India Fights COVID: Who Is Accountable For Crucial Policymaking and Clearing Confusion?

In the midst of a raging fire, of priority is to douse it and prevent further destruction — not be concerned about its origins and whether it could have been averted. So, despite the temptation to ask ourselves whether the current COVID-19 wave could have been averted, it’s more important to be concerned about — now what?As one scans through news of an enraged and frightened people, exhausted doctors and care-givers, bewildered politicians, and a confused media — hunting for a credible response to questions of ‘how’ and ‘why’ about the second COVID wave — it becomes clear that what is needed at this time is leadership.We need to see someone taking charge and calming frayed nerves.COVID: PM Modi Urges States to Avoid Lockdown in National AddressWhat Effective Leadership Truly EntailsAt such moments, effective leadership requires four key characteristics:Clarity in the goal to be achieved, placing the right people with the authority to achieve it, and providing the required fundingTaking people into confidence on the current realities, and taking action to allay their fears, apprehensions and insecuritiesListening to the critics and those knowledgeable on the subject even if of a different political persuasionTaking decisions and responsibility; inspiring people to do their best without fearIndia has not yet seen leadership that fulfils the above criteria. While the goal is clear, neither policy, funding nor institutional clarity is consistent. For example, containing this infection — that spreads through close physical contact, and now there is increasing evidence of it being airborne — requires people to wear masks and moderate social behaviour by avoiding crowding.But in reality, the political leadership — at both the Central and State levels — allowed elections, the Kumbh Mela, and other similar crowd-gathering activities for political gains that they felt would be compromised if people’s beliefs and practices were interfered with. Or for that matter, the goal of universal immunisation from 1 May 2021, but without clarity on funding and availability.Which Institution Or Authority Is Accountable For COVID Policymaking?Such inconsistencies contribute to more confusion and doubts over the governments’ decision-making abilities.Likewise, several institutions are at once engaged with crafting policy and no one is accountable – the PMO, Cabinet Secretariat, the Home Ministry, the Department of Health, the NITI Aayog, the Department of Health Research, the Ministry of Science and Technology, etc — with all decision-making in the hands of the prime minister (PM) and home minister (HM).Karnataka Govt Issues New Curbs: What’s Allowed, What’s Not?COVID Management: What Led to Huge Delays In Critical Infrastructure & Supply Issues?While centralisation can at times be helpful in ensuring uniformity, it can also add to enormous delays that are unaffordable in fighting fires.So, with the attention of the PM and HM diverted to crucial elections since March 2021 — not unexpectedly — there have been enormous delays in sorting out critical infrastructure and supply issues required for COVID containment strategy — be it timely tendering out of contracts for establishing 110 oxygen plants or the placing of orders to ensure a steady supply of vaccines for achieving the target of 23 crores vaccinated people by end-July.While the causes for delay in finalising the tenders for the oxygen plants is unclear, the shortfall of vaccines is certainly confusing. With the decline in case loads from October 2020 onwards, vaccination was positioned as the solution to nail the virus. Unfortunately, the controversies accompanying the approvals for manufacturing the two vaccines in India did contribute to vaccine-hesitancy, that ought to have been countered by a high-decibel multimedia campaign alongside tying-up vaccine supply.This did not happen. These myriad issues too have delayed availability:Failure to resolve the supply-side issues by helping the manufacturers ramp-up their production capacityFailure in getting into advance purchase agreements with a larger number of manufacturers to ensure a steady stream of vaccines in accordance with a planInability to take up issues with the US government in a timely manner to allow the export of key consumables required for vaccine-manufacturingThese issues seem to be getting addressed now at the prime ministerial level. It seems unlikely that supplies in adequate quantities will become available for vaccinating the younger age groups before July 2021.In other words, until supply is assured, the decision to make the 18+ age group eligible for vaccination from 1 May can only be a headline.If Only India’s COVID Vaccination Was As Sharp As Our ‘Vitriol’When Will Govt Ensure Transparency, Engage With People, and ‘Walk the Talk’?For fighting pandemics, the most critical requirement for the government and for the leadership is transparency and engaging with the people.The communication strategy of this government has been woeful and needs to be hugely stepped-up, a capability that the Department of Health has. Behavioural change cannot be enforced by the police… it has to be brought about by a set of facilitating policies. Penalising a driver in his car for not wearing a mask, but allowing rallies and political meetings without masks immediately creates distrust and non-compliance.The third must-do for this government is to walk the talk of ‘sabke saath’. In the UK, a parliamentary committee was constituted to monitor government orders, policies and implementation of matters related to actions pertaining to COVID-19. Such a committee would be useful to keep the Executive on their toes and lend some accountability, apart from pointing out critical issues for the government on a timely basis.Unfortunately in India, politics has become so acrimonious that even after elections, the adversarial attitudes continue. Non-involvement and exclusion of people and people’s representatives, from issues that are affecting the nation, only fuels suspicion and mistrust that then makes winning the battle against the pandemic seem impossible.It is vital and critical to be united at this time.Not Enough Doses to Meet COVID Vaccination Targets, Data RevealsWhy Union Govt Must Decentralise COVID EffortsFinally, it is important that the Union Government decentralises the efforts to states, districts and panchayats. Without people’s involvement, it is impossible to stamp out the novel coronavirus, that is ‘scared’ of only one thing — an alert people.This would imply that the governments give up their ‘hostility’ to civil society as key partners on the one hand, and the central government releases funds for states to engage the local bodies and civil society to implement a range of interventions — quarantine centres, isolation centres, migrant welfare, delivery of food rations, ensuring timely referral to hospitals, and rolling out vaccines.These cannot be done by governments alone, and much less from Delhi.It’s tough fighting a battle with a hidden enemy. But as the PM said a few months back, it’s a battle that not only needs to be fought, but won decisively.(K Sujatha Rao is Former Union Health Secretary, Govt of India. She tweets at @sujakrao. This is an opinion piece, and the views expressed above are the author’s own. The Quint neither endorses nor is responsible for them.)

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COVID Rages On: Who’ll Take Onus Of Policymaking & Remove Doubts?

Several institutions — PMO, Cabinet Secretariat, Health Ministry, etc — are crafting policy. Who is accountable?

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