PolicyWTF: April Is The Cruellest Month
This section looks at egregious public policies. Policies that make you go: WTF, Did that really happen?
It is difficult for us to write this edition with clarity. India is living through a dystopian nightmare that’s operating on two different timelines. In one, there’s whir of the virus raging across it leaving behind a trail of cremation pyres and plumes of smoke. Time fleets past on the X axis of many graphs that have reduced ordinary Indians into mere statistics on an exponential curve. On a different timeline is our policy response. Lumbering, reactive and unable or unwilling to anticipate the future. Here time is space. Infinite and uncalibrated. Where it can wait for inauguration ceremonies of hospitals, for department of legal metrology to waive approvals for import of Oxygen concentrators and for election commissions to clamp down on celebrations after election results.
Ordinary Indians are going about their lives between these differently paced worlds.
Public Policy Saves Lives
We are often asked about the point of discussing public policy. How does it make a jot of difference? The answer is all around us today, unfortunately. The virus might be an act of nature. But what about our response, or the lack of it? The basis for organising ourselves into a community or surrendering a few of our liberties to the state was to safeguard ourselves from the worst instincts – of human and of nature. Not caring about this fundamental role of the state and the society is not an option. We are here because of public policy failure at all levels of governance. But there’s also the collective failure of not concerning ourselves with policy while choosing or when holding the elected to account. Of letting primeval passions of identity and ideology guiding our choices.
We wrote in the last edition (“Flailing Again”) about the three public policy measures that would have been apparent in mid March 2020. Implementing them might have helped avoid our current plight. We arrived at them based on the ‘knowns’ at that time without the benefit of hindsight we have today. We argued this was all that was needed to be done. Yet we bungled on them. We received a mail from Prof Ajay Shah in response to that edition. He pointed us to a working paper he had authored (dated March 11, 2020) where he used the available data and ‘knowns’ to arrive at a comprehensive set of policy measures. He was politely telling us you might be doing this as a thought experiment now but I wrote about it last year. It is a remarkably prescient paper and as you read it a year later you cannot help but wonder why couldn’t we do what’s suggested in it. The sad answer is no one has time for public policy. Of course, we can debate endlessly the death of a film star during peak pandemic. A questioning media, an accountable government and an informed citizenry should have been discussing papers like these and forcing their implementation over the last 12 months. It would have saved lives regardless of the nasty surprise that the second wave sprang upon us.
Maybe this experience will mark a change. But I’m not holding my breath.
Anyway, given the ‘knowns’ now, what should be done?
Admit we missed the bus in buying them in advance from multiple makers and get on with sourcing them now. We had written about India and the global race for vaccines (May 6, 2020). I don’t want to bore with ‘I told you so’. This is what we had written (in summary):
A low-income country with a large population like India has significant risks even if a universal vaccine is developed quickly elsewhere in the world. India can ill-afford the huge economic costs and time for the vaccine to reach its shores. There are a few strategic options that it must exercise at this moment to make the best of a bad situation. These include
- Funding domestic vaccine research
- Advance contracts with global vaccine makers
- Offering manufacturing capacity
- Don’t piss off China: It is very likely China will be the first to produce a successful universal vaccine.
- Vaccines as strategic stockpile
We will reiterate these points today. Pay vaccine makers (not just one company) to build huge additional capacity in short time and get them cranking out vaccines for India. Vaccine prices will be higher if you need to produce huge numbers in a crunched time. Nobody can make the numbers we need without advance purchase agreements. These are basic economics. This is no time for nickel and diming. Just pay them for capacity now.
What the government pays to procure vaccines and what the ordinary citizens pay for vaccines are two different things. Don’t confuse the two and don’t let vaccine pricing become another policy front to engage in pointless debates. Make vaccines free for the citizens at all government hospitals and vaccine centres. Those who can afford to pay can vaccinate themselves at private hospitals based on market price. Since the government will have bought in bulk, it will be controlling the supply anyway.
We need to do a realistic assessment of potential cases over the next six months at pincode level. We then need to make sure the healthcare infrastructure including hospital beds, medicines, oxygen supply, ventilators, vaccines and medical & paramedical staff are available as quickly as possible. This has to be done on priority. Build makeshift beds, import ventilators, set up Oxygen plants in each district, manufacture medicines and train as many people on basic healthcare skills – just get going on it. We will have a shortage of nursing and healthcare professionals in the next few months given the current spike. This is no time to be embarrassed about asking for help from others or about importing supplies. People are dying on the streets of the capital. We should be beyond embarrassment at this time.
We need genuine and real-time data to mobilise resources and save lives. It is also needed to prevent future outbreaks and deaths. Build a pincode level dashboard of pandemic readiness. Track the quantities of key materials used, the current inventory and the supply needed based on daily and weekly moving averages of the cases. Make this transparent to people. Don’t stop this till every Indian who is eligible is vaccinated. We need to stop making people anxious for accessing basic life-saving infrastructure.
We need to get our act together really quickly. This is a humanitarian crisis. The government has to focus its time and attention to get this under control. Other things can wait.
Here’s a list of Don’ts for the Union government that will help with the focus.
- Don’t fudge data on number of deaths or cases. It won’t help the pandemic go away. Nor will it help with relief measures. We also need more genome tests done in India to know the nature of virus. Right now this number is pitifully low.
- Don’t blame people for the second wave. They let their guard down but so did you. Also, don’t call them stupid. They elected you.
- Don’t deny there’s a problem. Accept it and communicate how it will be solved soon. People forgive mistakes easily.
- Don’t blame the opposition run states for their pandemic response. The virus will singe everyone equally by the time it is finished.
- Don’t tell everyone now Health is a state subject after trying to manage it centrally from the start of the pandemic.
- Don’t file criminal cases against those looking for help in social media. Life is tough already.
- Don’t waste time celebrating waiver of import restrictions on relief materials or flagging off trains carrying Oxygen on social media. Things shouldn’t have reached here in the first place.
- Don’t draft petty responses to global media outlets writing about the second wave in India. Get over the notion the western world is conspiring against us. They have better things to do. You surely have better things to do.
- Don’t spend efforts on managing the narrative. The WhatsApp messages filled with conspiracy theories to divert attention can wait. You can do them three months later. You are good at it. Back yourselves.
- Don’t advertise unproven Ayush or other remedies to ‘cure’ Corona. People need genuine health advice today.
- Don’t blame the system. You are the system.
Read the full edition here.
Disclaimer: Views expressed on Anticipating the Unintended are those of the authors’ and do not represent Takshashila Institution’s recommendations.