ウィスパリング同時通訳研究会コミュのA Conversation With Tata Chairman Natarajan Chandrasekaran

GOLODRYGA: Hello, everyone. Welcome. I hope you’re enjoying your lunch, and coffee, and conversations with friends. I’m really looking forward to this conversation that I’m going to have with a new friend that I’ve just made. Natarajan Chandrasekaran is the chairman of the board at Tata Sons, and the holding company and promoter of more than one hundred Tata operating companies. You all know his background and his resume, and I don’t want to spend too much time talking about that. That’ll be a discussion in and of itself. Welcome. It’s great to have you.

CHANDRASEKARAN: Thank you.

GOLODRYGA: You have co-written a wonderful new book called Bridgital Nation, and I hope all of you if you haven’t picked up a copy there’s one out front. We’re going to talk a little bit about the book, we’ll talk about news of day, we’ll talk about India. And then we’ll open it up at about 1:30 for questions from the audience. Just so you know, everything here is on the record. And it’s going to be an interesting conversation. So I’m happy to be with all of you here today. My name is Bianna Golodryga, by the way. I’m with CNN News.

So I want to start with some of the economic headlines out of India. And it’s going to relate to the book in the sense that India has just now surpassed the U.K. and France as the world’s fifth-largest economy, with a GDP of 2.94 trillion. And a new report, it also suggests that India continues to develop a market economy. That’s the positive news. The not-so-optimistic news, however, is India’s real GDP growth, it is expected to weaken for the third straight year from 7 ½ percent to 5 percent, an eleven-year low. And India’s unemployment rate has reached a five-year high.

A lot of questions of how to marry the two, a growing economy, lots of internal problems and structural problems, and the role that technology can play in that. And that’s where this book comes in, because you really address it in a two-pronged approach. It’s twin challenge troubling India. Talk about how you address it in the book.

CHANDRASEKARAN: OK. It’s a good commentary that you gave. So we can talk about the economy a bit later. Let me talk about the book in the larger context of technology, India, artificial intelligence, and the general fear that AI will take away jobs, and so on and so forth. I think if you look at India, I have been reflecting on this for a very long time because all my career I ran a tech company. So I only applied tech to solve either business problems or large-scale public sector problems, and public services delivery, and so on. I also grew up in rural India. And so I have observed so many things over the last three decades.

And largely all of India’s problems, according to me, can be grouped into two categories. One category, I call it access. The second category is jobs. When I say access, it comes from the fact that we have a lack of everything. You take doctors, we are shortage. Teacher, we are shortage. And at any point of time we are shortage of four hundred thousand teachers, all you really need is forty thousand teachers. If you take doctors, it’s six hundred thousand shortage of doctors—2.5 million shortage of doctors. We are dealing with a global average, whether it is doctors or teachers, to patients a ratio—or ratio with students. And judiciary. We don’t quite have the number of judges we need for the country. I’m told that we need about seventy thousand judges and we have probably one thousand. So you take infrastructure, we have shortage. We have hospitals, we have shortage. And on the other side, we have a lot of talent.

GOLODRYGA: You have ninety million people entering the workforce by 2030.

CHANDRASEKARAN: Every month plus ten million people coming into the workforce, OK? And it’s going to be there for the next ten years. I think basically in the next ten years we will need about—more than one hundred million people coming into the workforce. I think if I’m right, the China number is about twenty-three, twenty-four million in the same ten years, and the U.S. is about ten million. So you see the scale. So if this is what the two problems are, you would have thought that we would have managed it in such a way that the supply and demand meet each other. There’s a lot of demand, and there’s a lot of supply—assuming that if you have the right human resources you can solve all these problems. But I think over the years we seem to be trying to solve all the problems in two different ways.

So the idea of the book is how do you connect the access challenge and the job challenge together. So you solve both problems, so that they meet each other. The basic principle is that if you take the access side of thing, you cannot solve this problem by putting more capital and going into building programs which will take next ten years and twenty years. If you go on a hospital building spree or you want to educate more doctors by opening hundreds of thousands of medical colleges, it’s not going to happen. So how do you use technology? So we started about doing pilots.

We did a health care pilot—multiple healthcare pilots. And to cut the long story short, some of the findings are if you take an expert, the expert doesn’t spend all his or her time on only doing the stuff that person needs to be done. Most of the time they are doing work way below their expertise. That’s because the entire middle is missing. So we have people who are low skilled or no skilled, or we have people who are super skilled. And the middle, there’s a lot of gap. So how do you use technology to augment the skill level of these people so that we can perform at a higher level.

So that led to the theme that AI, and machine learning, and all the things that go with—cloud and the entire digital stack—should be for all. It should not be elitist. Then you can employ people. You need to train everybody. Nationwide we need to train twenty-five to fifty million people all on digital. And it’s much easier to train people on digital than teaching them math, and science, and counting, and reading, and writing.

GOLODRYGA: So why hasn’t that happened yet, in the sense that when you talk about technology and the role that it plays in the U.S. economy—we have an aging population here in the United States. So there’s a real challenge as to people who are older, training them under certain technology, as we’ve seen advancements continue over the years. India has a very young population, about seven hundred million under the age of thirty. That’s twice the size of the United States that’s just under thirty. One would think, in theory at least, when it comes to exporting technology and training technology to a younger section of the economy and workforce, it would be easier. Why hasn’t there been any inroads made there?

CHANDRASEKARAN: I think the problem—the problem is you start comparing the deployment of technology the same way with India and the U.S. That’s where the fundamental problem lies. They are two different markets; two different problems. In economies like the U.S., you have aging population. So you use technology to replace people. Your usual video is about robot walking in the snow.

GOLODRYGA: Job killer, right? The AI job killer.

CHANDRASEKARAN: (Laughs.) So that’s your—that’s your metaphor. And the second thing is, you use technology to drive everything. You want to drive productivity in a market which is not going, in an industry which is capped out on growth you need to take costs down, so you apply technology to take costs down. The fundamental difference in India is that the market itself is not there, because the access is not there. Normally when you create the access, the market develops. So technology should be used to develop the market in an economy like India, whereas an economy—the advanced economies it is for revenue opportunities. So there’s a fundamental disconnect.

GOLODRYGA: So it’s a unique situation we’re talking about in India and developing countries.

CHANDRASEKARAN: All developing—India and all developing countries the market will get created by the deployment of technology. Whereas here, the market is being developed to be efficient through the use of technology.

GOLODRYGA: So what’s the barrier now, if in fact you can introduce, you know, technology on a mass scale?

CHANDRASEKARAN: So, access. So how do you—how do you train all these people? How do you—one is teaching. The other one is how do you build access. So you need digital solutions. And we did a pilot and it works. We can talk about that. It does two or three things. One is that you’re able to shift the work down dramatically. So the experts have so much time that they can actually do only the expertise that they have—the level they have to apply. There’s a lot of mid-level jobs. And then we’re able to dramatically increase the skill of a lot of people with no skill and low skill. And we’re able to reach people. And we’re able to go to people in rural areas, where there is no facilities. We’re able to reach people because everything is in a cloud, everything is—you know.

GOLODRYGA: Right. You talk about the disparity, and there’s a lot focused on income inequality in the U.S. It’s a big theme of the election here. It’s on a much larger scale in India, and income inequality throughout various states in the country. Is that getting worse? And how do you expect some of your suggestions and the role of technology to hopefully help overcome the disparities?

CHANDRASEKARAN: Well, it’s not getting worse. In fact, I’m very positive over India. So we’ll talk about that next. I’m not negative on India. So now I think the—it’s true that the inequality is there, because our per capital income is close to $2,000, but we have a state in the south which is $9,000 and we have a state in the middle of India which is $600. So that’s the kind of disparity that we see. So but fundamentally, if you are able to train people and employ people using technology, and if you can let them know how they can use these tools, you can solve the access problem. The moment you solve the access problem, market opens up. So health care can be solved, education can be solved. We talk passionately about small and medium enterprises. All those small and medium enterprises also suffer because they are very unorganized.

See, the other distinct difference that you should keep in mind is that in the U.S., you are 100 percent formal jobs. The first time you are getting used to informal jobs due to gig economy.

GOLODRYGA: Gig economy, right.

CHANDRASEKARAN: We are 80 percent informal jobs, OK? We are a country of people doing their own thing. And what this will do is to drive the formalization of jobs at a dramatic pace. If you formalize jobs, automatically you will see an uplift of minimum 15 percent in the benefits to people. And that will give them quality of life. That’ll give them access. That’ll increase the consumer spending. That’ll grow the economy.

GOLODRYGA: Well, another challenge to the economy is getting more women into the workforce. Currently only 23 percent of eligible women are in the workforce in India. And a lot of the issues that we’ve just been talking about really can’t be addressed unless you start to see more women enter, correct?

CHANDRASEKARAN: Yeah, that’s a big problem because we—if you take our economy, almost half of the people—only half of the people have secondary education. And we have about 120 million women over there who have the secondary education, but only 23 percent of them work. Also, the problem is that this ratio’s coming down. It was 27 percent and it’s come down from 23 percent.

GOLODRYGA: So why is that?

CHANDRASEKARAN: I think it’s there are lots of different reasons. And generally Indian women do a lot of miracle work, right? Because the facilities are not there. There are so many things that they carry. So most of them, once they get married and then decide to have children, after that they don’t come back to work. So there’s a lot of drop-out ratio. So a lot of—a lot of facilities need to be created or a policy framework needs to be created. Actually, some of the things have been done, but still the execution’s a problem. Many of our policies is right—policies are right. But then, they are not implemented the way they’re intended to be implemented. Or, they’re not adopted the way they’re supposed to be adopted.

GOLODRYGA: So unintended consequences, perhaps.

CHANDRASEKARAN: Unintended consequences.

GOLODRYGA: I want to go back to implementing some of your ideas, and the use of technology in health care in particular. There is a chapter that you open the book with where you focus on a middleman who basically drives his car to the center of town, and people from various areas come near and far with their medical problems, and he helps facilitate them to various doctors or receive the health care that they’re looking for and in search of at the time. That seems very primitive, right, at this day in age. And when you’re talking about the introduction of technology, the need for more doctors, talk about the pilot program in Kolar and how that can sort of rectify the issues facing the country.

CHANDRASEKARAN: See, Kolar is a district outside Bangalore. Most of you know Bangalore for software, but this is a district outside Bangalore. It’s about thirty-five lakh people. That’s—thirty-five lakh is 3.5 million? Yeah, 3.5 million people. And what we did was we created an AI machine learning-based software which can capture structure and sector data and created a huge healthcare platform. And we created—we took over the primary health center, spoke to the government. There’s a lot of—the primary health care is predominantly done by the government, most of it are dysfunctional in many of these states. They don’t meet the basic criteria, the work criteria, like, you know, minimum there should be two doctors, and so many nurses, and there must be four beds, and so on so forth. Many of these criteria are not met in these hospitals.

So we took over the hospitals in this district, and then we operated the technology, and then we—there are low-end workers called Asah workers, who basically interface with the patients. And we kind of trained them on digital. We gave them an iPad. And then we created a middle-skilled people, we call them digital workers, and basically gave them the tools that are required and the screens that are required so that they can take—you know, whenever a patient comes, first we register the patients. And going through the entire standard operating procedure and taking all the data, so that finally when the patient is ready the patient goes to the doctor, the doctor only—the doctor has all the information in the cloud, so that appears, and the doctor actually spends minimum amount of time.

We were able to increase the productivity of the doctors by more than 50 percent. And we were able to register all the people in that district into the system because we would proactively reach out, everybody to come into the—come into the registration. And the most important thing is, because these primary hospitals are not functional currently, most of these people end up going to either prayer clinics or go to the tehsil hospitals. So the tehsil hospitals are all over. But what we’re able to find is that most of those people that come there have a basic fever, or a viral, or, you know, they just needed to be spoken to half the time. So—

GOLODRYGA: Not an emergency.

CHANDRASEKARAN: Not an emergency. So a huge drop off upstream.

GOLODRYGA: And could this program be scalable?

CHANDRASEKARAN: Yeah, absolutely. Absolutely. I think the whole program can be scalable. All we need is—we imagine a situation where all these primary health care centers are beautifully connected. And there are many different ways it can be implemented, but the point is the health care is a state subject. So we will deal with every state. So there are implementation issues, and there are regulatory issues. So what can be done by technology? What can be done by technology? You have to be a qualified doctor to do certain things. So when you go into the details, I’m pretty sure there are more things we’ll find out. But those things can be overcome.

And two, three things will be achieved. We have extrapolated the number of doctors that we will need by 2030. What is the shortage? Eighty percent of the shortage will be met if you implement this, without adding more doctors into the system. What I think is that we will dramatically decrease the gap in the ratio between patients to doctors, because many of this—many of these problems will be take care of by the lower-level people. And we will additionally create one million jobs, only in this sector.

GOLODRYGA: That’s very promising.

CHANDRASEKARAN: Yeah.
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