India has never understood that health expenditure is not expenditure; it is investment. The success of the lockdown strategy is premised on an unprecedentedly vigorous building up of health infrastructure to fight the pandemic.
India’s decision to lock down was necessary. Two arguments are being advanced against it. India is a poor economy, with millions at the margins of subsistence, who cannot bear the consequences of a lockdown. The density and living conditions in India make social distancing difficult in many cases. The second argument is that the extent of community transmission does not justify such drastic measures.
But these arguments can also be turned on their head. Precisely because millions in India are vulnerable and will not later have the possibilities of quarantining or medical care, the only hope we have of securing their lives is to slow down the spread of the virus as much as possible. And the only shot you have at it is when community transmission is possibly still at manageable levels. There is, therefore, a bit of bad faith in using the poor as basis for expressing scepticism at the need for a lockdown. That is the most insidious form of privilege. The risks of any catastrophic spread will be even more incalculable for the poor.
Crises like these bring out the best and the worst. One of the more encouraging things has been the way in which several state governments like Punjab, Odisha, Kerala, Delhi and others have come into their own, innovating under difficult circumstances. The much neglected panchayat and local officials are key nodes in keeping track of possible cases and the creation of quarantining infrastructure. There is much to be done, and some dismal failures. But it would also be churlish not to acknowledge the ways in which most of the frontline workers of the state are responding, learning and innovating in this situation. If anything, this crisis is bringing home the importance of both federalism and decentralisation as central to a resilient governance architecture.
What is worrying is the national framing of the task ahead. India was good in recognising the gravity of the challenge. But the national preparation and follow-up to take full advantage of the lockdown does not inspire full confidence. The announcement of the lockdown has not been matched by a commensurate national strategy. This is manifest, most importantly, in the early signals on two important aspects: Containing the economic fallout for the poor and building up the health infrastructure. It is, admittedly, early days; but the signs are not good.
Critics of the Centre are correct in one respect: In the entire framing of the problem, the poor have been at best an afterthought, at worst expendable damage. Take, for instance, the economic package announced for this crisis, which turned out to be closer to a conjurer’s trick. Steps like health insurance cover for frontline workers, increased food rations, are welcome steps. But a crisis of this magnitude required an assurance to the most vulnerable that no stops will be pulled to secure their futures. Instead, what you got was incrementalism of the worst kind, masquerading as big commitment, as the details in P Vaidyanathan Iyer’s report in this paper (‘Holes in the net: Many who have been hit still left out, relief too little’, IE, March 27) demonstrates in detail. The cash transfers, in particular, through different schemes, are shockingly low. This crisis is one of the rare instances where economists and even bankers, from across the political spectrum, have rallied around the intellectual argument for unprecedented levels of social security support. So the government’s “support by stealth” strategy is even more mystifying.
The magnitude of the crisis unleashed for migrant labour could have been avoided with a little forethought. Early announcement of cash transfers, shelter and food availability, would have obviated the need for migration. It says something about us that we were given more time to prepare for the banging of utensils, than migrant labour was given time to reach home. The near criminalisation of their mere act of trying to walk home is not a reassuring portent. Some states have given clearer directions on how to handle migrant labour movement. But trust in the state has already been damaged.
The treatment of the poor in this crisis seems to bear all the hallmarks of what the state did to them during demonetisation: They are asked to sacrifice disproportionately for the common good, they are treated with impunity, and the state acknowledges their needs only very grudgingly. This economic and humanitarian myopia is also a risk for the social resilience we will need to combat this challenge. Managing the economic fallout will, admittedly, have to evolve as the crisis unfolds. But the initial hesitations, missteps and immobilising questions of justice are revealing about our priorities and do not inspire confidence.
But equally worrying is our opacity on the health infrastructure side. Opacity is often a consequence of scarcity. And nowhere is this more manifest than in our discussion of testing. Everyone understands that India has scarce testing capacity, though it seems it is also under-utilising what it has. The government is procuring more testing kits. But what is worrying is that there seems to be no publicly articulated statement of what exactly our testing strategy is, given the scarce resources. What objectives is it trying to meet? There is more than a whiff of suspicion that there is a view that more testing might spread more panic. Or it might put more pressure on the health care system than it can handle. But there is still no sense of how we plan to put a testing strategy in place (not just numbers of tests, but where can they be optimally deployed), that will minimise the need for future lockdowns.
India has never understood that health expenditure is not expenditure; it is investment. The success of the lockdown strategy is premised on an unprecedentedly vigorous building up of health infrastructure to fight the pandemic. There is a commitment by the Centre to infuse an extra Rs 15,000 crore in this sector. Some steps are being taken in building up capabilities, including ramping up production of ventilators and masks.
But this is an area where India needs almost a warlike mobilisation, to make sure we have enough testing, tracking, frontline workers, logistics and equipment in place to make sure that the duration of a lockdown is minimised or a repeat is not necessary. The creation of this kind of infrastructure will pay huge dividends even in non-pandemic times.
The prime minister is constantly asking the citizens to mobilise; and most of them respond. But it about time the state mobilises: On an economic stimulus that is truly meaningful and health infrastructure push that inspires confidence.
Courtesy Indian Express