Expert Speak Health Express
Published on May 02, 2021
Chronicle of a tragedy foretold At the best of times, India is a difficult country to govern, given its size, diversity and the argumentative Indian. Yet, it has successfully weathered many a crises. Never has it been so badly let down by its leadership that seems obsessed with scoring political gains, oblivious to the fact that the country faces its biggest challenge since the partition in 1947.

Smugness sets in

In January-February this year, Prime Minister Narendra Modi had good reason to feel satisfied. In India, COVID-19 numbers had declined steadily to one-tenth from the peak of 96,000 daily infections last September and the death rate was down from 1200 to 80. In contrast, January saw the US undergoing its third wave with an unprecedented 300,000 new cases daily and a daily death toll of well over 4000; European countries were in their third lockdown; and UK numbers had exploded with a new variant that was one-and-a-half times more infectious. Not only had India defied the dire predictions that many Western epidemiologists had made but India seemed to have also escaped a possible second wave or a new variant that was ravaging Brazil. The economy had opened up. After an 8.5 percent contraction in 2020-21, the 2021-22 projection was an encouraging double-digit growth. On 16 January, India rolled out a three-stage vaccination programme covering the 30 million health workers and frontline essential public services in the first phase followed by those who are above 60 along with those with co-morbidities and then the above 45 age groups. This accounted for 22 percent of the population, about 300 million people and the vaccination was supposed to be completed in six months, by July-August. An acceptable time frame only if the current decline in case load held.

Triumphalism takes over

A sense of triumphalism began to emerge, buttressed by a faith in Indian exceptionalism. Leading the pack were the cheerleaders, as the BJP prepared to launch election campaigns in five states going to polls in March-April. These included Assam, Kerala, Puducherry, Tamil Nadu and West Bengal, the last two seen as critical by the BJP. On 21 February, the senior leaders of the BJP and all the state unit chiefs met to adopt a resolution thanking Modi for his visionary leadership for effectively handling the pandemic and getting the country back to growth. Under a newly appointed chief minister, Uttarakhand was getting ready for the Kumbh Mela where millions of devotees were expected to congregate to pray and bathe in the Ganga. To top it all off, even the requirement of a negative RT-PCR test report was done away with a conviction that faith would protect the devotees. According to one school, the Kumbh was brought forward by a year, presumably because the BJP election strategists calculated that pulling off a huge exercise like the Kumbh in the middle of a pandemic would be an unparalleled electoral boost among the majority Hindu community. Addressing the annual conference of the Delhi Medical Association on 7 March, Health Minister Dr Harsh Vardhan proudly declared that we are in the “end game of the COVID-19 pandemic in India.” He went on to detail how India had emerged as “the world’s pharmacy” having supplied 55.1 million doses of the vaccine to 62 countries, in keeping with international obligations as a responsible global citizen. Praising Modi’s leadership at the time of a global crisis, he added that “India has emerged as an example to the world in international cooperation.” These paeans of praise harmonised well with the idea of India re-emerging under Modi’s leadership to reclaim its glory as a vishwaguru and he, with his newly cultivated flowing white beard persona, as the Pradhan Acharya of this Vishwa Gurukul.

Wilful neglect and data denial

Even as the BJP was adopting its resolution, a new outbreak of COVID-19 was emerging in Maharashtra. While doctors in the Indian Council for Medical Research blamed it on Covid-inappropriate behaviour, local doctors were voicing concerns about the possibility of a new variant. The Health Minister was declaring the “endgame” in the second week of March when daily deaths were up by 50 percent to 120 and daily cases had doubled to 18,000. But none of this registered. Cricket matches were played in stadiums packed to capacity. Goa saw a revival of domestic tourism. Domestic flights were running to over two-thirds capacity, amid complaints by some that often passengers were not even wearing masks. Hubris demanded that India was invincible. Home Minister Amit Shah, chief election strategist for the BJP was spending five days in a week on campaign rallies in the five states. By the third week of March, the National Institute of Virology was pointing to the existence of a new double variant strain in Maharashtra. By 4 April, India had exceeded the daily new case load peak of last September. It was registering over a hundred thousand cases with a daily death toll of 700. Active cases went up from 1,45,000 in early February to 800,000 in sixty days, a pace far more rapid than that seen in 2020. TV channels kept the focus on election rallies where neither the political leaders nor the crowds numbering hundreds of thousands wore masks. The Election Commission issued proforma communications to the state administrations to take steps to ensure COVID-appropriate behaviour. No political leader was ever reprimanded for not wearing a mask. Since the Election Commission had allowed political rallies, religious congregations could hardly be curbed. Three million pilgrims a day thronged the Kumbh sites on auspicious days, without masks or any social distancing. No meeting of the National Executive Council, the apex decision making body under the National Disaster Management Act that had been invoked in 2020, was convened between November and March, either to track the behaviour of the virus or to follow-up on implementation of decisions taken in 2020 to augment health infrastructure. There was a wilful neglect of the approaching tsunami because the leadership caught up with politics, turned its back towards it. Temporary COVID facilities set up by central organisations that were lying largely empty since December began to be dismantled earlier this year. Genome sequencing proceeded at a leisurely pace. In 2020, over 9000 sequences had been carried out; beginning January, the numbers dropped to a few hundred a month, making it difficult to identify new strains in a timely fashion. One hundred and sixty six oxygen generating plants had been sanctioned after the 2020 peak but there was little follow up and only 32 had been set up by mid-April. Other than banning exports of vaccines in end-March, no attempt was made to have a re-look at either ramping up vaccine production or accelerating the pace of vaccinations. Foreign vaccine developers that applied for authorisation were told to carry out bridging trials that would take a few months before emergency use authorisation could be given. By mid-April, the reality could no longer be denied.

The tsunami breaks

On 15 April, India crossed 200,000 new cases daily, doubling to 400,000 cases on 30 April, with a total of 3.2 million active cases, and was suffering over 3500 deaths every day. Numbers have exploded in the last fortnight. Health infrastructure has collapsed with oxygen shortages leading to deaths in hospitals. The vaccination rates have dropped from above 3.5 million jabs a day to below 2.5 million, reflecting a looming vaccine supply crunch in the near term. Since 17 April, Modi has been taking nearly daily meetings with his core group of advisers, with the three national task forces that had been set up last year to monitor disease spread, vaccine R&D and production, and medical infrastructure, state chief ministers and has addressed the nation twice. Emergency funding is being provided to ramp up vaccine production. Pending approvals of vaccines already approved for use in US, EU and Russia are being fast tracked. More than 500 new oxygen generating plants have been announced. Import duties of key drugs and vaccines have been slashed to zero. Having used the brahmastra of a draconian lockdown once with damaging political fallout, this option is no longer available. Instead, the states are being urged to create local containment zones. From 1 May, those in the 18-44 age group will also be eligible for vaccination but this part has been delegated to the state governments, except that vaccine stocks are woefully short leading to states refusing to expand the vaccination coverage. Election Commission has banned victory rallies when the results are declared on 2 May; in any case there will be little to celebrate in West Bengal that has seen a whopping 1800% increase in cases in a month. At a national level, India registered a total of 11 million cases over one year and added 7.5 million in last two months. Out of a total death toll of 208,000, one-fourth of the deaths have been added in March and April. From one million active cases during the last peak, India already has 3.2 million active cases and the peak lies somewhere in the future. The tsunami has crashed our shores and it is difficult to escape the waves now.

The collapse of vishwaguru

How did India go from being a vishwaguru and the world’s pharmacy to this when 60 days earlier, the ‘bhakts’ were caught up in a self-congratulatory frenzy of having defeated the pandemic? How did we sleepwalk into a disaster of such magnitude, the worst India has faced since the partition in 1947? The answer can be given in one word – hubris, the fatal flaw in leaders, consumed by arrogance and over confidence. For millennia, whether in the Mahabharat or in Greek mythology, we humans have been warned about the dangers of hubris, of the enormous ability of the human mind to delude itself out of its best interests by the mistaken certainties driven by false pride and over-confidence. If mythology is full of tales about heroes who sought to challenge the gods and then paid for their hubris, history is littered with tragic stories of leaders who ignored the warning signs and wilfully led their people into disaster. Hubris made our leaders blind to what was happening in February in Maharashtra, and later in March and April. The sad part is that denials and lies continue. Inaugurating a number of blood donation camps on 27 April, Dr Harsh Vardhan said that India “is better prepared in 2021 to beat the pandemic compared to 2020.” Such statements fly in the face of the daily reality faced by hundreds of thousands of Indians struggling for even the most basic medical care or even a dignified death. An unnecessary controversy has erupted about the differential pricing of vaccines. A back of the envelope calculation would indicate that if India were to vaccinate 75 percent of its 900 million strong population that is above 18 years, the total number of vaccine doses needed is 1.35 billion. If the government were to procure at INR 200 a dose, it works out to INR 270 billion or INR 27,000 crores. If the large corporates take charge of their employees and families, the amount will go down further. While a large sum, it is less than 0.5 percent of India’s GDP. The PM Cares Fund can be effectively employed for this, ending the controversy surrounding it.

Running a state and governing India

Modi became chief minister of Gujarat in 2001 and from there was catapulted into the position of prime minister in 2014. It was a bitterly fought election, particularly within the BJP about who their candidate ought to be and whether this decision was even necessary a year before the elections in a parliamentary democracy but Modi supporters carried the day. The campaign in 2014 was fought in presidential mode, and Modi came to Delhi with his Gujarat experience and a closed mind. The problem is that he never realised the difference between running a state and being prime minister of a large, diverse federal structure, and consequently, failed to make the transition from being the chief minister of a state to being the prime minister of India. As chief minister, he had ignored the opposition; from 2001 to 2014, on average, he went to the state assembly less than once a year. Second, he ruled Gujarat like an executive governor, not with his cabinet colleagues but through a group of loyal and committed civil servants. Third, he ignored the national media blaming them of bias but effectively controlled the Gujarati press, radio and TV that was dependent on the state for advertisement revenue and access. Finally, when his schemes did not take off, he had a convenient bogeyman; the Centre could always be blamed for misguided fiscal and monetary policies or for damaging India’s FDI opportunities because of unwarranted restrictions driven by crony capitalism. When Modi took over in Delhi in 2014, he often forgot that that the buck stopped with him. He continued to ignore Parliament, confident of his majority till the rude realisation struck him that national parliament proceedings are telecast live and his absence aroused unfavourable comment. He retained an arrogant approach towards the opposition, justified, perhaps, given its diminished presence but contrary to the fundamental precepts of parliamentary democracy. Given his difficult relationship with the Delhi-based national media, he cut himself off from it, adopting the direct communication radio chat Mann ki Baat (straight from the heart) medium. He surrounded himself with a bunch of loyal and committed civil servants to carry out his programs, forgetting that India is a federal country and the Gujarat governance model cannot not be scaled up for such a diverse nation. The results soon began to show. The ill-conceived disastrous exercise of demonetisation in November 2016 reflected his penchant for the grand gesture. It smacked of Indira Gandhi’s political move on bank nationalisation that hobbled the economy for decades. Yet, Modi survived it because he played on the psychology that if the poor Indian suffered, the rich fat cat lost more; the reality later emerged that the fat cat had managed to escape fairly unscathed. The same incompetent planning showed up in the roll out of the GST. His election strategy relied on consolidating the majoritarian vote, through a blend of populism and nationalism. The removal of Article 370, the Citizenship Amendment Act, the Balakot air strike a month before the elections in 2019, are pointers to this toxic but heady blend.

Loyalty above all

Modi is a gifted orator and that gives him both credibility and legitimacy. He used it effectively to win elections, so much so that he is the campaign mascot of the BJP for every state assembly election. For governance, Modi resorted to cleverly coined slogans (sab ka saath sab ka vikas, Make in India, Digital India etc) and slick abbreviations (3 Ds, 5Ts, AMRUT, PRAGATI, SAGAR, UDAN, at last count numbering nearly 50). In 2016, at a BJP national meeting, he received the accolade of MODI – Modifier Of Developing India) coined by his admirers. More appropriate may have been NaMo – National Acronym Manufacturing Organisation. Modi took pride in presenting himself as an ‘outsider’ in Delhi, dismissing the Delhi insiders with mocking references to the ‘Khan Market gang’ or ‘Lutyen’s Delhi’. ‘Merit’ was conflated with ‘elitism’ and loyalty became the criteria of acceptance in the circles of power. The ‘elite’ always knew it was a minority but it also stood for the middle-class ethos of hard work as the road to ‘merit’ and success; now the ‘elite’ was dismissed as the oppressor, and jettisoned alongside were the notions of expertise and merit. Civil servants, judiciary and media fell in line, keeping their reservations to themselves, but for a handful of exceptions. No first-time president or prime minister comes into position with prior experience. Effective and successful leaders grow into their roles but only if they have the tool kit to do so and the humility to accept that they need to grow. Modi has had some policy achievements to his credit but on balance, his reluctance to engage in a consultative process has led him astray more often. He has demonstrated, time and time again, that his skill lies in demagoguery and winning elections, not in translating that skill into effective governance. Modi has made no secret of his visceral dislike for the Nehru-Gandhi dynasty. Yet, his secret ambition is to be remembered as the architect of 21st century India just as Nehru is remembered as the institution building, architect of 20th century India. However, unless he changes his ways, he is more likely to be remembered as the institution derailing, insecure, autocratic “Indira Gandhi on steroids”. Just as the prime minister gets the credit for a successful policy initiative even though many work to make it happen, and Modi has deservedly received praise for his initiatives like Swach Bharat, open-defecation free India or Jan Dhan Yojana, it is at the prime minister’s door that the blame comes to rest for political judgement failures. And it is on Modi’s watch that the current tragedy is unfolding.
The views expressed above belong to the author(s). ORF research and analyses now available on Telegram! Click here to access our curated content — blogs, longforms and interviews.


Rakesh Sood

Rakesh Sood

Ambassador Rakesh Sood was a Distinguished Fellow at ORF. He has over 38 years of experience in the field of foreign affairs economic diplomacy and ...

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