In the award-winning play Harvest , the playwright Manjula Padmanabhan details the degradation of life in a futuristic Asia where families first condition and then sell their body parts or organs to customers in the West. Imagining such transactions is not far-fetched. The rich are now able to buy human organs, and elite hospitals in the metropolises of India cater increasingly to western and Arab customers. That this is occurring within the context of a crumbling public health system, where epidemics of malaria, tuberculosis and Aids are rampant and where basic health facilities for the masses are negligible, calls attention to the deep-rooted failure of the development agenda in South Asian countries.

This year's Human Development in South Asia report is the fifth in the series of annual reports on development brought out by the Mahbub ul Haq Human Development Centre in Karachi, Pakistan. It provides a comparative update on the state of development in the South Asian countries of Bangladesh, India, Nepal, Pakistan, Sri Lanka and the Maldives. Accepting globalisation as an inevitable process, it identifies policies that can minimise its risks and that can combine labour-intensive and capital-intensive production. It will be useful reading for anyone interested in issues of international development and for students specialising in the subject.

Observing that globalisation in South Asia has neither reduced poverty nor improved human development, it notes that economic reforms, conducted on the lines of International Monetary Fund and World Bank stipulations, have largely failed to increase trade levels or income growth as a whole. Challenging the myth of an objective market, it draws on the observations of the late ul Haq and notes that the market must be conditioned to provide a level playing field, and that the state must accelerate its support for human development and social protection.

Such statements take a sanctimonious approach to development and overlook the extent to which the structure, functioning and orientations of the state itself are in a crisis in many South Asian nations. Noting low trade levels, the report points out that weak financial and corporate sectors, including inadequate support structures in banking, accounting and legal standards, also contribute to problems in ensuring fair trade. Focusing on the social impact of globalisation, the report details comparative conditions in different South Asian nations, observing Sri Lanka's increase in urban poverty, wide interstate variations in India's growth and poverty levels, the significant increase in poverty in rural Bangladesh and the exacerbation of poverty levels in Pakistan in the 1990s.

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Drawing on the Human Poverty Index, first formulated by ul Haq, the report details the low survival levels, education and income in these countries. It notes the conundrum of development in the continent: widespread and increasing levels of illiteracy, poor health and inadequate housing facilities amid select islands of prosperity. It also focuses on the impact of deprivation on the opportunities for children, many of whom continue to be subject to malnutrition and ill-health. Observing the extent to which casualisation and informalisation of labour are dominant trends, the report notes that many of the policies are "implemented by politicians without a clear sense of priority or effectiveness". In this context, only Sri Lanka, with its record of higher ratios of expenditure for social sectors and its pre-liberalisation land distribution, has enabled a large proportion of its population to be covered by employment and social security.

The report provides a fairly critical overview of the impact of IMF policies, indicating the institution's failure to recognise the region's specific problems. Similarly, calling for adequate regulatory and governance institutions, it notes how the World Trade Organisation sets its agenda to cater for the interests of the developed nations. The report calls for a "humane globalisation", in which access to resources, health and education will be made possible by taming global finances and efficient governance of institutions.

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Though it sums up the economic and some social conditions in South Asia region, the report remains bound within the paradigm of "developmentalism" and its accepted parameters. As with much development discourse, balancing the "social fundamentals" of health and education is seen as adequate in bringing about development. It does not address the failure to establish genuine economic and social democratisation or to generate and sustain people's movements, which could ensure the attainment of these goals. On the whole, the report fails to recognise the widespread and multiple forms of violence - both structural and real - in these nations, which, in the convoluted links between economy, polity and society, have largely reproduced entrenched structures of privilege and deprivation. Until such trends are linked to deficits of democracy and the growing sectarian and religious fundamentalist violence in these nations, seeking ways to "develop" the region are futile. One hopes that the forthcoming reports will integrate such issues and indicate how violence-free nations, in which the conditions of wellbeing, justice and equity will be assured, can be made possible.

A. R. Vasavi, a social anthropologist, is a fellow at the National Institute of Advanced Studies, Bangalore, India.