How India is shaping the strongest generations of tomorrow

Dr Bakshi is asked what population-scale change in health is worth pursuing, and answers with the arithmetic of Indian birth rates and a programme he is building at iSPIRT. What follows is an edited transcript of his answer.

Good timing for this question, because we are sitting in India in 2024. There are 1.5 billion people here, but I do not think people realise that 23 million babies are born in India every year.

Do you know which country is next? China. And what is the number? Nine million. China has nine million births in a year; India has twenty-three million. After that comes Indonesia, then Nigeria. Add the next four countries together and you get to about India. So you may argue that India is producing the next batch of humanity, for whatever reason. That places a certain burden on us as a society.

I work at iSPIRT, and we are starting to build a programme around this. It is getting some traction with senior government and political leaders. The idea is this: a baby born in 2027 will be twenty years old in 2047, and 2047 is a hundred years of India. If that twenty-year-old has been nurtured and cared for in a completely different way, surrounded by intelligence even before delivery, the arithmetic changes.

The pregnancy is managed through coaches and telemedicine. Guidance goes to the mother if she is anaemic. High-risk pregnancies are detected early, and low birth weight is caught early. Then you continue it into a three-month-old, a six-month-old, with early detection of neurodevelopmental problems.

Take one example. Today an autistic child may be picked up at the age of five. AI can allow you to pick it up at two. And if you pick it up at two, the child may not end up autistic, because there are interventions you can make at two that you cannot make at five. Autism is a common problem, but the same logic applies to everything.

Look at the statistics and a great many Indian pregnant women and babies are malnourished. Why? Are we short of food? No. It is that they do not know how to get haemoglobin from nine to twelve. They do not know that diluting a baby's milk is what is causing the malnutrition, that a slightly softer stool is acceptable if the baby is getting the protein. There are real gaps in how we are raising the current generation.

It is not a lack of knowledge, exactly. The knowledge is on the Ministry of Health website. It is in the ASHA manual. The question is whether it is reaching the woman. There are a million ASHA workers in this country talking to women in villages. How can that ASHA worker be augmented by AI, or robotics, or drones?

So the idea starts here: India has a responsibility to shepherd the next generation of humanity. Across the world, in Japan, Italy, South Korea, fertility has fallen far enough that populations are shrinking. India is not there yet. It therefore falls to us to build the strongest humans possible, and I do not only mean physically. Are these children good at critical thinking? At play? At teamwork? Do they see the world as their playground, or are they caught up in narrow domestic walls, as Tagore put it in his famous poem?

Whether we work with the government or outside it, we should all be thinking about these questions. That is one thing I would credit Mr Modi with: he gave us the vision of asking what India looks like in 2047. Nobody was talking about that. We used to talk about the next five years, the next election, the next government, caught up in what I would call petty political battles. Now we should be asking how we want the world to be in 2047. It is an arbitrary number, but it is a good target.

I would push the thought further. The world has seen technology developed for Western problems, rightly so, because it was developed in the West. With the democratisation of technology, a large language model is available here. Drones are being built in India. Robots are being built in India. So there is a large opportunity to build tools that solve India's problems, and then take them to the world.

UPI and the citizen stack have already proved two things: that it is possible, and that it works like magic. Remember the UPI journey. Mastercard and Visa spoke heavily against it, saying it was a bad idea. It happened anyway. Aadhaar was supposed to be a bad idea. It happened anyway. And all those bad ideas combined into a system that now does something like thirteen billion transactions a month, free of cost. Nowhere else in the world is that possible, and India is leading it.

So why not in healthcare? And why not in education? Those are the two areas where we really struggle, and they are the real pillars of a society. Are you a healthy individual? Are you a well-educated individual? Not by the standards of NCERT and CBSE, but by the standards of critical thinking, teamwork, problem solving, and the ability to learn, to improve the world and to contribute to it. Health and education are where the effort has to go.