National affairs

Government’s chaotic response in India’s Covid Tsunami – Dr. Shashi Tharoor

Greetings,
 
This week, I have three articles to share with you.
 
As Covid-19 overwhelms India’s healthcare system with unprecedented violence, I examine the government’s chaotic response in India’s Covid Tsunami, syndicated in 88 newspapers around the world. Although I praised India’s export-led “vaccine diplomacy” in my piece just two months ago while warning that the government was failing to meet domestic demand, the immense scale of the problem has been laid bare only in the last few weeks. As hospitals struggle to obtain oxygen and vaccines, the Prime Minister has over-centralised power, ignored health experts’ advice, and grown grossly complacent on vaccine distribution while engaging in petty politics. Before engaging in soft-power ventures like the Vaccine Mantri program, India must focus on managing the disaster at home, one that is wreaking havoc among ordinary Indians.  
 
As I recover from my own bout with Covid, I write with my Congress Party colleague Salman Anees Soz in Vaccines should be free and for all, published in the Indian Express. We argue that the government’s announced vaccine policy, characterised by multiple price points for different categories of buyer, and by the creation of a private market for vaccine doses, is unconscionable and potentially disastrous. All vaccine procurement must be done by the Union government, with simple and transparent procedures to ensure that every Indian is able to obtain a vaccine free of cost. Failing to ensure this will prolong the crisis, worsening the devastating human and economic cost of a pandemic that has already inflicted unimaginable suffering.
 
On a different note, in The need to avoid a Cold War between US and China, my column in The Week, I write on the escalating tensions between the two global superpowers. Split both by economic interests and ideology, the US and China are focused on alliance-building, particularly the Quad group of democracies that President Joe Biden hopes will counter autocracies. Although such rhetoric points to the emergence of a new Cold War, this is not inevitable. The US and China are hugely economically intertwined and members of America’s proposed democratic front have their own interests in maintaining relations with China. Inter-dependence is also clearly needed to fight “problems without passports”, such as health and environmental crises. With enough imagination, the world can avoid an unproductive and dangerous splintering into ideological blocs.
 
1. India’s Covid Tsunami; Project Syndicate; April 26, 2021. 

It is humbling when a columnist must retract his words soon after penning them. Just two months ago, after India rushed millions of doses of COVID-19 vaccines to over 60 countries, I praised the country’s “vaccine diplomacy.” India’s aspirations to be recognized as a global power had been given a real boost. Now, with more than 300,000 new cases a day and the death toll evidently much higher than reported, India is no one’s idea of a global leader.
 
2. Vaccines should be free and for all; Indian Express; April 29, 2021. 

Covid-19 has unleashed a devastating second wave in India. The government has proven woefully unprepared for this crisis. We can blame hubris or incompetence or a combination thereof for India’s unfolding tragedy. However, it should now be everyone’s goal to shorten the duration of the broader crisis, which won’t remain restricted to this second wave. A humanitarian and economic catastrophe looms. With this in mind, we write to warn against the government’s recently announced vaccine policy. This policy is unconscionable and potentially disastrous. It will likely create confusion, limit vaccination coverage, breed inequality, and prolong the duration of the crisis. Better alternatives are available, which can help save both lives and livelihoods.
 
3. The need to avoid a Cold War between US and China; The Week; May 2, 2021. 

Even as the world continues to grapple with the ravages of the Covid pandemic, strategists with an eye on the long term are contemplating a potentially equally crippling prospect: the onset of a “new Cold War”, this time between the US and China. US Secretary of State Antony Blinken has dubbed Beijing a “threat to global stability” and denounced its record on human rights and trade. China has been equally harsh in its condemnation of US “imperialism” and domestic problems, including racism. Beijing has made no secret of its disdainful view that the US is a country in terminal decline.
 
As always, if these are getting too much, feel free to unsubscribe below.

With warm regards,

Shashi Tharoor
 
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India’s Covid Tsunami,
April 26, 2021,
Project Syndicate.
 
It is humbling when a columnist must retract his words soon after penning them. Just two months ago, after India rushed millions of doses of COVID-19 vaccines to over 60 countries, I praised the country’s “vaccine diplomacy.” India’s aspirations to be recognized as a global power had been given a real boost. Now, with more than 300,000 new cases a day and the death toll evidently much higher than reported, India is no one’s idea of a global leader.
In my own defense, I was worried that India had exported three times as many vaccines as it had administered domestically. The country was clearly lagging behind its own target of immunizing 400 million people by August, after vaccinating some three million healthcare workers in a campaign that began only on January 16. “[M]ounting concern about rising case numbers, the emergence of COVID-19 variants that may not respond to existing vaccines, and an economy that has not yet fully recovered,” I noted, “will intensify the challenge India confronts in fulfilling its obligations to developing countries while also meeting domestic demand.”

At the time, I did not realize the scale of the challenge. The number of infections surpassed 17 million in recent days, and the official death toll now exceeds 190,000. Hospital beds are now overflowing, oxygen supplies have dwindled, vaccination centers have run out of doses, and pharmacies are unable to meet the demand for antivirals. India is reeling.

How did everything go so wrong so soon after India recovered from the first wave of the pandemic last year, resumed normal life and economic activity, and started exporting vaccines? The list of errors is long.

Begin with symbolism over substance. On national television, Prime Minister Narendra Modi urged Indians to bang plates together. Two weeks later, he instructed them to light lamps at a specific moment. Superstition replaced science-based policies in confronting the pandemic.

Modi also enlisted Hindu nationalism in the fight against COVID-19. Just as the epic Mahabharata war was won in 18 days, he claimed, India would win the war against the coronavirus in 21 days. At no point was this based on anything more than wishful thinking.

Another error was ignoring the World Health Organization’s advice. From the start of the crisis, the WHO recommended a containment strategy that required testing, contact tracing, isolation, and treatment. While a handful of states, like Kerala (which recorded India’s first COVID-19 case on January 30, 2020), initially implemented such measures successfully, the Modi government’s ham-handed response resulted in their uneven application in several states.

Then there was over-centralization. From the first nationwide lockdown, announced by Modi in March 2020 with less than four hours’ notice, the central government managed the pandemic under obscure provisions of the Epidemic Diseases Act and the Disaster Management Act, which allowed it to ride roughshod over India’s federal structure. Instead of delegating India’s 28 state governments the authority to design strategies tailored to local conditions, the central government tried to manage COVID-19 by decree from Delhi, with calamitous results.

And, no surprise, the initial lockdown was mismanaged. State governments, the public, and even central government officials were caught unprepared. Chaos resulted, with some 30 million migrant workers, stranded without work in cities, forced to walk home, sometimes for days. It is estimated that 198 people died along the way. Some five million micro and small enterprises closed, unable to recover from the shutdown. India’s unemployment reached the highest levels ever recorded.

As the crisis began to slip out of control, the central government, following then-US President Donald Trump’s precedent, passed off more and more responsibilities to state governments, without adequate funding. The state governments struggled to mobilize doctors, nurses, health workers, testing kits, personal protective equipment, hospital beds, ventilators, oxygen cylinders, and medicines to fight the pandemic. The government mobilized a huge amount of funds for a new relief entity called “PM-CARES,” but to this day there is no public accounting of how much money is in the opaque PM-CARES Fund and where its resources have been allocated.

When the pandemic seemed to have waned, the authorities settled into complacency, taking no precautions or preventive measures against a possible second wave that many warned could be more devastating than the first. Testing, tracking, and isolation of infected people and their contacts fell rapidly into disuse by the end of 2020. And just when people stopped following appropriate behavioral guidelines, the virus evolved an extremely infectious variant. Super-spreader events proliferated: election rallies and religious festivals packed together unmasked throngs. The contagion raged.

Although India produces 60% of the world’s vaccines, the government took no steps to scale up production of the two COVID-19 vaccines cleared for manufacture in the country. Nor did it permit the import of foreign vaccines, help expand available manufacturing facilities, or license other Indian firms to produce doses. India launched its vaccination drive nearly two months after the United Kingdom, but by April, only 37% of health workers, and barely 1.3% of India’s 1.4 billion people, had been fully vaccinated. Only 8% had received at least one vaccine shot.

Here, too, the authorities initially bet on centralization, and its refusal to grant emergency-use approval to vaccines from abroad led to a nationwide shortage of vaccines by mid-April. It was only at this point that the government delegated the vaccine roll-out to state governments and public and private hospitals and permitted the import of vaccines approved by the United States, the UK, the European Union, Russia, and Japan. Even then, the central government failed to distribute vaccines equitably to the various states, resulting in some of the worst-affected (like opposition-ruled Maharashtra and Kerala) running short of vaccines as cases peaked.

Like India’s government, I was prematurely self-congratulatory about the country’s vaccine diplomacy. At a time when Indians were unable to access the vaccines that might have protected them, India’s “Vaccine Maitri” program was not smart, but hubristic. Global leadership must begin at home, and today home is a country whose mortuaries, graveyards, and crematoria are running out of space.

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Vaccines should be free and for all,
April 29, 2021,
Indian Express.
 
Covid-19 has unleashed a devastating second wave in India. The government has proven woefully unprepared for this crisis. We can blame hubris or incompetence or a combination thereof for India’s unfolding tragedy.

However, it should now be everyone’s goal to shorten the duration of the broader crisis, which won’t remain restricted to this second wave. A humanitarian and economic catastrophe looms. With this in mind, we write to warn against the government’s recently announced vaccine policy. This policy is unconscionable and potentially disastrous. It will likely create confusion, limit vaccination coverage, breed inequality, and prolong the duration of the crisis. Better alternatives are available, which can help save both lives and livelihoods.

What should be the goals of a vaccination policy during a global pandemic? We believe a good policy will seek to achieve maximum coverage, as close to universalisation as possible and do so as quickly and cost effectively as possible. We should also account for the institutional capacity to implement such a policy. Given that the pandemic disproportionately impacts poor and low-income families, it is vitally important that the policy also be equitable.
 
Since there is broad consensus that vaccinations provide the safest path to herd immunity, their deployment offers a relatively quick exit from the crisis. That path also ensures a sustained revival of economic activity, which is the surest way to avert a humanitarian crisis in India. Even as we combat the second wave, it is important that we already begin to prepare for future waves. Vaccines have a major role in ensuring that.
 
Currently, over 1 billion doses have been administered across 172 countries. India accounts for 141 million of these doses. After a relatively quick rollout, vaccinations have stalled. Only 1.6 per cent of the population is fully vaccinated. The goal of vaccinating 300 million Indians by August appears daunting. At the current rate, it may take India two years to vaccinate 75 per cent of the population. The government’s vaccine policy could make things considerably worse.
 
We believe the government’s policy is fatally flawed on almost all counts. Creating multiple price points for different categories of vaccine buyers will breed confusion. This will likely slow down vaccine procurement, as multiple buyers negotiate with manufacturers about purchase quantities, delivery logistics, and payment plans. When so many buyers are in a queue to purchase vaccines, private manufacturers could be in a position to determine public health outcomes. That is untenable. This confusion will clog vaccine logistics, delay the vaccine programme, and prolong the Covid-19 crisis.
 
The government’s policy is also iniquitous. In most major countries, vaccines are being given free to all residents. In that most capitalist of nations, the United States, even billionaires are getting free vaccines. Not just that, undocumented workers are also part of the free vaccine programme. The easiest way to ensure maximum coverage is to offer vaccines for free to everyone. By creating a private market for vaccines, in a situation where supply is limited, the better-off sections of society will get to jump the queue. That is unconscionable and an insult to those Indians who are the biggest victims of this crisis.
 
The government’s centralising tendencies are obvious to most, despite all the talk of cooperative federalism. However, in the revised vaccine policy, those in power have suddenly developed a taste for decentralisation. As the staggering toll of the second wave becomes evident, the crisis is being palmed off to the states. This is cynical at best. The Centre has a big role to play in dealing with this pandemic because the virus respects no state (or national) boundaries. The Union government cannot shirk its responsibilities. As we explain below, the states too have a critical role, as does the private sector.
 
We propose that all vaccine procurement in India be done by the Union government. Identifying manufacturers, negotiating prices, scheduling deliveries, and executing payments should be handled by the central government. The Centre should also devise a transparent formula for distributing vaccines to individual states. All data associated with the vaccine programme must be proactively published online.
 
Vaccine administration will be critical. Since speed is of the essence, we need a public-private partnership to scale up the vaccination programme quickly. For this, each state government can enlist private entities to vaccinate people at a pre-determined per dose price. This creates an incentive for private players and also enables people to get vaccines without having to queue up at fewer locations. Online registration systems can handle the queuing process. For those without access to the internet, mass vaccination sites that require no appointments can be set up. We must make it extremely easy for people to get a vaccine.

Won’t this be costly? No. The cost of a prolonged crisis will be far more devastating to the economy. In 2020-21, the crisis probably cost us close to Rs 8 trillion in economic output. Besides, we know what other countries are paying. The EU paid $2.15 for an Oxford-AstraZeneca dose while the UK and the US paid $3 and $4 respectively. India is a giant buyer. Surely, we can get doses for similar prices. We also have international data on costs to administer vaccines. This can help negotiate prices with private sector entities wishing to participate in vaccine administration.
 
The Covid-19 crisis threatens to erode decades of development gains. The first wave probably destroyed some economic output permanently. However, we were fortunate to escape with a relatively low death toll. But this second wave will leave a trail of unimaginable human suffering. We simply did not plan ahead and allowed the virus to run rampant. More waves are likely, given what we have seen elsewhere. But universal and rapid vaccinations can limit our losses.
 
Unfortunately, the government’s vaccine policy is a maze of confusion that could doom India’s future prospects. We need to correct our course before it is too late.
 
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The need to avoid a Cold War between US and China,
May 2, 2021,
Project Syndicate.
 
Even as the world continues to grapple with the ravages of the Covid pandemic, strategists with an eye on the long term are contemplating a potentially equally crippling prospect: the onset of a “new Cold War”, this time between the US and China.

US Secretary of State Antony Blinken has dubbed Beijing a “threat to global stability” and denounced its record on human rights and trade. China has been equally harsh in its condemnation of US “imperialism” and domestic problems, including racism. Beijing has made no secret of its disdainful view that the US is a country in terminal decline.

The Biden administration appears to be embarking on establishing a network of alliances against China. Likely areas of competition with China go beyond the conventional geopolitical issues to challenges in cyberspace and the risks of technological conflict. American thinkers have called for policymakers to evolve a comprehensive strategy to counter China, much as George Kennan’s famous “Long Telegram” from Moscow in 1946 led to the birth of the “containment strategy” that hemmed in the Soviet Union.

Ideology is seen as key to the division of the world into duelling camps. President Biden wants to forge an “alliance of democracies” against the world’s “autocracies”. The Quad is seen by some as the nucleus of a future such alliance. Democracy and liberal values are essential to keeping such an alliance together and to demonstrate that this is not just another amoral contest for military or geopolitical supremacy. This is why Washington prefers to couch its vision as being about principles, democratic governance and the maintenance of international order.

But “Cold War 2.0” is not inevitable. The Biden administration does seem to be more nuanced than its predecessor in its approach to China. Blinken has acknowledged that the relationship with China has adversarial, competitive and cooperative aspects. This was not true of the US-Soviet Cold War, where there was simply no economic interpenetration between the two blocs and almost no examples of cooperation, let alone investment or significant trade.
The countries that the US might hope to rope into its project also have complex concerns. Countries in southeast Asia would welcome the US or the Quad offering a counterweight to Chinese hegemony, but they are too conscious of their economic dependence on Beijing to espouse any overt hostility.

Even the Quad countries have too much at stake in their economic relations with China to simply write off the relationship. China is not known for its ideological zeal to convert the world to communism; it is far more interested in finding itself a dominant place in the current world order than to overthrow the international system.

Nor are there any proxy wars littering the landscape as in the original Cold War, nor much of an appetite for any in either Beijing or Washington. Positing another Cold War, therefore, overstates both the current situation and the risk of any threat from China to the global order.

It is also inescapable today that current global crises like the coronavirus pandemic and environmental disasters oblige the US and China to confront the same problems, face the same threats and seize the same opportunities. What we used to call, in my UN days, “problems without passports”, require blueprints beyond borders to resolve. Global cooperation would serve the world better than intensified rivalry.

As the Indian writer Pankaj Mishra put it recently in a piece for Bloomberg: “The urgent question today is not whether there will be a new cold war. It is whether modes of thought developed during the previous one… will again dominate political and intellectual life…. The crude division between democracy and autocracy won’t help us grasp such a topsy-turvy world. Though comfortingly simple, such cold war ideologies can never truly replace our messy reality.”

The ideological battle lines are not yet joined. Perhaps, with enough imagination, they will not need to be.
 
 
 
 
 
 

–> Copyright © 2017 Shashi Tharoor, All rights reserved.

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