Efforts by India to address the COVID-19 health pandemic seem to be yielding positive results.
The nationwide lockdown, now extended until 3 May 2020, is helping to contain the spread of the virus. One could argue that we are not testing sufficient numbers of people to find out the real truth. But it would be very difficult in a democratic country like India to conceal serious cases should outbreaks occur even in remote rural areas - given how proficient people are across the country in the use of mobile phones for messaging.
Steps taken by the Governments to augment resources for health care are beginning to yield results. Manufacturers in India have begun producing PPEs, face masks, gloves and other essential equipment need for protection of health workers and the medical community. The speed and agility displayed by the government and the private sector is commendable.
Greater efforts need to be made to ensure adequate supplies of sanitary napkins, contraceptives and several other hygiene products – now listed under essential goods.
We need to intensify efforts to spread awareness on how people (and women in particular) can access to health information and services. Innovative measures have been taken by both governments and the non-government sector to fight misinformation, myths, misconceptions and superstitions.
However, with the exception of states like Kerala, we see much less clarity and determination in governments to deal with the economic pandemic. Millions of Indians are staring at starvation and job losses because of the complete shutdown of the lockdown.
Newspaper reports and photographs reveal the plight of stranded migrant workers and those living in quarantined shelters. It is extremely sad to see dignified people lining up to receive food packages. It is difficult to even assess the humility and loss of dignity they must be experiencing.
The silver lining is the extraordinary efforts of several individuals and non-governmental organisations that have taken on the responsibility of providing food to stranded workers and helpless families.
The time is now to focus on the threat to livelihoods faced by millions of workers in the informal sector that accounts for close to 90 per cent of our national workforce. From all accounts, the immediate future does not look bright for a majority of them.
Several concerned Indians including economists, social activists and public policy specialists have made suggestions on what needs to be done. A common plea is to treat this as a human emergency, relax norms of conventional public finance, and not worry about fiscal deficits. Putting aside the issue of finances for now, there are at least four urgent actions that need to be taken without any further delay – and over the long term.
Four Short-Term Steps to Take
- Food: There is no option but to distribute foodgrains free to the millions of households that face the threat of starvation. Such families simply do not have cash with which to buy even the regular allocations of subsidised food through the PDS – let alone higher allocations that are being announced to take care of the COVID-19 crisis. Fortunately, India has sufficient food stocks to be able to do this. The second food intervention has to be for the governments to set up community kitchens for free distribution of cooked meals to everyone who walks in.
- Cash Grant: Foodgrains alone are not going to be sufficient for families to survive. It does not require much imagination to figure out what more besides say rice or wheat is needed if you are running a kitchen at home. There has to be a massive ramping up of unconditional cash transfers that are being announced. While several channels for cash transfers are being explored, MGNREGA account holders seem to be forgotten.
The possibility of transferring cash into the bank accounts of MGNREGA workers must be examined and implemented as an interim measure – even if there is no work to do.
- Safe places for quarantining people: An urgent need is to intensify the efforts that state governments are making to get ready centres for quarantining people. Equipped with water-cum-toilet facilities and bathrooms, stadiums in cities are an obvious choice for setting up such centres. Whether they eventually get used or not, this is the time to be prepared with sufficient such facilities.
- Safeguarding health centres and hospitals: Let us not forget that every day several thousands of people access health centres and hospitals for very many ailments that require medical attention. It is difficult – and unfair – to stop people’s access to medical care at such centres. Immediate steps should be taken (as has been in some places) to screen people entering such health centres for the COVID virus. If not, we are likely to face the closure of several hospitals and health centres – which would be a tragedy.
Four Long-Term Steps to Take
- First, the State must resolve to step up public investments in health. COVID has exposed the extremely brittle state of India’s health infrastructure. It is unfortunate that while a growing yet small segment of the country’s population has access to the best medical care, a sizeable proportion is still left to seek care from poorly trained, unscrupulous and unqualified private health practitioners. The COVID experience should remined us that efforts of the State health systems are what is keeping the pandemic from spreading. Almost every country in the world that has achieved close to universal health coverage has done it by investing in a strong public sector in health. India can’t be an exception. This is the time to make the political commitment to establish over the next five years one of the most robust public sector driven health care systems in the world.
- Second, the State must resolve to put in place a robust social protection system. It is paradoxical that while on the one hand we take pride in being able to launch space crafts to Mars, we are also struggling to provide for the basic social security of a large majority of informal sector workers. COVID has exposed the plight of the ‘unorganised worker’ – a term that should include home-based workers, self-employed workers, daily wage earners, migrant workers employed in construction and other industries, and everyone else even in the so-called organised sector who does not receive social protection benefits. Proposals for instituting a universal system of social protection should be re-examined and implemented as a priority.
- Third, job creation has to become a national priority. It is inevitable that short run disturbances will give rise to unemployment. Not finding such jobs is adding to the mental and psychological anxieties of young people – something we seldom factor into assessments of well-being. While a long run blueprint for job creation can be developed, India also needs to address the main root cause of the problem: a broken education system. India faces a crisis in both school and higher education.It is unfortunate that a large proportion of children go through school without acquiring basic competencies. No amount of investments in skilling can compensate for this shortcoming. The Central and State governments must pledge to invest adequately to transform India’s government school system for a start.
- Finally, the experience of dealing with COVID highlights the critical need for changing social norms and behaviours. Women have been facing the brunt of the COVID lockdown. In addition to the usual domestic chores, they now have the additional responsibility of looking after the family 24 hours a day. Men in most families hardly share domestic work with the women. On the contrary, it is worrying to read reports of increasing violence against women during the COVID lockdown. As a society, this is unacceptable. The long term solution lies in investing creatively in initiatives that seek to change social norms and behaviours. The best talents in the country must be mobilized to
None of these actions, both in the short run and in the long term, can be executed without a strong partnership between Governments and civil society organisations. This is the time for governments to harness the rich Indian tradition of voluntarism and social action to restore the livelihoods and dignity of the millions affected by COVID.
(Poonam Muttreja, Executive Director of Population Foundation of India)
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