partly social commentary.

Since I’m a doctor and I’m expected to think altruistically…here’s what could really be done with the money in terms of health care in India.

Lets just take the example of Tuberculosis, where we hold the dubious distinction of being ranked first among the 22 high-burden countries (according to this source).

According to one study² the estimated total burden of Tuberculosis in India (pulmonary & extrapulmonary) for the year 2000 was 8.5 million cases. Based on the quoted incidence rate of 1.8 million new cases per year, and a TB-related mortality of 370,000 per year the total burden for 2007 would be approximately 17 million cases.

The Indian health care system, powered for the most part by the huge public sector (i.e., government-run) hospitals and primary care centres has made stupendous progress in trying to control TB through its Revised National Tuberculosis Control Programme. The entire country has been covered under the Directly Observed Treatment, Short-course (DOTS) programme by March 2006.

By now, if you are still reading this, I’m sure you are wondering what this has to do with this meme.

I’m getting there (taking the long scenic route as usual).

According to two studies (free pdf downloads here & here), by the same group of researchers based at the Tuberculosis Research Centre in Chennai, the economic burden of TB in India was estimated to be about Rs.13,000 crores (about US$ 3.1 billion) in 1997. And the unit cost of completely treating one patient was about Rs.6000 (US$ 146). The treatment inclusive of diagnostic tests is totally free under the RNTCP.

Given the rate of inflation and the increased total TB case burden in the country the economic burden should have at least doubled by now.

Even the doubled estimate of 26,000 crore rupees is small change (0.86% to be exact) compared to the 18 lakh 70,000 crore rupees spent pushing the Iraqi society into the 19th century.

The same kind of rigorous war on TB could be fought for 117 years (you read it right, it is one hundred and seventeen years) with that kind of money.

Imagine what could be achieved in providing proper health care and fighting all the diseases prevalent in all the poor countries of Sub-Saharan Africa.

That is one way of spending the money.

But it would be irresponsible of me not to follow the peerless Dr. Rob….

So here are the goats (which are quite common in Tamil Nadu compared to Llamas, which may not be available even in our zoos)….

A full-grown adult goat would cost about Rs. 5000.

There are about 62 million people in Tamil Nadu. With US$ 456 Billion we could gift 60 goats each to every man, woman and child in Tamil Nadu.

If you’ve read this far, you deserve a special thank you.

I just realized that I almost forgot to tag people

1. Lakshmi & Arunn - both of you can answer either in your science or non-science blogs.
2. Moof
3. Ian
4. TJ

The idea of this meme - started by Sam Blackman at Blog, MD who was inspired by this pictorial feature in the Boston Globe - is to speculate better uses for the $456 Billion likely to be spent on the war in Iraq.

Footnotes:

1. For the American & British doctors - that is an annual salary of about US$ 4850 or UK£ 2450. Jaw-dropping isn’t it?! Now you know why so many of our guys are working in the US and the NHS in the UK in spite of all the bad things that you guys keep saying about your respective healthcare systems.

2. Source: Gopi PG, Subramani R, Santha T, Chandrasekaran V, Kolappan C, Selvakumar N, Narayanan PR. Estimation of burden of tuberculosis in India for the year 2000. Indian J Med Res 122, September 2005, pp 243-248.

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