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-Rajeev Kumar (Editor-in-chief)

Showing posts with label English Editorial. Show all posts
Showing posts with label English Editorial. Show all posts

Friday, May 7, 2021

A steep price (The Telegraph)

Prabhat Patnaik   

The Narendra Modi government’s ineptitude (or call it complicity with monopolists’ extortions) knows no limits. In the midst of a terrible pandemic when there is a shortage of vaccines, there are three obvious things any government must do: first, distribute the vaccine free among the people, which is but a recognition of everyone’s right to life; second, introduce monopoly purchase of the vaccine by the government, no matter what the criteria and through which channels it chooses to ration it out among the people; third, fix the purchase price at a fair mark-up over unit prime cost.

The vaccination regime in India began with these features (although private hospitals distributing government-procured vaccines charged Rs 250 per dose, which was questionable but not large enough to cause disquiet). Most inexplicably, however, the government ‘liberalized’ vaccine sale from May 1. The Central government would now buy only half the vaccine output and provide it free to those above 45. State governments and private hospitals would buy the other half and distribute it to those aged between 18 and 45.

The prices paid by the three sets of buyers are different. For Covishield, prices would be Rs 150 for the Central government (even though this is not yet settled), Rs 300 for state governments (originally Rs 400 but lowered later) and Rs 600 for private hospitals. Covaxin prices would be Rs 150, Rs 400 (reduced from Rs 600 originally) and Rs 1,200, respectively. Many state governments have announced that they would provide the vaccines for free but given the parlous state of their finances, they may not be able to do so. Several people would be forced to access private hospitals and pay hefty amounts to get vaccinated. India would be an exception among countries, almost all of which are now providing free vaccines to their people.

Even if the state governments find the resources to provide free vaccines, this would entail a wholly unwarranted transfer from state exchequers to a duopoly of vaccine-producing firms for the prices they are charging are scandalous. At the current exchange rate, what the Serum Institute of India, manufacturing Covishield, is charging state governments (Rs 300) translates to $4.00 per dose; its price to private hospitals (Rs 600) comes to $8 per dose. But AstraZeneca, whose product is Covishield, is charging $2.18 per dose to the European Union and $4 to the United States of America; the Indian prices are thus higher than the prices for the EU and the US.

It may be thought that since the Central government pays less, the higher prices to state governments and private hospitals are meant to cross-subsidize sales to the Centre. But the SII also wants to charge Rs 300 per dose to the Central government (Rs 150 is what it was charging earlier and the Centre has unilaterally stated that the same price will continue); so, cross-subsidization cannot explain the higher prices for state governments and private hospitals. Besides, the weighted average price, even assuming that the Central government buys at Rs 150 per dose, with the sale proportions being 1/2:1/4:1/4, respectively, to the Centre, the states and private hospitals, comes to Rs 300 or $4.00; this still exceeds the price charged to the EU, and equals the US price (despite manufacturing costs being much lower in India).

The higher price in India is not required to earn surpluses for expanding the firm’s capacity. For such expansion, the Central government has separately given SII Rs 3,000 crore. Besides, the SII can raise resources through the usual channels. The higher price for Covishield, therefore, is totally unjustified.

Over-charging is even greater for Covaxin manufactured by Bharat Biotech. BB is charging the Central government Rs 150, state governments Rs 400 (Rs 600 originally but later reduced) and private hospitals Rs 1,200. Its excuses for charging even more than the SII are ridiculously feeble.

It claims to have spent Rs 350 crore on clinical trials, which it wishes to recoup. But significant amounts of public funds have gone into the development of Covaxin (R. Ramakumar,, April 26). Besides, even if BB’s claim is accepted, the additional charge compared to Covishield, which it is levying on state governments and private hospitals, Rs 100 and Rs 600, respectively, assuming the same ratio of sales as above, and total sales of three crore doses per month from May onwards that it envisages (in fact sales are supposed to increase), would recoup this amount in just 20 days, after which higher prices on this score cannot be justified even by BB’s own logic.

Likewise, BB argues that Covaxin prices have to be higher than Covishield as the latter got a grant of $300 million from the Bill and Melinda Gates Foundation. But the weighted average price for Covaxin, again assuming the same ratio of sales, is Rs 475 per dose, which is Rs 175 more than for Covishield. On a sale of three crore per month, even ignoring increases in sales that must occur, this amount can be recouped in just over four months; what is the justification for higher prices after that?

The argument that resources are needed for expanding capacity is, once again, untenable, since the Central government has just given Rs 1,500 crore for BB’s growth. It is obvious, therefore, that the two firms are blatantly engaged in profiteering during a pandemic. This is ironically confirmed by the very reductions in prices they have announced.

Such profiteering is unacceptable. It is especially odious when public money goes to finance their growth, and has gone into developing the product of one of them. But profiteering has become possible because the Central government has ‘liberalized’ vaccine sale. ‘Liberalization’, amazingly, has not entailed any consultation among the manufacturers and state governments and private hospitals, or any scrutiny of their costs of production, or any agreement on the pricing formula based on such costs. For agricultural products, there is a Commission for Agricultural Costs and Prices that fixes the minimum support prices and the procurement prices by looking at costs of production; but for a critical commodity like the Covid vaccine, even this minimal procedure has not been followed. The companies have simply told state governments and private hospitals, ‘This is our price, take it or leave it’, knowing perfectly well that their clients cannot afford to ‘leave it’. And, strangely, the Central government, concerned about the price it has to pay, has left state governments and private hospitals completely at the mercy of these firms.

The motive for ‘liberalization’ is mysterious. In almost all other countries at present, vaccine producers do not sell to private hospitals, which was the case in India before ‘liberalization’. The earlier policy, of the Central government bulk-buying from the two firms at a pre-fixed price and then distributing the vaccines, should have continued. Why it was discontinued defies reason when this measure has encouraged profiteering.

Short of taking over the firms, either permanently or for the duration of the pandemic (as Spain did to private hospitals earlier), a Central government that cares for the people has two options which it must follow simultaneously: one, use ‘compulsory licensing’ to start new production facilities that break the stranglehold of the duopoly and expand capacity more rapidly; two, compulsorily buy the entire output at Rs 150 per dose and then distribute through various channels as before. And in all cases, it must arrange that vaccination is free for the people. But does the Modi government care?

Courtesy - The Telegraph.


Different response (The Telegraph)

Luv Puri  

India is reeling under one of the most serious public health challenges in the post-Independence era. The immediate crisis has a strong internal dimension and this fact cannot be overemphasized. One need not be a public health expert to realize that allowing mass religious gatherings, the lack of the leadership’s deference to science and expertise, poor public communication strategy regarding public health, the lack of preparation and a multi-stage electoral cycle are some of the visible factors that proved to be fatal. However, going beyond the immediate crisis, the ability of India and the rest of the world to prevent further losses and limp back to normality is also inextricably related to the prevailing international realities and structures that govern distribution of limited public health resources, particularly the vaccines.

During the first half of 2020, the pandemic demonstrated that even normative guidance and resolve on the question of meeting the challenge of Covid-19 were a matter of contention among global powers. In the midst of the rising death toll globally owing to Covid-19 last year, the United Nations security council impasse over a draft resolution on the pandemic was indicative of a wider institutional breakdown of the most important global body, which is becoming hostage to the rivalry between the United States of America and the People’s Republic of China. For several months, the US and China bickered over a draft resolution on the pandemic.

In the absence of an international regime that could facilitate equitable access to public health resources globally, as had been repeatedly pointed out by public health researchers, vaccine nationalism is slowing down the efforts to return to normality. In fact, it could further exacerbate the human condition, as is borne out by the recent Indian experience, with possibly more virulent mutants. Oxfam had warned in September 2020 that “just 13 percent of the world’s population have already cornered more than half (51 percent) of the promised doses of leading Covid-19 vaccine candidates”. The Global Health Innovation Center in the North Carolina-based Duke University has noted in its updated data that “[h]igh-income countries currently hold a confirmed 4.6 billion doses, while low-middle income nations hold 670 million”.

In April 2020, the World Trade Organization, made up of 164 member states, had warned that a lack of transparency about restrictions and failure to cooperate internationally could undermine efforts to slow the spread of Covid-19. Last year, the US, reeling under the pandemic, made a request to China to revise new export quality control rules for protective equipment after complaints were made that their rules were holding up supplies. Eighty countries had reportedly banned or limited the export of face masks, protective gear, gloves and other goods to mitigate shortages.  

With a population scale and financial muscle, the reality is that even the US faced a severe shortage of masks or personal protective equipment kits in March-April 2020, which led to an increase in the Covid-19 caseload among the medical staff. The rest of the richer cohorts are relatively smaller in size and more vulnerable. Covid-19 demonstrated that mere access to financial resources does not ensure availability of required medical equipment during a surge. It is unlikely that one country could start manufacturing all kinds of medical goods, such as masks, or anything a bit advanced, such as ventilators. Also, at times, it becomes difficult to anticipate which medical goods’ demand will outstrip supply on a given occasion. A case in point is that during April 2020 and February 2021, India had exported 12 metric tonnes of medical oxygen.

In the context of the fight against Covid-19, the old debate on intellectual property between the richer nations and developing countries is back. The developing countries are demanding temporary relaxations on intellectual property, patents and other such provisions laid out under the Agreement on Trade-Related Aspects of Intellectual Property Rights, also known as the TRIPS Agreement of the WTO, which came into effect on January 1, 1995. As expected, there is an opposition to the proposal from the European Union, the US, Japan and Canada on the grounds that innovation depends on respect for intellectual property. Patent-protected medicines are expensive as pharmaceutical companies price their products by factoring in research and development costs. A generic product drives down the price dramatically as had been seen with the much-cited example of antiretroviral drugs for HIV/AIDS. Brazilian and Indian companies started producing cheap drugs for HIV/AIDS and thus also supported the efforts of several AIDS-hit populations of African countries along the way. In the same way, India’s present crisis has put in jeopardy the vaccination programmes in low-income countries. India, the largest vaccine manufacturing hub, has exported 66.3 million vaccine doses to 95 countries under three categories — grant, commercial and Covax, a global initiative aimed at ensuring equitable access to vaccines. Now it has stopped the exports.

There may be a need for alternative institutional arrangements. Richard N. Haass and Charles A. Kupchan, in an article, “The New Concert of Powers”, in Foreign Affairs on March 23, argued for a new concert comprising China, the EU, India, Japan, Russia and the US, as the existing multilateral institutions are too formalistic and bureaucratic to respond to the urgent challenges. Though the purpose of this suggested concert, whose “members would collectively represent roughly 70 percent of both global GDP and global military spending”, is broader in scope, the authors argue that “the COVID-19 pandemic exposed the WHO’s inadequacies, and the concert would be the right place to fashion a consensus on reform”.

An early end to the fight against Covid-19 is predicated on ensuring greater global equity in terms of expeditious access to public health resources. The present international arrangements to forge consensus and advance solutions are proving to be inadequate to respond to the foremost existential challenge of this century.

Courtesy - The Telegraph.


Wednesday, May 5, 2021

Covid-19: When the courts step in (Hindustan Times)

By Abhik Chimni

India is in the midst of an unprecedented medical crisis. Four weeks into the second wave of Covid-19, and a year after the pandemic first struck, it is clear that the State had no plan for an emergency of this nature.

It is in this context that the Delhi High Court (HC) has been moved under Article 226 (extraordinary jurisdiction to protect personal liberty) of the Constitution seeking judicial interference by private entities and individual citizens. The petitions pertain to the production and allocation of medical oxygen and the urgent requirement of basic medical infrastructure such as beds and drugs.

Subsequently, the Supreme Court (SC), under Article 32 (extraordinary jurisdiction to protect personal liberty), has taken suo motu cognisance of the pandemic.

Two issues demand attention. First, is the suo motu petition being heard by SC an act of interference in the executive policy domain, specifically on the issue of vaccination?

During the 2G spectrum litigation, SC held that the allocation of natural resources ought to be done through public auction. Subsequently, a Constitution Bench overruled this finding and held that the allocation of natural resources is a matter of economic policy, within the domain of the executive. It is, therefore, clear that the court cannot enforce a policy decision on the executive. But while acknowledging this principle, let us look at the current vaccine situation and SC’s order.

There is, without a doubt, a major vaccine crisis. The Centre failed to anticipate the urgent requirement for vaccination. It engaged with only two companies, Serum Institute of India (SII) and Bharat Biotech. These companies today do not have the capacity to vaccinate India in a quick time. SII now is on record saying it did not know that the Centre expected a billion doses in a short period of time. The Centre failed to facilitate adequate manufacturing through existing entities, and did not make purchase orders in time to import a sufficient number of vaccine doses.

To add to this, there is differential pricing for vaccines for states and the Centre. Several experts have argued that the Centre is best placed to procure vaccines. Some suggest that the money can be raised through a one-time cess while others, including Opposition parties, want the ₹35,000 crore vaccination budget used to inoculate the public for free.

The apex court categorically asked the Centre for its policy for mass inoculation and medication, and framed some important questions/remarks.

First, what is the premise on which the State has concluded that decentralised procurement of a scarce commodity in the current health crisis is the best policy towards rapid mass inoculation? Second, as the right to life (Article 21) is a fundamental guarantee under the Constitution and the current vaccine policy has a direct effect on this guarantee to life, has the Centre finalised its policy keeping in view the commitment to protecting public health?

Third, has the socio-economic disparity between citizens been considered when shifting the burden of cost onto them? And fourth, why is the Centre, in this national emergency, not exercising powers under Section 92 and 100 of the Patents Act 1970, which would help various manufacturing companies augment the production of vaccines and drugs?

The suo motu hearing isn’t adversarial or seeking adjudication between two contesting parties. What the court is doing is exercising its constitutional authority under Article 32 to fulfill its constitutional role of maintaining checks and balances within the framework of judicial review. This is significant since the executive’s decisions affecting the lives of a billion people have been opaque. SC is not seeking to take policy decisions, but is seeking public accountability and transparency on the executive’s policy decisions and its failure to act in time. This exercise of judicial review to maintain accountability is the institutional duty of a constitutional court and an essential facet of constitutional democracy.

Second, should the Delhi HC have exercised judicial review and taken cognisance of petitions on questions of allocation and distribution of oxygen? When communications with the executive failed, private hospitals in the Capital approached HC seeking judicial interference in maintaining oxygen capacity.

HC was bound by its duty to protect the right to life under Article 21. As the hearings continued, one saw HC being forced to facilitate the supply and allocation of oxygen between the Centre and the Delhi government. For almost a fortnight now, the court has been monitoring the oxygen situation on the ground.

This is not because the court is eager to exercise its extraordinary constitutional responsibility for protecting the lives of people. It is because the federal cooperation expected between the Union and states has broken.

The basic structure of the Constitution holds federalism as essential to upholding our constitutional democracy. Therefore, HC is not only ensuring administrative compliance, but also enforcing federal cohesion to ensure executive stability. Today, private entities and citizens are left with no option but to seek legal recourse for essential amenities in a pandemic.

Let us not confuse this situation with busy body litigation or an act of judicial overreach. Those who have petitioned the court have locus standi to seek judicial remedy. They seek nothing less than the protection of human life. The judiciary, today, is being forced by citizens to step into a vacuum created by the executive, and thereby, fulfill its constitutional duty to do justice. And, this, by its very nature, unfortunately warrants judicial governance.

Abhik Chimni is a Delhi-based advocate

The views expressed are personal.

Courtesy - Hindustan Times.


A redux of the Linux movement in open source pharma (Livemint)

 Ajit Ranade

Thirty years ago, a 21-year-old student at the University of Helsinki put out a message on a bulletin board, “i am doing a (free) operating system (just a hobby, won’t be big or professional..)," and asked for feedback. Little did he know that these few words would be the beginning of a gigantic revolution that would transform digital life around the world. This was the birth of the free operating system that came to be known as Linux, named after the kid, Linus Torvalds, who invented it. It is the basis of all the open-source free software that powers most computers around us. For instance, all the world’s top 500 supercomputers run on Linux. More than 70% of mobile handsets run Android, which is free and open source, developed by Google and inspired by Linux. About 95% of public cloud services use an open-source hosting platform called Kubermetes, also part of the Linux revolution. Linux or its derivatives are in most embedded systems, automotive software, entertainment consoles, gaming, aviation and even high-end applications, including possibly space and defence. The ubiquity of Linux and its descendants is astonishing for something which is essentially free and developed by a community of tens of thousands of developers driven merely by their passion, not monetary gains. The free software is distributed under the Gnu Public License version 2 (GPLv2), whose key condition is that the complete source code be made available to the user, and any modification or improvement done by a user is to be ‘given back’ on the same terms to the open-source community. There are thousands of businesses that run on free software and are profitable. As all adherents to the free software dogma will tell you, it is free as in freedom (to modify) and not as in ‘free beer’. Thus, free software is not anathema to making profits. But the core ideology is allergic to patents and intellectual property rights, which ‘lock up’ knowledge, rather than keep it open for further improvements and creativity. Indeed, one maxim of free software developers is that “given enough eyeballs, all bugs are shallow", famously articulated by Eric Raymond. That is, all bugs get ironed out if the whole community is working on the software. The beta tester is the most valuable resource, and advocates of free software believe in frequent releases of newer versions, thus making it robust and stable.

Linus began his hobby project out of necessity, because he could not afford to pay for a Unix operating system to try out on his personal computer. But through his tinkering and by readily sharing his source code, he unleashed a movement. Maybe he accidentally stumbled onto a deep truism about creativity.

To be fair, the free software movement predates Linux by at least a decade. Its early diehard champion was Richard Stallman of MIT. For Stallman, not sharing the source code and not allowing users to modify stuff was a “crime". But his essentially centralized way of controlling the releases of free software ultimately stalled the idea’s progress and widespread acceptance. It was Linux which truly turbocharged the movement, with its highly decentralized approach to building software. It was much more democratic and non-hierarchical. Eric Raymond wrote about this contrast in a famous essay that became a bestseller, The Cathedral and the Bazaar. Happily, the two are very much intertwined and married, and referred to as Gnu/Linux or simply Linux.

This column space is too short to bring out the romance of the Linux movement and what it spawned. It is generous in allowing various ‘flavours’ of distribution to co-exist, of which a popular one is called Ubuntu, which means ‘compassion and humanity’ in Zulu. The programming languages R and Python, used heavily in the spheres of analytics, machine learning, artificial intelligence, visualization and econometrics, are also open source, linked to the GPLv2 licence.

The Linux movement gives us pause to think about intellectual property rights (IPRs) in general. At the heart of these are patents, which refer to the granting of temporary monopoly rights, so as to recoup the cost of developing the IP, be it software, a chip design, a drug or a vaccine. This crushing of competition to protect profits has always been a contentious issue, as there is mounting evidence that patents do not lead to a rise in productivity and further innovations. While patent filings have grown exponentially, innovation and productivity have not. And it has simply led to patent hoarding and trolling, plus endless litigation, especially in the field of pharmaceuticals. The saying here goes, ‘No patents, no drugs.’ A new drug now needs at least a billion dollars for development, but 80% of fixed costs are on phase 3 trials, which are in the nature of public goods. Surely, these costs can be reimbursed to parties through competitive bidding by the government. As economists Michele Boldrin and David Levine have argued in their essay, The Case Against Patents, the downstream social cost of monopoly pricing is most severe for life-saving drugs.

Indeed, since 2015, there has been an Open Source Pharma movement against restrictive patents. It supports the compulsory licensing of patents on life-saving drugs. According to Dr. Manica Balasegaram of the Access Campaign, open source pharma is against a protectionist proprietary silo-based approach, and promotes a culture of free and critical thinking, openness to ideas and sharing of information. Sounds similar to Linux, does it not? Happy 30th anniversary!

Ajit Ranade is chief economist at Aditya Birla Group.

Courtesy - Livemint.


Free shots for all: This must be India’s vaccination strategy (The Indian Express)

Written by Jean Dreze 


At a time when fair and speedy COVID-19 vaccination is of the essence, the Indian government has done a great job of putting us at the mercy of vaccine manufacturers. It is bad enough that we depend, as of now, on just two suppliers — the Serum Institute of India (SII) and Bharat Biotech. What is baffling is that the government has now allowed them to set their own prices — “whatever you want in terms of being reasonable and fair”, as SII chief Adar Poonawalla candidly explained in a recent interview to CNBC. For good measure, suppliers are also allowed to set different prices for different buyers (the Centre, states and private hospitals), enabling them to charge what different segments of the market can bear. This is the polar opposite of the “single-payer model” in healthcare, where the government tries to get the best possible deal from drug manufacturers by acting as the single buyer.

In the single-payer approach, the central government would order all the vaccines and then distribute them equitably between states, and possibly some private healthcare providers. This was, more or less, the situation in the first phase of the COVID-19 vaccination programme, when most of the vaccines were sold to the central government at a negotiated price of Rs 150 per dose. However, a radical change occurred on April 21 with the release of the central government’s policy note on “Liberalised Pricing and Accelerated National COVID-19 Vaccination Strategy”.

It is important to read the fine print of that policy, effective from May 1. The stated intention was clearly to supplement central procurement (limited to 50 per cent of vaccine supplies from then on) with a vaccine market where each manufacturer would charge one transparently declared price to all buyers other than the central government, that is, states and private hospitals. That intention, however, was defeated the very same day by SII, which announced different prices for states and private hospitals, with a much higher price (Rs 600 per dose) for the latter. And if suppliers can get a higher price from private hospitals, why would they take interest in selling to the states?

The danger of states being squeezed out was made worse by another aspect of the Centre’s new policy: It allows private hospitals to set their own prices for vaccination. Their prices will be “monitored”, but not controlled. In practice, monitoring is likely to be symbolic, giving private hospitals a free hand. In short, the stage has been set for a thriving vaccine market where private hospitals charge hefty prices for vaccination and manufacturers make money by selling a good portion of their supplies to private hospitals at inflated prices.

The central government’s policy note makes a virtue of “liberalised” pricing on the grounds that it will incentivise vaccine production. But production can equally be incentivised in the single-payer system by paying an adequate price — it’s just that the central government would have to foot the bill. So, the real function of this pricing policy is to save the central government some money. Why not tax the rich instead and foot the vaccine bill? It’s not a lot: Even if the price paid by the central government were to be raised from Rs 150 to (say) Rs 300 per dose, buying two doses for two-thirds of India’s adult population of 850 million or so would cost Rs 34,000 crore — less than what has already been allocated for COVID-19 vaccination in the 2021-22 Budget. Further, in a single-payer framework, the government would probably be able to negotiate a much lower price than Rs 300 per dose (perhaps even lower than Rs 150) without undermining production incentives.

Leaving the financial aspects aside, why would we prefer central procurement to “liberalisation”? The main reason is that it would lead to a more equitable distribution of vaccines in the population. Today, India is facing an acute shortage of COVID-19 vaccines. In the public sector, there is (or was, until now) a reasonably equitable system where vaccination is provided free of charge to everyone in expanding priority categories such as health workers, the elderly, everyone above age 45, and so on. In the private market, on the other hand, scarce vaccines are distributed according to their ability to pay: The poor are excluded as the rich jump the queue. The problem gets worse when private provision degenerates into an extortionate black market, as might happen in a situation of vaccine scarcity (much as with oxygen and COVID-19 medicines today).

If it were the case that expanded vaccination is held up by the government’s lack of capacity to vaccinate, rather than by a shortage of vaccines, there might still be an argument for promoting private provision: It would augment vaccination capacity. But the main constraint today is a shortage of vaccines. India’s public sector is perfectly capable of vaccinating en masse, if vaccines are available. This has been well demonstrated in earlier vaccination programmes, including some that involved 100 million shots in a single day.

As argued earlier, liberalisation does not really ease the shortage of vaccines, it just shifts some of the financial burden from the central government to private buyers. But the savings are at least partly illusory, since liberalisation also enhances the bargaining power of manufacturers in public procurement negotiations. In any case, trimming the vaccination budget is hardly a priority when COVID-19 threatens to sink the economy.

The central government’s vaccine policy is an extension of liberalisation to a domain where it does not belong. The way it came about, as Adar Poonawalla revealed in the CNBC interview, is that the private sector “lobbied” (sic) for it. As far as the public interest is concerned, free vaccination at public health centres is a much better strategy. Any proposed departure from it should be examined “not only with the most scrupulous, but with the most suspicious attention” as Adam Smith wisely advised us to consider business-sponsored proposals many years ago.

The writer is visiting professor at the Department of Economics, Ranchi University.

Courtesy - The Indian Express.


In healthcare, Gujarat is in BIMARU league (The Indian Express)

Written by Christophe Jaffrelot , Sharik Laliwala

The government was high on confidence as the BJP had outperformed expectations in the local elections held a few weeks before. But the hubris was misplaced, since the second wave had started in February.

On March 3, 2021, Nitin Patel, Gujarat’s deputy chief minister, who is also the finance and health minister, congratulated his state government for having excelled at containing the COVID-19 virus while presenting the annual budget in the legislative assembly. He went off-track in his budget speech to note how other states kept patients in open grounds and stadiums, but, in contrast, none of that took place in Gujarat because of “our speedy decisions to ramp up health infrastructure.”

The government was high on confidence as the BJP had outperformed expectations in the local elections held a few weeks before. But the hubris was misplaced, since the second wave had started in February. By the first half of April, non-availability of hospital beds, life-saving drugs, and oxygen supply became an everyday sight in major cities across the state. Even the most privileged citizens — elites and the middle-classes — for whom Narendra Modi as the state’s CM carved out special concessions like tax breaks and land policies, were left to fend for themselves.

The malaise in Gujarat stems from a systemic problem that piecemeal augmentation cannot ameliorate — the retreat of the state from essential infrastructure and the privatisation of the health industry. In turn, it left the state organs unprepared to deal with the pandemic. Just in terms of hospital beds, Gujarat fares worse than most of India. Data from the Centre for Disease Dynamics, Economics and Policy show that there are 138 hospital beds in the country per one lakh population, while in the rich, industrial state of Gujarat, this number is below 100. Even socio-economically backward regions like Rajasthan and Uttar Pradesh have a better hospital bed availability with 123 and 130 beds per one lakh people respectively. The same holds for critical care beds.

Instead of filling these deficits, the government’s chest thumping in the budget presentation hid finer details. Even in times of the pandemic, the state government cut capital expenditure on public health infrastructure — as opposed to the budget estimate of Rs 914 crore, it spent only Rs 737 crore in 2020-21. The budgeted capital outlay on medical and public health is just Rs 856 crore in 2021-22 translating to less than Rs 150 per resident. It is lower than the budgeted figure for the same in socio-economically backward states like Bihar (Rs 2,437 crore). The total budget for Gujarat’s health and family welfare ministry stood at Rs 11,323 crore for 2021-22. In other words, the state government reserved less than 0.7 per cent of the state’s GSDP and fewer than Rs 5 daily expenditure per state resident’s healthcare. The percentage on healthcare services in the budget declined from 5.54 per cent in 2018-19 to 4.98 per cent in 2021-22 — far below the 8 per cent recommended by the National Health Policy.

The state’s withdrawal from the public healthcare system in the last few decades, a phenomenon that runs parallel with economic liberalisation, has put its track record on health indices in the league of the so-called BIMARU states. As per the NFHS-5 (2019-20), close to 80 per cent children in Gujarat under the age of five years suffer from anaemia. Not only is this figure worse than in Assam and Bihar, it is a jump of nearly 17 percentage points from that recorded in NFHS-4 (2015-16) when Gujarat was already performing worse than the national average of anaemic children. Almost 40 per cent of the children under the age of 5 years are stunted in the state. Amongst women aged between 15 and 49 years, 65 per cent are anaemic as per NFHS-5 (2019-20), a rise from 55 per cent in NFHS-4 (2015-16).

Gujarat is anything but vibrant on cumulative parameters of income, education, and healthcare as measured by the Human Development Index (HDI). Based on the Global Data Lab’s estimation, Gujarat ranked 23rd amongst 36 states and union territories of India in 1990. The high-growth trajectory of Gujarat under Modi’s chief ministership made no difference to this ranking. By 2018, the state was still at the 22nd position.

It was not always the case. Under Madhavsinh Solanki’s regime in the early 1980s, Gujarat experimented with welfare measures by improving access to education for SCs and OBCs, strengthening its public distribution system, and initiating mid-day meal programmes for school-going kids. However, it soon faced a backlash in the form of a political convergence of anti-reservation Patels and upper castes that resulted in the rise of BJP. The political discourse, subsequently, shifted from rights and emancipation to the law-and-order situation — given a grim history of Hindu-Muslim violence — and ethnic (sub)nationalism, leading to the folding of the then nascent welfare state.

Under a BJP dispensation since the mid-1990s, movements for rights are abhorred and questioning the state provokes repressive measures. Aspersions on the people and dissenters, which diverts attention from state responsibilities, continues even today in the face of the COVID-19 crisis. For instance, in the Gujarat High Court’s ongoing suo motu litigation to audit the COVID situation, the state counsel repeatedly chided the press for giving bad publicity and instigating fear in the minds of the public at large. Instead of correcting course, by building trust in the public, cabinet ministers in Gujarat, in their media interactions, blame Opposition parties for spreading anxiety amongst masses. Not a single all-party meeting has been called for, the kind that Kerala and Maharashtra have done to brief Opposition leaders and seek their views and support. Perhaps, it is not surprising that the destruction of an infant welfare state — which lies at the crux of its present inability to deal with the pandemic — took place at a time of “democratic backsliding” in Gujarat. The systematic underestimation of the number of casualties by the state reflects the same trend.

Jaffrelot is senior research fellow at CERI-Sciences Po/CNRS, Paris, and professor of Indian politics and sociology at King’s India Institute. Laliwala is a researcher on Indian Muslims and Gujarat’s politics. He was previously associated with Trivedi Centre for Political Data at Ashoka University and Centre for Equity Studies, New Delhi.

Courtesy - The Indian Express.


What explains the high numbers of COVID cases in Delhi? (The Indian Express)

Written by Neelkanth Mishra

A study found that in January this year 56 per cent of Delhi residents had COVID-19 antibodies, suggesting that the number of infections in the city was 16 times the number of reported cases at the time.

Does seroprevalence (the presence of antibodies) help at all in preventing serious infections and death due to COVID-19? If yes, then why is Delhi, which appears to have crossed herd immunity levels of infection, still seeing such a high number of daily new cases and deaths? Why are cities across north India reporting deaths several times higher than normal?

Let us start with Delhi. A study found that in January this year 56 per cent of Delhi residents had COVID-19 antibodies, suggesting that the number of infections in the city was 16 times the number of reported cases at the time: An infection becomes a case only after a test. This infection-to-case ratio appears high, but is nearly half the national average of 28 in December last year, and is consistent with a well-known characteristic of this disease, that most infections are asymptomatic.

Cases since January add up to about 3 per cent of the population, implying that even if the infection-to-case ratio was 8, another 24 per cent of the population has been infected. Add to that the 15 per cent who have received at least one vaccine shot, and we reach a hard-to-believe 95 per cent of the population with antibodies. There is undoubtedly some double-counting in this (some people have been infected twice; some after being vaccinated), the infection-to-case ratio may be lower in this wave, and the January seroprevalence study may have errors. However, even if the cumulative number is 75 per cent, it is above levels at which herd immunity is reached, making it hard to explain 24,000 new cases a day at a positive-test ratio above 30 per cent (a high ratio means cases are being under-counted). More importantly, even if re-infections occur or vaccinated individuals catch symptomatic disease, the probability of serious illness or death is materially lower. And yet, Delhi has been reporting more than 400 COVID-19 deaths a day, almost the same as daily registered deaths in a normal year due to all causes.

Suspicion that the virus evades antibodies is natural, but there is strong evidence of vaccines being effective against serious illness and death, including in India. Similarly, in Mumbai, the slums, where 57 per cent of the population was estimated to have antibodies at the end of the first wave, account for less than 10 per cent of active cases in the second wave, and the non-slums, where only 16 per cent had antibodies, are badly hit. More anecdotally, such trends have been observed in other cities too.

Why then is the impact not visible in Delhi? One reasonable explanation can be patient migration. Compared to the first wave, the virus appears to have made deeper inroads this time, with significant rural and semi-urban spread being reported from several states. Unlike last year, when district borders were closed for a long time, patients can now travel, and are most likely reaching neighbouring big cities in search of better medical care. Some states have sealed district borders, but one assumes and indeed hopes that patients in need of serious care are permitted to cross. The factors that led to the rural areas being largely spared in the first wave perhaps still apply (like higher pre-existing immunity and fewer social situations that spread the virus including air-conditioned offices, restaurants or malls) but higher infectiveness of the new strains could have increased their vulnerability. The lack of testing infrastructure may have exacerbated the spread.

This can also explain the abnormally high deaths in several cities in north and west India, where the daily death numbers have been reported to be several times above normal. This distress is not visible in the southern states, which have deeper penetration of healthcare services, and people do not have to travel to cities for relatively simple ailments. Even in cities where more than half of the population above the age of 45 (90 per cent of all COVID deaths are in this age group) has been vaccinated, death numbers are not falling. Nearly 60 per cent of the deaths are still occurring in districts with Tier-1 and Tier-2 towns, even though they account for only a third of the population. As only serious patients would make the long inter-city journey for medical attention, this influx of often earlier undiagnosed cases increases the reported case fatality ratio (CFR) in cities (the ratio of deaths to cases). In Delhi, despite the number of active Covid cases now falling, the number of occupied beds continues to rise. The inflow of patients from other districts also changes herd immunity dynamics (the calculation of the level at which a population reaches herd immunity assumes a closed system).

This hypothesis should not be hard to test: Home addresses of admitted patients even for a statistically relevant sample size should suffice. Obviously, the objective of this exercise would not be to deny access to “outsiders”, but to understand the problem better, and then devise the right strategies. More frequent seroprevalence studies, deeper spread of testing kits and involvement of ASHA workers to improve awareness can be useful interventions.

Such an exercise would save lives: Better awareness and testing in rural and semi-urban areas can help slow transmission, provide the needed early treatment that can be critical (it is often too late by the time patients make it to a city hospital, that is, if they can get a bed), reduce vaccine hesitancy, and also reduce crowding of urban hospitals.

It can also reduce the economic impact of the pandemic, as hurt livelihoods also affect lives. If governments are better informed about where the spread of the infection is, they can better choose where to impose activity restrictions, obviating state-wise restrictions. As a hypothetical example, Pune’s COVID centres can continue treating patients from surrounding villages, and even as the reported number of deaths remains elevated, the city can be gradually opened up.

Once a flood has hit, one must provide succour to the affected population and pump out the water, but often, the best way to deal with it sustainably is to stem the flow upstream. If the hypothesis of rural and semi-urban infections showing up as serious cases in cities is correct, it is as important to increase testing and awareness in rural areas as it is to expand the capacity of oxygen beds in large cities. As we prepare for the inevitable future pandemics (or even a third wave of this one), a revamp of the rural healthcare system needs to be front-and-centre in government’s priorities.

The writer is co-head of APAC Strategy and India strategist for Credit Suisse.

Courtesy - The Indian Express.


Pandemic 101: The IPL jolt underlines how much all economic activity is dependent on controlling Covid (TOI)

Times of India’s Edit Page team comprises senior journalists with wide-ranging interests who debate and opine on the news and issues of the day.

Indefinite suspension of the Indian Premier League after participants tested Covid positive underlines that no one and no economic activity is safe until everyone is safe. By keeping crowds out of stadiums, IPL had eliminated the superspreader dangers of mass political or religious gatherings. But keeping players protected and preserving the bio-bubble in Delhi while the pandemic raged outside proved too tough. BCCI should also examine how the basic protocols followed by franchises successfully in UAE last year failed in an Indian milieu.

Staging IPL amid a public health emergency had its supporters and detractors. BCCI noted that it had “tried to bring in some positivity and cheer” amid difficult times for India. In addition sport is a jobs and revenue generator. So what has happened here is definitely relevant for the country at large. It is a stark reminder that reviving economic activity to pre-pandemic or pre-second-wave levels will be possible only when the tools to fight Covid are optimally deployed and the current surge is brought down to manageable levels. This could be why CII president Uday Kotak has mooted a “nationwide maximal response measure at the highest level” and curtailment of all “non-essential economic activity” to break the chain of transmission.

But the widespread destruction of livelihoods by last year’s “hard” lockdown should not be forgotten, nor the painful logjams created in separating essential and non-essential activities, many of which actually worsened the health toll of the pandemic. Of course different restrictions are anyway under effect in different parts of the country, and localised controls will continue to be needed for some time. As far as the stated aim is to reduce viral transmission and bring down caseloads to manageable levels for doctors, many of whom are close to breaking point, governments should not use movement curbs as a proxy for essential pandemic governance. As the undermining of green corridors for ambulances by increased police chowkis illustrates, lockdowns can even aggravate India’s medical supply chain crisis.

Fixing the vaccine pipeline, enabling mass uptake of medical grade masks, improving the quality of testing, more genome sequencing, plugging the logistical leakages for medicines and oxygen, upping triage management to reduce the exhaustion of both health seekers and health givers etc – experts have been clear and convincing on what will really make a difference.  Lockdowns are no magic bullet. Getting these fundamental public health responses right is the only path to normalcy.

Courtesy - TOI


Sickly state, healthy democracy: Elections held during deadly pandemic surge expose India’s real flaws and strengths (TOI)

Ruchir Sharma

Ruchir Sharma is the author of the upcoming ‘10 Rules of Successful Nations’

Those of us who see these as dark times for Indian democracy can take heart from the recent elections, not only because of the way regional parties stood up to the Centre’s ruling party machine, but also because of the highly unusual nature of their win in the key battleground state.

In surviving the BJP onslaught in West Bengal, Mamata Banerjee also beat overwhelming odds. She became only the 10th CM to win a third term in more than 200 major state elections held since the mid-1970s, when India became a true multi-party democracy. BJP had many advantages – from voter hostility towards a long-serving incumbent to the brute power of its heavily financed machinery – but still fell short.

India’s problem right now is not a broken democracy, it is the broken state. In the late phases of the balloting in West Bengal, BJP lost more momentum as the pandemic started spinning out of control. This turn is likely explained at least in part by growing popular anger at the central government’s handling of the rising caseload.

In recent weeks India has suffered one of the biggest surges of any country so far. Cases rose roughly twelvefold according to official figures, and the real toll is likely many times worse. A crisis of this magnitude would stress even the world’s best healthcare system. In India, it has exposed a pre-existing frailty – a broken state.

A few developed countries, such as France and Italy, also suffered rapid second waves, but managed to lower death rates from the first wave. Their health systems had readied for the shock. In India, the second wave has brought with it scenes of devastation reminiscent of the dark ages.

When I watch overwhelmed hospitals turning away patients at the gates, leaving them to die at home or suffer in the streets, I am haunted by thoughts of my grandfather. He died of a heart attack under similar circumstances, turned away from a public hospital in Uttar Pradesh, where there was no doctor on night duty and an orderly tried but failed to install a pacemaker. That was 1993. India’s underlying tragedy is how little progress has been made since.

Among the world’s 25 biggest emerging markets, India ranks last for the number of hospital beds per 1,000 citizens, fifth from last for doctors, fourth from last for nurses and midwives. Even if you drop richer emerging markets and compare India to other large countries with per capita incomes between $1,000 and $5,000 – which includes Pakistan and Bangladesh – India still looks mediocre on these basic healthcare measures.

Government spending generally rises as a share of the economy as countries grow richer. India’s government spends the equivalent of about 30% of GDP, which is roughly in line with other nations in its income class. So the problem is not the size of India’s state, but how it spends.

When PM Modi brought BJP to power in 2014, he mocked the welfare populism of his predecessors. Yet soon he was vying with them in his promises of generous freebies, from gas to food and pucca homes. Today, welfare spending accounts for 9% of GDP – far higher than the miracle economies India would like to emulate, like South Korea and Taiwan, when they were at similar levels of development.

Modi has meanwhile done little to modernise the basic structure of India’s state, which harks back to British rule. Many of India’s laws, and the structure of its federal ministries, including home and finance, date back to the late 1800s. The corruption in public works that author Munshi Premchand was vividly describing in his novels a century ago has yet to abate.

Our healthcare system was supposed to be revamped along lines described by the Bhore commission of the 1940s, but its comprehensive blueprint for hospitals and clinics throughout the country has yet to be realised. Instead, we have the sad reality of underfunded clinics, featuring operating rooms without surgeons, x-ray machines without radiologists. Some have beds without nurses, others have nurses without beds to attend. Economists who say India needs to spend more often have little to say about how badly our resources are currently deployed.

It is no surprise this unfinished and uncoordinated health system would falter in the face of a global pandemic. Modi promised “minimum government, maximum governance” but rather than reform India’s outdated state, he has centralised power to a greater degree than any other leader in India’s democratic history.

He set himself up as the nation’s saviour, who would solve its every problem. Even a Formula 1 driver would not make much progress in an Ambassador, the old Indian-made jalopy. The reality is that BJP can no longer claim to offer a superior model of governance, and that reality is starting to catch up to it at the polls.

The good news is that private groups, as they have before, are rushing in to provide what the government does not. Expats are sending money and medical resources from abroad. Residential associations are providing whatever assistance they can muster to ailing neighbours. So far, the Indian stock market has barely flinched over the rising death toll, perhaps reflecting a collective intuition that India will survive this crisis too despite its broken state.

Courtesy - TOI


Keeping Left: On Kerala Assembly election results (The Hindu)

The spectacular victory of the Left Democratic Front (LDF) in the Kerala Assembly election has put the spotlight on its lead author, Chief Minister Pinarayi Vijayan. His resolute leadership style and daring political experiments found resounding approval among the State’s electorate that re-elected an incumbent government for the first time in four decades. With this historic victory, Mr. Vijayan has further reinforced his already unassailable status as the supreme leader of the CPI(M) and the LDF. At 75, his challenge now will be to use his authority to transform the party so that its current dynamism outlasts his position in command. By replacing several old warhorses with fresh faces in the polls, he has already set the ball in motion. A transition in the CPI(M) — and the LDF — is under way and this will also be reflected in the choice of new Ministers. K.N. Balagopal, P. Rajeev and M.B. Rajesh could make the cut. Administrative challenges will be immense for the government, starting with the COVID-19 pandemic. The second successive defeat for the Congress and the United Democratic Front (UDF) is not a warning signal, but a marching order for its listless, self-serving leaders. The current crop of Congress leaders is out of touch with the evolving Malayali. Instead of exchanging chairs with one another, they must all go at once and pave the way for imaginative and inspiring leaders.

The BJP’s grand plans for Kerala have been dashed, and how. From 14.93% in 2016 to 12.47% this time, the BJP-led NDA vote share plummeted, but more notably, it got 4.29 lakh votes fewer. The BJP leaders are out of sync with Kerala, but the party’s slide is more because the people find its politics unacceptable. Centrist voters who considered the BJP as an option have been taken aback by its politics in Kerala and beyond. Some refreshing trends that run contrary to the national slant of BJP politics are evident. The new Kerala Assembly is a cross-section of the State’s religious diversity — with Hindu, Christian and Muslim communities finding representation in proportion to their populations. In terms of caste and gender this may not be true. A Hindu-majority constituency in Kerala chose a Muslim candidate (Congress) against the BJP’s Chief Ministerial face E. Sreedharan. The Indian Union Muslim League, a constituent of the UDF, saw its support shrinking, as the current generation of the community seeks new options. The CPI(M) has been relatively more successful in appreciating the myriad changes that are under way in Kerala and in responding to them. The Congress, which swept the Lok Sabha poll, will have opportunities to reinvent itself to pose a challenge to the Left in the Assembly election. But for the BJP, without a metamorphosis, Kerala will remain a nightmare, not a dream.

Courtesy - The Hindu.


DMK returns: On Tamil Nadu Assembly poll results (The Hindu)

Some elections are decided on key issues, some on the incumbent’s performance, and others on alliance arithmetic and local factors. The outcome of the Tamil Nadu Assembly election, in which the DMK emerged triumphant and its leader, M.K. Stalin, is set to be sworn in as Chief Minister, seems to be an unequal mix of all these. The DMK’s comeback was a foregone conclusion after the alliance led by it scored a landslide victory in the 2019 Lok Sabha election, and a third successive term for the AIADMK was unlikely. Mr. Stalin has been rewarded for his patience. He has led the party successfully for the second time after the demise of M. Karunanidhi, his father and the party’s towering figure for over four decades. The DMK rode mainly on a popular desire for change, to win 133 seats on its own, including some secured by allies who contested on the DMK symbol. The front ended up with 159 seats. The Congress’s performance is more impressive, as it won 18 of the 25 seats allotted to it. The two Left parties won two seats each, and the Viduthalai Chiruthaigal Katchi (VCK) won four seats, of which two were in the general category, showing that it draws its appeal from a base wider than the Dalits it represents. Amid expectations that the Tamil Nadu voter would reject the idea of an alliance with the BJP, the AIADMK managed to win 66 seats, while five seats went to its ally, the Pattali Makkal Katchi (PMK); the BJP re-enters the Assembly after 20 years with a tally of four.

The results may be difficult to interpret in terms of whether the voters accepted the DMK’s campaign point that the AIADMK, led by Edappadi K. Palaniswami, surrendered the State’s rights to the Centre, but it may indicate that Mr. Palaniswami managed to mitigate the adverse impact of having a tie-up with the BJP. In the ultimate analysis, the DMK cadre’s fieldwork prevailed over the AIADMK’s mass appeal. The AIADMK has retained much of its vote base, and its bastion in the western region is intact. The outgoing regime’s handling of the COVID-19 situation, farmers’ loan waiver and the 7.5% quota for government school students in medical admissions seem to have stood Mr. Palaniswami in good stead. However, the sub-quota for the Vanniyar community seems to have had only limited impact, as the AIADMK-PMK alliance performed below par in the northern districts, where most of the seats went to the DMK. The entry of the Left parties, the VCK and the MDMK — which were part of an unsuccessful third front in 2016 — to the DMK front has added to the DMK front’s tally. The DMK front’s vote percentage went up from about 39% in the last poll to 45% now. Tamil Nadu remains a two-front arena, with aspirants such as the Naam Tamilar Katchi, whose share has jumped to 6.58%, the Makkal Needhi Maiam and Amma Makkal Munnetra Kazhagam consigned to the fringe.

Courtesy - The Hindu.


Wonder woman, India’s political chemistry is changing (The Telegraph)

Saba Naqvi  

The passion and conviction were all too visible in Mamata Banerjee’s first words to the media after the magnificent win registered by her party in West Bengal. She would be going to a Constitution bench, she said, because “we have faced the horrors of Election Commission and if we tolerate whatever they have done in Bengal, then in India there will be no democracy.” She invited other political parties to join her petition to the Supreme Court and said that Bengal has saved India today.

So are we getting ahead of ourselves by asking if Mamata Banerjee can save India tomorrow in a national coalition against the Bharatiya Janata Party? She does, after all, have the temperament for a protracted fight and has just triumphed in the most epic of battles, with not just politics but also institutions ranged against her. Other regional leaders won too, such as the Dravida Munnetra Kazhagam’s M.K. Stalin in Tamil Nadu and Pinarayi Vijayan in Kerala, as much a regional satrap as a Left worker. But none had the entire might of the BJP and Central agencies ranged against them. It is, therefore, the Bengal mandate that has really shattered the illusion of invincibility around the Narendra Modi regime two years into his second term as prime minister.

The Bengal victory is all the more substantive as it was not just against an irrational burst of BJP energy in the last two months of campaigning. The national party was playing the long game in Bengal and had framed policies with the state elections in mind. The Citizenship (Amendment) Act, which was passed by Parliament in December 2019, was always targeted at Bengal that is believed to have the largest population of Hindus tracing their roots to Bangladesh (the Act fast-tracks their citizenship while blocking that of Muslims). The CAA would lead to nationwide trauma: protests and, eventually, riots in Delhi in February 2020. The Matua community, the largest group of Hindu migrants from Bangladesh, have indeed supported the national party in these polls although ironically, after creating so much bad blood, the Centre is yet to frame the rules of the CAA that are required to make it operational — a display of the cynicism with which Hindutva agendas are given a dry run.

 The West Bengal chief minister has often asked the Opposition to unite, but the question remains whether she would be willing to step out of her turf and wage a national battle. The last chief minister to do so was Narendra Modi, who had also won three terms in Gujarat. The difference was that he had a national party as a vehicle for his ambitions. Mamata Banerjee does not and were this idea to ever have wings, she would have to work with both the Congress and the regional forces. The apparent reluctance of the Gandhis to hold office could be a factor that does not make this an impossible idea.

There has already been editorial commentary about the power of regional satraps and the question has been asked if disparate forces could take on an entrenched national player. It can happen, but only if the Congress is on board because in spite of the defeats in these polls, the party still has bases across the country. Because of its failure to win Kerala and Assam, there is likely to be some implosions in the Congress but if the past is an indicator of the future, then after the hurly-burly is done, the Gandhis will still be at the helm of affairs.

The good news is that although Rahul Gandhi has shown none of the street-fighting grit that makes Mamata Banerjee so exceptional at this moment in contemporary history, he has taken wise and far-sighted positions on the coronavirus epidemic that currently rages through the land. At a time of acute oxygen shortages in the national capital, Priyanka Gandhi has been personally overseeing a youth Congress team delivering oxygen cylinders to homes, hospitals and even embassy compounds, small gestures that do show that the heart is in the right place.

But hardheaded political acumen would require the Congress to recast state strategies and not contest against traditional regional players as it did in Bengal, eventually getting out for duck. Adhir Ranjan Chowdhury, the leader of the Congress in the Lok Sabha, also oversaw its Bengal strategy and often speaks of Mamata Banerjee with disrespectful phraseology. Should the Congress be serious in its intent to take on Narendra Modi in 2024, it would have to dispense with certain fixtures in its state units and look at the larger picture. The next round of state polls will take place in early 2022, first in Punjab, where the BJP no longer remains a serious contender after the split with the Shiromani Akali Dal over the farm laws, and then in Uttar Pradesh, hit by Covid-19 spreading into the hinterland but also missing a strong Opposition.

Mamata Banerjee has been part of two coalitions in the past, the National Democratic Alliance of Atal Bihari Vajpayee when she was not in power in Bengal and the United Progressive Alliance, eventually leaving UPA II led by Manmohan Singh in 2012 over foreign direct investment in the retail sector. Unlike the Bahujan Samaj Party chief, Mayawati, or the late J. Jayalalithaa, both former women chief ministers, the Bengal leader is not unapproachable. She has excellent relations with Sonia Gandhi and with state leaders across the country. Of importance would also be her equation with Sharad Pawar, the Nationalist Congress Party supremo, who is considered a smart practitioner of statecraft and is credited with being behind the design of the regime that now rules Maharashtra. Both Mamata Banerjee and Pawar are former Congress members who would go on to create significant regional parties. The UPA is currently almost defunct as a forum and Sonia Gandhi is the chairman; the game would indeed be afoot again were the national party and regional players to reach out and make the Bengal chief minister chairperson of the UPA.  

Mamata Banerjee takes risks. There is something beautifully human about her defeat in Nandigram. She left a safe seat for a tougher one when she was, in fact, the TMC face for every seat in Bengal. She was injured both physically and metaphorically in Nandigram, but as does happen in protracted battles, the hero gets wounded, copes with the pain and keeps charging till the enemy is vanquished. The eventual defeat from Nandigram only makes her human and, therefore, more relatable in the age of carefully manufactured leadership.

At a time when many state leaders even from opposing parties are careful about what they say about Narendra Modi and Amit Shah, it’s a breath of fresh air to see Mamata Banerjee speak her mind fearlessly and honestly from her point of view. Under the homely exterior of a spontaneous leader in a simple cotton sari is an individual with nerves of steel. That’s what is needed to fight the cult of the Indian prime minister, propped up by big money, manpower and a pliable national media. There is some distance between 2021 and 2024, when the next general election takes place; can the Opposition start devising a strategy? There are chinks in the BJP’s armour and the national chemistry is changing. Mamata Banerjee has shown India that no victory is impossible.

Courtesy - The Telegraph.


पूंजी को कलंक न समझें (बिजनेस स्टैंडर्ड)

भारत में टीकाकरण की प्रक्रिया पहले ही विलंब से चल रही है। 18 से 44 वर्ष की उम्र के लोगों का टीकाकरण शुरू करने के बाद टीकाकरण की गति और धीमी हुई है। इसे बढ़ाने यानी वितरण अथवा आपूर्ति बेहतर करने के लिए सरकार को निजी क्षेत्र के साथ बेहतर साझेदारी करनी होगी। बहरहाल लग रहा है कि निजी कंपनियों के बारे में हमारी पुरातन सोच इस प्रयास की राह में आड़े आ रही है। सीरम इंस्टीट्यूट ऑफ इंडिया (एसआईआई) के प्रमुख अदार पूनावाला ने हाल ही में द टाइम्स ऑफ लंदन को दिए साक्षात्कार में कहा कि उन्हें राजनेताओं समेत कई जगह से 'आक्रामक' फोन आ रहे थे। माना यही जा रहा है कि वह आरोप प्रत्यारोप से बचने तथा खलनायक की तरह पेश किए जाने से निजात पाने के लिए ब्रिटेन चले गए।

इस बीच विपक्षी दल एसआईआई तथा दूसरी टीका विनिर्माता कंपनी भारत बायोटेक पर 'मुनाफाखोरी' का इल्जाम लगाने लगे क्योंकि उन्होंने खुले बाजार में टीकों की बिक्री के लिए कीमत थोड़ी बढ़ाकर पेश की। पूनावाला ने ट्विटर पर दिए गए अपने दूसरे वक्तव्य में कहा कि वह लगातार सरकार के साथ संपर्क में थे और उन्हें सरकार से उल्लेखनीय समर्थन भी मिला। उन्होंने यह भी स्पष्ट किया कि टीका उत्पादन बढ़ाने में समय लगेगा। इस सवाल का जवाब नहीं मिल सका कि टीकाकरण शुरू करने के पहले उत्पादन में इजाफा क्यों नहीं किया गया।

पूर्व मुख्य आर्थिक सलाहकार अरविंद सुब्रमण्यन ने एक बार कहा था कि देश में निजी निवेश से जुड़ी एक अहम समस्या यह रही कि पूंजी को गलत माना गया और निजी निवेशकों को संपत्ति निर्माता के बजाय समस्या के रूप में देखा गया। हमारी राजनीति और नीतियों ने भी मुनाफे की प्रवृत्ति को आम बेहतरी का जरिया बनाने के बजाय उसके साथ विपरीत रिश्ता कायम करने की प्रवृत्ति दिखाई। देश में टीका विनिर्माण को लेकर सामने आई समस्या पूंजी को गलत दृष्टि देखने के नकारात्मक परिणामों का सटीक उदाहरण है। यदि एसआईआई और अन्य कंपनियों को टीकाकरण को एक लाभकारी कारोबार के रूप में आगे बढ़ाने की इजाजत दी जाती तो इससे न केवल निवेश आकर्षित होता बल्कि देश भर में टीकाकरण की गति बढ़ाने में भी मदद मिलती। परंतु इसके बजाय ऐसा माहौल बनाया गया कि राजनेता टीका विनिर्माताओं को परेशान करने लगे कि उनके राज्य को प्राथमिकता दी जाए। इस बीच केंद्र सरकार को लगा कि वह भी इन्हें परेशान करके कम दाम पर टीका देने पर मजबूर कर सकती है। टीका निर्माताओं द्वारा राज्यों और निजी अस्पतालों के लिए टीकों की नई कीमत निर्धारित करने के बाद केंद्र ने दखल दिया और उनसे कहा कि वे कीमत कम करें। ऐसा हस्तक्षेप अनुचित है।

टीकों में निवेश और निवेशकों के साथ व्यवहार को लेकर केंद्र और राज्य सरकारों को अपने रुख पर पुनर्विचार करना चाहिए। सरकार के साथ सहयोग करने वाली निजी कंपनियों को मुनाफा कमाने देना चाहिए वरना वे सरकार से समझौता नहीं करेंगी। अतीत में कई बुनियादी क्षेत्रों में ऐसा हो चुका है। पूनावाला के साक्षात्कार ने दुनिया को बता दिया कि भारत में उद्यम चलाने में क्या दिक्कतें हैं? आपको डराया जाता है। सरकार का काम है उद्यमों और उद्यमियों की रक्षा करना न कि उन पर दबाव बनाना। आशा की जानी चाहिए कि टीकाकरण में आई दिक्कतों से यह सबक मिला होगा कि निजी क्षेत्र के साथ बेहतर रिश्ता और पूंजी के साथ उचित व्यवहार करके ही किफायत, निवेश और वृद्घि हासिल की जा सकती है। हाल ही में प्रधानमंत्री ने लोकसभा में कहा था कि अर्थव्यवस्था में निजी क्षेत्र की भूमिका अहम है और इस क्षेत्र को प्रताडि़त करने की संस्कृति अब स्वीकार्य नहीं होगी। हर किसी को इस राय का पालन करना चाहिए।

सौजन्य - बिजनेस स्टैंडर्ड।


The tweaks vaccine policy cries out for (The Economic Times)

Quick takes, analyses and macro-level views on all contemporary economic, financial and political events.

India’s Covid vaccination drive has expanded eligibility for the jab, even as production is yet to ramp up. This means policy must be finetuned to allocate vaccines to those who need them most. First, instead of leaving allocation of vaccines among the states to vaccine manufacturers, the Indian Council of Medical Research must guide vaccine makers, based on transparent parameters such as vulnerable populations size, rate of vaccination, number of Covid cases, positivity rate and record of vaccine wastage. Vulnerability should be measured in terms of both the current pace of pandemic spread and size of both healthworker/frontline worker groups and the elderly population. States should prioritise vaccine delivery by vulnerability.

Second, ICMR must provide clear information on the minimum and maximum gap between the two doses of vaccines being administered. This will help avoid panic among those who have already taken the first shot but are finding it difficult to get the second. Third, the central government must strengthen and simplify the technological backbone of the vaccination drive, the CoWIN app. It must be easy to access irrespective of technological savvy. The app must be programmed to prioritise those who have had their first dose, so that they can get their second jab within the stipulated time frame. Voluntary organisations should help the digitally non-savvy to get enrolled, till vaccine supplies increase to a level when walk-in registration at vaccination centres becomes feasible. Four, map out delivery centres to maximise access and minimise crowding and infections.

Rather than a few big centres, favoured by some states, the focus should be on many smaller centres—using local primary health centres, community halls and other such facilities to set up vaccination centres. Arrangements must be made to whisk away those who develop allergic reactions to well-equipped intensive care units. It will make it easier for people particularly those who are daily wagers and informal sector workers to get vaccinated.

Courtesy - The Economic Times.


Why the RBI should buy NBFC bonds (The Economic Times)

Quick takes, analyses and macro-level views on all contemporary economic, financial and political events.

Uday Kotak has stated that the Reserve Bank of India (RBI) might inevitably have to expand its balance sheet to support the economy amidst the raging pandemic. The central bank does precisely that when it carries out long-term repo operations. However, there is scope for the RBI to provide direct liquidity support to large non-banking financial companies (NBFCs) that play a vital role in meeting the credit requirements of swathes of small and medium industry.

It is true that RBI has shored up liquidity conditions for the banking system in the past one year for onward lending, and is providing further liquidity support this fiscal. Note that the central bank has announced its pathbreaking G-SAP, government securities acquisition programme under which RBI would purchase government paper to the tune of Rs 1 lakh crore in the first quarter of FY22. Further, its targeted long-term repo operations (TLTROs) are meant to provide credit to smaller NBFCs, but, again, via bank funding. But NBFCs do have a critical role in India’s credit system, providing, as they do, credit for largely un-banked segments, and the way forward is for the RBI to directly purchase the paper issued by major league NBFCs. It would rightly and speedily step up credit support across the board.

The central bank is in the process of thoroughly revamping its oversight on NBFCs with a four-layered regulatory structure, based on such parameters as operational size, leverage, interconnectedness and nature of activity. The way ahead is for the largest NBFCs to issue bonds for direct subscription by RBI. The central bank needs to phase in making use of corporate bonds in its liquidity management operations, to boost demand for these bonds.

Courtesy - The Economic Times.


Tuesday, May 4, 2021

Delhi to London, a reconnection (The Indian Express)

Written by C. Raja Mohan 

Labour Prime Ministers Tony Blair and Gordon Brown certainly sought to make amends, but the party drifted steadily away from India. (Illustration by C R Sasikumar)

As Delhi and London break the corona jinx on the long-scheduled summit between Prime Ministers Narendra Modi and Boris Johnson with a digital conversation scheduled for Tuesday, cooperation on taming the pandemic is inevitably at the top of the agenda. Like India today, Britain had gone through a horrendous COVID crisis some months ago; and there is much for the two leaders to talk about.

Beyond the immediate relief supplies of oxygen and other medical equipment needed to treat COVID victims, India and the UK must tap into the enormous potential for bilateral strategic cooperation in the health sector and contributions to the global war on the virus.

The issue of resilient medical supply chains is expected to figure not only in the bilateral conversation between Modi and Johnson, but also at the Group of Seven ministerial meeting in London this week. Foreign ministers of India, Japan and Australia would also join this meeting to set the stage for the “Group of Seven Plus Three” physical summit next month hosted by the British Prime Minister.

The possibilities range from ramping up vaccine production to the structuring of a strong public health system in India, the absence of which has been so terribly felt in the last few weeks. The current pandemic is neither the first nor will it be the last.

Even as it overcomes the current COVID wave, Delhi must seize the opportunities to work with its international partners in overcoming India’s failings that have been so mercilessly exposed in the last few weeks. Britain and the G-7 are well-positioned to help transform India’s internal capabilities as well as benefit from them in the management of future global pandemics.

While the health sector will necessarily dominate the conversation between Modi and Johnson on Tuesday, there is other bilateral business that has been pending for too long. Few Western powers are as deeply connected to India as Britain. Yet, building a sustainable partnership with Britain has been rather hard. While India’s relations with countries as different as the US and France have dramatically improved in recent years, ties with Britain have lagged.

One reason for this failure has been the colonial prism that has distorted mutual perceptions. If the anti-colonial resentment against Britain is always seething barely below the surface among the Indian political and bureaucratic classes, London has found it difficult to shed its own prejudices about India.

The bitter legacies of the Partition and Britain’s perceived tilt to Pakistan have long complicated the engagement between Delhi and London. To make matters worse, the large South Asian diaspora in the UK transmits the internal and intra-regional conflicts in the subcontinent into Britain’s domestic politics.

While there is no way of fully separating South Asian and British domestic politics, Delhi’s problems have been accentuated by the British Labour Party’s growing political negativity towards India. For generations, Indian elites grew up thinking Labour was more empathetic towards India, while resenting the Conservative condescension.

The last three decades have seen an important turnaround. The Tories have become natural partners for Delhi, while Labour has become more meddlesome in India’s domestic politics. Here is a paradox: The Labour Party and its intelligentsia that never miss a chance to denounce the empire can’t seem to resist talking down to India. The Tories, who are certainly sentimental about the Raj era, are more open to seeing India in its own right. They are also more willing to view India through the prism of shared interests.

A quarter-century ago, the Labour Foreign Secretary Robin Cook, travelled with Queen Elizabeth to the subcontinent to mark the 50th anniversary of Independence in 1997. Speaking in the name of a values-based foreign policy, Cook held forth on self-determination for Kashmiris.

The soft-spoken Indian Prime Minister Inder Kumar Gujral, who heard about Cook’s remarks on Kashmir when he was on an official visit to Cairo, reacted by dismissing Britain as a “third rate power”. Gujral also accused Britain of creating the Kashmir problem in the first place and slammed its temerity to tell India how to solve it. Both sides quickly got into damage limitation, but the Queen’s visit, meant to signal goodwill, ended up doing the opposite.

Labour Prime Ministers Tony Blair and Gordon Brown certainly sought to make amends, but the party drifted steadily away from India. Under Jeremy Corbyn’s leadership, the Labour Party had become rather hostile on India’s internal matters, including on Kashmir. More recently the Labour Party was quick to jump into controversy over the farmers’ agitation.

In contrast, the Conservatives have been warming up to India. Tory Prime Minister John Major was quick to support India’s economic reforms in the 1990s. David Cameron, who wrested power from Labour in 2010, sought to revive the relationship with India. His successor, Theresa May, too was eager to advance bilateral ties but Delhi and London continued to struggle in translating the new goodwill into strategic outcomes.

What is new in the relationship is the strong political will on the part of Modi and Johnson to find a fresh basis for the bilateral relationship. The two leaders are expected to announce a 10-year roadmap to transform the bilateral relationship that will cover a range of areas.

Both Modi and Johnson confront a whole new set of circumstances for their countries and recognise that India and Britain need each other to achieve their larger goals. On trade, for example, both are on the rebound from their respective regional blocs. Britain has walked out of the European Union and India has refused to join the China-centred Regional Comprehensive Economic Partnership. Although both will continue to trade with their regional partners, they are eager to build new global economic partnerships.

While remaining a security actor in Europe, Britain is tilting to the Indo-Pacific, where India is a natural ally. Delhi, which is looking at a neighbourhood that has been transformed by the rise of China, needs as wide a coalition as possible to restore a semblance of regional balance. Britain could also contribute to the strengthening of India’s domestic defence industrial base. The two sides could also expand Delhi’s regional reach through sharing of logistical facilities.

Delhi and London are said to be exploring an agreement on “migration and mobility” to facilitate the legal movement of Indians into Britain. Both sides are committed to finding common ground on climate change. As they deepen their bilateral partnership and expand regional and international cooperation, Delhi and London may find it easier to manage the irritations over Pakistan and South Asian diaspora politics in Britain. If Modi and Johnson succeed in laying down mutually beneficial terms of endearment, future Labour governments might be less tempted to undermine the partnership.

The writer is director, Institute of South Asian Studies, National University of Singapore and contributing editor on international affairs for The Indian Express.


An avoidable tragedy: Scores of patients dying because they couldn’t get oxygen in time points to a failure of governance (TOI)

Times of India’s Edit Page team comprises senior journalists with wide-ranging interests who debate and opine on the news and issues of the day.

A most visible reminder of India’s governance failure on the heels of the second wave of Covid-19 is the constant flow of news about shortage of medical oxygen. Cases of patients dying after hospitals run out of oxygen are being reported from across the country. In the latest tragedy, 24 patients are reported to have died in Karnataka over the weekend after hospitals ran out of oxygen. While the state government says it is examining the exact cause of deaths, what is not in doubt is that there is an oxygen crunch.

The underlying causes of the problem became evident when the Supreme Court recently took up a suo motu writ petition in the backdrop of this humanitarian crisis. In India, steel plants are major suppliers of oxygen. As they are unevenly distributed, allocation of oxygen is decided by the Centre, with states responsible for organising transport. Problems begin here. Oxygen requirement of a state changes constantly depending on the case load. Political incentives to fudge data can’t make this task simple. Moreover, some states may simply not be in a position to lift their supply from far away.

There are heart-wrenching accounts of citizens being left to fend for themselves even as the solicitor general has stated that there’s enough oxygen supply for the country but there’s a shortage in some states. Weeks into this cruel shortage – or allocational mismatch – different administrations remain entangled in bureaucratic faceoffs even though India’s Covid-19 battle is supposed to be underpinned by a “whole-of-government” approach. The capital’s plight is particularly notable. The apex court has asked the Centre to solve Delhi’s problem by the midnight of May 3 after hospitals have been reduced to taking to social media to plead for oxygen day after day, even as erratic supplies cause tragic deaths.

What the recent weeks reveal is that both Centre and states have been woefully unprepared for the second wave. To make matters worse, there appear to have been coordination issues not only between the Centre and states, but also within districts in states. There’s an urgent need to sort out basic logistics and ensure that petty procedural holdups don’t lead to loss of lives. Simultaneously, we need to be prepared for coming challenges. In this context, the Centre’s decision to expand the healthcare force by suspending the medical PG entrance exam is a good step. Governments must stop passing the buck and get their act together.

Courtesy - TOI


The nuclear challenge: On North Korea's economic worries (The Hindu)

President Joe Biden’s call for “stern deterrence” in response to North Korea’s nuclear programme and Pyongyang’s angry reaction, accusing the Biden administration of being “hostile”, suggest that both countries are headed towards a diplomatic showdown. In his first congressional address last week, Mr. Biden said the nuclear programmes of Iran and North Korea posed a “serious threat to America’s security and world security” and promised to respond through “diplomacy and stern deterrence”. His administration has also completed a review of the U.S.’s North Korea policy. Mr. Biden is likely to steer between Barack Obama’s “strategic patience” and Donald Trump’s top-level summitry in dealing with the North Korean nuclear challenge. North Korea has remained an unresolved foreign policy puzzle for all post-War American Presidents. In recent times, U.S. Presidents have shown a willingness to diplomatically engage with Pyongyang. The Clinton administration had signed a framework agreement with Pyongyang to halt its nuclear programme. Mr. Obama had initiated talks with North Korea in 2012, which collapsed after Pyongyang launched a satellite. He then adopted a wait-and-watch approach, which came to be called “strategic patience”. Mr. Trump altered his predecessor’s North Korea policy by reaching out to the regime and meeting its leader, Kim Jong-un, thrice, but without a breakthrough.

In theory, the Trump administration and North Korea had agreed to a complete de-nuclearisation of the Korean peninsula, but failed to agree on its formula. In the 2019 Trump-Kim summit at Hanoi, the U.S. proposed removal of sanctions for de-nuclearisation, but North Korea rejected it. Pyongyang had taken a phased approach and sought sanctions removal in return. Ever since, there has been no improvement in ties. After Mr. Biden assumed office, North Korea had conducted short-range missile tests, which the U.S. saw as a provocation. Mr. Biden does not have many good options in dealing with North Korea. The U.S.’s key goal in northeastern Asia is the de-nuclearisation of the Korean peninsula. And the only practical way to achieve this is through diplomacy as a military strike on North Korea, a nuclear power, is out of the question. Though the Trump-Kim summits did not lead to any breakthrough, they have still created a diplomatic momentum for engagement. Despite its threats to expand its nuclear programme, North Korea sticks to the self-imposed moratorium on nuclear and long-range ballistic missile tests. The North, as acknowledged by Mr. Kim recently, is going through a tough economic crisis and is open to talks. Mr. Biden should seize this opportunity and try to reach common ground with Mr. Kim that addresses both North Korea’s economic worries and the U.S.’s nuclear concerns. That should be the focus of the Biden administration’s new North Korean strategy.

Courtesy - The Hindu.

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