For Ashish Yechury (1986-2021), journalist.
It’s hard to overstate the hold COVID-19 has over India. WhatsApp bristles with messages about this or that friend and family member with the virus, while there are angry messages about how the central government has completely failed its citizens. This hospital is running out of beds and this hospital no longer has oxygen, while Prime Minister Narendra Modi and his cabinet shy away.
Thirteen months after the World Health Organization (WHO) announced the world was in the midst of a pandemic, the Indian government is staring into the headlights like a pierced animal, unable to move. While other countries are well advanced in their immunization programs, the Indian government is resting and watching a second or third wave land heavily on the Indian people.
On Sunday April 25, 2021, the country recorded 354,531 cases over a 24-hour period, the fifth consecutive day of records. Keep in mind that in China, where the virus was first detected at the end of 2019, the total number of cases detected stands at less than 100,000. This peak in India has raised eyebrows: is it a new variant, or is it the result of a failure in the management of social interactions (including the 3 million pilgrims who collected at this year’s Kumbh Mela religious festival) and at vaccinate enough people?
At the heart is the utter failure of the Indian government, led by Modi, to take this pandemic seriously.
Contempt and derisory responses
A glance around the world shows that governments that ignored WHO warnings have suffered the worst devastation from COVID-19. From January 2020, the WHO had asked governments to insist on basic hygiene rules – washing hands, physical distance, wearing a mask – then later suggested screening for COVID-19, contact tracing and social isolation. The first set of recommendations does not require immense resources. The Vietnamese government, for example, took these recommendations were very serious and immediately slowed the spread of the disease.
The Indian government has acted slowly, despite evidence of the dangerousness of the disease. On March 10, 2020, before the WHO declared a pandemic, the Indian government reported around 50 cases of COVID-19 in India, with infections doubling in 14 days. The first major act Prime Minister of India was a 14 hour curfew, which was dramatic but not in line with WHO recommendations.
This ruthless lockdown, with four hours’ notice, sent hundreds of thousands of workers on the road from their homes, penniless, some dying by the side of the road, many carrying the virus to their towns and villages. Modi executed this lock without check with his own services, whose advice could have warned him against such a hasty and unnecessary act.
Modi has taken the whole pandemic lightly. He urged people to light candles and bang pots, make noise to scare off the virus. Lockdown continued to be expanded, but there was nothing systematic, no national policy that could be found anywhere on government websites. In May and June 2020, the lockdown continued to expand, even though it made no sense for the millions of working-class Indians who had to go to work to survive on their daily wages.
A year after the start of the pandemic, there are now over 17 million people in India with detected infections, with 185,000 people confirmed dead from the pandemic. You have to write words like “detected” and “confirmed” because the mortality data in India during this pandemic has been totally unreliable.
Consequences of privatization
The consequences of the transfer of health care to the private sector and the underfunding of public health have been devilish. For years, advocates of public health care, such as the Jan Swasthya Abhiyan, called for more public spending on public health and less reliance on profit-driven health care. These calls have fallen on deaf ears.
Indian governments have spent very little the amounts on health – 3.5% of GDP in 2018, a figure that has remained the same for decades. India’s current health expenditure per capita, by purchasing power parity, has been 275.13 in 2018, around the figures for Kiribati, Myanmar and Sierra Leone. This is a very low number for a country with the kind of industrial capacity and wealth of India.
At the end of 2020, the Indian government admitted that it possesses 0.8 doctor per 1000 Indians, and he possesses 1.7 nurses per 1,000 Indians. No country the size and wealth of India has such a low medical workforce. It’s getting worse. India possesses only 5.3 beds per 10,000 inhabitants, while China, for example, has 43.1 for the same number. India possesses only 2.3 intensive care beds per 100,000 people (compared to 3.6 in China), and it has only 48,000 ventilators (China had 70,000 ventilators in Wuhan alone).
The weakness of the medical infrastructure is entirely due to privatization, where private sector hospitals run their system on the principle of maximum capacity and do not have the capacity to handle peak loads. The optimization theory does not allow the system to cope with power surges, because in normal times it would mean that hospitals would have excess capacity. No private sector will voluntarily develop excess beds or excess fans. This is what inevitably causes the crisis of a pandemic.
Low health spending translates into low spending on medical infrastructure and low salaries for medical staff. It is the wrong way to run a modern society.
Vaccine and oxygen shortages in “the world’s pharmacy”
Shortages are a normal problem in any society. But India’s shortages of basic medical supplies during the pandemic have been scandalous.
India has long been known as the “pharmacy of the world” as the Indian pharmaceutical industry sector is adept at reverse-engineering a range of generic drugs. It’s the the third-The largest manufacturer in the pharmaceutical industry. India accounts for 60% of global vaccine production, including 90% of WHO measles vaccine use, and India has to become the largest producer of pills for the US market. But none of this helped during the crisis.
COVID-19 vaccines are not available to Indians at the necessary rate. Indian vaccinations will not be completed until November 2022. The government’s new policy will allow vaccine manufacturers to increase prices, but not produce quickly enough to meet needs (India’s public sector vaccine factories are inactive). No large scale rapid supply is on the cards. There is also not enough medical oxygen and the promises of capacity building have been dissatisfied by the ruling party. The Indian government was export oxygen, even when it has become clear that domestic reserves ran out (he also exported from Remdesivir injections).
On March 25, 2020, Modi mentionned that he would win this Mahabharat – this epic battle – against COVID-19 in 18 days. Today, more than 56 weeks after that promise, India looks more like the bloody fields of Kurukshetra, where thousands of dead lay, with the war not even at halftime.
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