There is fierce competition in the news bulletins between three big stories: who paid £85,000 to refurbish the prime minister’s Downing Street flat; whether Boris Johnson did or did not say “let the bodies pile high”; and the catastrophe in India’s health system, where a Covid “second wave” is killing many thousands a day. There, vast public cremations are lighting up the sky like a re-creation of Bosch’s hell. But the Number 10 stories still seem to be winning in the British media.
I am reminded of a thought experiment conducted by Adam Smith in The Theory of Moral Sentiments. He contrasts a distant catastrophe of a vast earthquake in China, killing millions, with our likely reaction to the prospect of a little finger being amputated. Smith concludes that if someone knew he “was to lose his little finger tomorrow, he would not sleep tonight; but, provided he never saw them, he will snore with the most profound security over the ruin of a hundred million of his brethren”.
Smith’s vivid depiction of the limits of compassion has to be updated a little. Thanks to global communications we can actually see today’s victims on the news. And many of us – I am one – have relatives and friends in India, in towns and cities affected by the new outbreak. Furthermore, we have seen the human devastation of Covid in our own country. Yet modern-day India is still a long way down our list of priorities.
This is irrational as well as uncompassionate because the rampant spread of Covid in India makes it, like Brazil, the perfect breeding ground for new and lethal variants of the disease. Our current optimism, and smugness, in the UK over the vaccine roll-out could be punctured rapidly if an Indian variant emerges which renders the vaccines ineffective.
Current Indian figures, thought to be a massive understatement of the problem, suggest that there are around 350,000 new cases a day and 3,000 deaths on top of 200,000 earlier recorded Covid deaths. This is recognised to be the small urban tip of a much larger iceberg, but the vastness of India’s population tends to dehumanise even large-scale death. If the death rate is, say, 10 times higher than has been reported, it would affect barely one tenth of one per cent of India’s 1.4 billion population.
The dehumanisation of these figures is assisted by the sad fact that many more Indians die unnecessarily every day from preventable, poverty-related diseases than die from Covid. For the same reason, crude but effective preventive measures like lockdowns can be counter-productive in India, as the country discovered last year. Throwing millions of marginal workers and migrants from rural areas out of work adds to extreme poverty and premature death.
India’s disastrous economic contraction of around 12 per cent in 2020 reversed years of real progress in poverty reduction. The country accounts for a sizeable proportion of the 125 million people estimated by the IMF to have slipped back into extreme poverty because of Covid.
This recent Covid upsurge owes a lot to the Modi government’s complacency and incompetence. Warnings of a second wave were ignored. Large gatherings for religious festivals, like the Kumbh Mela on the Ganges, were actively encouraged by politicians from the ruling BJP, which relies on Hindu nationalist votes, despite clear knowledge that densely packed crowds of pilgrims would constitute a “super-spreader” event. In addition, state assembly elections are being held in five states including populous West Bengal and vast rallies have gone ahead despite obvious health risks.
A deeper problem is that of Indian economic nationalism. India is far more protectionist than, say, China or Russia, and has found its own rules create a stumbling block to importing overseas vaccines and equipment. India is also rightly proud of its excellence in pharmaceuticals; but its largest vaccine producer, the Serum Institute, is privately owned and committed to export contracts even though India does not have the capacity to vaccinate its own population. The level of domestic vaccination is derisory.
Meanwhile, successive Indian governments have neglected health in general and public health in particular. Health is a devolved responsibility of the states and while some states, like Kerala, have taken the issue seriously, most have not, citing lack of money. Although there are some outstanding private hospitals and exceptional clinicians, largely serving the urban middle class, most Indians are lucky to see even the most shoddily equipped local clinic in their area. Moreover, public hygiene is appalling with large-scale public defecation in the absence of toilets (despite the prime minister’s championing of the issue).
It is now profoundly to be hoped that a belated domestic government response combined with international help and a very creative and energetic civic society will manage to stem the spread of the disease; ease suffering and death with oxygen supplies and drugs; and vaccinate against new waves of infection. But many will die of the disease. And many more will die because economic recovery is aborted and hundreds of millions lose income which they need to survive.
A risk remains that the same fate befalls other populous Asian countries like Bangladesh, Pakistan and Indonesia. They have so far kept Covid more or less at bay; but they have the same problems of dense population, poverty and governments of questionable effectiveness. The Philippines is already submerged in another Covid wave. And there is a real horror yet to come of a variant of Covid which gets into the crowded mega-cities of Africa like Lagos, Kinshasa, Nairobi and Dar-es-Salaam, where health provision is at a level lower even than in India and poverty greater still.
While we in Britain cheerfully look forward to the end of lockdown and the “coiled spring” of recovery, many of the poorest countries have yet to get to a recovery stage and will struggle to get to that point. The IMF recently calculated that in 2022 the advanced economies of the West and China will be back to levels of per capita income forecast in 2019 before the pandemic. But low-income countries will be over 6 per cent poorer than expected. Some are now heavily laden with Covid debt. For those countries, there is the grim prospect of higher interest rates to come as western economies get into their post-Covid growth stride, forcing central banks to raise rates to restrain inflation.
That China will resurge with the West, while India languishes, creates another, bigger geo-political and geo-economic problem. The Chinese have long argued that they have a superior economic and political model to that of the West, and of emerging countries seeking to operate a democratic model with basic human rights. For a while it seemed as if India was the counterpoint. Its messy but functioning democratic system, combined with rapid growth and falling poverty, offered an alternative model.
The democratic story in India was already being undermined by Modi’s sectarian and intolerant “strong man” government. Now, if the West has any interest in retaining India’s credibility in this race of ideals, it will have to act quickly and decisively to help Modi avert Covid disaster. The alternative is total Chinese victory not just in the race to control Covid but in a competition of ideologies, too.
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