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The Covid-19 Crisis in South Asia
Coping with the Pandemic
Sumit Ganguly, Dinsha Mistree, Sumit Ganguly, Dinsha Mistree
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eBook - ePub
The Covid-19 Crisis in South Asia
Coping with the Pandemic
Sumit Ganguly, Dinsha Mistree, Sumit Ganguly, Dinsha Mistree
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About This Book
This edited book provides a range of perspectives on the handling of particular aspects of the Covid-19 pandemic across the principal states of South Asia.
As the first academic volume to deal with the COVID-19 pandemic in South Asia, it examines such issues as how India has dealt with the fallout of the pandemic on its substantial diaspora in the Middle East; the competitive Sino-Indian vaccine diplomacy strategies in Bangladesh; Nepal's attempts to cope with the pandemic in light of its limited health infrastructure; Sri Lanka's differential treatment of its population based upon ethnic preferences; and how Pakistan's civil-military relations shaped its handling of the pandemic. The Introduction and the first section summarize the responses to the pandemic made by each principal state in the region. These chapters assess the process of decision-making within each state, with special attention placed on identifying and analzying the actors involved. The Covid-19 pandemic is also reshaping international relations of the subcontinent and the pandemic has laid bare several new cross-border challenges and opportunities that states will have to contend with in the future. The book also considers five of the most pressing issue areas. First, it considers how diaspora communities in the Gulf were affected by the pandemic, and what lessons South Asian sending states can take from protecting their citizens in the future. Second, the Covid-19 pandemic will affect how countries engage in status politics, shaping which countries will be able to lead in regional relations. Third, the Covid-19 pandemic is likely to affect prospects for regional cooperation, both for dealing with the current pandemic as well as future crises. Fourth, it will shape how South Asian states engage in global governance. Fifth, South Asian states may revisit their relations with China in light of the pandemic.
This book will be of much interest to students of South Asian politics, human security and international relations.
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1 Introduction
The Covid-19 Crisis in South Asia: Coping with the Pandemic
DOI: 10.4324/9781003248149-1
The ongoing Covid-19 pandemic is the most serious tragedy to afflict South Asia since the end of British colonization. Hundreds of thousands of people have died, and millions more have faced health challenges serious enough to require hospitalization. Apart from the human suffering, the economic toll has been staggering, with economies across the region shutting down for extended periods, to reopen open at partial strength.
Although they were not responsible for the initial outbreak of Covid-19, the five principal states of South Asia—namely Bangladesh, India, Nepal, Pakistan, and Sri Lanka—each had to craft and execute responses to what ultimately became a pandemic. The decisions that were made by the governments of South Asia carried serious consequences, not just for the people of South Asia, but for all people across the world. For example, consider the emergence of the Delta variant of SARS-CoV-2. The Delta variant emerged in India in late 2020. Over the next several months, the Indian government actively downplayed the threat of Covid-19 and encouraged the country to return to normal operations. Scientists and public health officials were discouraged from conducting investigations, and only a chosen few could make public statements. Without much resistance, the Delta variant rapidly spread through India, ultimately overwhelming a country that was not prepared for such a virulent strain of the virus. The Delta variant soon spread to other countries in the rest of the region and across the world, in a disturbing demonstration of the international nature of this pandemic. What could have instead transpired? One need only look at the Omicron variant, which was detected in South Africa in November 2021. Instead of trying to understate the dangers of this new strain, South Africa’s own scientists and health officials brought attention to this new variant. Although the Omicron variant is likely to spread through the rest of the world, the freedom of frontline scientists to speak to the new threat—combined with a supportive South African government—has given the rest of the world a chance to contain this new variant and has enabled researchers the opportunity to begin processes much earlier.
This volume assesses how the states of South Asia have so far performed in responding to the Covid-19 pandemic. As of the time of writing (early 2022), the Covid-19 pandemic continued to rage. Scholarship on the political determinants and effects of Covid-19 is scant, and for good reason: it is always easier to assess crises and politics when one knows how the story ends. But the contributors to this volume have commendably chosen to examine the politics of the Covid-19 pandemic to date.
The core proposition of this volume is that politics are playing a central and unwelcome role in how states respond to the Covid-19 pandemic. Across the world—and especially in South Asia—technical guidance and subject matter expertise have frequently been marginalized. Instead of deferring to experts, the pandemic response for most states has been set by politicians, generalist bureaucrats, and even militaries. As a result, processes of policy decision-making and policy execution are often colored by considerations that go beyond public health. Also, with the sidelining of expertise, we see a corresponding neglect in cross-state coordinated pandemic response. If public health officials truly had the power to craft state-level policies, they could rely on transnational epistemic networks to inform and coordinate policy. We contend that the real challenge of managing this pandemic involves getting these processes “right:” if the Covid-19 pandemic is to ever be brought under control, it will require technically informed state intervention with a profound level of international coordination. To get this process of governance right, we must first identify why states have marginalized expert-level guidance as they respond to the Covid-19 pandemic, and we must take stock of how states are attempting to coordinate pandemic responses on the regional and global stages. Recognizing the possible the risk of a rushed analysis, there is a critical need for scholars to develop a strong understanding of the politics shaping the pandemic response.
Addressing State Capacity
Some might argue that low state capacity is the true culprit limiting an effective pandemic response for the states of South Asia. Owing to decades of chronic underinvestment in public health infrastructure across most of the region, states have long struggled to implement effective public health policy. Consider healthcare spending as a percentage of GDP. For the principal states of South Asia, healthcare spending as a percentage of GDP has been modest: all countries have averaged below 4 percent from 2014 to 2018, with the exception of Nepal (see Table 1.1). For comparison, middle-income countries spent an average of 5.4 percent of their GDP on healthcare in 2018 (World Bank 2021).
Facing limited resources, the states of South Asia have traditionally provided limited basic healthcare services and have instead prioritized addressing and containing disease outbreak. And indeed, we observe that the states of South Asia have a successful track record in dealing with many other instances of infectious disease. Consider India, which coped moderately well when confronted with previous epidemics. For example, despite widespread global concern, India handled the HIV/AIDS crisis of the late 1980s reasonably well. Despite understandable fears, the pandemic did not overwhelm India’s public health services. It is possible that public health campaigns, the efforts of various nongovernmental organizations, the rapid development of retroviral drugs, and their production and dissemination across the country stemmed the tide of that particular epidemic. In 1994 there was also a plague outbreak in the western Indian state of Gujarat. Once again, there were reasonable fears that it would sweep across the country. However, a spurt of civic action on the part of many municipalities across the country and the swift distribution of powerful antibiotics contained its spread.
Table 1.1 Healthcare Spending as a Percentage of GDP, 2014–18
| Country/Year | 2014 | 2015 | 2016 | 2017 | 2018 |
|---|---|---|---|---|---|
| Bangladesh | 2.5 | 5.5 | 2.3 | 2.3 | 2.3 |
| India | 3.6 | 3.6 | 3.5 | 3.5 | 3.5 |
| Nepal | 5.8 | 6.2 | 6.3 | 5.5 | 5.8 |
| Pakistan | 2.7 | 2.7 | 2.9 | 2.9 | 3.2 |
| Sri Lanka | 3.6 | 3.9 | 3.9 | 3.8 | 3.8 |
Source: World Bank. “DataBank: Health, Nutrition, and Population Statistics.” World Bank DataBank. Accessed October 8, 2021. https://databank.worldbank.org/source/health-nutrition-and-population-statistics.
The Covid-19 pandemic, however, has completely overwhelmed India’s ramshackle public healthcare apparatus. At first blush, a key difference between the first two epidemics and the current pandemic has to do with the disease vector. HIV/AIDS, as is well known, was based primarily upon sexual transmission. Rudimentary prophylactic measures coupled with a robust information campaign could thereby stem its dispersion. Similarly, the plague outbreak could also be contained with a reasonable effort to tackle waste disposal and the reliance on efficacious antibiotics. In the case of the Covid-19 pandemic, however, given India’s population density—especially in major cities where the poor live cheek by jowl—airborne transmission has proven to be highly contagious.
Setting aside differences between the disease vectors, it is also becoming clear that the way in which the Government of India has chosen to respond to the Covid-19 pandemic is different from how it has handled the previous epidemics. At the beginning of the Covid-19 pandemic, government leaders chose to cut off technical expertise from the decision-making process. Prior to the Covid-19 pandemic, India had made considerable investments in building out infectious disease agencies like the National Centre for Disease Control and various structures housed under the Indian Council for Medical Research. According to national-level plans, the leaders of these agencies were supposed to lead and coordinate pandemic response. Instead, these agencies were mostly estranged from the process, with most decisions being routed through the Prime Minister’s Office.
What did this decision-making look like for India? As the initial reports of the prevalence of the virus surfaced, in March 2020 the government of Prime Minister Narendra Modi gave four hours’ notice before imposing a countrywide lockdown for a duration of three weeks. As all rail, bus, and other modes of public transportation were also shut down, millions of migrant workers were stranded across various parts of the country. In the end, most, but not all of them, wended their way back to their home villages, with some covering several hundred miles on foot. The government, in addition to shutting down most transportation networks, had also made meager economic provisions to assist this acutely vulnerable segment of the country’s citizenry.
Even as the Indian government imposed this draconian lockdown, it failed to utilize the breathing space to rapidly acquire personal protection equipment, to boost the capacity of public hospitals, and above all failed to contract public and private firms to swiftly produce vaccines on a mass scale. This particular lapse was especially egregious, as India is no stranger to vaccine production and is, in fact, the largest producer of vaccines in the world. Worse still, apart from state-run facilities, it is also home to the Serum Institute of India, a private company that has long been a producer of vaccines on a mass scale.
Even as the second surge was under way in the early days of 2021, the government’s own taskforce on the pandemic did not meet in February or March. Finally, convinced that it had effectively beaten back the virus, the government not only assumed a posture of complacency at home but also went ahead with exporting millions of doses of the vaccine to neighboring countries and beyond as part of an exercise of soft power. In the meanwhile, it failed to stockpile vaccines at home to deal with a possible exigency. Consequently, when the second wave of the virus was well under way, the government was caught completely flatfooted.
Another set of choices on the part of the government led to a significant deterioration in matters. Despite the onset of a second wave of infections, the Bharatiya Janata Party (BJP), faced with elections in four states across India—Assam, Kerala, Tamil Nadu, and West Bengal—and a Union Territory (an administrative unit that reports to New Delhi) decided to proceed with them as planned. Worse still, the Prime Minister and his Minister of Home Affairs, Amit Shah, frequently attended election rallies where no form of social distancing was attempted, let alone practiced, and the vast majority of the attendees were unmasked. To compound matters, the government also permitted the holding of a mammoth Hindu religious festival, the Kumbh Mela, for a period of close to three months starting in January 2021. Over a million devotees participated in this event, where only rudimentary public health measures were implemented to prevent the transmission of the virus.
These lapses alone were shocking enough. However, irresponsible statements from a number of BJP stalwarts did little to advance the cause of public hygiene and medical science. For example, a notable BJP member of parliament (MP) in the state of Uttarakhand claimed that bovine urine was an effective disinfectant and could prevent the spread of the virus. At an election rally in West Bengal another BJP MP claimed that a combination of bovine urine and cold water could eradicate the virus. Finally, although no BJP leader formally endorsed the practice, many people in BJP-ruled states, especially in Gujarat, smeared cow dung on their bodies to ward off the infection. The practice had become so widespread that the head of the Indian Medical Association felt compelled to issue a public notice stating that the procedure had no basis in medical science. Furthermore, it could lead to a false sense of complacency, thereby contributing to increased spread of the virus.
Even after the second wave of infections from Covid-19 engulfed much of the country with public parks being turned into crematoria, bodies being dumped in the Ganga (India’s holy river), hospitals running out of spaces to accommodate patients, and some even running out of oxygen, the government directed much of its efforts toward managing the optics of the situation. To that end, it sought to muzzle social media outlets ranging from Facebook to Twitter from posting accounts that highlighted the disastrous conditions prevailing across much of India. And instead of working to forge a national vaccination strategy, in mid-May 2021 it turned over the task to India’s states, most of which are ill-equipped, to obtain the necessary vaccines in the first instance.
Apart from India, similar dynamics seem to hold across South Asia. In Sri Lanka and Pakistan, decision-making has been led by the military, whereas Bangladesh’s authoritarian leader, Sheikh Hasina, has shown little interest in deferring to experts. Limited implementation capacity has exacerbated the pandemic response, but the fundamental issue concerns the political process of decision-making. Therefore, although we recognize the limitations that states face with respect to implementation capacity in pandemic response, we choose to focus our attention in this volume on the domestic and international politics of pandemic decision-making.
Outline of the Book
This book is divided into two parts. The first part consid...