It is becoming increasingly obvious that the government’s response to the coronavirus pandemic over the last 3 months has failed on almost every front. Not only has it been unsuccessful in containing the exponential spread of the disease, but has through its actions given rise to one of the biggest humanitarian crises our country has ever seen. It has violated the basic human rights of lakhs of Indians through its narrow-mindedness, short-sightedness and insensitivity.
The top ministers and officials of the government have given short shrift to scientists and doctors and thereby failed to ground their decisions in the latest scientific research concerning the progression of the pandemic. The government chose to hire the American corporate consulting agency, Boston Consulting Group (BCG) for advice on how to handle the crisis, even though BCG is best known for providing strategic advice on management solutions and claims no expertise in responding to public health crises. Why then did the government opt for the services of such a firm while failing to meaningfully engage with Indian medical experts and organisations who have been handling the crisis on the ground?
In a joint statement released by the Indian Public Health Association, the Indian Association of Preventive and Social Medicine and the Indian Association of Epidemiologists, the country’s foremost doctors, epidemiologists and public health activists have criticised the government for not consulting experts: “Policymakers apparently relied overwhelmingly on general administrative bureaucrats. The engagement with expert technocrats in the areas of epidemiology, public health, preventive medicine and social scientists was limited.”
The government has been unable to build up adequate healthcare capacity, something which should have been top priority right from the initial days of the lockdown. There have been reports of patients having to share beds in hospitals and shortages of medical staff. In addition, regular medical services for life-threatening conditions such as tuberculosis, HIV and cancer have been severely disrupted which has led to thousands of avoidable non-COVID-19 deaths.
The administration has also failed to prevent blatant private profiteering. For example, private labs have been accused of making a 300% profit per test due to the erroneous government-imposed price cap of Rs. 4500 for a test which should not have cost more than Rs. 1500. Since the announcement of the price-cap, the government’s own agency, the Indian Council of Medical Research, has evaluated 83 COVID-19 test kits (RT-PCR) and found 35 satisfactory (of which, 20 are of Indian companies). One of the tests found satisfactory was manufactured by a Pune-based company which quoted its cost as Rs 100 per test. But in spite of this, the price-cap was not revised. In fact, it was recently removed altogether, without any guidelines on how the new price-cap would be determined.
While challenging the rationale for charging Rs 4500 per test, the AIDS Society of India (a national HIV medical experts’ network) also questioned why private laboratories were being allowed to mint profits of Rs 10-15 crores per day from testing presumptive cases of COVID-19 and people with non-COVID-19 conditions for whom COVID-19 test has been made mandatory (such as those who needed medical care for pregnancy, dialysis, chemotherapy, surgery, etc). Private hospitals are also plundering patients by charging inflated prices of thousands of rupees for personal protective equipment (PPEs).
The alarming number of COVID-19 cases among healthcare providers is exposing the weaknesses in the infection control strategies and protocols being followed by our healthcare system. The shortage in PPEs has been a major factor in this. This problem has been around since the beginning of the pandemic but is yet to be adequately addressed at many hospitals. Corruption in PPE procurement has also come to light in some states like Himachal Pradesh.
Further, the government has been accused of suppressing COVID-19 related data and making misleading claims about their success in containing the pandemic.
The plight of India’s migrant workers over the last few months has been covered extensively by the media for all to see. The fact that the government, in imposing the lockdown, failed to consider the perspective of the millions of people who live far away from home and subsist on daily wages, shows how out of touch it is with the day to day lives of ordinary Indians. Its move to disallow migrants from travelling resulted in widespread violence and hardship, and had adverse consequences for the fight against COVID-19.
If the migrants had been allowed to travel to their homes in the first week of the lockdown, or even at any point later when the government realised it was going to be a long haul, when the disease was yet to enter community transmission, they would have been far less likely to take the virus with them to their communities and families than they are now. Instead many were compelled to undertake arduous journeys on foot, bicycle or in overcrowded vehicles which resulted in dozens of deaths due to accidents, hunger and exhaustion. Once special trains for migrant workers began to be arranged, their functioning was ridden with mismanagement and negligence. Over 80 people have died of hunger and exhaustion on these trains.
These oversights indicate the extent to which the powerful are disconnected from the ground realities of our country and point to the dire need for the decentralisation of power and much greater representation of people from marginalised sections of society in public offices. It is also an indication of the inward-looking, autocratic nature of our present government, which has sought to control every aspect of India’s COVID-19 response, denying autonomy to state and local governments, and due respect to medical and scientific bodies.
In light of these events, Socialist Party (India) demands:
- Immediate and full implementation by all states and the central government of the Supreme Court directives for migrant workers’ return. All the people who have had to pay for their return home either on government or private transportation should be given refunds. The government relief meant for returning migrants should be extended to all and not just be restricted to those who have used government transportation as many did not have the choice or could not wait for government transportation in a desperate situation.
- To support the call for ‘Atma-Nirbhar Bharat’, consultancy or other forms of contracts from foreign firms must be cancelled immediately. The government must engage only domestic experts to help the government shape its COVID-19 response and other development work. Foreign groups like BCG and PricewaterhouseCoopers (PwC) must be disengaged with immediate effect.
- The maximum price caps on COVID-19 tests, other non-COVID-19 medical tests, PPEs, medical care, consultation fees, etc., in the private sector must be urgently revised keeping the same profit margin as a farmer gets from the sale of her produce which is not more than 1.5 times the investment. The private organisations which have over-charged for COVID-19 tests should now be asked to make refunds to the patients.
- COVID-19 has made it clear that it is only government healthcare facilities that are reliable in times of pandemics. Nationalization of healthcare services is an urgent requirement. Nationalization of healthcare facilities (infrastructure, staff, etc.) including diagnostics, medical devices and drug manufacturers, pharmacies and biotech firms must be done without any further delay.
- ICMR (Indian Council of Medical Research) should lead the country on medical research. Price negotiations, procurement of medical devices etc. should be done by other appropriate bodies in the government system.
- Senior government doctors who were leading the COVID-19 response have resorted to private hospitals for care when they themselves tested positive which raises questions on the trust people have in the quality of healthcare in government facilities. If the 2017 High Court order of Justice Sudhir Agarwal of Allahabad High Court was implemented in letter and spirit, then we would have had a much stronger government-run healthcare system today which could have been better prepared to deal with pandemics. This order made it compulsory for all government staff and elected representatives to seek medical care from government-run facilities and from the available on-duty doctor only. This order should be implemented in UP and the entire nation with immediate effect. Also, those government staff and elected representatives who are seeking COVID-19 and non-COVID care from private healthcare facilities should not be compensated from public funds (such as CGHS etc).
- When the highest-ever number of COVID-19 cases have been reported in the last 24 hours (8237 on 1 June 2020), why has the government announced the ‘unlock-1’ phase? What was the rationale for the lockdown then in the first place? Decision making has to be made more participatory, evidence-based, and key government agencies need to take responsibility for the action (or inaction) in management of COVID-19 response, as well as the humanitarian crises that have unleashed havoc in the lives of millions of people.
- Those who are responsible for this unconscionable and unjustifiable mismanagement must be held accountable. This includes first and foremost the Prime Minister and Home Minister, as well as other highly placed officials who have held the reins of the government’s COVID-19 response.
Pannalal Surana, President, Socialist Party (India) | Ph: 9423734089
Sandeep Pandey, Vice-President, Socialist Party (India) | ashaashram@yahoo.com
Bobby Ramakant, Spokesperson, Socialist Party (India) | bobbyramakant@yahoo.com
Surabhi Agarwal, Spokesperson, Socialist Party (India) | surabhiagwl@gmail.com
