The HINDU Notes – 04th May 2020 - VISION

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Monday, May 04, 2020

The HINDU Notes – 04th May 2020

📰 ‘Economic recovery may take over a year’

Allow high performing districts to resume all industrial activity, says CII(NOTE from writer: This story is embargoed for publication until Monday, May 4, so it should not be carried online until midnight. Also, data for graphics is available in the attached document on the CII poll, if needed.)

•The country’s high performing economic districts should be allowed to play by different rules in the third phase of the lockdown beginning on Monday, according to the Confederation of Indian Industry (CII).

•In a strategy paper submitted to the Centre on Saturday, the CII called for changes in zone classification, saying that the 100-150 districts with the highest economic value — identified either through GDP contribution or density of industrial clusters — should be allowed to restart industrial activity, even in containment areas, if stringent rules are followed. It argued that the cost of 100% testing and aggressive health protocols is lower than continued shutdown in these areas.

•In a CII poll of 300-odd CEOs released on Sunday, almost half said an economic recovery would take over a year. More than half foresee job losses. Three out of four participants identified the complete shutdown of operations as their biggest problem, followed by a lack of demand, supply and distribution chain woes, and a credit crunch.

•In such a situation, the industry body argued for a calibrated exit from the lockdown in the country’s most crucial economic regions.

•Within these districts, small restricted areas such as the actual street, mohalla , building or industrial complex where COVID-19 cases have been identified should be treated as containment zone. An area of about 500 m radius around these areas should be treated as orange zone. The remaining area of the district should be classified as green zones.

•The CII suggested that full industrial operations could be restarted in these priority districts, even within containment zones, if aggressive door-to-door testing, or group testing covering 100% of the population is carried out, and stringent sanitation and distancing protocols are followed.

📰 BRICS against COVID-19

The New Development Bank’s financial model can become a template to address natural disasters

•In the global war against the novel coronavirus, emerging economies, many belonging to BRICS, have reached out to other countries humbled by the pandemic. India has reinforced its credentials as a rapidly emerging pharmacy of the world. As the world’s largest producer of hydroxychloroquine, India has recently exported the drug not only to SAARC countries and to its “extended neighbourhood” in the Gulf, but also to Russia, Brazil, Israel and the U.S. This has set the stage for India to forge an inclusive BRICS-driven pharma alliance, which could also actively explore the production of vaccines.

Workshop of the world

•Despite allegations that it had delayed sounding the alarm about COVID-19 infections that had broken out in Wuhan, China has, subsequently, responded strongly in containing the pandemic, leveraging its position as the workshop of the world. Notwithstanding teething problems and quality concerns, China has steeled the transcontinental response to the disease by providing the “hardware” — masks, gloves, coveralls, shoe covers and testing kits — to hotspots across the globe. Under its Health Silk Road doctrine, the Chinese reached out to two of the worst global hotspots, Italy and Iran. A Chinese shipment of 31 tonnes, which included essential supplies and equipment, including respirators, protective suits, masks and medications, arrived on March 12 in Rome. Six days later another Chinese team flew directly to Milan. Soon China was running a medical air bridge bound for Europe.

•Despite fighting the virus at home, Russia too sent its doctors and virologists overseas, including the launch of the famous ‘From Russia with love’ air mission to Italy. At the request of U.S. President Donald Trump, a Russian Antonov-124, packed with medical supplies and experts, landed at New York’s John F. Kennedy International Airport. Since Soviet times, Russia has top-of-the-line emergency services, which are equipped to handle any kind of emergency including biological attacks, nuclear radiation, and chemical weapon attacks.

•On the African continent, South Africa, the current rotating head of the African Union, is engaged in framing a pan-African response to COVID-19. Among the BRICS nations, only Brazil’s response may need a course correction, as its resistance to breaking the infection chains through travel bans, lockdowns, isolation and testing appears to have led to an infection surge.

Time to coordinate efforts

•Having demonstrated their comparative strengths as providers of Humanitarian Assistance and Disaster Relief (HADR), BRICS countries now need to pool and coordinate their efforts, in partnership with the WHO, and Europe and North America, both badly affected by the pandemic, as part of a global assault on the virus. But for seeding a robust institutional HADR response, the BRICS countries may have to reactivate an existing disaster response mechanism, and earmark resources and assets to combat a whole range of natural disasters, with special focus on the emerging economies and the global south.

•The Shanghai-based New Development Bank of the BRICS countries has already demonstrated the way forward to allocate financial resources to combat COVID-19. In April, during a meeting of the NDB Board of Governors, NBD President K.V. Kamath announced that apart from disbursing a $1 billion emergency loan to China, and subsequently to India, South Africa and Brazil, the NDB had the financial heft to provide $10 billion in “crisis-related assistance” to BRICS member countries. The NDB’s financial model, demonstrated to address the pandemic, can now become a template to address natural disasters.

📰 India’s disease surveillance system needs a reboot

There is enough reason to fear a combination of COVID-19 with existing illnesses and medical complications in India

•In a recent press briefing, the Ministry of Health and Family Welfare reported noticeable trends with respect to COVID-19 cases in India. Its data shows that 75.3% of deaths have been concentrated in the age group of 60 years and above, and in 83% of deaths, the deceased were battling pre-existing identified health conditions. Evidently, we have reason to fear the novel coronavirus for which we have no established cure. However, there is even more reason to fear a combination of COVID-19 with existing illnesses and medical complications. The disease is lethal for those with compromised immunity brought on by age, existing respiratory infections, or essentially, malnutrition. In technical medical terms, this is a situation of comorbidity, which in ways makes it difficult to differentiate between dying of COVID-19, or, dying with COVID-19.

Issue of disease watch

•In comparison to many western countries combating the disease, India appears to have the advantage of a relatively young population. This is, of course, negated by the poor health conditions of the vast majority of Indians. It is then imperative that we do not ignore already prevalent diseases and illnesses. Unfortunately, the recent experiences of the public health-care system in India indicate the side-stepping of precisely this issue.

•There are many among the poor who are battling various diseases but now have little access to major public hospitals in the wake of the lockdown. Routine functioning, particularly of out-patient department services in public hospitals, has been severely affected, and largely, emergency cases are being entertained. Patients now complain of even greater high-handedness of hospital staff in the still functioning emergency intensive care unit, labour rooms, tuberculosis (TB) wards, etc. Ironically, cardiology and neurology departments that cater to elderly sick patients are turning away many in the bid to streamline “critical” cases. In such circumstances we can expect an aggravation in the poor health conditions already affecting large sections of people who have limited access to health-care services.

•Let us scrutinise this issue more closely. Many of the adverse medical conditions prevalent among the vast majority of our country are not even identified due to the lax disease surveillance system. The failure of disease surveillance requires explanation. For one, a significant number of the infected (poor and marginalised people) do not have access to health-care facilities and so fail to report their condition to certified medical practitioners. Even when an infected person has access to such facilities, their clinical case does not always culminate in the required testing (blood/serum, throat swab, sputum, stool, urine). Third, there is a widespread practice among pathological laboratories to categorise diseases on the basis of the pre-existing classificatory system, which results in failure to identify the definitive cause (aetiology) for an illness by differentiating and separating pathogens (disease-causing microorganisms) on the basis of variations in groups, subgroups, strains, etc.

Silent epidemics

•There is, consequently, pervasive non-identification of a definitive cause behind a number of illnesses. Many ailments are simply clubbed together and referred to by generic names such as ‘Respiratory Tract Infection’ (RTI), ‘Urinary Tract Infection’, ‘Acute Febrile Illness (AFI)’, ‘Acute Undifferentiated Fever’, ‘Fever of Unknown Origin’ (FUO). Certain of these undifferentiated illnesses are known to affect lakhs of people every year worldwide. They claim many lives, especially of the poor who are victims of low immunity and have limited access to health care. Sources claim that RTI kills over 900 people in India every day. Likewise, Acute Lower Respiratory Tract Infection (ALRTI), which affects mostly children below the age of five years, has been known to infect approximately 3.40 crore people every year worldwide. In recent years it has led to roughly 66,000 to 199,000 deaths. Shockingly, 99% of these deaths are reported from developing countries, and India has a larger share in it. The large number of hospitalisations, enormous deaths and suffering caused by contagious undifferentiated diseases indicate the prevalence of persistent but undeclared silent epidemics.

•Even if the definitive cause of an illness is identified, it does not necessarily gain the focused attention of scientific research. As the disease evolves but “interest” in it remains fleeting, the differences developing in the sub-groups, strains in genotype of the pathogen concerned fail to be consistently tracked. Knowledge of the pathogen, and, consequently, the required disease control soon lag behind. This overall process is due to the selective, biased approach of mainstream scientific research that is driven by the profits of private pharmaceutical companies, and is the fallout of the lack of priority that governments assign to general health care and diseases of the poor.

•Even when the identity of a contagious disease and its treatment are well known it does not mean that the disease’s prevalence will generate the necessary reaction. TB is a suitable example. According to public health experts, one person in every 10 seconds contracts TB, and up to 1,400 people in India die every day of the disease. This indicates that TB has a R0 value (basic reproduction number) and fatality rate that is way higher than those attributed to COVID-19 so far. However, it is important to note that TB and many other contagious diseases are ignored as “ordinary”, and elicit very low attention. In contrast, some diseases are quickly identified as epidemics of greater public concern.

•Diseases are being selectively discovered and have the propensity to be identified as an epidemic when they have a signalling effect for the scientific community. In a majority of instances, it is only when there is a threat of transmission to the well-to-do sections of society or wealthier regions that the disease actually has such a signalling effect. It is not a coincidence that a relatively downplayed disease such as TB is largely a poor man’s disease.

•Clearly, we are confronted by a skewed relationship between our ways of knowing (social epistemology) and epidemiology. It is precisely in this context that COVID-19 has gained singular prominence over several other lethal diseases. Importantly, pre-existing diseases have the potential to combine with COVID-19, and with devastating consequences. It becomes imperative to identify the comparative fatality rates of many of the silent epidemics, which in their own right require urgent attention.

📰 Pandemics without borders, South Asia’s evolution

Rather than deliver an autocratic wasteland, the epidemic should be an opportunity to transform the region’s politics

•Even if the COVID-19 pandemic spares South Asia the worst impact it has reserved thus far for the northern latitudes, it is certain that this region of nearly a fourth of the global population will be wounded gravely — economically, and as the process unfolds, socio-politically. Holding the largest volume and density of poverty in the world, the countries of South Asia are looking into an abyss of distress and discontent.

Dire sign

•As the region from the Indian Ocean to the Himalaya is hit by recession, more than half a century’s effort against poverty could be wasted. The coddling of the middle class and neglect of the majority underclass, so starkly seen during the pandemic response, points to all that has gone wrong in our electoral democracies; no country of South Asia is presently a formal dictatorship.

•Amidst our separate insularities, South Asians should take the pandemic as a wake-up call beyond public health, on ills ranging from plastic pollution to global warming, extinction of species, hijacking of the commons, dirty water, toxic air, a weakening of the welfare state, infrastructural exceptionalism — and the rapid conversion of our demographic diversity into the worldwide sameness of a suburban mall.

•If we fail to act, the COVID-19 episode will be but an interlude as we wade further into the Anthropocene quicksand. You can see the return to ‘normalcy’ in the aircraft tracking apps that show China’s airways bustling once again, as they were before the coronavirus radiated out from Wuhan.

•As a dire telegram sent by Earth to Humanity, COVID-19 has laid bare the demagoguery that marks the democracies of South Asia. The response of the regimes has been to entrench themselves further, and they are shifting blame on mal-governance to the pandemic even as they tighten state control through surveillance, repressive laws and radical populism backed by ultra-nationalism.

•The public’s fear of the virus is allowing Presidents and Prime Ministers to press on with top-down rule, whereas the lockdown should be the time to generate momentum towards federal devolution and Gandhi’s empowering ‘gram swaraj’ — a term that must be revived without a sense of embarrassment.

•In Sri Lanka, President Gotabaya Rajapaksa takes advantage of COVID-19 to grant pardon to a war criminal. In Pakistan, the Army has Prime Minister Imran Khan against the ropes, and Nepal’s political class uses the pandemic for political adventurism and Prime Minister K.P. Sharma Oli engages the military to carry out key COVID-19 tasks, from buying protective gear to contact tracing. The virus has solidified the foundation of Sheikh Hasina’s one-party rule in Bangladesh.

•India’s continent-sized polity craves federalism, but COVID-19 has energised Prime Minister Narendra Modi’s centralising mission. His Hindutva-backed, Pakistan-focused ultra-nationalism creates a web of control that strengthens Mr. Modi but weakens India. After a series of polarising actions from Kashmir to the Citizenship (Amendment) Act, we watch unbelievingly as Islamophobia is injected into the pandemic response.

•The majoritarian attitude exhibited by the state, mass media and social media towards India’s 200 million Muslims will before long transfer to the Dalit, tribal and Adivasi communities, and the underclass as a whole. The anti-poor imperiousness seen in the demonetisation of November 2016 was evident also in the four-hour notice given for lockdown on the night of March 23, in a country of more than 350 million workers, many of whom are internal migrants. Since Mr. Modi shuns unrehearsed encounters, journalists and academics are not able to challenge him about the fabric of India that is tearing.

Soft power

•The reason to talk at length about India within South Asia is that the country comprises much of the region by population and geography. Further, the actions and the omissions of India impact each neighbour. While all the other capitals have adversarial positions vis-à-vis New Delhi, however, it is also true that modern India has been aspirational for neighbouring societies — till now, that is.

•The trajectory of India, with its galloping centralisation, removes governance from the people’s reach. There was a time, decades ago, when New Delhi’s messaging was limited to promises of ‘ roti , kapda aur makaan’ , but ever more populist slogans were required to maintain command. Hence, the strident Hindutva-laced nationalism, which can only divert attention of the huddled masses, not spread prosperity nor social justice.

•In both India and Pakistan, the two large countries of South Asia, ending insensitivity and inefficiency in governance require power and agency to pass to the provinces/States. Self-correction is only possible in smaller, devolved polities. As has been seen during the ongoing crisis, the States of India have risen to the occasion and are seen to be more caring, for the simple reason that they are closer to the ground and more accountable.

•India has shone in the world because of its soft power, defined by a textured history, empathetic open society, “scientific temper” and Gandhian legacy. India simply cannot succeed as a hard power, which is why under the Bharatiya Janata Party-Rashtriya Swayamsevak Sangh, the country is losing the very values that command respect abroad.

•If India were an internationally confident nation-state, as in decades past, it would have used its clout to lobby and build demand for a sitting of the UN Security Council to discuss the global security threat represented by the COVID-19 pandemic. India is also weakened internally by the New Delhi intelligentsia’s China fixation, which must be overcome. Unknowingly or with deliberation, New Delhi seeks to copy-paste Beijing’s centralism as well as its xenophobia, both of which are bound to backfire in a country whose historicity and circumstances are quite different.

A reformatting

•The unflinching lack of caring for the citizenry by governments in South Asia can only be reversed through a formula that incorporates the internal and external to the nation-states, a reformatting of relationships. Internally, power must devolve from the capital to the provincial units of the two larger countries (Pakistan and India), as well as empowerment of local governments all over (as done in Nepal under the 2015 Constitution, but not yet fully implemented).

•Externally, the countries of South Asia must bring down the hyper-nationalist mind barriers to allow porous borders, thereby reviving historical synergies in economy, ecology and culture. This is essential for both social justice and economic growth, and cannot happen without a palpable reduction in military expenditures that will come with abandonment of the national security state.

•South Asian regionalism requires resuming the evolution of the subcontinental polity that was terminated in 1947 with Partition.

•Regionalism would lead to collaborative battles against pestilence, and for wealth creation through trade, comparative advantage, and economies of scale. Regionalism would help fight plastic pollution in our rivers, battle the air pollution that wafts across our frontiers, promote cooperation in natural and human-made disasters, and boost the economies of the geographical “periphery” of each country.

•The push for South Asia-wide thinking and planning need not be seen as a malevolent attempt to subvert India. Instead, it is the path for India’s own socio-economic advance, and the way to garner international recognition of its soft power. Internal devolution and cross-border bonding has always been a necessity but impossible for some to contemplate. Hopefully, the shake-up of the COVID-19 pandemic will succeed where past exhortations have failed.

•The opinion-makers of India — economists, political scientists, philosophers, sociologists, diplomats and others — have tended to be New Delhi-centric, and, as a result, downright reluctant to address issues of both federalism within and regionalism without. They have thus far been unable to see the jungle for the trees.