COVID-19: The Situation in India

In this interview, Christophe Jaffrelot, senior researcher of the CERI Sciences Po and the CNRS, analyses the situation in India in the context of the COVID-19 health crisis. Interview by Corinne Deloy, CERI.

The epidemic seems to have hit India later than in other countries. Is this a fact or is it that the virus has not been sufficiently taken into consideration seriously?

Christophe Jaffrelot: It is difficult to say, but what’s sure is that India has limited the use of screening tests until recently. For weeks, the only people tested were those returning from a trip abroad. The country lost precious time after the discovery of the first case of COVID-19 at the end of January. But the limited detection was also the result of a failing public health system, and in particular the lack of available tests (which private hospitals charge for at a high price).

There are 1.3 billion inhabitants in India, and a great many of them live in overcrowded places. What strategy can the government adopt to limit the spread of the virus?

The government has imposed lockdown, but it is extremely difficult to quarantine people in India, in particular in slums and in rural areas where many migrant workers have gone. Hundreds of thousands of them, at least, have returned to their native villages and have probably spread the virus. The government can do more in terms of screening tests, but not much can be done to prevent community-acquired infections and the country from entering stage 2 of the epidemic. In fact, the government’s policy can mostly help the population cope with the crisis by focusing on the economic and social aspects (without neglecting the sanitary aspect). But the plan announced to help the poorest is too limited (barely more than 22 billion US dollars, 0.8 percentage point of the GDP) and mostly ignores the informal sector and its employees who are returning, to the extent that they can, to their home villages.

Additionally, the repressive method put forth by the police to impose quarantine is counter-productive: not only does it add fear to misery for the poorest members of society, but also, it may break the supply chain if trucks do not reach shops and delivery men do not dare go out…

What is the state of the health system in India? Can it meet the sanitary challenge?

The Indian health system is bicephalous. The private sector developed recently to serve the middle class, and more specifically the Indian elite. The public sector is more than neglected by public policies. India spends less than 1.2% of its GDP on health. The country counts 710,000 hospital beds (i.e. 0.7 per 1000 inhabitants while in Western Europe all countries have more than 3 for 1000). Even worse, beds equipped for intensive care represent only 10% of this total.

Experts consider that the hospitals will reach their saturation point even if only 10% of adults are contaminated by the end of the spring. About 80 million people may well be infected by the virus and ought to be hospitalised…This is why, today, the authorities are pondering upon the need to hospitalise those whose symptoms are not severe.

How has Prime Minister Narendra Modi reacted for the time being? What announcements has he made? What measures has he planned?

Narendra Modi mentioned COVID-19 for the first time on 19 March, in an address to the nation during which he presented himself as a gatherer and protector of the nation. The only thing he announced then was a “people’s curfew”, inviting Indians to stay home the following Sunday. He moved up a gear the next Monday, after many Indian Union states—all led by members of opposition parties—announced forms of lockdown in their states. It was then that Modi decreed a 21-day national lockdown, without having consulted the heads of state governments as would have been the philosophy of Indian federalism (generally referred to as “cooperative federalism”).

This decision caught everyone by surprise, as did the demonetisation of 2016 when Modi announced the immediate withdrawal of the 500- and 1000-rupee notes—i.e. 86% of the money supply—a decision that had already plunged the informal sector into crisis. Modi governs in this way whatever the subject, hoping that stewardship will follow. He is much better at politics than he is at policies, and the plan announced on 26 March surprised many economists, especially since some states of the Indian Union are much more attuned to the problems of the population. This style of government could undermine Modi's popularity if the health, economic, and social crisis deepens. But for the time being, the television channels that helped bring him to power continue to highlight the Prime Minister's great determination and he successfully cultivates his image as a strong man. In fact, the immediate challenge India is facing so far as its politics is concerned pertains to the relations between the state governments and the Union government: the former, which have not been associated with the decision of the lockdown and which have seen hundreds of thousands of migrant workers to come back, are now asking for money to New Delhi. Tensions may mount quickly on that front, as most of the taxes are collected by the Centre, which is supposed to redistribute them. Such a process is more complicated to achieve when resources decline…

What could be the economic consequences of the epidemic in a country that is already experiencing an economic slowdown?

The economic downturn linked to the lockdown has had the effect of bringing the informal sector to a standstill: domestic workers and migrant workers have been the first victims of this situation. The formal sector will find itself in the same situation as soon as factories stop and public transportation no longer works. Unemployment—which had already reached a 45-year high by 2019—may well explode; growth, already at low levels, is likely to fall from 4.5% to 2 or 3% according to forecasters (which I find a little too optimistic) and public finance, already in difficulty with a budget deficit of almost 10% of GDP if we include the federal states and public enterprises, will be collateral victims of these processes.

There is nothing very different from what we see elsewhere in the world, except that this kind of crisis takes on a very different dimension in a country that is already suffering from an economic slowdown and, above all, where the poor are already in a state of daily struggle for survival: they are threatened by poverty and disease on a large scale. For the first time in the history of such data, the proportion of Indians living below the poverty line increased between 2011-2012 and 2017-2018. The emerging crisis will further aggravate this trend. India is paying for part of what I called “growth without development” in 2012 in my book Inde: L’envers de la puissance, i.e. a process that has deepened inequalities, especially but not only at the expense of the rural areas. At the time, people believed in the benefits of globalisation and said, “The sky is the limit...”. Nobody listened to the researchers who sounded the alarm: Amartya Sen, Jean Drèze, Atul Kohli... The crisis that is looming, in India as elsewhere, will force political leaders, businessmen, and experts to put many certainties back on the table... hoping that it is still possible to change the course of events!

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