Two statements were made by a senior minister and a bureaucrat regarding the criteria for the Indian COVID-19 vaccination programme last week. Union Minister for Health and Family Welfare, Dr. Harsh Vardhan, touted the “success” of the government’s vaccination registration portal, Co-WIN. He tweeted that he was, “Pleased to note our world-class CoWIN platform ensured smooth rollout of beneficiary registration for Phase 3 of the world’s #LargestVaccineDrive. In just first 3 hours: 80L+ people registered, 1.45 cr SMS successfully delivered, 38.3 cr API hits recorded”.
RS Sharma, the CEO of the National Health Authority (NHA), which implements the Union government’s public health insurance scheme, tweeted: “There have been 79,65,720 registrations on Co-WIN today, most of these in the last three hours (16:00-19:00) and mostly of 18-44 age group. We have seen a traffic of 55,000 hits per second. System functioning as expected.”
In addition to numerous public health problems in India, it also suffers the tyranny of vanity tech metrics. No number of API hits changes the fact that India is facing an acute vaccine shortage with a majority of states putting off their vaccination plans to a later date. Those who were able to register themselves on the CoWIN app and website had little to cheer as they were told that there were no vaccination centres nearby or could not get a confirmation for an appointment.
There is blind faith on a magical technology fix for all the ills in India. The belief of “there’s an app for that” permeates every level of decision-making in the government. This tech solutionism often creates hollow impressive numbers, but masks the actual scope of the problem and also whether or not the solution is actually addressing the said problem.
Consider this 2018 statement by Nandan Nilekani, Chairman of Infosys and an advisor to several technology groups in the government, who advocated that Indians could monetise their data to get better healthcare and publicised his vision of “data empowerment”. Privacy, informed consent, and public health infrastructure concerns can take a back seat. This “data empowerment” doesn’t build more hospitals, primary healthcare centres or any other infrastructure needed to respond to a public health disaster.
Another obsession that drives technology decisions is the insistence on using Aadhaar biometric authentication, despite a growing mountain of evidence that it is flawed and leads to large-scale digital exclusion. Bureaucrats do not seem to understand a simple logic that is inherent in biometric systems—the very natural and human phenomenon that a person’s biometrics change and that people age. Updating systems with the latest biometrics is an arduous task and incredibly invasive to one’s privacy. Last month, when India was recording more than 300,000 COVID-19 cases every day, both Mr. Nilekani and Mr. Sharma were pushing a government project for the use of facial recognition for vaccination. But it begs the question whether it would actually help in increasing vaccination numbers? Would people be turned away from vaccination if the facial features do not match record files? Would people be turned away if biometric scanners can’t be connected to the internet due to poor connectivity in the hinterlands? One can’t help but wonder if the resources for this project could have been used to shore up for other needs in the crisis. Technology solutions cannot fix problems of public health infrastructure. Only public health infrastructure solutions will work for public health crises.
In the technology world, there is always an emphasis on reducing “friction” in the real world. But, the technology solutions for containing COVID-19 in India are only erecting barriers. It seems that the government and CoWIN team haven't learnt lessons from the failures of the contact tracing application, Aarogya Setu. Though there is much to cheer with India’s story in telecom penetration, there still exists a very stark digital divide with a majority of the population unable to access these services.
India has more than a billion mobile connections, but the number of mobile connections are not equal to the number of unique users as India has a multi-SIM culture with each user having multiple connections. Further, it is estimated that the number of feature phone users is about 550 million. Feature phones can’t download the CoWIN or Aarogya Setu applications and aren’t connected to the major app stores. Smartphone penetration in India is still not universal and a majority of the population can only afford feature phones and only use 2G services.
Trust in the Aarogya Setu application is in tatters as social media is littered with examples of how users are shown that they are safe and that there are no COVID-19 cases nearby, despite entire cities and neighbourhoods being shut down by the virus and crematoriums overflowing with the dead. One of the glaring faults with Aarogya Setu is that it requires users to be “honest” with their COVID-19 symptoms in their questionnaire and update it constantly. However, the social costs to being honest about medical conditions is too high as the trust in the medical system has fractured. E-commerce delivery personnel are still mandated to have the application installed on their mobile devices even as many fall to the virus. For the application to work, it requires personnel to update their symptoms honestly and the costs of being honest if symptoms manifest require them to take time off from work to recover which in turn hurts their income. Faulty data on every level gave a false sense of security and led us into the second wave. Such data tampering on COVID-19 infections and deaths will only exacerbate the situation further.
Trust in the digital world is inextricably linked to utility, i.e., people trust systems that work as intended. Any new technology solution proposed by the government will be wise to pay heed to this tenet. CoWIN risks making the same mistakes as Aarogya Setu with more people becoming more distrustful of the vaccination drive as citizens do not get appointments or are turned away from vaccine centres due to shortage of jabs. The need of the hour is to procure vaccines and distribute them freely to all. The Health Ministry’s strategy of containment, and not elimination, has failed. Universal vaccination is the only way out and no one is safe till everyone is safe. It is the only way to prevent the formation of new mutant strains.
In the march towards universal vaccination, citizens should not face digital exclusion and the requirement of registration on the CoWIN app for a vaccine must be scrapped. Registration and details of people can be collected at the vaccination centres itself. The reliance on technology is becoming a hurdle. At this point in time, it is not a question of keeping track of appointments and registrations, it's just making sure that there is a record of people getting two vaccines. When people come to a vaccination centre, they can create an ID which keeps a vaccination record. Basic Know Your Customer (KYC) using Aadhaar, driver’s licence, voter’s registration card, PAN card, and passport can be used to capture details. More resources need to be dedicated for follow-ups for the second round of vaccination with calls and ground teams. There are lessons to be learnt from India’s successes with polio and smallpox eradication, which did not use modern day tech, but combated the diseases by building institutional capacity and a drive to eliminate these viruses.
Technology interventions must be imbued with human moral frameworks and its goal should be the enablement of humans. Tech that stands in the way of betterment of fellow humans must be rejected. The need of the hour is a compassionate government which can provide relief to people suffering during this tragedy. The mishandling of this pandemic in India was due to concessions made for political and religious gatherings. It has been made worse by the infighting between central and state governments. An inordinate amount of effort has been spent in trying to manage headlines, which would be better spent on helping people in distress. Statements made by ministers, officials, and lawyers representing the central government in various cases come across as heartless, which do not acknowledge the grim situation on the ground. These values must be kept in mind while dealing with the pandemic, especially when touting tech as a solution when it is actually creating more problems.
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Shashidhar K J was a Visiting Fellow at the Observer Research Foundation. He works on the broad themes of technology and financial technology. His key ...
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