Moral elasticity

The stretched notions of what is proper and fitting for the influential elites suggest greater political flux and socio-economic instability in the days to come.

AT least there was a little bit of good news in the press a few weeks ago: the information that public pressure had managed to thwart (at least for the moment) an egregious example of conflict of interest in a critically important area of health policy.

The prestigious Postgraduate Institute of Medical Education & Research (PGIMER) in Chandigarh hosts an annual conference on nutrition sponsored by the Indian Society for Parenteral and Enteral Nutrition (ISPEN). This year, the 16th Conference of ISPEN would have been co-sponsored by the Nestle Nutrition Institute, which is a front organisation of the multinational food conglomerate Nestle.

According to its website, the Nestle Nutrition Institute was ostensibly set up to contribute to the continuing nutrition education of health professionals and one of its avowed goals is to partner the medical and scientific community by providing enhanced access to the latest knowledge in nutritional sciences to enable continual improvement to healthcare of people of all ages.

Unsurprisingly, this latest knowledge often involves implicit (and sometimes even explicit) promotion of Nestle's own products, such as breast milk substitutes, and packaged biscuits, which are supposed to be as good if not better than fresh and hot locally cooked food for children taking school meals.

Such a collaboration of the PGIMER with the Nestle Nutrition Institute would have directly contravened the Indian Milk Substitutes Act, which was amended in 2003 to ensure the following: No producer, supplier or distributor (of infant milk substitutes) ... shall offer or give any contribution or pecuniary benefit to a health worker or any association of health workers, including funding of seminar, meeting, conferences, educational course, contest, fellowship, research work or sponsorship.

However, this does not seem to have bothered the senior doctors who were associated with planning the conference, or the large number of invitees to what is an important event in the calendar of Indian health professionals.

Fortunately, a non-governmental organisation (NGO) that is part of the Right to Food campaign was able to highlight this matter in the press and point to explicit letters from Central government officials to State health departments asking them to make sure this law is implemented effectively. After some pressure the event was ultimately called off and a major conflict of interest was averted, at least for the present.

But why is this such good news? After all, it was not as if anything positive happened. Rather, it was only that a blatant and illegal act of conflict of interest was prevented with respect to one particular event. It does not even mean a major boost to the cause of breastfeeding, for who is to know the other ways in which nutrition and health professionals and policymakers continue to be influenced by similar institutes?

Yet such are the times that even this seems like a major achievement, in fact, an unexpected victory in a society in which ethical norms and minimal concerns about propriety seem to have disappeared altogether.

In fact, there is no reason why one should blame just some health professionals and one particular event when much larger and possibly even more damaging conflicts of interest are now so routine that they do not cause even a minor raising of eyebrows.

Outrageously scandalous behaviour and evidence of large-scale corruption on the part of politicians, corporate honchos and media personalities do indeed still hit the front pages of newspapers, especially when they are presented in serialised form as in the release of transcripts of the Radia tapes. But the instances of wrongdoing now proliferate with such profusion that perhaps one will soon get inured even to such cases.

This is related to a more general blurring of boundaries, such that probity in public or professional life is not easily defined in terms of clear principles. In the Radia tapes, for example, one of the more startling features is not the strong whiff of corruption because this is almost to be expected. Rather, it is revealing just how familiar and casual all sorts of important people are with corporate lobbyists, the sheer intimacy of and time given to such interaction, and how this is seen as completely normal and unlikely to excite remark.

Consider this: a representative of a well-known industry lobby spends an hour or two just chatting with possibly the foremost economic decision maker in the Central government, talking of this and that and how to strategise for the future.

Can one imagine that equal time for open-ended and personal discussion would possibly be given in the same quarters to a trade union representative? Or to a farmers' organisation? Or, to take an extreme example, to representatives of youth (that is, those who are not occupying almost hereditary seats in Parliament)?

If not, what does that tell us about the sources of information, analysis, opinions and perspectives that important policymakers regularly expose themselves to? And what does this mean, in turn, for the objectivity and degree of social sensitivity with which policies are formulated and implemented? This is made more extreme by another fact that the Radia tapes expose: that the social life of policymakers is also dominated by such interaction with corporate honchos and their lobbyists, and that parties, weddings and similar functions are the places where not only are deals struck but opinions and attitudes are reinforced.

These often have a more insidious way of determining policies than in-your-face lobbying because they shape what has been called an epistemic community. Certain assumptions are inevitably made and particular arguments are axiomatic, and they happen to be those which implicitly and explicitly support the interests of those involved in such socialising. The implications of policies for the majority of people are rarely considered and even less likely to be understood not because of mala fide intentions but because the policymakers never really come across them or interact with them in any meaningful way.

The few occasions when there is such interaction of the influential with ordinary citizens are usually so stilted, forced, formal and hierarchical (as well as so brief) that they cannot make any impact in terms of changing opinions, much less actual policies.

More cynical readers will ask what is surprising about all this. Do we not already know that ruling elites band together, internationally, nationally and even locally?

Whether through Bertolt Brecht's Threepenny Opera or Shyam Benegal's early films set in rural India, we have enough artistic evidence of such collusion and the social forms it takes. So why make a big fuss about such cosy relationships when they are so well known?

The reason is that political and socio-economic systems created by such a pattern tend to be very fragile. When a mutually reaffirming set of elites gets increasingly divorced from and ignorant about the vast majority of the society that it supposedly controls, its ability to rule effectively is also affected.

This is also something history teaches us: that ruling requires both knowledge of the ruled and some degree of understanding of what will confer legitimacy. Operating in a little hothouse of People Like Us is therefore a problem, not just for society in general but also for the continued survival of the elites.

So the blurring of ethical boundaries, the greatly stretched notions of what is proper and fitting for people with important social and political responsibilities, and the moral elasticity that is being revealed by various recent exposes have implications beyond the obvious ones. They suggest that a period of much greater political flux and socio-economic instability is now inevitable in India.