Event ReportsPublished on May 08, 2020
Good opportunity to rethink public health: Former Revenue Secretary
Former Union Revenue Secretary, M R Sivaraman, is of the view that “it is clear we have entered a new world order” following the Covid-19 Pandemic. Initiating an online discussion on Covid-19 titled “Lessons learnt for the future”, organised jointly by ORF Chennai Initiative and the Madras Management Association (MMA), on 23 April 2019, Sivaraman outlined the major dimensions which needed to be deliberated when analysing the impact of COVID-19, namely, the political, social, medical/health and economic dimensions. Beginning with the political dimension, Sivaraman believed that the sentiment behind the aphorism “that government is best which governs the least” is no longer relevant. In times of crisis, governments are invariably thrust to the forefront as seen during the 2008 global financial crisis. “Today with the pandemic, governments have entered the area of private individual management, and it is very much a case of government which governs the most. Governments are going to play a greater role in the years to follow,” he observed. Given this new political scenario in which governments will increasingly wield enormous power, “it is extremely important that there is more transparency, and more accountability, he remarked.

New world order

Sivaraman explained that going forward, the world will seem a very different place.  Processes and practises that were once the norm will have to be looked at through a new lens. “Globalisation will not be the same anymore. People will travel much less,” he said. Passenger-traffic which has been increasing every year will drastically drop. He said self-sufficiency and self-reliance will become new goals, as inter-dependence and inter-connectedness of the global economy will be reconsidered. Industry will look to break long-distance supply-chains and countries will work at becoming self-reliant, particularly with regard to medical equipment and pharmaceutical drugs. “Both governments and multilateral organisations such as the WTO will need to review agricultural policies, particularly their rules regarding food reserves for the purpose of meeting a disaster, while keeping food security in mind,” said Sivaraman, who was also a former Executive Director of the International Monetary Fund (IMF). In India, on the positive side, Sivaraman pointed out, the pandemic has given the Central Government an opportunity to begin consulting with State governments on issues related to health. “Ultimately, it is the State government that works in the field and therefore it is very important for the Central Government to consult the State in all matters of national importance. This is happening right now, for instance with Prime Minister Narendra Modi’s video-meetings with Chief Ministers.” Sivaraman also underlined the importance of governments at the Centre and in the States consulting members of the political Opposition. “This is a very good beginning for India. Such consultation between the Centre and State should be institutionalised,” he recommended.

Social behaviour and interaction

Looking at the social dimension, Sivaraman said the pandemic had presented India with an opportunity to change social behaviour and social interaction. He believed that as a result of surviving mass destruction and devastation due to two World Wars, the citizenry of most countries in Europe had a strong sense of civic responsibility and civic discipline, which he regretted was lacking in India. This resulted, among other things, in unenviable social behaviour in public settings, such as people aggressively jostling for space and/or jumping queues at airports, railway and bus stations. The current need for maintaining social distance he hoped will give people the opportunity to appreciate better discipline in social settings. However, he added, it was also important for governments to ask why people behave this way. Often it was due to lack of space. If maintaining social distance is to become the norm in the future, the Centre will need to think about redesigning bus stops, airports, railway stations. “They will have to ensure there is enough space to stand so as to allow for contactless interaction in public at all times.” he noted. “Certain social behaviour should be made punishable by law, such as spitting in public. Enacting such laws will not just be beneficial to individual hygiene but society at large.  Personal well-being and civic well-being are closely intertwined,” he said. It was important for children to learn such discipline at a young age and to this end he recommended schools offer a weekly lessons on social discipline and social interactions which could cover such topics as how to behave in society, how to respect public spaces, how not encroach on another’s personal space, the importance of maintaining distance etc.

Public spending on health

Moving on to the health dimension, Sivaraman remarked, “India’s public expenditure on public health has been dismal.” While the global average for public health is 10 percent of the GDP, in India it is 1.2 percent. The intensity of the coronavirus pandemic has highted this flaw and also provided a good opportunity to rethink public health. Ideally, the budget should continuously increase expenditure on public health every year, he stated. Sivaraman recommended that every government hospital needed to have an infectious diseases ward and that the Government ought to start planning for this going forward. “They may need to increase taxes for it, but they shouldn’t hesitate to do so for improving public health in this manner,” he said. Sivaraman felt strongly that while health is a state subject it should come under the ‘Concurrent List’ of the Constitution, for both the State and Centre. He referred to the Srinath Reddy Commission which had concluded that every citizen should be provided with national health insurance and that crucially the government should finance this through the budget. “I don’t know if we will reach that level but a healthy citizenry will ensure a healthy country. I would strongly advise the GoI to have a national health policy in consultation with the State government,” he said.

SOPs for industry

“When one looks at the overall economic situation, there is utter confusion everywhere, this is not just in India but all over the world.” Several questions remain unanswered, such as, how should industries be regulated, how should they restart after the shut down? Should they have been shut down so abruptly? Was it necessary for all industries to come to a complete shutdown? There is an urgent need for GoI to put together Standard Operating Procedures (SOPs) for every industry. Sivaraman explained that though industries would have put together SOPs for emergencies, he doubted they would have considered the complexities of functioning during a pandemic.  He recommended that the GoI, CII and other Chambers of Commerce needed to work together on SOPs. “The National Disaster Management would not have considered a pandemic. It would have only considered earthquakes, floods, fires, cyclones but never a pandemic of this kind” he reflected. He strongly recommended that essential training be given to the IAS & IPS on how to handle pandemics. In addition, he felt Chief Ministers would also benefit from such training. However, these could be more short-term courses, 2-3 months which could be provided at the IIMs around the country, he suggested. On the economic front, leadership was more important than anything else, Sivaraman noted. “GoI had been effective so far. Though there have been inefficiencies and delays these are normal.” The biggest setback however, was with regards to the migrant workers. This was regrettable, as “there is enough regulation and legislation to take care of such problems, relating to various aspects of their well-being such as providing them with medical facilities, proper food and even transport facilities” pointed out Sivaraman.

Tourism and aviation

Tourism which employs billions of people around the world is going to be affected severely. “I don’t think it will recover…tourism will not be same as before.” Sivaraman suggested GoI consider charter flights for tourists, where passengers are given thorough health check-ups beforehand and only those who have clearance are allowed to travel. GoI will need to look at tourist spots and rethink policies in terms of hygiene and cleanliness. In order to provide stimulus to the aviation industry, Sivaraman said, “first, aviation fuel must be brought under the GST, and the rate of tax will go down and this will bring enormous relief.” Second, some reduction on parking and navigation charges should be worked out with the private airports.

Package for MSMEs

GoI needs to provide packages for its industries. In the US, the Congress approved an $310 billion emergency loan programme for small businesses impacted by the coronavirus pandemic. “GoI needs to think about the MSMEs and may need to announce a similar package as the US. Interest on loans in the MSME sector could be waived and borne by the central government. In fact, we should also take on the responsibility of extending the period of the loan”, Sivaraman suggested. Indian banks and Indian industries need to work in consultation, he added. Looking at the future, Sivaraman said, working from home will become the norm in most sectors. This will affect the construction industry but in the long term it will balance out. However, it is unlikely that governments can work remotely, as they need to be visible and to make their presence felt. “This is the right time to look inwards for the GoI, remove red tape, particularly around the unemployment insurance scheme,” he concluded.
This report was written by Dr. Vinitha Revi, Independent Researcher, Chennai
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