Chapter 19 · 13 of 15
Classroom & Clinic
A state that vaccinated a billion in two years — and took four years to open its death registers.
Education First outcome win on an old shameHealth Both faces
BEFORE AFTER
Before → after
Class 3 reads a Class 2 text (govt schools)
Before 16.3% 2022
After 23.4% 2024 — highest ever
Class 3 can subtract
Before 25.4% 2014
After 33.7% 2024 — decade high
Education spending, % of GDP
Before ~3% 2014 · 6% promised
After ~3% now · still 6% promised
Vaccine doses
Before 0 Jan 2021
After 220 crore world's largest drive
Medical colleges
Before 387 before 2014
After 846 Aug 2026
Infant deaths per 1,000 births
Before 39 circa 2014
After 26 SRS 2019–21
Maternal deaths per lakh births
Before 167 circa 2014
After 93 SRS 2019–21
Health costs paid out of pocket
Before ~62% before
After <40% 2021–22
COVID deaths — three rulers, lakh Extra deaths in govt registers, 2021 alone
21 lakh
WHO excess estimate, 2020–21
47.4 lakh
The registers, released four years late, sit far closer to WHO than to the official count.
MBBS seats Postgraduate seats nearly tripled; 22 new AIIMS approved, 19 teaching.
One person, before and after
R
Rekha an ASHA health worker in a Madhya Pradesh village A composite — built from thousands of real accounts. 1 2014 Rekha, ASHA worker. The health centre is a locked room.
2 Apr 2021 She begs for oxygen. Two funerals in her lane.
3 Winter 2021 Her whole village gets vaccinated.
4 2024 Half of Class 5 reads a Class 2 text — the best in years.
Before 2014 Enrolment won: 96%+ in school. Learning lost: half of Class 5 can't read a Class 2 text. Health spending ~1% of GDP. Child and mother deaths falling under every govt. After 2014
NEP 2020
6% vs 3% promised vs spent on education
6% first promised in 1968. Mother-tongue teaching; flexible degrees.
The fight over NEP
₹2,000+ cr Tamil Nadu school funds withheld
Passed without a Parliament vote. Textbook cuts: Mughals, evolution. Universities: state vs Governor.
A real win
16.3% → 23.4% Class 3 reading, 2022 → 2024
Best ever measured. Govt schools recovered faster.
Exams
67 perfect scores in the leaked NEET 2024
2026: student protests; minister resigned. 13 lakh students study abroad.
COVID toll
5.3 · 21 · 47 lakh official · govt registers · WHO
Oxygen deaths: 'none reported'. Registers released 4 years late.
Vaccines
220 crore doses
Two Indian-made vaccines. CoWIN certificates. Free after an SC push.
The build-out
387 → 846 medical colleges
MBBS seats: 51,348 → 1.4 lakh. Infant deaths: 39 → 26 per 1,000. Out-of-pocket: 62% → <40%.
Pharmacy, two faces
19–23 children killed by Coldrif syrup
Pharmacy of the world. Drug inspections at half strength. Still fighting about
1
COVID: triumph, or tragedy?
Government's case The biggest vaccine drive anywhere. Fed 80 crore people. VS
Critics' case Second wave after declared victory. The dead went uncounted.
The book: Both — in the same two years.
Where do you lean?
Government Both hold Critics
2
Schooling vs learning
Government's case First real learning gain in 20 years. VS
Critics' case Still half the class. ~10 lakh teacher posts vacant.
The book: The hardest number moved. It still fails half.
Where do you lean?
Government Both hold Critics
3
What health model?
Government's case Insurance, colleges, falling costs. VS
Critics' case Public clinics underfunded. ASHAs paid honorariums.
The book: Kerala does it the unfashionable way.
Where do you lean?
Government Both hold Critics
The verdict
Education First outcome win on an old shame Rule 6 Strongest verified FOR ASER 2024: best foundational reading ever measured
Strongest verified AGAINST Half of Class 5 still cannot read a Class 2 text; 3% spent against 6% promised
Strongest verified FOR 220 crore vaccine doses; colleges 387 → 846; ruinous health costs falling
Strongest verified AGAINST The COVID toll: 5.3 lakh official, ~21 lakh in the state's own registers, 47.4 lakh by WHO
Yours
The book gives none. Slide; it is saved to your scoreboard on this device.
Clearly worse Worse No real change Better Clearly better
Read the full chapter — the book’s own words
The classroom and the clinic run on one more input this book has not yet audited: power. The solar farms and the coal records, the net-zero promise and the choking winter air — the era's energy bet, and the climate bill attached: Chapter 20.