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COVER STORY

28-08-2020

NEP 2020 August 28

Decoding the New Education Policy

Briefing

Culture

Whose Sanskrit is it anyway?

Mundoli Narayanan cover-story

One major aspect of the Narendra Modi government’s National Educational Policy, which has raised quite a few eyebrows, is its rather strident emphasis on Sanskrit. The policy states that along with the other “classical languages”, the importance of which “cannot be overlooked”, Sanskrit “will be offered at all levels of school and higher education as an important, enriching option for students, including as an option in the three-language formula”. It rationalises the decision on the basis that Sanskrit “possesses a classical literature that is greater in volume than that of Latin and Greek put together, containing vast treasures of mathematics, philosophy, grammar, music, politics, medicine, architecture, metallurgy, drama, poetry, storytelling, and more (known as ‘Sanskrit Knowledge Systems’), written by people of various religions as well as non-religious people, and by people from all walks of life and a wide range of socio-economic backgrounds over thousands of years.”

Now, what is wrong with learning a language that has such a long, hoary tradition and is a rich repository of some of the greatest treasures of human thought and expression, some may ask in all innocence. They may add that it is the language from which most Indian languages have either descended or drawn profusely at various crucial points of their development. Some others may venture to say, without being quite sure of their sources or the full veracity of their claim (Whatsapp being the culprit at large), that quite a few Western languages owe their origin to Sanskrit, if not directly, at least indirectly.

There is nothing wrong with learning Sanskrit or any language for that matter. Languages are windows to cultures, histories and ways of life. Learning a new language opens a whole new world of experience and expression, which otherwise one will never get to know. Languages also initiate one into new ways of thinking and new perspectives arising from the particular life environment in which they developed. Languages thus open up the world for us, showing us its infinite variety and plurality. Coming to Sanskrit specifically, as one who grew up in an environment that was to a great extent suffused with Sanskrit, in the form of poetry and performance, and as one whose ears have been attuned from infancy to the rhythmic, musical cadences of recited slokas, I would hardly be averse to the idea of learning it. Further, although it is the English language that puts food on my plate, as a theatre student whose major area of research is Sanskrit theatre and performance, particularly its Kerala variety, Kutiyattam, I would be the last person to deny its richness or its knowledge value.

However, when it makes its appearance in a national policy on education in the manner in which it has, as a language to be “mainstreamed and prioritised” at all levels of school and higher education, then the question assumes very different dimensions. We are no longer then in the realm of personal interests or individual choice or even the simple matter of learning or teaching a language. On the contrary, we are in the thick of a political agenda that seeks to appropriate and lay its stamp on not just the present but the past, too.

Picture of the past

What is the picture of the past that this policy presents us with? It says, “The rich heritage of ancient and eternal Indian knowledge and thought has been a guiding light for this Policy. The pursuit of knowledge (Jnan), wisdom (Pragyaa), and truth (Satya) was always considered in Indian thought and philosophy as the highest human goal. The aim of education in ancient India was not just the acquisition of knowledge as preparation for life in this world, or life beyond schooling, but for the complete realisation and liberation of the self.” Sanskrit then appears not just as a language but as the very lingua franca of this venerable past. However, even a cursory look will make it evident that this is at best a fabricated past, a past attributed with an imposed homogeneity that is far from the truth. On the one hand, in depicting the past in such glorious terms, this discourse effectively effaces from view the deeply riven social divisions and conflicts that characterised Indian society. It attributes to that past a false homogeneity wherein the divisions and differences of caste and community are glossed over and ignored. Any reasonably informed student of history will be able to tell you that this celebrated heritage was the prerogative of a select few and that the great majority was forcibly excluded from the so-called Sanskrit knowledge systems. In addition, in thus homogenising India’s past under the arch umbrella of Sanskrit, the immense plurality of Indian culture and the knowledge systems and cultural expressions produced by other communities and in other languages are effectively erased from view.

There also seems to be a complete lack of understanding that vast segments of the Indian population do not see this past in a favourable light, given that their forefathers were subjected to the most inhuman and horrendous structures of exclusion and oppression as a result of the Sanskrit knowledge systems that this policy document looks up to. Their real response to this “classical tradition” would probably be best exemplified by B. R. Ambedkar’s burning of the Manusmriti. That Sanskrit was part and parcel of, indeed the medium that provided the discursive rationale for, the structural institution of graded inequality, in the form of the social philosophy of chaturvarna (the system of four varnas), that condemned more than half of the population as untouchables or outcasts seems to have been forgotten or missed by the keen eyes of the policy drafters. That this is not an inadvertent omission is clear in the epithets heaped on “Bharat” and its illustrious heritage.

Obviously, for the policymakers, Sanskrit is not merely a language or a set of knowledge systems; it is emblematic of a way of viewing the past, of understanding it in partial terms. More importantly, in endeavouring to resurrect it in a selective manner in the present, it becomes emblematic also of a political culture that has clear designs on the present and the future. The British political theorist Roger Griffin’s concept of “palingenetic ultranationalism” assumes tremendous significance here. It is an extreme, quite often violent, form of nationalism that bases itself upon a promised return to a “golden age” in the country’s history, and the rebirth or recreation of a society that is supposed to have existed earlier. Such a selectively represented, often fabricated, past thus becomes a guidebook to a better tomorrow and the template of a social order in the making.

The focus on Sanskrit then turns out to be far from innocent, and deeply rooted in the very ideology that spurs the right-wing forces that have laid siege to the political sphere of the country. It is also part of a large package that has the brand “Hindutva” writ large on it and includes yoga, astrology, irrational beliefs and veneration of ‘godmen’. More than anything else, it is the grounding rationale for a particular kind of political power that is fascist, dictatorial and exclusionary, and if permitted to take its natural course it will result in the loss of freedom and lives of millions of people. Acceptance of it can only be at the peril of the democratic, multicultural fabric of the country. So, my answer to the question in the title? Sorry, no, this is not my Sanskrit. Mine is more in the tradition of the iconoclastic Bhasa, the questioning protocols of the Lokayata, the biting sarcasm of the Chakyars, and the subversive subtexts of the Mahabharata because that is what I understand my India to be—critical, plural and irreverent.

Mundoli Narayanan is Professor of English at the University of Calicut. His major area of research is theatre and performance, particularly Kutiyattam, the Sanskrit theatre of Kerala.

Interview: Prof Shyam B. Menon

For the middle class and the market

Divya Trivedi cover-story

The National Education Policy (NEP) ruffled more than a few feathers with its contentious recommendations on medium of instruction, revamp of the education system, and emphasis on rhetoric rather than detail. Frontline spoke to Prof. Shyam B. Menon, former Vice Chancellor of Ambedkar University of Delhi, to understand the broader implications of the policy. He has had a distinguished career spanning more than three decades as an educationist. Excerpts from an interview:

Is the intent behind the NEP more political than pedagogical?

To answer your question, I need to first try and locate the policy in a context. In a sector like education where the bulk of the operations are within the domain of the States, a national policy should be seen for what it is: it is merely a statement of intention promulgated by the Union government. Operationalising a national policy in education is a vicarious exercise—it involves a complex process that also comprises in a big way persuading the State governments to implement the provisions of the policy.

As it stands now, it is actually even difficult to call NEP 2020 a truly “national” policy. It was never debated in and approved by Parliament. I am not sure whether it had been examined and deliberated on in the CABE [Central Advisory Board of Education] with any application of mind. Actually, it baffles me why the legitimacy of approval by Parliament was denied to this policy. This undermines both the policy and Parliament. There may not be a constitutional requirement for it. But there is definitely a set convention. It would have been easier to take the States along in the implementation of the policy, had NEP 2020 been taken through Parliament.

Every policy document has essentially two parts. The first part is the vision that sets the stage by painting the big picture as a backdrop. The second is the substantive part that sets out more specifically the intentions of the government. While setting the stage, usually some recollection of history, sometimes somewhat selective, happens. Also, as props for the stage would be a few keywords, often drawn from the Constitution, strung together and woven into the document as a background tapestry. The political messaging is located here, not just in the usage of particular keywords but also in the omission of certain others.

It appears to me that the utility of a national policy in education is primarily as a political document addressing particularly the core constituency that the dominant political formation draws support from. There are of course conflicting interests within this core constituency. I see two distinct segments that see a common cause with each other and at the same time have conflicts of interest. One, the market forces and an upwardly mobile and fiercely aspirational middle class whose fortunes are critically aligned with those of the market forces; and two, those who are ideologically oriented towards cultural nationalism. It becomes imperative for a policy not to explicitly go against the ideological segment while painting the big picture. At the same time, the specific provisions of the policy, although couched in rhetoric, will need to give scope for multiple interpretations, ensuring that in practice these will not go against the interests of the middle class and the market. Ambiguity and vagueness are thus a virtue in policy formulation.

How does the NEP fare when compared with the earlier policies on education? Does it intend to replace scientific and secular principles with traditional Indian value systems?

It is not that NEP 2020 is totally at disjunction with the earlier national policies on education. There is continuity as well as shift of emphasis. Several key concepts invoked in NEP 2020 are similar to the ones used in NPE 1968 and NPE 1986. For instance, when envisaging an educated individual, scientific temper and ethical/moral values are categories that are used by all three policies. On the other hand, when it comes to citizenship, NEP 2020 talks about “engaged, productive and contributing citizens” (p.4), while the earlier policies talked about “creating a sense of common citizenship and culture and strengthening the national integration” (NPE 1968, p.2), and “contribut(ing) to national cohesion … and independence of mind and spirit” (NPE 1986/1992, p.4). NPE 1986/1992 is explicit in its invocation of democracy, socialism and secularism (p.4), and NPE 1968 has a clear mention of “realising the ideal of a socialist pattern of society” (p.2). However, these categories are conspicuous by their absence in NEP 2020.

Does this mean that NEP 2020 has jettisoned democracy, secularism and socialism from public discourse? Perhaps not. But, it is definitely attempting to normalise a discourse that does not display these categories prominently. That is how the present is sought to be depicted as distinct and disjointed from the past. These constitute posturing, and that is presumably what the core constituency wants to see in the policy.

My sense is that NEP 2020 steers clear of being seen as tilted too much to one or the other of the two segments of the core constituency that I mentioned earlier. This tightrope walk is evident not merely in the vision or posturing part of the policy, but in its substantive part as well. The ambiguity and the reluctance to get into details are indicative of this. There is also no mention of a strategy for financing or implementing the policy, not even a strategy to arrive at strategies in various contexts (a meta-strategy if you like).

So, in response to your question, I would not say that NEP 2020, as a document per se, has the potential to replace the secular and scientific values with traditional values. It is seldom that an education policy left to itself creates major social transformations. If it could, then because of NPE 1968, we would have been a socialist society by now. Secular and scientific values are more likely to be undermined by political processes than through an education policy.

Of course, a whole lot depends on which provisions of the policy get activated, negotiated, pruned and adjusted in the process of implementation, and when and in what sequence it is likely to happen. And, more important, it depends critically on what other major political and economic disruptions are likely to unfold in the next few years in the larger arena. Anyway, it is going to be one long-drawn process and perhaps quite a messy one at that.

On medium of instruction

One of the major polarising ideas in the NEP is around the medium of instruction: “…uptil grade 5 and preferably till grade 8 and beyond will be home language/mother tongue/local language.” What might be the implications of doing away with English as a medium of instruction?

The paragraphs on Multilingualism and Power of Language make interesting reading to students of education policy. It is clear that the formulations in these paragraphs are carefully crafted, leaving enough scope for multiple interpretation and vagueness. They have inserted the phrase “wherever possible” in a few places, vesting the onus of interpreting the implications of this provision on the States and the school systems. So, I don’t see any clear position as regards English as a medium of instruction. While the policy makes postures in favour of home language or mother tongue, in the letter of the policy there is still enough ambiguity that leaves several backdoors ajar for English to sneak in.

As I said earlier, it is quite unlikely that a national policy on education in this epoch will go against the market forces and the interests of the middle class. History teaches us this very clearly. The Education Commission (1964-66) recommended the establishment of a “common school system of public education” and the “neighbourhood school” as a single site of education for both the poor and the rich, implying that there would no longer be multiple channels of education for children from varying backgrounds. However, by the time it was incorporated in NPE 1968, the term “neighbourhood school” had been dropped. At the level of political posturing there was enormous support for a common school system. All the same, a system of schools that were common for the poor and the rich could never become a reality, thanks to a powerful and determined nexus of elites—within the government, in the professions, in business—and the upwardly mobile middle class, who together quietly ensured the subversion of this policy initiative which had held enormous potential for social transformation.

Caste and reservation

Is the absence of terms caste and reservation from the NEP document a matter of worry?

NEP 2020 is reticent on the subject of equality as a guiding principle. It does not acknowledge the enormous inequality in Indian society and its historical roots, nor does it envisage education as a potential equaliser in a normative sense. It is as though the policy uncritically accepts inequality as a given.

The terms “SEDG” [socio-economically disadvantaged groups] and “under-representation” hide the structural and historical exclusion and injustice that the S.C., S.T., OBC [the Scheduled Castes, the Scheduled Tribes and the Other Backward Classes] and women have suffered. I see this as an attempt to create and normalise a new discourse that views every social category through the empirical lens of under-representation, and does not recognise the structural dimensions and the historical roots of exclusion and marginalisation.

The social policy of reservation, however, has deeper roots and a greater political significance. It is secured in terms of constitutional provisions. So, I am not too worried that it does not find mention in NEP 2020. In fact, reservation had not been mentioned explicitly in the earlier policies as well.

What is your view on the revamping of the higher education system by the abolition of M.Phil, one-year integrated master’s degree, and options for opting out?

While envisaging structures and programmes in higher education, the default template is often natural sciences and engineering. NEP 2020 found M.Phil redundant essentially because of a lack of appreciation of how this programme plays a meaningful role in preparing researchers and practitioners in some of the best known institutions of social sciences and humanities. The nature of initiation into research is very different in these disciplines, and therefore needs a different imagination of a pre-doctoral programme.

Another problem with the discontinuation of M.Phil is that it is based on the false assumption that people pursue pre-doctoral and doctoral studies only as a requirement for an academic position. In the social sciences and humanities, there are a large number of M.Phil graduates who have got into positions in development sector, journalism, market research, corporate sector, government, etc. These are people who did not want to get into academic research through a doctoral programme, yet wanted a research orientation and deeper understanding of a specialised area, something more than what they got at the master’s level. In some universities, there are special M.Phil programmes in areas like development practice, psychotherapy and social entrepreneurship for preparing master’s degree holders to become practitioners after advanced training, internship and a dissertation. Such programmes are stacked above the master’s degree, but do not lead to a doctoral programme.

In any case, a national policy should not get into micromanagement. They should leave some of these innovative ideas to be pursued by universities which have the capacities to do so. It would have been better for the policy to stick to broad structures and talk in terms of an expansive space of choices for universities than to specify which programme is in and which is out. After all, there are regulatory bodies that the policy has envisaged for thinking in those terms.

To your general question on the revamping of higher education, I have a short answer. Flexible templates of integrated programmes with multiple exit options can be quite useful for an innovative university to build some of their academic programmes on.

Public funding

While it has progressive ideals such as universalisation of education, controlling dropouts and increasing the Gross Enrolment Ratio (GER), how easy will it be to implement the NEP? Given the COVID pandemic, universities have cut the salaries of teachers citing unavailability of funds. Some have even said they might not be able to pay the salaries beyond two months. Where will the funds to implement the NEP come from?

Implementing most provisions of NEP 2020 will need substantial increase in public investment in education. The policy reiterates the commitment made in the previous national policies to increase public funding on education. This is one place where NEP 2020 invokes partnership with the States. “The Centre and the States will work together to increase the public investment in education sector to reach 6 per cent of the GDP at the earliest” (p.61). But, how may this be achieved and how soon? Already there is an educational cess being levied, which now goes into the budget outlay for education. In spite of this, the public expenditure on education incurred by the Union government has been declining proportionately and in absolute terms for the past few years. Given the state of the economy, not to mention the contraction that it has suffered because of the pandemic and the lockdown, it cannot be a realistic expectation that there will be any enhancement in public spending on education for the next few years. Also, there are other competing sectors like health and defence that may receive greater priority in these difficult years.

NEP 2020 talks somewhat vaguely about public institutions mobilising funds from private philanthropic sources. While this may be helpful, this is no substitute for the grant-in-aid that supports them. It may be possible for private players to set up institutions, but the education they offer will in all likelihood be unaffordable and inaccessible to young people from the social and economic margins. The huge additional intake of students on account of the increase in GER in higher education targeted by NEP 2020 will largely become the responsibility of public institutions.

It will need substantial transfer of funds from the Centre to the States for the next five years or more in the form of grants or through Centrally sponsored schemes for the States to increase public investment in education and to begin to implement the provisions of NEP 2020. But, will the Centre be capable of and willing to do so? That is a question to which one does not have a definite answer for the present.

NEP&the pandemic

NEP 2020 implementation and timeline worries

Kumkum Roy cover-story

National Education Policy (NEP) 2020, approved by the Union Cabinet and announced on July 31, has evoked a variety of responses. Immediately afterwards, Education Secretary Amit Khare announced speedy implementation of its provisions that would not have immediate financial implications (August 1, 2020, The Times of India). This, in itself, raises questions. If educational institutions mobilise and/or are taken over by those who can afford to do so, the ongoing process of privatisation will probably proceed at breakneck speed. These possibilities are worrying, to say the least.

As many as a hundred recommendations are apparently in the pipeline, many of which are to be initiated/implemented within a month. Therefore, examining the provisions and implications of the policy acquires a certain urgency. Here I focus on two issues—timelines and traditions, even as there is much more that deserves, and will hopefully receive, attention.

First, Khare’s immediate timeline. This pertains primarily to higher education. Academic credit transfers are expected to be put in place by December 2020 for select institutions; multiple exit and entry points into higher education will be available from 2020-21; the four-year degree programme will be introduced by 2021 for Central universities and for others by 2022. Common entrance tests will be worked out by February-March 2021, and administered, possibly, by May 2021.

This speed does not factor in the enormous strain that most higher educational institutions have faced during the pandemic, which is by no means over. This strain has been particularly severe on the vast majority of the diverse student population that finds a space, not necessarily ideal, within public universities, both State and Central. This space will probably be transformed beyond recognition. Apart from the human cost, there are likely to be financial costs as well.

There are other far-reaching changes envisaged within a year or two. These include “The formulation of a new and comprehensive National Curricular Framework for School Education, NCFSE 2020-21” [NEP 4.30], as also a Curriculum Framework for Teacher Education [NEP 5.28]. By 2022, we may expect National Professional Standards for Teachers to be laid down [NEP 5.20] and the assessment system for schools may be transformed by the academic session of 2022-23, in accordance with the proposed NCF 2020-21 [NEP 4.39]. Thus, the next two years will see far-reaching changes in both higher education and high school education.

Subsequently, the proposed pace of change slows down a bit. Also noteworthy is the shift in priorities. So, although declared to be “the highest priority of the education system”, the target of achieving “universal foundational literacy and numeracy in primary school” is set for 2025 [NEP 2.2]. And it is by that year that “at least 50% of learners through the school and higher education system shall have exposure to vocational education” [NEP 16.5].

The next significant year is 2030. Interestingly, extending support for Early Childhood Care and Education (ECCE), which has earned considerable appreciation and applause, “must thus be achieved as soon as possible, and no later than 2030” [NEP 1.1]. That is also the year proposed to attain 100 per cent gross enrolment ratio (GER) in preschool to secondary level [NEP 3.1] and by when a new integrated B.Ed degree is expected to become the universal norm [NEP 5.23]. Also, by then we may expect at least one large multidisciplinary higher education institution (HEI) in or near every district [NEP 10.8]. Further, we learn that “Since this process will take time, all HEIs will firstly plan to become multidisciplinary by 2030, and then gradually increase student strength to the desired levels” [NEP 10.7].

The next landmark year is 2035, by when the GER in higher education, including vocational education, is expected to reach 50 per cent [NEP 10.8]. It is also the year by when affiliated colleges are to be phased out [NEP 10.12] and “all HEIs in India will aim to become independent self-governing institutions”, having Boards of Governors in place [NEP 19.2].

It is only in 2040 that we can expect “an education system…that is second to none, with equitable access to the highest-quality education for all learners regardless of social or economic background” [NEP, Introduction, page 3].

Several provisions are introduced without mentioning any time frame. Consider two examples: “All scholarships and other opportunities and schemes available to students from SEDGs [socially and economically disadvantaged groups] will be coordinated and announced by a single agency and website to ensure that all students are aware of, and may apply in a simplified manner on such a ‘single window system’, as per eligibility [NEP 6.18].… HEIs will have the flexibility to offer different designs of Master’s programmes: (a) there may be a 2-year programme with the second year devoted entirely to research for those who have completed the 3-year Bachelor’s programme; (b) for students completing a 4-year Bachelor’s programme with Research, there could be a 1-year Master’s programme; and (c) there may be an integrated 5-year Bachelor’s/Master’s programme. Undertaking a Ph.D shall require either a Master’s degree or a 4-year Bachelor’s degree with Research. The M.Phil programme shall be discontinued” [NEP 11.10].

Notice a certain brisk breathlessness in the way in which these provisions are enumerated. Some of these, such as the discontinuance of the M.Phil programme, have also been announced over the media, and one is left wondering about the proposed pace of transformation and the logic behind them.

Where do the presence/absence of timelines lead us? For one, the “flexibility” with which the timelines are drawn, or their absence, makes it difficult to track them and figure out their implications. In some cases, such as school curriculum, we are likely to see rapid changes. In other instances, such as ECCE, changes may be much slower, and again may seem to correspond with the timeline. In yet other instances, where there are no timelines, or there are relatively long timelines, we may encounter rapid implementation, even before the implications of the provisions have been absorbed, understood and responded to. This will possibly happen in the case of HEIs.

The impact is likely to be felt most sharply by those making the transition from school to HEIs in the next few years, in a situation where the pandemic and the preceding and succeeding economic downturn have destabilised the intertwined worlds of education and employment in unprecedented ways. A degree of deliberation and care would perhaps make for a far more humane response, rather than adding to the enormous stress being faced by young people by briskly announcing and implementing policies designed in a pre-pandemic situation, whose implications are uncertain in a rapidly changing, unpredictable world.

Second, one would expect that the changes in ECCE, which have been widely welcomed, would have been prioritised. But, as noted above, the priorities for implementation seem to begin midstream in the life of the learner—with the transformation of high school and HEIs targeted within the next two years. The logic behind these choices is not apparent.

Turning to and away from traditions

I would also like to draw attention to the relationship between the NEP and two different traditions—one ancient and the other modern.

First the ancient. An examination of the lists of languages mentioned in the NEP reveals the special place accorded to Sanskrit. To cite one instance: “Due to its vast and significant contributions and literature across genres and subjects, its cultural significance, and its scientific nature… Sanskrit will be mainstreamed with strong offerings in school—including as one of the language options in the three-language formula—as well as in higher education…. Sanskrit teachers in large numbers will be professionalised across the country in mission mode through the offering of 4-year integrated multidisciplinary B.Ed. dual degrees in education and Sanskrit.”[NEP 22. 15]

There is also a recurrent claim about the 64 arts mentioned in Sanskrit literary traditions as somehow providing the roots of a liberal education [for example, NEP 11.1]: “… among these 64 ‘arts’ were not only subjects, such as singing and painting, but also ‘scientific’ fields, such as chemistry and mathematics, ‘vocational’ fields such as carpentry and clothes-making, ‘professional’ fields, such as medicine and engineering, as well as ‘soft skills’ such as communication, discussion, and debate.” The very idea that all branches of creative human endeavour, including mathematics, science, vocational subjects, professional subjects and soft skills, should be considered “arts” has distinctly Indian origins. This notion of a “knowledge of many arts” or what in modern times is often called the “liberal arts” (that is, a liberal notion of the arts) must be brought back to Indian education, as it is exactly the kind of education that will be required for the 21st century.

We have now become accustomed to claims that are reiterated time and again acquiring a certain currency, so it may be useful to revisit this list of 64 from the Kamasutra (1.3.15): “Singing, playing musical instruments, dancing, painting, cutting leaves into shapes, making lines on the floor with rice powder and flowers, arranging flowers, colouring the teeth, clothes and limbs, making jewelled floors, preparing beds, making music on the rims of glasses of water, playing water sports, unusual techniques, making garlands and stringing necklaces, making diadems and headbands, making costumes, making earrings, mixing perfumes, putting on jewellery, doing conjuring tricks, practising sorcery, sleight of hand, preparing various forms of vegetables, soups and other things to eat, preparing wines, fruit juices and other things to drink, needlework, weaving, playing the lute and the drum, telling jokes and riddles, completing words, reciting difficult words, reading aloud, staging plays and dialogues, completing verses, making things out of cloth, wood and cane, woodworking, carpentry, architecture, the ability to test gold and silver, metallurgy, knowledge of the colour and form of jewels, skill at nurturing trees, knowledge of ram-fights, cock fights, and quail fights, teaching parrots and mynah birds to talk, skill at rubbing, massaging and hairdressing, the ability to speak in sign language, understanding languages made to seem foreign, knowledge of local dialects, skill at making flower carts, knowledge of omens, alphabets for use in making magical diagrams, alphabets for memorising, group recitation, improvising poetry, dictionaries and thesauruses, knowledge of metre, literary work, the art of impersonation, the art of using cloths for disguise, special forms of gambling, the game of dice, children’s games, etiquette, the science of strategy and the cultivation of athletic skills.”

I leave it to the reader to decide whether this assortment of skills can be described as liberal arts and if this is what needs to be imparted to learners in the 21st century.

This turning to the past is accompanied by a tendency to turn away from more recent traditions, such as those enshrined in the Constitution, including the directive principles and the fundamental rights, on which the NEP maintains a studied silence. That both teachers and the taught should ideally be aware of these seems to be either taken for granted or ignored. As is well known, there have been robust discussions and debates around fundamental rights, and these are the cornerstone of the Constitution. They include guarantees of equality, freedom of expression, freedom from exploitation, freedom of religious belief and practice, and the rights to education as well as constitutional remedies. Knowledge and access to these is by no means automatic, and for future generations for whom critical thinking may be crucial for survival, awareness of these rights acquires a special importance.

Socially and economically disadvantaged groups

Within educational policy, moreover, the National Policy on Education 1986, along with the Programme of Action (POA) 1992, could have laid the foundation for a different tradition, even as, like all policy documents, these may seem dated. One of the salient features of these documents was detailed discussion on what NEP 2020 classifies as the SEDGs.

In the 1986/1992 set of documents, it was recognised that if implemented with sensitivity, vigour and persistence, the proposals contained in the POA regarding reorientation of the whole system to promote women’s equality, special provisions for the Scheduled Castes, the Scheduled Tribes, other educationally disadvantaged sections, minorities, and the physically and mentally handicapped, and for the areas that need special attention will enable the educational system to move towards the democratic and socialist ideals enshrined in the Constitution [Introduction, paragraph 7].

Further, the document contained special sections outlining the perceived needs and possible policy measures for each of these categories [pages 101-106 for women and women’s studies; pages 106-109 for S.C./ S.T. and other backward sections; pages 109-116 for minorities’ education and pages 116-23 for “education of the handicapped”].

In contrast to these detailed provisions, these categories, now grouped together as SEDGs, receive cursory attention in NEP 2020. Interestingly, section 6.2 of the NEP has been expanded by adding clauses 6.2.1 to 6.2.6 to “include” women, S. Cs, S.Ts, Other Backward Classes, minorities and children with special needs. While this seems an afterthought—forethought would certainly have been preferable—it opens a tiny window for thinking about the implications of the policy for all these groups.

It is also worth looking at the context in which NPE 1986/ POA 1992 discussed the issue of ECCE. The first paragraph in the section reads: “1. Some of the significant parameters of the quality of life of any nation are the infant mortality rate, incidence of malnutrition, the morbidity picture and the literacy rates. The infant mortality rate today stands at 104 (1984). The rural-urban IMR differential is striking, being 113 and 66.”

I searched for some mention of the skewed sex ratio in several parts of the country, revealed in census after census, which could have informed and animated the present policy, but, unfortunately, found none.

And where are the Chinese?

Finally, it is curious that the NEP chooses to ignore the Chinese completely, in contexts where one would expect them to feature. For instance, we are told: “In addition to high quality offerings in Indian languages and English, foreign languages, such as Korean, Japanese, Thai, French, German, Spanish, Portuguese, and Russian, will also be offered at the secondary level, for students to learn about the cultures of the world and to enrich their global knowledge and mobility according to their own interests and aspirations” [NEP 4.20].

The Chinese are also, curiously, absent from statements such as the following: “Indeed, some of the most prosperous civilisations (such as India, Mesopotamia, Egypt, and Greece) to the modern era (such as the United States, Germany, Israel, South Korea, and Japan), were/are strong knowledge societies that attained intellectual and material wealth in large part through celebrated and fundamental contributions to new knowledge in the realm of science as well as art, language, and culture that enhanced and uplifted not only their own civilisations but others around the globe” [NEP 17.1].

An educational policy that ignores the past, present and future of our largest neighbour will deny learners of the 21st century access to crucial resources. One wonders what Kautilya would have thought of such a policy.

Kumkum Roy is Professor, Centre for Historical Studies, Jawaharlal Nehru University.

Interview: Prof Krishna Kumar

Prof. Krishna Kumar: ‘NEP 2020 offers more of the same remedy’

Divya Trivedi cover-story

After being in the pipeline for many years, the National Education Policy (NEP) 2020 is finally here at a time when educational institutions are shut for the foreseeable future owing to the coronavirus pandemic. Does the NEP match up to the demands of the times or does it threaten to entrench the age-old hierarchies of caste and other inequities? Professor Krishna Kumar, who served as the Director of the National Council of Educational Research and Training (NCERT) from 2004 to 2010 and who was awarded the Padma Shri in 2011, spoke to Frontline on some of these issues.

Excerpts from the interview:

Coming as it does during the pandemic, the NEP does not fully acknowledge the COVID-19 situation. How feasible would it be to implement such a document now?

It is astonishing that the ground realities created by COVID-19 find no significant acknowledgement in the NEP, although the word “pandemic” is used a few times in passing. Several international organisations concerned with children and education have issued elaborate advisories. They have asked member states to recognise the problems that education systems will have to face in the coming years. These are not merely financial, but finances to redesign institutions will also constitute a major challenge.

The document talks about the familiar 6 per cent of the gross domestic product (GDP) being spent on education. If the GDP itself contracts, an increased educational spending may not be substantial enough to compensate for the losses that have already been incurred. Consider just one example. We have no estimates at the moment as to how the closure of cooked mid-day meals has affected children’s nutrition levels over the recent months. Grain and money have been used to substitute cooked meals. Any estimation must take into account the impact of prolonged hunger on children’s health in different age-bands of infancy and early childhood.

The COVID-19 pandemic has had specific impacts on later stages of childhood, such as adolescence, that no one can claim to grasp today. It is related to the economic conditions their parents are facing. A recent study of artisans indicates how severe their losses are and how much support they will require if crafts as a source of livelihood are to survive the COVID-19 crisis. For their children, too, the crisis could have irreversible consequences.

What will happen to Right to Education (RTE) Act and all the progress that was made under it? The NEP offers a new structure for children from ages three to six. How feasible is this structure?

This is a serious concern. The document does not seem to recognise the shift that RTE, its enactment as law, signified. When it was promulgated a decade ago, complying with its demanding norms and applying them to the burgeoning private sector were major tasks for Central and State governments. Many States had a seven-year [school] cycle, involving a four-year primary stage. It took considerable effort to persuade these States to move to an eight-year cycle with a five-year primary stage. The financial implications of this move are still waiting to be addressed.

The RTE Act basically envisaged the acceptance of an elementary stage, grounded in sound psychological and pedagogic imperatives. Progress towards this systemic adjustment will now be hampered by the introduction of yet another structure that the NEP proposes, clubbing the first two years of primary schooling with three years of nursery. This clubbing will encourage people to formalise the nursery period, which is unfortunate for children. This has already been happening on a large scale.

There are infrastructural issues too. The NEP mentions anganwadis and nurseries in the same breath. Anganwadis represent a childcare system. Their workers have been struggling for recognition, dignity and reasonable emoluments. The NEP does not clarify whether the new 5+3 structure will bring in new salary scales. Apart from anganwadis, there are lakhs of privately run nurseries where unrecognised teachers work in exploitative conditions. The NEP says a curriculum will be drafted for the new composite stage, but a curriculum alone cannot deal with the anomalies this step entails.

Apart from this, the NEP attempts to revive the pre-RTE era parlance of non-formal instruction which featured the involvement of local community volunteers to help children. In the background of this revival, quality becomes a matter of judging by outcomes of a curtailed curriculum. This outcome-driven strategy needs to be read against a scenario formed by curricular minimalism which hits the poorest sections hardest. Financially, too, there was pressure to reduce the curriculum mechanically; now it has got into a policy document in the form of emphasis on old basics like literacy and numeracy. The RTE had kindled the hope that norm-governed schooling with a comprehensive child-centred curriculum would be made available to all children. The NEP does not want us to sustain that hope.

The RTE is facing another challenge today. Millions of children have gone back to villages this summer with their parents. They have been studying in far-off cities in different linguistic regions. Back in their villages, they might remain out of school unless proactive measures are taken to enrol them in local schools, with specific measures taken to address their linguistic needs. Since their parents are struggling for a livelihood, these children are exposed to the danger of joining the child labour market. It is disappointing that the NEP does not address their particular vulnerability. The financial problems of implementing RTE have been growing over the years, especially in the northern belt. With the difficulties that low-fee private schools are facing because parents are unable to pay on account of job loss, the RTE’s hope is getting thinner. I expected the NEP to address this.

Vocational education

In a departure from the current practice where vocational education begins at Class 11, the NEP proposes the inculcation of vocational education from Class 6 onwards.

RTE laid down eight years of compulsory schooling for all, with a comprehensive curriculum that includes science, health and arts education, apart from language and math. The NEP talks about an exposure to skill-centric experience, starting with the upper primary level. The integration of productive skills in the academic curriculum is hardly a new idea. By delaying the introduction of vocational learning, the Kothari Commission and other older policy documents attempted to give sufficient time to children from all social strata to attain an all-round academic exposure.

This was deemed important in a social set-up where hierarchies rooted in a knowledge versus skill binary are very sharp and deeply entrenched in the caste system. Reluctance to acknowledge the role of caste does not help. Letting vocational opportunities be introduced from Class 6 runs the risk of resuscitating entrenched hierarchies, especially at a time when unemployment might be high, traditional livelihoods are under severe strain and the mindless adoption of new technologies is deskilling people.

In general, does the NEP fulfil the expectations it created through the long period of its gestation?

Documents of educational policy are usually difficult to decipher, and this is no exception. I can empathise with those involved in the exercise of formulating a policy in our times. They had to balance so many contradictory demands and trends. Since the early 1990s, educational planners have been in a dilemma. Economic policy demanded opening up education to private investment while social policy demanded that emphasis on equity and social justice should continue. This is not a simple binary and its implications differ according to region and stage. Over the years, the education bazaar has become increasingly cluttered. In higher education, tools like accreditation and licensing were applied, but these tools could hardly cope with the scale and diversity of the market. The NEP negotiates the task of balancing between public funding and private investment with the customary instruments of generalised hope and distant time horizons. The text carries many signs of an overconscious attempt to balance the awareness of a slippery reality and the necessity to sustain the hope of radical reforms.

For handling the tension between Centre-State orbits, the NEP presses old remedies into service. One is the three-language formula. Since the time it was first proposed, its meaning has remained ambiguous. Within the Kothari Commission report, its deceptive attraction was duly indicated. Yet another instrument to keep systemic functioning in order has been the good old examination system controlled by boards, one at the Centre (in addition to a private one) and one in each State. Board exams handle and hide social disparities (between the clientele of State boards and the restricted all-India clientele of the Central board) by upholding the regime of merit. This arrangement has discouraged significant curricular pedagogic reforms. Failure rates have been high in many States. Shortly before the NEP’s public arrival, syllabus cuts were announced as a special measure for the COVID-19 situation. Now the NEP also indicates curricular shrinking in the name of efficiency. These ideas are not compatible with concern for quality.

The abolition of M.Phil, multiple exit points for certificate, diploma and degree courses and the one-year integrated Masters programmes are being hailed as innovative steps. The document emphasises controlling dropouts. But would such a system not encourage more dropouts?

One does not expect a macro policy to come down hard on a specific degree course. The case of M.Phil is a bit surprising, given the NEP’s fondness for flexibility, choice and exits. The M.Phil course suited students who could not commit themselves to the length of a doctoral programme. Why it has been axed is puzzling.

Barring this exception where an alternative degree is being banned, the NEP shows its preference for a United States-type self-tailored academic trajectory. Elements of this shift from the old British-type frozen degree programmes to a U.S. model have been gathering favour over the recent years. Experience shows that this transplanting has not proved easy or fertile. Even the semester system has not enhanced academic rigour, mainly because the exam pattern has remained unreformed and the infrastructure has not expanded. The four-year B.A. programme at Delhi University proved a failure. The NEP wants to make it the norm. Let us see where it finally germinates.

A host of new frameworks and bodies have been envisaged in the policy, such as Special Education Zones; School Quality Assessment and Accreditation Framework; Performance Assessment, Review and Analysis of Knowledge for Holistic Development (PARAKH); and National Curricular and Pedagogical Framework for Early Childhood Care and Education (NCPFECCE). How would they integrate with the existing system?

These kinds of remedial regulatory measures have been in fashion for some time. They illustrate the scale of the problem our [educational] system is facing. Its historically shaped character continues to exert resistance and one expects national policies to recognise it. Since its birth in the 19th century, the system evolved in response to provincial diversity and demands. Later a Central layer was put in place. Mitigating the friction between the two has constituted the core policy space.

With the entry of commercial players, regulation replaced administrative control as the preferred instrument for maintenance of standards. The question is not how centralised the regulatory mechanism may be; more important is the question whether it works. From capitation fee to single entrance tests, so many issues have demonstrated the vulnerability of regulatory mechanisms, not to mention the endemic corruption that the judiciary has noted with distress several times in professional education. The NEP offers more of the same remedy, indicating that the box has no innovations for now.

Foreign universities are going to be allowed now—which is surprising, given the avowed preference for indigenous resources—and they will pose another challenge for regulation. I suppose a basic division of labour has been accepted: social justice is for the public system to handle, while its private counterpart handles the interface with economy and industry.

In higher education, the focus is more on regulation by a centralised board of governors more accountable to the Central government than to the autonomous university system. While the NEP talks about teachers, it does not address their precarious conditions.

Yes, these difficulties are there, partly because no recovery plan is offered. The system has been functioning with a range of tacit policies. Vacancies in the higher education system became endemic more than two decades ago. The Fifth and Sixth Pay Commissions were anticipated to bring in a reduction in staff size, but the speed and extent of the growth of ad hoc appointments proved remarkable, destroying countless careers and pushing a vast talented pool of young people away from teaching. I had expected the NEP to present a recovery plan, but all it offers is a time-bound recruitment promise.

Disseminative use of technology may further deplete real academic strength. Few private institutions adhere to salary norms, and public institutions have learnt to function with chronic shortages. Both teaching and research have suffered though the inner reality remains invisible to the world outside.

Latin America

Suffocating democracy in the Andes

Vijay Prashad world-affairs

In late July, United States President Donald Trump casually tweeted that he might “delay” the November 3 presidential election because of the global pandemic. As polls show his support slowly declining, he has indicated that the elections might be “rigged” and “stolen”. His promotion of doubt about the outcome of the election suggests that he wants to use it either to rally his social base or to refuse to accept the results of the election. But the suggestion about delaying the election puts another layer of doubt about the entire process. The U.S. Constitution gives Congress the power to set the date for the election; the President plays no role in this process. While Trump’s suggestion might not be taken seriously in the U.S., the idea of delaying elections has become a reality in Bolivia, which will not have had an elected government for at least a year.

But delay of elections is only one part of a broad anti-democratic strategy that has taken hold of the Andes region, particularly in Bolivia, Colombia, Ecuador and Peru. Here, parties of the far right have utilised various mechanisms—some constitutional, some unconstitutional—often to prevent popular political forces of the Left from contesting elections. The coup in Bolivia in November 2019 that removed President Evo Morales Ayma from office was followed by a deliberate attack on his political party (MAS, or Movimiento al Socialismo) and the social movements that support it. In Ecuador, former President Rafael Correa and his party (FCS, or Fuerza Compromiso Social) have been denied the right to contest the 2021 presidential election. In Peru, President Martin Vizcarra got into a dispute with the Congress of Peru, with the country now caught in both the coronavirus pandemic and a political crisis. In Colombia, over a hundred leaders of social movements have been assassinated thus far in 2020, with the far-right government of President Ivan Duque offering those responsible for these murders complete impunity. Democratic processes in the Andes have shuddered to a halt.

Bolivia

In November 2019, the Bolivian military, backed by the far-right political forces in the country and by the U.S. government, overthrew the democratically elected government of President Morales. He was exiled to Mexico and then Argentina. At stake was his resource socialism, which had held the country’s vast lithium reserves for the benefit of its people and not transnational corporations. The far right and the military settled on Jeanine Anez, a minor political figure, to replace Morales, and she became interim President in November 2019. Before Morales left Bolivia, the military, the police and far-right paramilitary groups began a concerted attack against the MAS’ leaders and supporters. Several well-documented massacres transpired, with Jeanine Anez showing her eagerness to give those who killed her socialist opponents immunity from prosecution. She has shown no interest in investigating these massacres; the Plurinational Legislative Assembly, however, empanelled a multiparty commission to look into them and it will deliver its report in August.

Five months after the coup, the liberal press in the U.S. acknowledged, grudgingly, that Morales had been a victim of a coup and then began gingerly to criticise Jeanine Anez for her attack on the MAS and on democratic institutions. Lucien Chauvin and Anthony Faiola of The Washington Post (March 6) noted: “Since being sworn in, the fiercely anti-socialist Anez has presided over the detention of hundreds of opponents, the muzzling of journalists and a ‘national pacification’ campaign that has left at least 31 people dead, according to the national ombudsman and human rights groups.” Anatoly Kurmanaev and Maria Silvia Trigo of The New York Times (June 7) wrote that the government of Jeanine Anez had “persecuted the former president’s supporters, stifled dissent and worked to cement its hold on power”. The Harvard Law School’s International Human Rights Clinic published a report on July 27 that plainly made the case against the violence driven by the government of Jeanine Anez: “State-sponsored violence, restrictions on free speech, and arbitrary detentions have all contributed to a climate of fear and misinformation that has undermined the rule of law as well as the prospects of fair and open elections.” “Para-state groups”, the report says, operate without check to beat and detain activists of the MAS and allied groups, particularly in areas where the socialists have political strength.

The Anez government made sure that the hugely popular Morales would not be allowed to return to Bolivia and contest the election. On December 5, 2019, she said that she would not be a candidate for the presidency but then changed her mind on January 24. She trails in the polls behind Luis Arce, the MAS candidate. Bolivia has not had an election since November 2019 and, indeed, has not had an elected government since then. Jeanine Anez, who knows that she cannot win an election, first set the election for May 3, then postponed it to September 6 and has now postponed it once more, to October 18. It is likely that it will be postponed further since the government has been incompetent in its handling of the pandemic (her Health Minister was arrested for corruption over the purchase of ventilators).

Peru

The COVID-19 pandemic has struck Peru’s 33 million people hard, with 422,000 confirmed cases at the start of August and 19,408 deaths. Despite an early lockdown, the country has struggled. Close observers of the situation suggest that this has to do with the extreme social inequality and poverty in the country; since nearly half the population has no refrigerator, people by necessity have to congregate in markets, which makes the lockdown a mockery. The country went into the pandemic with a serious constitutional crisis on hand between President Vizcarra and the Congress of Peru, which he dissolved in September 2019. The Congress retaliated by suspending Vizcarra’s presidency and appointing Vice President Mercedes Araoz as President; but, a day later she resigned. Legislative elections were held in January, which sent to Lima a parliament where no single party received more than 11 per cent of the vote.

The crisis emerged out of a popular upsurge in September 2019 over the systematic corruption of Peru’s elite. Vizcarra has tried to drive an agenda against the corruption but has faced obstacles from the entrenched parties of the elite and by their institutional capture of the system. Four of the Presidents before Vizcarra were swept from office in corruption scandals. In July, as Vizcarra campaigned to hold a referendum to end the impunity enjoyed by Presidents, Ministers and lawmakers, the Congress hastily passed a Bill that did the same thing but with loopholes. Speaking of the reform process, Vizcarra said that the Congress “has distorted it” and that “surely someone will go to the constitutional court to have it annulled. Then, the parliamentary immunity will continue.” The paralysis in Peru’s institutions remains, with democracy smothered in the process. Vizcarra is up for election next year.

Ecuador

Inefficient governments that adopted the austerity policies of the International Monetary Fund (IMF) have seen the pandemic spin out of control. In Ecuador (population 17 million), for instance, the coronavirus pandemic overran the city of Guayaquil in March and April, with numbers of dead so high that their bodies were left on the streets. The situation in Quito, the capital, has become serious once more as lockdowns have eased. By early August, there were 86,232 confirmed infections and 5,736 deaths. IMF-driven cuts to public health care systems have negatively impacted Ecuador’s ability to tackle the virus. Meanwhile, President Lenin Moreno is driving an anti-democratic agenda in his country. On July 19, election officials refused to allow many parties, including former President Correa’s FCS to register for the presidential election of 2021. This manoeuvre comes alongside the National Court of Justice handing down an eight-year prison sentence for Correa on false corruption charges; this sentence bars him from electoral politics for 25 years. Each of these is an attempt to muzzle Correa, whose significant popularity in the country threatens Moreno. Moreno has used every measure—corruption, terrorism—to repress the opposition. Correa, who lives in exile, tweeted: “We are robbed of democracy again.”

Colombia

Colombia (population 50 million) faces a range of problems, among them the pandemic (306,000 confirmed cases, with 10,330 deaths), an endemic economic crisis, the paralysis of the peace process largely produced by the far right and the paramilitaries, and the use of Colombia as a staging ground for the hybrid war against Venezuela. President Duque, close to Trump in his orientation, has flailed about trying to please Washington and the Colombian elites. He faced a wave of protests late last year over both the economic crisis and the failure of his party to back the peace process. The incompetence of the government to handle the pandemic has further challenged his grip on power.

It is here that the assassinations of leaders of the social movement come in. Not a day goes by without either a failed attempt at or a successful assassination, with these leaders, often Afro-Colombian and poor, facing the brunt of state and para-state violence. On December 22, 2019, three such leaders were killed: Efrain Cabal Rendon (a teacher in the Toez indigenous area), Jairo Ortiz (of the Nasa indigenous area in Huila) and Nilson Caicedo (of the Community Council for the Development of Black Communities of the Mountain Range). These are brave people whose will to improve the conditions of their communities and to give their fellow community members confidence was taken away by force. Democracy, which grows through the work of such leaders, is not being allowed to emerge in Colombia.

Senator Victoria Sandino, a leftist lawmaker, tweeted: “The state is responsible for these crimes as it has failed to guarantee the lives of those who exercise social leadership in the country. Seeing these crimes only as numbers dilutes the importance for the communities. We need to know what happened, who gave the order and to make sure that history doesn’t repeat itself.”

Across the Andes, from Bolivia to Colombia, different procedures have been used, from coups to assassinations, to erase the possibility of democracy. The pandemic is being used to justify most of these processes although they long predate it. The pandemic is being used as an excuse to stifle democratic institutions and permanently destroy social movements and Left political parties.

Turkey

Reconversion of Hagia Sofia: Triumph or tragedy?

Irfan Engineer world-affairs

Hagia Sophia was a patriarchal cathedral built by Justinian I in 537 C.E. Its conversion into the Hagia Sophia Grand Mosque took place in 1453, after the conquest of Constantinople by Sultan Mehmet II, and into a museum, by Kemal Ataturk, in 1934. On July 10, 2020, it was reconverted into a mosque with the same old name. This controversial action by the Turkish government with regard to the Christian-Muslim monument signifies the growing strength the world over of right-wing politicians of all religions who misuse religion for their political ends and to stoke religio-cultural coflictss. The museum was a great tourist attraction.

I was pained at the sight of the first juma namaz held on the streets surrounding the museum and the khutba delivered by the imam, with the Ottoman-era sword in his hand. Muslims pray to one universal God to guide them to the righteous path. On seeing the video of the namaz on the streets (if those who were praying were doing so to mark their triumph), I wondered whether they were praying to Allah or to the brick-and-mortar structure. The Blue Mosque is just a few hundred feet away from Hagia Sophia. Those who wanted to pray to Allah could have done so there.

The reconversion of the Hagia Sophia Museum to the Grand Mosque is not a triumph of Islam. It is, I dare say, a triumph of politics that is alien to Islam. It is the triumph of a right-wing politician, President Recep Tayyip Erdogan, who is accused of corruption and is rapidly losing his popularity owing to the poor performance of his government on the economic front, and whose authoritarian rule represses the opposition. Erdogan reconfigured the Kemalist state, which imposed secularism, to an authoritarian state by misusing Islam to consolidate and perpetuate his rule. United States President Donald Trump is manipulating Christian sentiments to rally right-wing Christian evangelists to back him for a second term. Former Republican President George W. Bush stoked religious sentiment by calling the U.S.’ invasion of Afghanistan and Iraq in 2003 a crusade. Islamists such as the Islamic State (I.S.), the Taliban and Al Qaeda misuse Islam to achieve their political objective of an intolerant state. The Bodhu Bala Sena in Sri Lanka and the Myanmarese military misuse Buddhism to mobilise faithful followers for their version of Buddhist nationalism and an authoritarian state, and in India, the Bharatiya Janata Party (BJP) government misuses Hindu religion to weaken all democratic institutions and push for the centralisation of power. The reconversion of Hagia Sophia will fuel Islamophobia and immensely strengthen right-wing politicians across the board.

Misusing religion

Erdogan is misusing Islam for another political objective as well—to expand the boundaries of Turkey, re-conquer the Ottoman territories and become the leader of the Muslim world. However, Muslim countries were never united as they had their respective national goals to pursue. Erdogan’s military interfered in the Syrian conflict with the objective of annexing Syria’s Kurdish-inhabited territory. It failed miserably. Then it interfered in the Lybian conflict without making much headway.

Islam respects the freedom of conscience. There are several verses in the Quran in support of the freedom of religion. The Quran explicitly states that there is no compulsion in religion. “For you your religion; and for me mine.” Jews and Christians are considered people of the book. Sufi saints in India considered even Hindus as people of the book. Allah has sent prophets to all regions of the world to guide people and the Quran reveals the same truth that has been revealed through earlier prophets. Maulana Abul Kalam Azad, in his commentary on the Quran, stated that a Muslim must believe all religions to be true. Non-Muslims in Muslim-majority countries must enjoy equal rights. The Quranic righteous path is to strive for justice, struggle against inequalities in society, serve the neediest, deliver them from oppression and respect diversity. Diversity is God-ordained so that we know each other. Quran 2:148 lays down: “For each [religious following] is a direction toward which it faces. So race to [all that is] good. Wherever you may be, Allah will bring you forth [for judgement] all together.” The centre of all religions is Him, even though their ways may be different. We are ordained not to fight with each other but to compete in doing good deeds.

Political Islamists have emerged as hypocrites. They are supporting Erdogan’s conversion of the Hagia Sophia Museum. Their support is not only to a mosque, as in Islam no mosque is holier than another as you do not pray to the mosque but in a mosque, as congregational prayer is recommended. Political Islamists and Islamic evangelists feel triumphant at the conversion as they think that Islam is superior to other religions, and the Sharia, which has considerable human element and interpretation, must be established in Muslim-majority countries and imposed on non-Muslims or they should live as second-class citizens subjugated by Muslims. However, wherever they are in the minority, they claim the right to practise their religion and follow the Sharia. If the Islamists are celebrating the conversion of Hagia Sophia into a mosque, would they accept similar conversion of mosques into religious structures of other religions where Muslims are in a minority? They willy-nilly justify the treatment meted out to the Rohingya Muslims in Myanmar and the Uighur Muslims in China.

However, the majority of Muslims in their everyday life desire to live peacefully with non-Muslims in their neighbourhood and have an attitude of cultural dialogue, which leads to diversity within Islam. Islam is a matter of faith for them and they have learnt to live peacefully with non-Muslim neighbours. They know the place of religion in their life. Conversion of Hagia Sophia is not a conflict between Islam and Christians. It is a conflict between a minority, political Islamists like Erdogan, and the Islam of the ordinary faithful.

Monuments of power

Religion should be a source of knowledge and values. All religions have common values. They teach spirituality They teach us not to be vulgar consumerists and individualistic persons but to be conscious about our duties to society, share space with others and live in solidarity, coming to the aid of the needy. Imposing structures such as Hagia Sophia have been monuments of power and authority to overawe and mesmerise ordinary people who need livelihoods, housing, education, access to health services, and fair opportunities to work hard and succeed. Imperial religious structures mesmerise ordinary people into submission to the will and desire of the elite. Hindu nationalists are also constructing such monuments. The BJP installed a grand statue of Sardar Vallabhbhai Patel in Narmada district of Gujarat and the Maharashtra government is constructing a statue dedicated to Chhatrapati Shivaji Maharaj in the Arabia Sea off the Mumbai coast. The proposed Ram temple in Ayodhya is also a statement of power rather than a place of piety where the faithful experience the presence of God and feel liberated and inspired to pursue truth and the true meanings of life.

There should be an end to the conversion of religious structures. Monuments like Hagia Sophia should be the heritage of humanity accessible to people of all faiths; the mosque should be restored as a museum. Those in possession of Hagia Sophia and such monuments should hold them in trust as the heritage of all. Here I am reminded of the Prophet of Islam inviting Christians who came to meet him in Medina to pray in their own tradition inside the mosque. One day, when no classroom was available for my lectures for an honour’s course on Islam at St. Xavier’s College, Mumbai, the college management opened its chapel for my lecture. I wonder if Muslims would open their mosques for people of other faiths to pray. The Lotus Temple in Delhi is built and maintained by the Bahai community but for people of all faiths to pray in their own traditions.

Irfan Engineer is Director, Centre for Study of Society and Secularism, and Fellow of Islam and Liberty Network.

Jammu&Kashmir

Silent rage in Kashmir

Anando Bhakto the-nation

The first anniversary of the revocation of Jammu and Kashmir’s special status on August 5 was accompanied by a low-key yet determined exhibition of political resolve by mainstream actors, who emphasised their commitment to fight in the Supreme Court and outside for the restoration of Articles 370 and 35A.

The administration had imposed a two-day curfew on August 4 and 5. As a result, the all-party meeting called by former Chief Minister Farooq Abdullah to chalk out a programme to take forward the Gupkar Declaration, a document which multiple leaders had signed under his aegis on August 4, 2019, could not take place. The declaration stated that any unilateral action on the part of New Delhi would be an “aggression against the people of Jammu, Kashmir and Ladakh”. The following day, the government revoked Articles 370 and 35A, which guaranteed the people of Jammu and Kashmir exclusive rights in employment and ownership of property.

Several leaders took to social media to condemn the curbs put on the operation of mainstream politics, while appealing to the Supreme Court for a favourable verdict on their plea for the restoration of special status. Iltija Mufti, daughter of former Chief Minister Mehbooba Mufti, who is detained under the Public Safety Act, maintained that the exercise of coercive force would not prevent mobilisation of the Kashmiri emotion. She tweeted: “A year ago we witnessed how a majoritarian govt mutilated & robbed J&K in broad daylight. Seasons may have changed but the betrayal will never be forgiven or forgotten. Prolonged enforced silence wont suppress emotions forever.”

The National Conference (N.C.) had invited many leaders, including its Lok Sabha members Hasnain Masoodi and Akbar Lone, the Peoples Democratic Party (PDP) MP Fayaz Mir, the Communist Party of India (Marxist) leader Mohammed Yousuf Tarigami, and the Awami National Conference (ANC) leader Muzaffar Shah, for the meeting. Masoodi and Mir were stopped at the Gupkar road, while Tarigami, Muzaffar Shah and Akbar Lone were not allowed to venture out out of their homes.

Muzaffar Shah’s mother and ANC president Khalida Shah said “nowhere in the world has curfew been imposed owing to the COVID pandemic, the single exception being Kashmir”. She said the Centre’s strong-arm tactics could not mask the resentment that was brewing against it, not just in Kashmir Valley but also in Jammu and Ladakh. “The events in the State in the past one year have demonstrated that the Narendra Modi-led Bharatiya Janata Party (BJP) government has lost the plot in Kashmir,” she said. She expressed the hope that the Supreme Court would mitigate their grievances.

Khalida Shah, the eldest daughter of Sheikh Abdullah, said: “The act of Parliament on August 5, 2019, was not only a gross contravention of the Indian Constitution, its basic and fundamental tenets and structure, but also a contemptuous one. The Supreme Court is legally and constitutionally duty bound to declare the same null and void without any duress or pressure and create history in protecting and preserving its impartial status and its role as given to it under the Constitution.”

On August 5, Jammu and Kashmir Lieutenant Governor G.C. Murmu resigned from his post. The following day, Manoj Sinha, former Union Minister and senior BJP leader from Uttar Pradesh, was appointed to the post. The move gave rise to speculation that the Centre was likely to restore statehood to Jammu and Kashmir., which was revoked last year. The State was split to form the Union Territories of Jammu and Kashmir and Ladakh. Ladakh does not have a legislature. Ram Madhav, BJP general secretary, said in July that the party’s Jammu unit was in favour of statehood.

The N.C. outlined the atmosphere of fear and frustration in which people were living. Imran Dar, party spokesperson, said in a statement: “The commitments [for autonomy] had come from the country [India], profusely guaranteed by its Constitution. While the people of Jammu and Kashmir stood by their word, the Union of India chose to backtrack from its solemn commitments made to the people of Jammu and Kashmir unilaterally and undemocratically. The decisions on August 5, 2019, were taken on false excuses, all of which stand debunked today. One year later the situation is as it is; it has rather become more fragile and unstable.”

The N.C. asserted that it would constitutionally and legally fight against the infringement on Jammu and Kashmir’s rights. Imran Dar said: “The people of Jammu and Kashmir have been at the receiving end; we don’t want to put them through added trepidation. Our struggle has always been peaceful. We will continue with that proclivity of ours until our rights are restored.” The N.C. has decided to mark August 5 as a day of mourning.

On August 3, the Srinagar District Magistrate issued orders promulgating curfew in Kashmir on August 4 and 5 by virtue of the powers vested in him under Section 144 of the Code of Criminal Procedure. “Protests are not ruled out. There are specific inputs about violent protests endangering public life and property,” the order, which was applicable across all 10 districts of Kashmir, stated.

The government used the anniversary to catalogue its achievements in the Union Territory and share its vision for “Naya Kashmir”. Minister of External Affairs S. Jaishankar said that a “transformation was under way” in the Union Territory. He listed expansion of education, employment opportunities and advancement of women’s rights as major takeaways. Earlier, the Murmu administration had claimed that Jammu and Kashmir had progressed in the direction of decentralisation and economic revival. It listed 10 fields where Murmu’s regime registered growth; these included the health sector, ease of governance and democratic decentralisation, social sector development, economic revival, implementation of Swachh Bharat mission, and skill development and employment.

But Tarigami, a four-time legislator from Kulgam, questioned these claims. He said although “Prime Minister Narendra Modi and Union Home Minister Amit Shah justified the decision saying it would end decades-long militancy, separatism and corruption in the region and bring development, jobs and prosperity, one year down the line the promises proved to be a mirage and the claims a hoax”.

“None of the aforementioned claims pass the test of reality. Not only people of the valley, but residents of Jammu and Ladakh regions, too, are suffering because of the wrong policies of the BJP government. The uncertainties and uneasy calm combined with alienation pose a greater threat to the socio-politics of the State,” he said.

It is pertinent to note that in the past one year Kashmir’s economy has suffered losses to the tune of Rs.40,000 crore. This was largely because of restrictions in movement, which hit the apple industry badly, and the prolonged discontinuation of Internet connectivity.

Although people remained locked indoors, the day was punctuated by violence. In South Kashmir’s Kulgam district, at Vessu village in Qazigund block, militants opened fire on the BJP sarpanch, Sajad Ahmad Khanday. Khanday was rushed to hospital in Anantnag, but doctors there declared that he was brought dead. On August 4, a BJP panch, Arif Ahmad, was critically wounded after militants shot at him in Kulgam.

Several voices from different pockets of the world have condemned India’s hard-fisted policies in Kashmir. The culture of detentions and the prolonged shutdown of Internet connectivity, which have become a permanent features in the valley, have also come under attack. Prominent among such critical voices is Amnesty International, which has asked India to “urgently stop the protracted clampdown” in Jammu and Kashmir. It has also pressed for the release of all political leaders, journalists and activists.

Amnesty International India said in a statement: “Over the last one year the Government of India has been systematically dismantling all avenues for justice for the people of Jammu and Kashmir. With zero representation, protracted Internet restrictions, arbitrary use of some of India’s most stringent laws, verbal orders of detention and crippling of the local media —most of this disproportionately higher in Kashmir – it has been a complete year since we have heard the people of Jammu and Kashmir speak.”

Social Issues

‘The fight for reservation is not over’

ON July 27, the Madras High Court created history when it ruled that there was no impediment, constitutional or legal, for extending the benefit of reservation to Other Backward Classes (OBCs) under the all-India quota (AIQ) of seats in State government-run medical and dental colleges in Tamil Nadu. It asked the Centre to constitute a committee to arrive at the percentage of seats and address other issues relating to the OBC quota from the next academic year. The Medical Council of India (MCI) argued against reservation in AIQ seats, relying on a rather strange logic that since the Supreme Court had created the AIQ in 1984, only it could give an order in the matter.

The significant verdict was delivered by Chief Justice Amreshwar Pratap Sahi and Justice Senthilkumar Ramamoortrhy, on a batch of writ petitions filed by the State government, the ruling All India Anna Dravida Munnetra Kazhagam (AIADMK), the Dravida Munnetra Kazhagam (DMK), the main opposition party in the State, and a host of others. The prayer was uniform: 50 per cent reservation for OBCs in 15 per cent of undergraduate and 50 per cent of postgraduate seats in the AIQ in State-run government colleges.

Tamil Nadu’s has a long history of fighting for and providing reservation. Both the DMK and the AIADMK, which have ruled the State alternately for over five decades now, have been in the forefront of the fight for reservation in jobs and education as a measure to ensure social justice. The State has taken steps to create reservation within the reserved quota in some cases. It is a pioneer in extending reservation to the OBCs, Most Backward Classes (MBCs), Backward Classes (B.Cs) and other special categories of people. These measures were based on the socio-economic conditions of the people and have helped contribute to the development of a social fabric whose fundamentals rest on equity in education. The Supreme Court laid down in Indira Sawhney vs Union of India (1992), or the Mandal judgement, that the total quantum of reservation should not exceed 50 per cent, but Tamil Nadu had been approaching the apex court every year since then for a breather—and had obtained it—to protect 69 per cent reservation in the State. Later, a constituional amendment gave legal sanctity to this.

Thangam Thennarasu, DMK leader and former Education Minister, who is well-versed in theoretical and contemporary issues facing the State, said the High Court verdict was a victory for the DMK and its leader, M.K. Stalin, as the party had been raising the issue ever since the AIQ came into force. A Member of Legislative Assembly representing Tiruchuli constituency, he said that whenever a problem arose with regard to reservation in any sphere, particularly education, the DMK had always been the first political party to take up the issue and ensure that the rights of the oppressed and the backward classes were established. Thennarasu, who was Minister for School Education in the erstwhile DMK government, said the fight for reservation was in a continuous mode because the forces opposed to it were constantly trying to undo the gains made for the people by the DMK. He said that despite several differences, most of the political parties in Tamil Nadu had steadfastly remained on the same page with respect to the issue of reservation when it mattered. Thennarasu, who is DMK’s Virudhunagar North district secretary, said the party remained extremely vigilant in the case of reservation, and that was why Stalin directed that a caveat be filed before the Supreme Court. In this interview to Frontline, he traces the history of reservation in Tamil Nadu and places the current court battle in context. Excerpts:

In the OBC quota case, what was the main contention of the DMK and other political parties that demanded reservation in the AIQ for medical seats?

The Supreme Court permitted reservation in the AIQ, “including” reservation for Scheduled Caste/Scheduled Tribe, in the Abay Nath case on January 31, 2007. The line of judgments in Pradeep Jain and thereafter on AIQ stands modified by Abay Nath & Ors vs University of Delhi & Ors. While this is the reality, the Central government, using the 2006 Central Act, implemented 27 per cent reservation for OBC, 10 per cent for the economically weaker sections [EWS] and 5 per cent for persons with disabilities [PwD] in AIQ seats contributed by Central educational institutions without approaching the Supreme Court in view of the order in the Abay Nath case before the 2019 Lok Sabha election. But, the position of the government changes only in the case of OBC reservation. In the Gulshan Prakash case [2009] the Supreme Court held that the Abay Nath case’s clarification relating to reservation applied to seats in AIQ only. The ratio laid down is that the State has complete control over reservation and Central reservation does not apply to seats surrendered by the State. This is the most important issue that had to be raised.

The four MCI and Dental Council of India [DCI] notifications enabled application of State-specific reservation in medical and dental seats. Hence, the State reservation of 69 per cent under the TN Reservation Act 45 of 1994 shall stand automatically applied. The regulations never categorised seats as ‘All India Quota seats or States filled up seats’ for the purpose of reservation. The Director General of Health Services [DGHS], under these regulations, is to hold counselling for AIQ and is an agent /trustee to handle seats contributed by the State to AIQ. The DGHS has just that role and cannot dictate to a State government or the Central government in the matter of reservations or reduce or deny the same after enabling MCI and DCI regulations granting State-specific reservation in all seats without any demarcations.

The problem here is the DGHS overstepping its remit. Although the DGHS is not applying the 50 per cent OBC reservation formula to the seats contributed by the State to the AIQ, contrary to the orders of the Supreme Court in the Gulshan Prakash case, it has been currently applying a wrong reservation scheme to State-surrendered seats in Tamil Nadu insofar as reservation to S.C./S.T./PwD is concerned. Such wrong application of reservation by the DGHS is illegal and against the MCI and DCI regulations and the State’s reservation policy.

What was the crux of the argument of the DMK and other parties?

The total reservation granted by the Central government in Central educational institutions is as follows: S.C. 15 per cent; S.T. 7.5 per cent; OBC 27 per cent and EWS 10 per cent. After the EWS category was added (and there is a long discussion on the whys and ifs of this), the total in the reserved quota exceeded the 50 per cent mark and now stands at 59.5 per cent. Thus, when Central government grants more than 50 per cent of reservation, it is not proper to dictate terms to the State government to restrict all reservation to 50 per cent. Such a stand of the Central government runs counter to the principles of natural justice, is certainly against the letter and spirit of the federal structure established under the Indian Constitution, and is in violation of the MCI and DCI regulations. It has to be remembered that medical and dental education seats are State resources. The principle of reservation as per the Tamil Nadu Act applies to the seats surrendered by the State to the AIQ. It is a fact that the State seats do not get de-reserved merely because it is in the hands of the DGHS while it is handling the AIQ as these seats are filled in State educational institutions only. In fact, if the State-contributed seats are not filled up by the DGHS after the second round of counselling , it comes back to the State to be filled up by it. Hence, the character of the seat as the State seat is not lost merely because it is handled by the DGHS under a scheme because there is no law that dereserves the seat in the hands of the DGHS. Such an interpretation is against the letter and spirit of Article 15 and is impermissible in law. Reservation is a means to achieve equality. Social justice is a fundamental right and equally economic empowerment is a fundamental right to the disadvantaged people of India. Right to reservation backed by reservations laws is certainly a fundamental right. The Central government gave 10 per cent reservation for the EWS category while for OBC candidates, for the past four years, it is not abiding by its own affidavit filed before the Supreme Court.

The High Court has ordered the formation of a committee to look into the issue of granting reservation from next year. Is the issue settled now?

We will be watchful. If there is an appeal on the part of the MCI, then we will have to again fight it in the Supreme Court. It is easy to settle this issue right here in the High Court, if the AIADMK and the BJP want to. The BJP government just needs to direct the MCI to not go in for an appeal.

Is there any difference in stance between the AIADMK and the DMK on the issue?

On the question of reservation, both parties have been on the same page. But in this case, it was clear that the AIADMK had some hesitation in taking on the issue at hand, possibly because it is beholden to the BJP. This is the issue of a State’s rights. The AIADMK, which runs the government, should have been the first one to fight for it in all fora possible—courts, legislature and even the streets—when the need arose. Take NEET for example. They did not fight. In this [AIQ] case, it was Stalin who took the issue seriously and fought all the way and finally got this verdict. Like all other issues, this is not a single day’s battle, and the fight is not yet over. Every time there is an assault on the rights of the State, we need to stay together and fight as one. The problem in this case was some political parties thought that it was better to fight for 27 per cent reservation, instead of Tamil Nadu’s right of 69 per cent. This is a wrong approach; 69 per cent is what we have arrived at after a long fight stretching over decades. Why should we settle for anything else? We see the fruits of this move in society, and we need to preserve it because of what it has achieved for Tamil society.

Both the DMK and the AIADMK accuse each other of politicising this issue. Why does this happen when they are largely on the same page?

The problem here is the BJP. If the BJP so wishes, there was no need to go to court. When we filed a writ, the BJP could have said that this was a fact and agreed to implement the reservation. What is the MCI? Or the DCI? Are these bodies outside the control of the Central government? No, right? When that is the case, why is the Central government not directing both the bodies to implement the reservation as it exists in each State? What stops the BJP? This is clearly a case of double standards of the BJP.

The AIADMK is an ally of the BJP. The Chief Minister, the Deputy Chief Minister and others routinely meet the Prime Minister and several other Ministers of the Union Cabinet. Why is it that they are unable to press this issue, though they keep saying that they will preserve reservation? This is actually the problem with the AIADMK. They adopted the same stand on NEET. Finally, they let down the entire State.

Tamil Nadu has a long history of fighting for reservation. The Communal Order of 1921 and the subsequent attempts at affirmative action are public knowledge. Where and when does the struggle begin? Why is it important? And where is it now?

This has been a long-drawn-out fight and it still continues. Tamil Nadu’s struggle for reservation is spread over three centuries and pre-dates our independence struggle—19th century, 20th century and the current struggles in the 21st century. Each generation has a major history and context of why the fight happened and how it progressed. The first recorded instance of a fight is in 1854. A survey at that time found that one community, which constituted about 3.5 per cent of the population, was occupying all positions of power. There are instances where members of one family occupied all positions of government power in a given geography. In 1854, a government order, numbered 138, was issued, which directed that key positions in a district should be distributed among communities. You can say that the seeds of the concept of reservation were sowed at that time. The Census of 1871 reaffirmed these facts.

Subsequently, there were efforts to distribute government positions on the basis of the ratios of the populations of communities. In 1891, Iyothee Thassa Pandithar, the pioneering anti-caste activist, managed to highlight the problems faced by the S.Cs, and set in motion a thought process on the need to address the issues of those who were ostracised in society. All this crystallised in 1916, when Sir P.T. Theagarayar, one of the founders of the Justice Party, brought out the non-Brahmin manifesto when the party was formed. This was the first time that a formal demand for reservation was voiced.

The Justice Party was the precursor of the Dravidian movement. In 1920, the first Justice Party government was formed. Soon after, the first legal attempt at reservation was made via the communal G.O. The G.O. held that students from the oppressed sections should be given reservation in educational institutions. In 1928, again, after Justice Party came to power, Muthiah Mudaliar was responsible for consolidating all the thoughts and actions of the movement until then, and a comprehensive communal G.O. No. 1021 was brought for reservation in jobs, too. This G.O. was in operation until India attained freedom. In 1950, this G.O. was struck down by the Supreme Court, with the ruling that the Indian Constitution did not provide for reservation on the basis of caste.

A large section in the Indian National Congress backed this move. After the reservation was denied to the oppressed classes, a massive agitation was launched by the pioneers of the Dravidian thought and movement. ‘Periyar’ [E.V. Ramasamy] launched an agitation and gave a call to observe August 14 as ‘vaguppurimai naal’ [reservation rights day]. C.N. Annadurai [the founding father of the DMK, who later became Tamil Nadu Chief Minister] wrote on the issue and began a campaign on how rights of the oppressed classes were snatched away.

At this time, Congress leader K. Kamaraj, endorsed the struggle, which became a shot in the arm for the movement. So, on one side, there was a powerful campaign launched by Periyar and Annadurai, and on the other, there was a section within the Congress that endorsed the stand of these two leaders. The series of agitations attracted the attention of New Delhi and a constitutional amendment was enacted in 1951 for reservation on the basis of caste. In independent India, this was a major turning point. Soon after Kalaignar [M. Karunanidhi] assumed office as Chief Minister, the Sattanathan Commission was constituted to study the situation of the B.Cs and make appropriate recommendations. On the basis of the Commission’s report, the government increased the reservation quota of the B.Cs in educational institutions and government employment from 25 per cent to 31 per cent and for the S.Cs from 16 to 18 per cent. Karunanidhi appointed, for the first time, a Minister for Backward Classes.

The M.G. Ramachandran [MGR] government, which succeeded the DMK government, changed the community-based reservation into economic status-based reservation. MGR capped the upper income limit at Rs.9,000 per annum for reservation. But after his party lost the 1980 Lok Sabha election, many in the party claimed that the change in the reservation policy was responsible for the defeat. MGR took this view seriously and increased the reservation to 50 per cent for the B.Cs. Representatives of some communities approached the court, and the court directed the State to appoint an independent body to study the order. The independent body, headed by an Indian Administrative Service officer, gave a report in favour of the government.

To cut the long story short, there were two developments at this juncture. One is the demand for implementation of the Mandal Commission recommendations, and two, the Vanniyar agitation in Tamil Nadu, led by Dr S. Ramadoss. MGR passed away [in 1987] and the Kalaignar [Karunanidhi] Ministry took charge in 1989. Kalaingar [Karunanidhi] as the Chief Minister introduced 20 per cent reservation for the MBCs. Later, during the chief ministership of J. Jayalalithaa, the total percentage of reservation was increased to 69, which was challenged in the court. Finally, because of combined efforts, a constitutional amendment was moved to secure 69 per cent reservation. This is not there in any other State. Only people of Tamil Nadu have the privilege of this provision. Here, B.Cs enjoy 26.5 per cent reservation, MBC 20 per cent, Muslims 3.5 per cent, S.Cs 18 per cent and S.Ts 1 per cent. Within the S.C. reservation, Kalaignar provided 3 per cent reservation to the Arundhadhiyar community—who are among the most backward among the S.Cs. Now, there is a new criterion, the EWS, for whom there is a 10 per cent reservation.

Why are political parties opposed to the creamy layer concept?

Economic prospects change with time but the social status of a person does not change. Economic indicator fluctuates. MGR brought a criterion of Rs.9,000 annual income for reservation in 1980. This was opposed because economic situation can never be a measure. You can only have a classification for socially and educationally deprived sections.

The word ‘economic’ was sought to be included during Jawaharlal Nehru’s time. It was rejected then. We have had this debate since then. I am exasperated; how many times and across how many decades should we have the same arguments over and over again. Taking into account all the recent policies of the Centre on education—EWS reservation, the New Education Policy [NEP] and NEET—do you think the government is serious about upholding the hard-fought gains of reservation and education for the deprived sections?

It does not appear so. In the NEP for example, there is simply no mention of reservation. Why is this? I can only conclude that this is because the BJP is not concerned about social justice or uplift of the depressed and poorer sections of society. If you do not have any interest in social justice, then any policy that is drawn up will not benefit the backward and depressed classes.

Communalism

Christians as target during the lockdown

Ziya Us Salam the-nation

At least two reports by Christian organisations in India say that life has been precarious for the members of the minority community during the lockdowns imposed because of COVID. They were ostracised, threatened, intimidated, harassed, and in some cases fatally assaulted, the reports say. There were even instances of prayers being disrupted.

According to a report released in mid-July by the Religious Liberty Commission of the Evangelical Fellowship of India (EFI), there were 135 cases of attack against Christian houses, churches and individuals until June this year. The EFI, founded in 1951, is an umbrella body of more than 65,000 churches across the country.

The incidents include lynching, social boycott and attempts to hinder worship. The report states: “A lynching, community ostracisation, concerted attempts to stop worship and gospel-sharing mark the 135 cases registered by the EFI in the first half of 2020.”

Says Vijayesh Lal, its general secretary: “We thought attacks on Christians would die down during the lockdown when businesses, markets, schools and colleges were closed. When nobody would venture out. But we were mistaken. The attacks on Christians increased during the lockdown. There were 33 attacks in March and 21 in June. There has been a further increase in July.”

A few days after the EFI released its report, Persecution Relief, an organisation that aims to protect the right to worship guaranteed by the Constitution, released its half-yearly report stating that hate crimes against Christians in India had risen by an alarming 40.87 per cent in spite of the nationwide lockdown. It records 293 cases of hate crimes against Christians, including five rapes and six murders, compared with 208 incidents last year.

According to Shibu Thomas, founder of Persecution Relief, the aim of the report is to draw attention to the “intensifying hostility against the Christian minority in India which has become progressively common. The cases chronicled in this report are only a fraction of the actual violence perpetuated and reported on the ground.”

According to Thomas, six murders, “influenced by religious bigotry”, were recorded in Jharkhand, Chhattisgarh and Odisha in the last three months. He says hate crimes have been committed against Christians in as many as 22 States in the country.

Uttar Pradesh fares worst

According to the Persecution Relief report, the maximum number of attacks against Christians (63) has been in Uttar Pradesh. That is, every fifth incident of attack on Christians in the country happened in Uttar Pradesh. Tamil Nadu came second with 28 cases, including two hate crimes resulting in death, and the burning of a church structure. Chhattisgarh accounted for 22 cases, including a rape and the murder of a widow, and Jharkhand closely followed with 21 cases and one murder. Karnataka recorded 20 cases of attacks against Christians in the first half of 2020.

The report mentions 51 hate crimes of heinous nature against women and children, of which five were rape cases. There were 37 cases of boycott and ostracisation, rendering many Christian families homeless and forcing them to hide in jungles or stay at temporary shelters or safe houses. There were 130 cases of harassment, threats and intimidation and 80 incidents of physical assault, according to the Persecution Relief report.

“Over the past seven years, India has risen from No. 31 to No. 10 in the ‘Open Doors’ World Watch List, ranking just behind Iran in persecution severity. As of 2020, the USCIRF [the United States Commission on International Religious Freedom] has listed India as a CPC (Country of Particular Concern),” says Thomas. Open Doors, its website says, is an outreach to persecuted Christians in the most high-risk places. The World Watch List is an annual report prepared by its research team.

‘Impunity in administrative apparatus’

Condemning the targeted violence against the community, the EFI has sought the immediate arrest of the purveyors of hate violence. It turned down as false the allegations of coercive conversion, which is often cited as the reason for the violence.

The EFI report states: “The absolute sense of impunity generated in the administrative apparatus of India by the lockdown during the COVID pandemic, and the consequent absence of civil society on the streets, has aggravated the environment of hate and violence against Christians in major states and the National Capital Territory.”

Cases under-reported

The reports suggest that crimes against Christians are under-reported. The police are not willing to register complaints in some cases and when they do so, the incidents seldom get reported in the media, the reports say. “With the courts being virtually closed and the police failing to record all complaints, the access to justice is severely restricted,” the report says.

Significantly, the EFI did not regard the much-reported custodial death of Bennicks and Jayaraj in Tamil Nadu in June as a case of targeted killing of Christians as propagated in some quarters. The organisation also did not read communal motives into the murder of pastor Balwinder Singh in Ferozpur in Punjab in July end.

Incidentally, both reports claimed that the most number of attacks against Christians took place under Yogi Adityanath’s rule in Uttar Pradesh. The EFI report put the number of attacks against Christians in the State at 32. In early July, one Vikash was assaulted in Azamgarh at the residence of Sunita Maurya during a prayer service. Last year, Sunita Maurya was herself subjected to physical abuse, with a hot cup of tea poured on her allegedly at a police station.

“It is difficult to control attacks these days. The poison has reached very deep, right up to the grass-roots level. Until a few years back, there was only the Bajrang Dal whose members were often involved in such attacks. Now new bodies have mushroomed,” says Lal. Apparently, groups like Abhinav Bharat, Modi Sena, Amar Sena, and Dharm Sena have a crucial role in many of the recent incidents. Their volunteers go to almost every lane, every village, and speak about conversion to whip up an anti-minority atmosphere.

The atmosphere of hatred generated by these groups, says Lal, has resulted in attacks on not just Christian houses and churches but in the disruption of private prayers too. Says Lal: “The RSS [Rashtriya Swayamsewak Sangh] has percolated to the grass-roots level. Until 1990 or so, the term conversion was not heard of in everyday life except maybe in the Sangh circles. But today, a mere mention of the word Christian evokes images of conversion. It is due to sustained indoctrination over a long period of time. The lockdown attacks are a manifestation of that indoctrination.”

The worst manifestation of hatred came on June 4, when a group of people crushed to death with a stone a 14-year-old boy at Odisha’s Kenduguda village in Malkangiri district and then chopped the body to pieces before burying them in several places. In the first information report (FIR), the police noted that the victim and his family had adopted Christianity three years ago and that since then, a few villagers had been harassing them. He had been attacked in February this year.

Jharkhand and Chhattisgarh

The EFI suggests that the increase in number of anti-Christian violence in Jharkhand and Chhattisgarh is because of the greater confidence among the minorities to report the crime thanks to the change in political dispensation in these States. “In Chhattisgarh, now at number three from its earlier sixth position (in the crime list), the rise is attributed to Christians more willing to report violence in the Bastar region where there had been so far a blanket of fear of both underground militant Maoist forces and the armoured police,” the EFI report says.

According to it, Chhattisgarh saw six documented cases of targeted violence against Christians in April alone. This happened after Christians who were summoned to village meetings refused to participate in religious rituals against their conscience. They were apparently under pressure to recant, and when they refused to do so were assaulted.

In three separate incidents on May 5, May 7 and May 18, in Bastar and Dantewada districts, Christians faced stiff opposition to bury their dead. They were told that since they had not followed village religious rituals, they could not bury the dead there. “There have been 15 such confirmed incidents in these districts since 2019,” according to the EFI report.

Things were worse in neighbouring Jharkhand, which had earlier reported a spate of lynching incidents targeting Muslims. During lockdown this year, Christians were at the receiving end. The EFI report says: “Jharkhand saw four major assault cases in May alone. Though no one was killed, women were molested. On May 25, local authorities had banned Christians in Pundiguttu village from getting ration from the government outlet. In Jharkhand too there were cases of Christians being socially ostracised. The Pundiguttu village panchayat in May ordered the Christian converts to rejoin their parent faith at pain of being denied water from the community well and other penalties.”

The Pundiguttu case brings to memory the attempted Ghar Wapsi incident in Agra in 2014 when some Muslim families were sought to be lured to Hinduism with sacks of wheat and rice.

Increasing violence

The attacks on Christians are becoming increasingly common. In 2014, Bajrang Dal activists attacked 12 pastors in Greater Noida in western Uttar Pradesh during a private meeting. At the local police station they were advised to discontinue the meeting. In 2017, goons attacked a Christian woman putting her kids to sleep after prayer in Dalli Rajhara in Chhattisgarh and asked her not to pray.

“While the churches have often been attacked in the past, now it is becoming increasingly difficult even to offer prayers even in private. There are objections to Sunday prayers at home. The malaise is much deeper in the interiors and tribal areas. Even a regular prayer is considered a step towards conversion. First a prayer is attacked. Then a social boycott follows,” says Lal, adding that “most of the attacks are by local people. They are mostly OBCs [Other Backward Classes] who have been brainwashed by self-styled outfits like the Abhinav Bharat and the Modi Sena, besides the Bajrang Dal.”

‘Government in denial’

Activist and veteran journalist John Dayal puts the findings of the various Christian bodies in perspective: “Five murders of Christians in the COVID-impacted first six months of 2020 mark a new high in the viciousness of targeted hate against the community. Not since the pogrom in 2007-08 in Kandhamal district of Odisha have so many people died for professing the Christian faith. That they include pastors, young boys and women adds to the tragedy. The half-yearly reports by Persecution Relief and Evangelical Fellowship of India spell out the gravity of the targeted violence against Christians in India. The government is not just in denial, but positively on the side of the assailants, it would seem. The ruling party’s cadres where it is in power enjoy immunity, but surprisingly even where other ideologies govern States, the Sangh and its groups are aggressive and seem to defy the law. The international organisations, including the UN bodies, seem helpless in the face of government obduracy and the ruling party using the nationalistic rhetoric and sovereignty argument to insulate itself from all international inspection and exhortation.”

According to Dayal, the data “as reported by the Religious Liberty Commission of the Evangelical Fellowship of India, the Alliance Defending Freedom, the Morning Star News and the Persecution Relief” carry authenticity to the numbers reported.

Lal says there have been instances when policemen have asked peaceful worshippers, including pastors, not to go ahead with their religious meeting, saying it is not allowed in “Hindu Rashtra”. “Are we still ruled by the Constitution or the mob which attacked houses, desecrated churches, objected to gospel-sharing even during the lockdown?” he asks.

COVID-19 Update

COVID-19: Global distress

John Cherian world-affairs

The worst pandemic to hit humanity in a century shows very little signs of ebbing. In fact, it was only six months ago that the World Health Organisation (WHO) declared the outbreak of the novel coronavirus a public health emergency of international concern (PHEIC). There were only around 8,000 confirmed cases at the time and only 82 confirmed cases of COVID-19 outside mainland China. Tedros Adhanom Ghebreyesus, Director-General of the WHO, said at the time that the PHEIC was issued to warn the international community of the danger the new virus posed to countries “with weaker health systems” that were ill-prepared to deal with it.

The spread of the virus since then graphically illustrates the fact that the international community did not pay sufficient heed to the WHO’s warning. It was only on March 11 that the WHO deemed the epidemic to be a pandemic. It has now conceded that governments around the world were slow to implement a comprehensive strategy to effectively combat the virus. By July, the pandemic had made a comeback in countries and regions where authorities had seemed to have successfully contained it. The daily cases of COVID-19 had reached a record global weekly average of 260,000 by the end of July, with 665 people dying daily around the world and the numbers of cases rising.

Australia, Japan and South Korea are witnessing a resurgence of the virus. Vietnam ordered a lockdown in the city of Da Nang in July as coronavirus cases were detected there for the first time since February. The country seemed to have successfully tackled the pandemic when it first struck the region. The Central government closed down the country to international travel and introduced strict quarantine restrictions in the third week of March.

Vietnam is heavily dependent on the tourist sector. The latest developments do not bode well for its economy. The World Bank has forecast that annual economic growth this year will be around 2.8 per cent. With coronavirus cases having been detected in the capital, Hanoi, and in Ho Chi Minh City, the country’s two major cities, the Vietnamese government will face an uphill battle this time. Like most governments in the region, it has limited testing facilities. The government has had a field hospital built inside a soccer stadium in Da Nang. Prime Minister Nguyen Xuan Phuc told his countrymen that they had to move quickly to prevent a catastrophic spread of the virus. He said that the “early August period” would be decisive in the fight against the virus.

The Philippines, too, is facing a renewed spurt in infections. President Rodrigo Duterte has reimposed a lockdown in the capital, Manila, and surrounding areas. Leaders of over a hundred medical associations in the country issued a warning that the health system, overwhelmed by the spike in coronavirus cases, was on the verge of total collapse. The number of those affected by the virus in the Philippines was officially said to be around 107,000 in the first week of August. There have been 5,302 deaths so far. The country is the second most affected in the South-East Asian region after Indonesia. The Indonesian government reported a total of 113,134 coronavirus infections and 5,302 deaths up to early August.

‘State of disaster’

In Australia, the State of Victoria declared “a state of disaster” for six weeks. Major cities, including Melbourne, are under a strict lockdown. Australia was relatively successful in halting the spread of the pandemic in the first phase but is now facing a new challenge as it grapples with higher numbers of community transmissions and cases of unknown origin. After reporting new cases of infections, the South Korean government is now saying that the situation is under control as there is a downward trend of locally infected patients. The country has reported only 301 deaths in the past six months.

North Korea, which had been insisting that it was pandemic free, announced that a former “defector” who re-entered illegally from South Korea in the last week of July had COVID-19-like symptoms. North Korean leader Kim Jong-un immediately declared a state of emergency and ordered a lockdown in the border city of Kaesong. He warned that the development could lead to “a critical situation in which the vicious virus could be said to have entered the country”. North Korea has received thousands of coronavirus testing kits from Russia and other countries.

Japan was also initially successful in curbing the spread of the virus but now figures among the growing list of countries where there has been a resurgence of the pandemic. The infections were largely concentrated in the capital, Tokyo, but have now spread to different parts of the country. More older people are getting affected. The country is home to the world’s oldest population. According to critics of the government, Prime Minister Shinzo Abe was more focussed on reviving the economy than combating the virus. Although the Japanese government had imposed a state of emergency in the initial months of the pandemic in the effort to combat the virus, it had kept the economy more or less open. Offices, bars and restaurants were not shut. Now, Japan is reporting more than a thousand infections every day.

In Okinawa prefecture, where residents have been resenting the continued existence of a United States military base on their island, the Governor unilaterally imposed a state of emergency for two weeks in early August. The local administration is holding the U.S. base responsible for the rise in coronavirus infections. More than 248 U.S. soldiers and their dependants on the base have contracted the virus.

Protests in Israel

In Israel, thousands of people took to the streets of the capital, Tel Aviv, and cities such as Jerusalem to protest against the government’s handling of the pandemic. Twice a week throughout the summer, protesters have been gathering outside Prime Minister Benjamin Netanyahu’s office and residences, both public and private, and calling for his immediate resignation. The police have had to use water cannons and have made arrests, but the protests have continued. The Israeli government has assumed special powers until the end of 2021 under cover of tackling the pandemic. Many Israelis believe that the Netanyahu government opened up the economy too quickly, allowing the virus to resurface with lethal impact. The country is now dealing with a record number of coronavirus cases. The unemployment rate has surged up to 20 per cent.

Meanwhile, the pandemic is raging on in full fury in South Asia, North America, Latin America and Africa. When western European countries such as France, Spain, Italy and the United Kingdom tried to reopen their economies, the virus resurfaced, forcing governments to reintroduce quarantine measures. By early August, the numbers of those affected had crossed the 18 million mark with nearly 700,000 deaths recorded worldwide. India is the worst affected country in the South Asian region, with the COVID-19 deaths per million of the population exceeding that of neighbouring Pakistan.

The real numbers of those affected and dead are much more than is being reported in South Asian countries. Globally, India continues to occupy third place as the worst affected country behind the U.S. and Brazil. Mexico witnessed a huge spurt and has overtaken the U.K. as the country with the third highest mortality rate. By early August, the number of those dead was fast approaching the 50,000 mark. The U.S. had already recorded 156,000 deaths by the first week of August, followed by Brazil with more than 95,000 deaths.

Latin America’s plight

The pandemic has profoundly affected Latin America and the Caribbean region. By the end of July, more than 180,000 people had died in the region because of the virus. Cases have doubled in the past one month to more than 4.7 million infections. Brazil, Mexico and Peru are listed among the top 10 countries worst affected globally. The death toll in Colombia has already passed 10,000, and the infection rate is climbing fast. Economies have been devastated, leaving millions of people unemployed and starving. According to the United Nations, 16 million people in Latin America are expected to fall into extreme poverty as a result of the pandemic, reversing all the gains made in the past two decades.

Authoritarian regimes and corrupt elites are using the pandemic to undermine the democratic gains that people in countries such as Bolivia, Ecuador, Haiti and Brazil had made.

In Brazil, President Jair Bolsonaro has not changed even after contracting the virus himself. He continues to rail against social distancing, the wearing of masks and quarantine measures as the mortality rate in his country is on the verge of touching the 100,000 mark. In the last week of July, the Union of Brazilian Health Workers (“UNI Saude”) complained to the International Criminal Court at the Hague accusing the Brazilian President of “committing crimes against humanity”. The union, which represents tens of thousands of Brazilian health workers, accused Bolsonaro “of serious and deadly failures” in the effort to tackle the pandemic. Bolsonaro’s “negligent and irresponsible actions”, the union said, amounted to “genocide”. In April, the Brazilian Association of Jurists for Democracy accused Bolsonaro of crimes against humanity. Brazil’s death toll is rapidly closing in on the U.S.’ death toll.

Disruption of education

In the first week of August, the U.N. released a report that said that the closures of schools and other learning spaces since the pandemic struck have affected 94 per cent of the world’s student population and up to 99 per cent in low- and middle-income countries, causing the “largest disruption” in the field of education ever witnessed in history. More than one billion students have been affected according to the U.N. When U.N. Secretary-General Antonio Guterres released the report, he said that the reopening of schools “must be the top priority” once the pandemic is under control. A report the international charity Save the Children published in July states that 10 million children may never go back to school because of deep budget cuts and rising poverty resulting from the pandemic.

Taming the pandemic may yet take quite some time to achieve. Reports have emerged that a few countries are getting ready to vaccinate their people against the virus. During a media briefing on COVID-19 on August 3, the WHO chief warned: “A number of vaccines are now in phase three clinical trials and we all hope to have a number of effective vaccines that can help prevent people from infection. However, there’s no silver bullet at the moment and there might never be.”

Controversy

COVID ventilators: Who cares?

“Never let a good crisis go to waste.” This quote, attributed to Winston Churchill’s motivational public engagements during the Second World War, has once again come into wide circulation against the background of the COVID-19 pandemic in India. The bon mot has been repeated with diverse emphases in different contexts. But sections of the Indian business class, officialdom and political apparatus seem to have taken it to heart in a totally mercenary manner and exploit the health crises caused by the pandemic to enhance their financial resources through means that are legal, extralegal or even illegal. Several key public health initiatives of the government, such as the Prime Minister’s “special package” to reduce dependency on imported APIs (active pharmaceutical ingredient) and drug intermediates and “allotments from PM CARES Fund to expedite the purchase of ventilators required for critical care of acute patients”, seem to have been tainted by questionable financial deals. Notably, many of these deals seem to have been done without due diligence and appropriate processes and the deciding factor appears to be the proximity of the business class beneficiaries of the schemes to the political leadership, including Prime Minister Narendra Modi (see “A scam in the making”, Frontline, July 31, 2020).

The Frontline expose showed how B.R. Shetty, a business tycoon based in the United Arab Emirates and a self-proclaimed “blind diehard follower and disciple” of Prime Minister Modi, was the closet beneficiary of the private-public partnership scheme to reduce dependence on imported APIs and drug intermediates, which was launched amidst the pandemic. Some discrepancies with regard to the purchase and deployment of ventilators had already come out in the open, particularly in relation to the ventilators that were procured for the Ahmedabad General hospital from Jyoti CNC Automation Ltd, a Rajkot-based firm, whose owners are close to both Prime Minister Modi and Gujarat Chief Minister Vijay Rupani. However, a perusal of the details of the purchase of ventilators at the national level makes it clear that the Ahmedabad story may well be just the proverbial tip of the iceberg. Using the Right to Information (RTI) Act and other means, social activists and independent investigators have sought clarifications on the ventilator deals. The responses from several government and quasi-government agencies to these queries have been marked by systematic denial of information, indicating a possible cover-up.

The procurement story

The national level procurement and deployment of ventilators was done on the basis of the recommendation of the “Special Empowered Group” (SEG), which the Union government set up in the third week of March under the chairmanship of NITI Aayog CEO Amitabh Kant, to urgently procure ventilators in the months of May and June. When the SEG was set up, it was estimated that over two lakh ventilators would be required by mid May, whereas only 19,398 high-end ventilators were available. The Union government cited this shortfall when it earmarked Rs.2,000 crore under the PM CARES Fund to procure some 60,000 ventilators. On March 27, the SEG floated tenders for the procurement of 20,000 ventilators, one-third of the total number identified as needed urgently.

The SEG’s frame of reference had the clear objective of developing collaborations with the private sector, non-governmental organisations (NGOs) and international agencies and overseeing and guiding cross-sectoral dialogue on production of health equipment and personal protective equipment (PPE). HLL Lifecare Ltd was eventually designated as the sole agency to carry out ventilator procurement. By the last week of April, however, the estimate for the total number of ventilators to be bought was revised to 60,884. Additional tenders for as many as 40,884 ventilators were issued separately; this includes a tender issued on April 18, 2020. At the end of all this, on May 1, HLL Lifecare Ltd placed orders to procure 60,884 ventilators, of which 59,884 ventilators were to be ordered from Indian manufacturers.

The following Indian companies were also among those that got orders to manufacture ventilators: joint venture of Bharat Electronics Limited (BEL) and Skanray Technologies Private Limited, Mysuru, Karnataka, for 30,000 ventilators; joint venture of AgVa Healthcare and Maruti Suzuki Limited, for 10,000 ventilators; Andhra Pradesh MedTech Zone (AMTZ), a medical devices manufacturing initiative of the government of Andhra Pradesh, for 13,500 ventilators; Allied Medical Limited (AML), Gurugram, Haryana, for 350 ventilators. The deadline for delivery was June 30. However, only AML had supplied the full order of 350 ventilators by the first week of July.

In response to an RTI query filed by the social activist Saket Gokhale, BEL stated on June 15 that it had produced 4,000 BEL-Skanray ventilators against an order of 30,000. However, in a press note on June 23, the Prime Minister’s Office stated that only 2,923 ventilators had been manufactured until then. BEL-Skanray’s claim in the last week of June was that 15,000 of the order for 30,000 ventilators had been delivered. As of the first week of July, AgVa Healthcare and Maruti Suzuki Limited delivered 1,500 of the order for 10,000 ventilators. Details of deliveries by AMTZ are not available.

Significantly, AML has a track record of having supplied more than 2,000 ventilators to many State governments and hospitals in the public sector, including Army hospitals, over a considerable period of time. The BEL-Skanray collaboration and the AgVa Healthcare-Maruti Suzuki association were stitched up after the COVID-19 outbreak. According to technology specialists focussing on the clinical equipment industry, AgVa and AMTZ have no prior experience in manufacturing high-end ventilators. These experts, who did not wish to be named, pointed out that manufacture of high-end ventilators was time-consuming and that the government had either misjudged the capacity of these companies to deliver or had misrepresented facts about them deliberately.

Even more significantly, of the ventures that received the orders, only AML seems to fulfil the certification and accreditation requirements specified in the tenders floated for the ventilator contracts. Certification bodies in India are accredited by the National Accreditation Board for Certification Bodies (NABCB). Globally, accreditation is done by a member of the International Accreditation Forum (IAF). An important requirement in the tender was that the ventilators must be certified by the United States Food and Drug Administration (FDA) or they must have European Union standard of CE marking. (CE marking is a certification mark that indicates conformity with health, safety and environmental protection standards for products sold within the European Economic Area (EEA). The CE marking is also found on products sold outside the EEA that have been manufactured to EEA standards. Governments within the EEA framework as well as outside periodically insist on CE certification. There are authorised agencies that can provide this certification.) No Indian manufacturer has an FDA-certified ventilator, though AML has ratified CE certification. Medical equipment specialists and researchers at different levels have questioned Skanray’s claims about having CE certification. AML’s director, Aditya Kohli, has also expressed doubts on Skanray’s claims.

Problems in the tender and certification

Separately, KEN, the niche portal primarily focussing on technology issues, pointed out in early July that apart from non-compliance of these firms with the specific parameters mentioned in the tender, there were fundamental problems with the tender itself. According to KEN, the open tender released by HLL was based on the specifications of AgVa’s ventilator. KEN claimed that that the minutes of an HLL meeting that it had obtained proved this. The portal further pointed out that the tender specifications were released in the public domain a full 18 days after they were decided. “So, while AgVa sat pretty, nailed on to win the tender, other manufacturers were at a disadvantage,” the KEN article said. KEN said that HLL did not respond to questions sent by email.

The portal has pointed out other issues related to certification. AgVa apparently has a certificate from a third-party company that says it is FDA-compliant. The portal says: “There are two problems with this. The FDA doesn’t certify companies, just products. And the FDA compliance can only be issued by the FDA itself. In 2018, AgVa was certified by Unitas Certification Services, a company with a UK-based address. Unitas, incidentally, doesn’t appear to exist beyond its website. As recently as last month (June), AgVa received an IEC 6,0601 compliance certificate from NFI Certifications Ltd, another UK-registered entity, which appears to be a shell company. According to company filings, it has assets worth £1 ($1.25). AgVa did not respond to questions sent by email.” The KEN article went on to add that the absence of relevant laws had not just led to a rise in the importance of accreditation bodies but had also spawned an entire industry of opportunistic and unscrupulous certification companies (https://the-ken.com/story/ventilator-procurement-problems).

Unanswered questions

Saket Gokhale’s pointed RTI queries on the pricing of ventilators elicited obfuscatory responses from these entities, including BEL. Gokhale had sought information on the number and price of ventilators bought with funds from PM CARES and asked for copies of invoices. BEL rejected the query saying that the request was “non-specific with regards to time”. Saket Gokhale pointed out that the PM CARES purchase was billed as a one-time order to be delivered by June 30. Gokhale had also asked how many BEL-Skanray ventilators were bought between March 25 and June 18 at what cost and which hospitals these were supplied to. This question was not answered on the grounds that “giving this info would harm the competitive position of BEL”. Gokhale wonders how a “a public authority” can argue about harming its competitive position. He says that BEL is not in the ventilator business and that the ventilators it is manufacturing along with Skanray constitute only a COVID-related government project funded by PM CARES. More importantly, he notes, a government-owned company cannot suppress information on the prices at which it sells to the government.

On pricing, too, Saket Gokhale has raised pertinent questions. He points out that PM CARES has allocated Rs.4 lakh for every ventilator. According to the company’s own publicised claims, AgVa Healthcare ventilators are priced at Rs.1.5 lakh. The designer of BEL-Skanray ventilators, Dr Hiremath, said on record that their price was under Rs.1 lakh. “So, where is the extra money going?” asks Saket Gokhale.

Amidst all this, new advisories by the Union Ministry of Health and allied agencies are underplaying the importance of ventilators in treating COVID patients. According to the findings of some of these agencies, most patients in India require only simple oxygen delivery through nose prongs, using non-invasive ventilation (NIV) or BiPAP mode. Only 5 per cent of COVID patients need ventilators for invasive ventilation, they claim.

In the light of this new understanding, estimates for the number of ventilators required are set for a drastic revision from the original estimate of two lakh instruments. Even so, questions on the pricing, certification, underproduction and inadequate delivery of ventilators remain, as do questions on their quality and functional efficiency. Doctors at the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, rejected, in the last week of July, 10 ventilators delivered to the institute. The machines, bought with PM CARES funds, were found to be “not effective” and “faulty”.

Sources at the institute revealed that a total of 20 ventilators were sent to two health care facilities in Chandigarh. Ten were given to Government Medical College and Hospital and the other 10 were sent to PGIMER for its COVID-care hospital. Sources at the hospital said that a team of doctors—pulmonologists, anaesthesiologists and intensive care experts—carried out regular and mandatory checks on the ventilators. The majority opinion of the team was that the ventilators were not up to the mark. “We cannot use these substandard machines and put patients, especially COVID patients, at risk,” a senior doctor said.

A couple of weeks earlier, doctors at Ahmedabad General hospital had rejected many of the ventilators bought from Jyoti CNC Automation Limited for the same reason.

These rejections highlight the flagrant violations, mismanagement and suspected underhand dealings in the procurement and deployment of ventilators funded by PM CARES. An investigation seems to be in order. However, the Prime Minister and his government have steadfastly ruled out any sort of inspection of PM CARES funds and what it spends on.

The ventilator story gets curiouser and curiouser.

Sheetal P. Singh is a freelance journalist and social activist. He is co-founder of the Satya Hindi web portal.

Prisons

Prisons become breeding grounds for the coronavirus

Divya Trivedi the-nation

As early as May, the International Legal Foundation, which has two decades of experience in protecting detainees impacted by infectious diseases, warned that it was not a question of if, but when, COVID-19 would overwhelm incarceration facilities.

When 57 girls became COVID-positive in a shelter home in Kanpur, and seven of them were found to be pregnant, it shook the administration’s complacency and turned the spotlight on the spread of the virus in closed facilities such as detention centres.

A number of prisons across India have emerged as COVID-19 hotspots. These include prisons in Delhi, Jaipur, Puzhal Central Prison Chennai, Cuddalore Central Prison, Rajamahendravaram Central Prison Kakinada, Warangal Central Prison, Sangli District Prison, prisons of Behrampur circle, Rourkela Jail, Agra Central Jail, Jhansi Prison, Ballia district jail, Arthur Road Jail Mumbai, Nagpur Central Prison, Yerwada Central Prison, Guwahati Central Jail, the district jail in South Kashmir's Anantanag, Pratapgarh Jail in Udaipur, the Vadodara Central Prison and Bareli sub-jail of Madhya Pradesh. The Delhi Prison has 16 jails spread across three complexes in Tihar, Mandoli and Rohini; more than 220 inmates and staff members of Delhi Prison have tested positive.

Unsanitary conditions, overcrowding, poor nutrition, co-morbidities and a shortage of hygiene products in these confined spaces have rendered inmates vulnerable to disease outbreaks even in normal times. Indian prisons are overcrowded by upto an average of 150 per cent, which makes social distancing impossible to maintain. Legal researchers have pointed out that in some prisons, there is not enough space for all the prisoners to even sit comfortably, let alone sleep at the same time.

On June 16, large-scale violence broke out inside Delhi's Tihar Jail. Apparently, foreign inmates were protesting against an order that prevented them from getting interim bail. Such protests have increased in the months after the pandemic erupted, but the authorities quickly suppress them. The June 16 incident came to light when Pinjra Tod (an autonomous collective of women students) member Natasha Narwal alleged that inmates were prohibited from getting in touch with family members via videoconferencing because of the violence. Narwal is one of several student activists arrested during the lockdown for her role in the anti-Citizenship Amendment Act (CAA) protests.

At a time when prisons are being decongested the world over in view of the pandemic, and even the Supreme Court of India has ordered the release of prisoners, Indian investigating agencies are working overtime to fill prisons with more arrestees.

Several States have introduced punitive measures for citizens who fail to comply with lockdown rules. United Nations High Commissioner for Human Rights Michelle Bachelet expressed deep concern that some countries were threatening to impose prison sentences on those who failed to maintain physical distancing. Such actions were likely to exacerbate the grave situation in prisons and would do little to halt the disease’s spread. “Imprisonment should be a measure of last resort,” she said.

The prison population is not static. Though prisons are opaque facilities, there is a considerable traffic of people entering and exiting them. Every week thousands of people are arrested and released and transferred between jails, creating a floating pool of prisoners. Moreover, the cumulative number of staff employed by the prison-industrial complex is also substantial. Prison administrations across India have stopped meetings between prisoners and their friends or families (mulaqats). But there is still frequent movement of prison staff, visitors, vendors, service providers and prisoners that threatens to endanger communities inside and outside prisons.

COVID deaths

In June, Kanwar Singh, 62, who did not have any symptoms, died in his sleep at the Mandoli Jail in Delhi. He was later found to be COVID-positive. A judge of the Karkardooma District Court who examined his body for inquest proceedings had to go into home quarantine. The senior citizens’ barrack where Kanwar Singh had been lodged had 29 other inmates. All of them were tested after Kanwar Singh’s death, and 17 of them tested positive. One of them was Mahender Yadav, 70, a former Congress MLA, who developed symptoms and succumbed to the infection soon after. His family alleged that the police did not inform them of his hospitalisation after he tested positive. The Supreme Court had refused to entertain a plea for interim bail on the grounds that Mahender Yadav was in intensive care (ICU) after testing positive.

Mahender Yadav’s was the sixth reported COVID death in an Indian prison. Four deaths were reported from prisons in Maharashtra, the worst affected State. So far, 2,191 COVID-19 cases have been identified in prisons across India. But the actual numbers of cases sand fatalities are suspected to be much higher, according to the Commonwealth Human Rights Initiative (CHRI).

A legal expert speaking on condition of anonymity spoke of how intertwined communities inside and outside prisons were with each other. “It is all the more reason why policymakers should take care of the prison population. If not from the angle of humanitarian concern, then at least out of self-interest,” the legal expert said.

The case of Guwahati Central Jail

The situation is especially bad in Guwahati Central Jail, where as many as 435 inmates have been infected. The entire prison was declared a containment zone in the second week of July. Soon after, a letter written in Assamese by an inmate describing conditions in the jail was thrown outside prison gates from a bus that was transporting COVID-positive prisoners to another facility. The writer, who identified himself as Dudul Das, claimed that though 95 per cent of the inmates were infected not all of them were tested. “Even after we tested positive, nothing has been done regarding treatment or diet...Both positive and negative patients are staying together. Two people are sleeping in a two-feet space. More than 50 inmates have been made to sleep in a single room...When asked, the jail authorities said they knew nothing [about it]…” he wrote. The letter concluded in English, “Please save us, we are also human being and not a bluddy [sic] ghost!”

Dissatisfaction among prisoners was high even before this call for help surfaced. In the last week of June, almost all inmates of Guwahati Central Jail went on a two-day hunger strike after several letters to the jail authorities demanding better health-care facilities went unanswered. They demanded that new inmates be quarantined before they were assigned cells to share with existing inmates. They also demanded regular supply of clean drinking water and visiting rights for lawyers and others to be restored with COVID-19 protocols.

Political prisoners

Several political prisoners, including Krishak Mukti Sangram Samiti (KMSS) leader Akhil Gogoi, his associates Bittu Sonowal and Dhaijjya Konwar and Jawaharlal Nehru University student Sharjeel Imam, are incarcerated in the same prison as Dudul Das is. All of them have reportedly tested positive for COVID. Sharjeel, who was to be brought to Delhi by the Special Cell of Delhi police, will now not be transported until he is cured of the infection. Manas Konwar, president of the student wing of the KMSS, who was released on bail, told the press that the prison conditions were deplorable. In December 2018 the prison had an occupancy rate of 93.5 per cent, but the inmate population had surged in the past two years. It currently operates at more than 100 per cent of its capacity, which is for 1,000 inmates.

Eight of the 12 accused in the Bhima Koregaon case– Mahesh Raut, Anand Teltumbde, Sudhir Dhawale, Vernon Gonsalves, Arun Ferreira, Surendra Gadling, Gautam Navlakha and Rona Wilson–are in Taloja Jail in Mumbai where a thousand inmates have reportedly displayed COVID-like symptoms. Professor Hany Babu, who is currently in NIA custody, is expected to be transferred to Taloja Jail. But in the absence of systematic testing and information sharing with the lawyers, family members of the accused are a worried lot.

On March 23, the Supreme Court directed the States and Union Territories to constitute a high-powered committee to determine the categories of prisoners to be released on interim bail, parole or furlough to reduce overcrowding in prisons. While Assam said it would release 3,550 prisoners in order to decongest, it had released only 722 prisoners until July 23, according to CHRI.

Sanjoy Hazarika, who is CHRI’s International Director, took up the issue of the delay in arranging medical help for human rights defenders, including Akhil Gogoi and Varavara Rao in Maharashtra. He said: “Both had known existing ailments and co-morbidities and were hospitalized only after they tested positive. Till that time, they had been held inside prisons without adequate precautions. This is part of a larger wave of infections affecting other prisoners, who are similarly placed and continue to be at risk of contracting COVID-19. Factors like confined space, overcrowding, poor health and sanitary conditions, underlying health conditions like TB, HIV, hepatitis make the prison population extremely vulnerable to contracting and spreading the virus.”

Prof. G.N. Saibaba, who is lodged in Nagpur Central Prison, informed his family that despite preventive measures undertaken by the prison authorities, there had been an uncontrolled outbreak of COVID-19 with hundreds of prisoners, both convicts and undertrials, and even jail guards getting infected. His family was quoted in the media as having said that the infection was widespread and that “barrack after barrack” was infected. The family also reportedly said that one prisoner tested positive after all 20 prisoners of the jail’s “Anda” cell were tested on July 8. The family says that it is only a matter of time before Saibaba gets infected. Saibaba was convicted in 2017 for having Maoist links.

The National Platform for the Rights of the Disabled (NPRD), a non-governmental organisation, sought the National Human Rights Commission's intervention to shift Saibaba to a hospital for treatment. NPRD general secretary Muralidharan said in a letter to the NHRC that Saibaba, who was 90 per cent disabled, was highly susceptible to the virus and that a COVID infection might prove dangerous and fatal for him.

Experts’ opinions

Dr Lokendra Dave, a pulmonologist from Bhopal, said prisoners in general did not enjoy good health because of undernutrition. “Tuberculosis, respiratory diseases like asthma and COPD [chronic obstructive pulmonary disease], diabetes and cardiac issues are widely prevalent in the prison population. Mental issues like depression and suicidal tendencies and poor immune response of the body are also common. It is important that their nutritional needs, co-morbidities and immune status are addressed, apart from overcrowding, in order to curb the pandemic in jails,” he said.

He proposed that the following steps should be taken: a daily record of prisoner health should be maintained; CBNAAT (Cartridge Based Nucleic Acid Amplification Test) laboratory facilities should be installed on prison premises to ensure fast testing; pool sampling should be applied for tests; a diet high in proteins and Vitamins C and D should be provided to prisoners; co-morbidity analysis should be undertaken for inmates and safety protocols such as physical distancing, wearing of masks and washing of hands should be enforced. (In pool sampling, samples from a group of people are tested together in a single tube; the samples need to be individually tested only if the result is positive.)

Dr Gagan Shrivastava, a cardiac anaesthetist from Fortis Hospital in Delhi, echoed these views and said that barracks should be regularly cleaned and prisoners should be asked to sleep head to toe rather than mouth to mouth. Periodic health check-ups of prisoners with regular monitoring of their health status should also be undertaken by the prison authorities, he said. While it was nearly impossible to maintain social distancing or hygiene measures as ordered by the government or World Health Organisation, it was important to segregate new entrants for ten to 14 days before allowing them to mingle with other prisoners, he said.

Prison administrations are taking standard precautionary measures, but these are inadequate. Dr Gagan felt that preventive measures such as stopping the mulaqat altogether further compromises prisoners’ mental well-being. Not allowing prisoners visits by their lawyers or loved ones creates anxiety, especially in a situation of confinement. Dr Gagan suggested that visiting hours could be specified and the meetings regulated with certain protocols in place, he said.

After the Supreme Court’s directive on the decongestion of prisons, States such as Chhattisgarh, Goa, Haryana, Kerala, Karnataka, Punjab, Uttar Pradesh and Delhi took proactive steps to address the issue. But some States, Bihar for instance, did not act on the directive. The prison administration in Bihar created sub-jails to isolate new entrants.

CHRI and the Madhya Pradesh Prisons & Correctional Services organised a “virtual” national consultation on “Prisons and Ensuring an Effective Response to Covid-19”. Prison administrators from 15 States shared their strategies and challenges on combating the virus. Restricting or altogether stopping the mulaqats, spraying disinfectants, providing kaadha (ayurvedic drink) and homoeopathy medicines and mass screening (in Punjab) were some of the steps taken by them.

Pravin Kumar Sinha, Additional Director General of Prisons, Punjab, said that social distancing could not be maintained in prisons. “The only way to control the pandemic was to chase the virus,” he said. Sandeep Goyal, Director General of Prisons, Delhi, said that the pandemic had showed that the concept of barracks was now obsolete and it was time to think of single cells for prison inmates.

APPEAL, a non-profit organisation dealing with legal issues, has demanded temporary or early release of prisoners convicted of non-violent offences whose appeal applications have passed the single judge screening stage (via bail); prisoners on remand charged with non-violent offences; prisoners aged over 70; prisoners with pre-existing serious health conditions, including heart or lung disease, diabetes; immuno-suppressed prisoners suffering from cancer, HIV, or autoimmune diseases; pregnant women prisoners; prisoners in Mother and Baby units; and all prisoners in Category D minimum security open prisons with staff deployed to other prisons to boost capacity.

According to India Justice Report 2019, much of the overcrowding in prisons is on account of the presence of undertrials. If anything, the pandemic makes a strong case for the Indian justice system to review its prison policies and release low-risk prisoners who pose no threat to society.

Interview: K. Srinath Reddy

‘Swinging from lockdown to laxity’

T.K. Rajalakshmi the-nation

The continued upward trajectory of COVID-19 infections in India is a matter of concern. After the United States and Brazil, India has the third largest number of confirmed cases in the world. On August 3, India’s daily COVID-19 count surpassed that of the U.S. and Brazil. Even though the fatalities as a percentage of the confirmed cases are low, the alarmingly high positivity rate is an added cause of concern. The lockdown period was an opportunity to aggressively test, track and treat and fill the gaps in public health infrastructure, but that opportunity seems to have been frittered away. Professor K. Srinath Reddy, a public health expert and member of the Indian Council of Medical Research’s (ICMR) high-level technical expert committee on COVID-19, spoke to Frontline on India’s contribution to the global pool of knowledge on COVID-19, the reasons for the virus extending to new territories and the lessons learnt. He underscored the need for doubling India’s health expenditure and for a drastic reduction in out-of-pocket expenditure from its current levels. He also said there was a serious shortage of personnel at all levels of care and that investing in expansion of the health workforce was both a health system imperative and an economic opportunity for job creation. Excerpts from the interview:

What explains that even after a long period, India continues to have an upward trajectory of confirmed and active cases? Why is it that India has not able to reverse this trend as has happened in several other countries?

Our story has been one of the pendulum swinging too widely from lockdown to laxity. The COVID-19 virus exploits every weakness in containment measures. It is active again even in countries that had achieved good control earlier. This is now evident from Spain to Germany and Hong Kong to Japan. This sends a clear message that we cannot take this virus for granted and must maintain vigil for several months more.

The weakness of our public health systems came to the fore after we opened up. Early detection of cases, through symptom-based syndromic surveillance of households, prompt testing and isolation of suspected cases and close contacts, accompanied by vigorous contact tracing, are measures that are essential components of a sound surveillance and containment strategy. These have not been implemented adequately as a full package. The virus was also given ample opportunities to spread. Large gatherings were allowed for social or religious reasons. Masks came in late and have not always been worn properly, failing to prevent effective transmission.

However, it must also be noted that India is a vast country with a large population. The roll-out of the epidemic here has geographic and time dimensions that differ from [those of] a small country. If each of our States had acted with alacrity and efficiency from early on, rather than being dependent on Central directives, we may have seen more vigorous control. Within the States, district-level decision- making would have been needed from the very beginning, given the size of our districts. Even now, that is the level at which the response must be shaped, with monitoring at the State level and support from the Central level.

When is this likely to change and what would be the additional measures needed to achieve this?

The virus is now extending its presence to new territories even as those affected earlier are battling it out. So we will see different calendars for the epidemic in different parts of the country, with a landscape of many peaks and undulating hills portraying the infection.

We need to vigorously contain the transmission within the already affected urban zones while we energetically block passages of entry into villages and small towns. We have to step up the frequency of primary healthcare personnel-led household surveillance of symptomatic persons and close contacts for early testing and isolation, followed by energetic and extensive tracing of all named or indicated recent contacts. Citizen volunteers and elected local bodies can add to the strength of the formal primary healthcare system in performing these functions. Mild cases may be isolated, cared for and monitored at home, while persons with moderate or severe illness must be hospitalised without delay.

We need to develop integrated data systems that combine socio-demographic profile, emerging epidemiologic information, health workforce availability, healthcare facility capacity and readiness, supply chain status and transport data to quickly profile local area challenges and resources for a swift and contextualised response. While such data may be transmitted to higher levels of district, State and Central administration, village and ward-level data must be readily available to local implementers for responding without undue delay. So, people-partnered public health and decentralised data-driven decision-making must become the main engines of our epidemic response from now on.

Spread in south India

Within India, the number of cases were low in the southern States (except for Tamil Nadu) earlier, but are now accelerating. What explains this trend, especially as the lockdown and the easing of lockdown happened uniformly across the country.

More travel, into and within, these States, is a likely cause. The virus hitch-hikes with asymptomatic or pre-symptomatic travellers and spreads to more people in new areas. It is also possible that reports of good control in these States gave both the administrators and the public a false sense of assurance that the epidemic has ended locally, leading to a lowering of the guard. Bengaluru is a classic example of how public health failure has been snatched from the jaws of victory. If you give this virus an inch, it will take a yard. I do hope, however, that the well-earned reputation of the southern States for efficient administration will help them to quickly course-correct and regain control over the virus.

Are we clear about the reasons for the spread to new areas?

The virus moves with people and celebrates with crowds. Initially it entered via the international airports. Now it moves through road, rail and air to other parts of the country. If asymptomatic and pre-symptomatic persons are carrying the virus as they travel, neither do they know this nor can thermal screening detect it as they start their journeys. Physical distancing and masks can help cut the transmission but they are not universally followed. During travel, physical distancing becomes difficult. However, crowded events should certainly be avoided. Unfortunately, they have not been prevented in several areas.

Given the Indian experience, what have we contributed to the global pool of knowledge on the virus, treatment and so on?

We could have done more by way of organised research on clinical manifestations, outcomes and their determinants in different age groups. Our vaccine development efforts have been quite successful and clinical trials have begun to assess safety and efficacy. Characterisation of the virus strains and some mutations have been reported by Indian scientists. India is part of the World Health Organisation’s ongoing Solidarity trial on treatments, and other treatment trials, too, are under way in different parts of India.

This experience reinforces the need to build good epidemiological and clinical research capabilities in medical colleges across India. Presently, we depend only on a few elite medical colleges and research institutes. Many government and private hospitals are out of this circuit. The ICMR, State Health Departments and the National Board of Examinations (which affiliates private hospitals providing post graduate medical education) must build countrywide capacity for collaborative research and develop protocols which can be quickly implemented.

Among COVID-19 patients who have died, there are those who have not had any co-morbidity. What does this imply?

There are several possible explanations for this. First, several of them may have been repetitively exposed to a very high viral load under stressful conditions which sap immunity. This applies to healthcare providers and other frontline workers who come into contact with many patients and also to family members who have been in close and unprotected contact with a sick person. Second, several persons with co-morbidities may not have been diagnosed earlier. It is well recognised that many persons with diabetes, hypertension or coronary heart disease in population surveys are unaware of their condition. Third, risk factors such as high blood sugar and high blood pressure have a continuous relationship with blood-vessel damage and cause some harm even below the cut-off levels used for clinical diagnosis. This results in sub-clinical co-morbidity. Pre-diabetes, for example, has been found to be widely prevalent and carries the risk of vascular and renal disease. Fourth, high levels of air pollution may have already damaged many lungs. Fifth, malnutrition may have compromised immune status. Sixth, delays in diagnosis, transport, admission and treatment contribute to preventable deaths. The contribution of each of these factors would probably vary across different locations in India.

Acquired immunity

Earlier we were told that once infected, a person was not likely to contract it again. What is the current status of evidence from India about how long does immunity last among people who have recovered from the infection?

Acquired immunity, arising from infection, has two components. “Humoral immunity” is conferred by antibodies produced in response to viral invasion. “Cellular immunity” is conferred by thymus-derived T lymphocytes which mount additional defence. It has been recently reported that the anti-COVID-19 antibodies produced by an infected person decline by three months. However, it is believed that T cell-mediated immunity lasts longer. Since this is a novel virus, the extent and duration of immunity conferred by each of these pathways are still under investigation. Some stray cases of clinically manifest re-infection have been reported internationally but these appear to be very few. Most of the reports of positive viral tests in recovered persons have been attributed to “dead viruses”. It is possible that persons with low immune status could get reinfected. The Indian experience of such cases is very limited.

The ICMR sero-surveillance in May had suggested that 0.73 per cent of the population had been exposed to the infection. Since then the number of cases has multiplied manifold. Delhi’s surveillance data show 23 per cent exposure. What percentage of the population now is likely to have been exposed?

The ICMR report was on district-level surveillance data, reflecting rural and small-town populations surveyed in mid May. The Delhi survey was from June to July and covered a large city. So, differences are bound to be there. The sampling methods of each survey will have to be carefully examined to assess both internal validity and comparability. In general, the rates of viral exposure will vary across the country, being the highest in the big cities and the lowest in the villages as of now.

It must be recognised, though often not adequately publicised, that antibody tests can yield “false positive” test results too. This is because other coronaviruses, including those which cause common cold, can contribute cross-reactive antibodies. We do not know to what extent they are prevalent in our population at different times of the year. For statistical reasons, these false positive results get amplified when the test moves from a laboratory or hospital setting, where its accuracy was assessed in clinically proven cases, to the field setting, where the prevalence of infection is lower. So the 23 per cent positivity rate in Delhi is likely to be an overestimate of the true prevalence. Even if we think it will be 15 per cent instead of 23 per cent, that is a high number. So the virus has spread with ease. The good news is that most of the persons found positive were asymptomatic. The sobering news is that even at 20 per cent, Delhi will be below the herd immunity threshold, variably estimated to be at 50-70 per cent. The need to observe public health measures for containment is still very high.

India’s testing rate

Has India’s testing rate grown too slowly? Has it ended up chasing the spread of the infection or helped us to get ahead of the infection and help control its spread?

Our testing rates have varied over time. Low testing rates in the beginning were both due to operational constraints of testing kit availability and low numbers of people meeting the criteria for test eligibility. The testing rate picked up as kits, labs and eligible persons rose in number. They were still considered inadequate by international comparison, though there is no correlation between different testing rates and mortality rates per million population in any geographic zone of the world. Otherwise, the U.S. should have had far fewer deaths than most countries.

The need for increased testing is for quickly identifying cases and contacts for isolation. Since the real-time polymerase chain reaction (RT-PCR) test has only around 60 per cent sensitivity, it should be complemented with clinical and contact information for making decisions on isolation. It should not be assumed that a negative RT-PCR test rules out infection. Such expanded case definitions were not followed in practice. As criticism of low testing rates mounted, antigen tests were introduced. They had even lower sensitivity than RT-PCR and would miss more than half the infected persons. While testing rates went up and test positivity rates came down with these tests, the numbers of missed cases rose. We need to judiciously combine information from clinical data, contact history and RT-PCR or antigen tests to guide our strategy for identifying infected persons for isolation. Case identification must also lead to efficient contact tracing. The media, the public and even some policymakers are too fixated on testing numbers alone to recognise this composite template. That blinkered view, too, is as unhelpful as low testing rates.

Should the lockdown period not have been used to ramp up testing faster than we did? Did we lose an opportunity there?

During the full lockdown period, testing numbers were less important than preparing for larger scale testing as the lockdown ended. This is because the principal purpose of testing is to identify cases and isolate them as well as their close contacts. In the first 21 days of strict lockdown, this purpose was served even at low levels of testing as all potential cases and contacts were already isolated at home and symptomatic cases reached healthcare facilities. It is when that phase ended that testing and contact tracing should have been ramped up.

There were shortages of testing kits initially, in India and even globally, but the lockdown period gave time to fill those gaps. If symptom-based syndromic surveillance of households was routinely conducted by primary healthcare teams and citizen volunteers, more suspected cases would have been identified for testing.

Stigma and fear also kept people reporting for testing. Efficient and empathetic primary healthcare services would have countered that hesitancy too.

It must be recognised that a testing strategy must not merely chase numbers and do haphazard testing. It must be based on clear criteria. Once those are defined, all those who meet those criteria must be tested through active search strategies. Lag times in these could have been cut down through stronger primary healthcare services. Lamentably, our urban primary healthcare services are mostly absent or very feeble. Different States pursued different strategies for identifying persons to be tested, leading to missed cases and contacts.

Given that there is no specific “cure” for the virus, and many therapies are listed as investigational therapies, what is your opinion on whether there should be a definite treatment protocol or whether it should be left to the discretion of the individual clinician?

It bears repeating that this is a new virus and large clinical trials are still under way to identify which drugs can effectively reduce deaths in infected persons with different levels of clinical severity. So far, dexamethasone has been shown to reduce deaths in patients who require oxygen or mechanical ventilation. Others are still being evaluated for their impact on mortality. Some drugs have shown effects on the viral load or the duration of hospital stay, but not on mortality. Until we are better informed by ongoing clinical trials, clinicians will use their best judgement to manage patients under their care, by choosing among the various options available. It is too early to lay down a single evidence-based protocol for all clinical situations. Research in this area is still in a fluid state and science has not yet crystallised in the form of definitive recommendations.

As the number of cases are growing and the demand on the health system is increasing, do we not have a problem of inadequate personnel? While beds and infrastructure can be ramped up, are there not constraints even now regarding the availability of healthcare professionals?

We do have a serious shortage of trained personnel at all levels of care. From contact tracers in the field to intensive-care doctors, nurses and technicians who can confidently provide ventilatory support, we have the challenge of low numbers and low skill levels. This is where our long neglect of the need to build a sizeable, multi-layered and multi-skilled workforce is biting us now. Investing in expansion of the health workforce is both a health system imperative and an economic opportunity for job creation. We should learn this lesson at least now and start investing in creating an adequate health workforce which is also well distributed across the country.

From the COVID-19 experience in India, do you think that it is appropriate that such a large proportion of its healthcare facilities should lie in the private sector and that there should be significantly greater public investment in health?

I believe that a strong public sector should lead the way, even in a mixed health system that has grown by default rather than by design. This applies to all levels of care but is especially essential in primary and secondary care where most of the healthcare needs of the population must be met. Such transformation calls for higher levels of public financing for health, by both Central and State governments.

Whether for effectively combating public health emergencies like COVID-19 or for efficiently delivering universal health coverage, a strong public sector has to lead the way. It will not happen with only 1.2 per cent of the gross domestic product being spent on health. We need a doubling of that figure in three years and a further steady annual rise until we can reduce out-of-pocket expenditure on health to less than 20 per cent from the present 62 per cent. These additional resources must be used for strengthening both rural and urban primary healthcare, district hospitals, medical college hospitals and government laboratories.

Disease Surveillance

How the poor die

Maya John the-nation

For the human race that has seen approximately 100 billion of its species die in the past 50,000 years, death is an inescapable reality. What has changed now is its enhanced ability to systematically track down death to specific causes. With its national-level tracker for COVID-19 deaths, India has perhaps for the first time launched a daily tracker for deaths caused by a disease. However, the current conjuncture reveals an unsettling fact: while certain diseases gain singular prominence by attracting funds for exhaustive scientific research and treatment, many others are neglected as “ordinary”. In this light, the actual disease burden of a population is highly underexplored because several ailments and illnesses fail to be identified as specific diseases with a definitive cause (aetiology). Given the darkness surrounding many illnesses, it is essentially symptomatic treatment that is administered to patients.

Conspiracy theories

The identification of diseases and the spread of old as well as new diseases requires robust disease surveillance and expansive public health-care facilities. Unfortunately, there are systemic problems with the existing disease surveillance. Piecemeal disease surveillance often paves the way for conflicting assessments and opacity about the origins of disease outbreaks so much so that conspiracy theories soon take root. It is in this regard that even certain reactions to the COVID-19 outbreak may be contexualised.

For instance, shortly after the United States saw a spurt in COVID-19 cases earlier this year, President Donald Trump unleashed a bitter volley of accusations against China that it had concealed information about the novel coronavirus outbreak in Wuhan (China). In some quarters, COVID-19 has been projected as an engineered outbreak and the virus as one that has been produced in a laboratory. Considering that this is the U.S. presidential election year, many political commentators have labelled Trump’s accusations as part of an unsavoury attempt at jingoistic politics and to divert attention from his mismanagement of the COVID-19 outbreak in the country.

The allegations were accompanied by Trump’s formal announcement about ending the U.S.’ membership in the World Health Organisation (WHO) and withdrawal of $450 million it grants to the WHO as financial support. Accusing the WHO of being “controlled” by China, the U.S. government claims it will channelise its funds towards other global public health organisations. Such aggressive posturing by the U.S. conveniently sidesteps the important contribution of the Chinese disease surveillance system in identifying the new disease. What if China had not identified the virus strain and derived a definitive aetiology for the new disease from amidst a host of symptoms that are common to other known contagious and severe respiratory diseases?

Moreover, it is important to recognise the most recent compromises the U.S. government has made with respect to disease monitoring, such as a two-third deduction in funding for the country’s Global Health Security Agenda, which was introduced in 2014 with the aim of setting up an early-warning system for infectious diseases across the world. Likewise, the Trump administration almost discontinued the $200 million epidemiological research programme, PREDICT, that is funded by a grant from the United States Agency for International Development (USAID), but the COVID-19 pandemic compelled it to extend funding temporarily for six months beyond March 2020.

By then the damage had been done, with many scientists, including those researching in China, been laid off just before the Wuhan outbreak. Set up in 2009, PREDICT, with its focus on locating viruses with the potential to cause human disease and pandemics, has been engaged in regions like the Amazon Basin, South and Southeast Asia, and the Congo Basin. All these recent measures stand to affect not only the American population but also weaken ongoing intergovernmental disease monitoring tie-ups across poorer regions of the world.

Class, region and other social dynamics are crucial factors that steer the thrust of disease monitoring/surveillance across the world. The adverse medical conditions prevalent among the labouring poor and the less-wealthy regions do not get adequate attention because of their insufficient signalling effect on private pharmaceutical companies, and also because governments do not assign priority to the general health care and diseases of the poor. The profit-oriented pharmaceutical industry controls the lion’s share of funding for scientific research. Its funding priorities determine the quantum of funding and thereby shape the scientific community’s interest in certain diseases over others, stunting in the process the potential and quality of research carried out by the majority of scientists. In other words, the pharmaceutical industry tends to set the health agenda for intergovernmental agencies and influence the institutional priority of governments with respect to the scope and direction of scientific research.

This unfortunate reality is best captured by the growing dominance of the vertical model of health intervention wherein powerful donors (internationally recognised foundations), intergovernmental agencies and pharmaceutical companies, eager to promote certain drugs, dictate what constitutes as health exigencies for a country. The vertical health model propagates a surgical mode of intervention on a singular disease, leaving the collateral damage unaddressed, i.e. increasing fatality rates of numerous other debilitating diseases and illnesses prevalent within a population, which only horizontal health intervention or an expansive public health-care system can resolve. The fallout of this is that while some diseases gain singular prominence and are declared epidemics/pandemics by the scientific community, scores of infectious diseases and illnesses affecting largely the poor are brushed aside as “ordinary”. As the U.S.-based medical practitioner Siddharth Mukherjee aptly puts it in his award-winning book, The Emperor of All Maladies, “A disease must win politically to win scientifically.”

Narrow focus

Given the increasingly narrow focus on specific communicable diseases and the consequent skewed channelisation of resources, the process of neutral discovery of a disease rarely unfolds. For one, a significant number of clinical cases that can be captured by a disease surveillance system are not even made out, considering that the infected poor and marginalised people do not necessarily report their condition to certified doctors; they fall prey to quacks who are more easily accessible to them.

The dismal scenario with respect to fake doctors was exposed in a 2016 WHO report, which claimed that 57 per cent of the allopathic “doctors” in India in 2001 did not have any medical qualifications. The report further said that 31 per cent of the allopathic “doctors” in urban India were educated only till Class 12, while rural India had access to only 18.8 per cent allopathic doctors with proper medical degrees.

Even when infected persons report their ailments to public health institutions, an overburdened system often averts the essential testing of their blood/serum, throat swab, sputum, stool, urine, and so on, and restricts diagnosis to symptomatic treatment. If clinical cases lead to microbiological or cytological investigations, the tendency for pathology laboratories to categorise diseases on the basis of pregiven classification and parameters is so predominant that differentiating and separating pathogens on the basis of variations in groups, subgroups, and strains in genotype is minimal.

This way many pathogens are wrongly categorised into existing classificatory schemes, and the specific cause behind numerous diseases and ailments fail to be identified and differentiated. Many ailments are then simply clubbed together under catch-all categories such as “Respiratory Tract Infection”, “Urinary Tract Infection”, “Fever of Unknown Origin”, and “Acute Febrile Illness”. Some of these diseases are on the rise, and many are more contagious and fatal than diseases that gain prominence. However, given the incomplete diagnosis, it is at the most symptomatic treatment that is made available to the common masses, leading to the persistent spread of the disease and continuous heavy loss of life.

TB, an undeclared silent epidemic

Even when the aetiology of a contagious disease and its treatment are well known, the disease’s prevalence does not generate adequate reaction among the people concerned. Tuberculosis (TB), a disease generally associated with the poor, is an apt example. Sources highlight that every 10 seconds a person contracts TB, pointing to a very high R0 (basic reproduction number) for the disease. With four to five lakh persons succumbing to the disease every year in India and with more drug-resistant cases being reported yearly, TB has had not only a higher mortality rate than COVID-19 so far, but is clearly an undeclared persistent silent epidemic. Furthermore, there is an urgent need to recognise the issue of comorbidity, that is, the possible combination of preexisting medical complications with diseases that plague the majority of Indian people. Expectedly then, an eventuality of the ongoing pandemic is dying with rather than of COVID-19. The other eventuality is the neglect of coexisting diseases, which points to a situation where many poor people, if not succumbing to COVID-19, are dying from the rising fatality rates of other diseases. Evidently, the Indian population is falling prey to the sinister synergy between coexisting diseases and the vulnerability fostered by the overall functioning of our socio-economic system.

Considering the social dimensions impacting scientific inquiry and the resulting prevalence of undifferentiated and downplayed diseases, what could have unfolded if the Chinese disease surveillance system failed to tap the outbreak of the novel coronavirus and differentiate the aetiology of the outbreak? Among the most probable consequences would have been the misidentification of the disease’s symptoms and aetiology with existing severe and acute respiratory diseases that otherwise trigger mass hospitalisations and a significant number of deaths in many parts of the world. Case studies from Italy and the U.S. highlight that the COVID-19 death toll has been predominantly confined to elderly persons of the same age group who usually succumb to influenza (flu), pneumonia and similar diseases. For a typical flu season, COVID-19 nonetheless quickly caught the attention of governments in the West mainly because the population that was infected initially turned out to be well-to-do travellers. If this had not been the case and if China had not identified and differentiated COVID-19 from a host of similar diseases, COVID-19 would have in all probability gone under-reported as a somewhat unusual long spell of flu or pneumonia deaths.

The Surat outbreak

Outright non-identification, mistaken or undifferentiated identification of diseases, and downplaying of disease outbreaks are the ingrained reality of the existing disease surveillance systems. In turn, the opacity bred by mainstream epidemiology and disease surveillance systems allows for marked contestation. We have seen this in the context of recent and older disease outbreaks. The so-called “pneumonic plague” outbreak in Surat, Gujarat, in September 1994 is an important instance of the ambivalence that accompanies disease analysis and the conflicting interests that play themselves out in disease outbreak reporting.

The Surat outbreak reflected the frictions that exist between member-states and the WHO. At that time, the WHO was carving out a new role for itself in the context of the growing dominance of economic liberalisation policies which pushed for less public involvement in health-care services, the shrinking of the WHO’s traditional funding sources, and the competition posed by well-funded health programmes of the World Bank and the United Nations Children’s Fund (UNICEF). Through a somewhat unprecedented interventionist role in Surat, triggered by the pressure mounted by India’s affluent trading partners, the WHO sought to make an example of the epidemic and assert the importance of enhanced disease surveillance at the global level. Interestingly, WHO officials maintained a relatively ambivalent position on the cause of the outbreak. The WHO Team Executive Report claimed: “Yersinia pestis is the likely causative agent of the Surat outbreak…. [However] the identification of plague as cause of the outbreak cannot be established in the absence of confirmed isolation… from clinical materials….” Meanwhile, the National Institute of Communicable Diseases, New Delhi, confirmed that the outbreak was the plague whereas the Gujarat Chief Minister denied the plague thesis, claiming that it was more likely to be pneumonia.

The Indian government interpreted the WHO’s intervention as the undermining of the sovereign realm of state authority. It set up its own Technical Advisory Committee (TAC) that ran a parallel investigation to that of the international team constituted by the WHO on October 7, 1994. The TAC attributed the aetiology of the so-called pneumonic plague to Yersinia pestis, although it had to also acknowledge that its assessment was based on preexisting and contaminated cultures. It also sought to establish that the genetic mutation indicated the external origin of the strain, thereby projecting the emergence of a new disease whilst challenging the notion of poorer countries being the sites of disease and contagion. The outbreak was consequently connected to the enhanced mobility of disease vectors in a highly globalised world of trade, business and commerce, as well as to a possible act of bioterrorism. The politics of locating the origins of the outbreak stemmed from the Central government’s preoccupation with regional tensions involving hostile South Asian neighbours, who were allegedly antagonised by India’s bid to integrate with the globalised world economy.

The Gujarat government tabled a different assessment. The Gujarat Expert Plague Committee’s report questioned the Indian government’s assessment of the plague diagnosis and attributed the origin of the outbreak to internal issues of hygiene, unplanned industrialisation and social deprivation. Interestingly, conflicting assessments allowed for the labelling of over 6,000 cases as plague cases whereas they were actually due to other diseases. Taken together, the diversity of views revealed the ambivalence surrounding the origins of the disease outbreak and the inadequacy of sample data, both of which highlighted the acute need for a more robust disease surveillance system. Not surprisingly, the Surat outbreak became a crucial example worldwide and compelled the TAC itself to acknowledge the need for a new, integrated surveillance and response network in the country.

Challenges of disease surveillance

A dedicated disease surveillance programme in India was established in 1997 under a pilot project known as the National Surveillance Programme for Communicable Diseases (NSPCD), which started off in five districts and was later expanded to 101 districts by 2004. The nodal agency of the NSPDC was the National Centre for Disease Control (NCDC), New Delhi, and the implementing agencies were States/Union Territories. The programme was based on weekly reporting of outbreaks of epidemic-prone diseases (including nil reporting) directly from districts to the higher centres. However, the NSPCD failed to give a complete picture of disease burden in the country, given its limited coverage of districts and inadequate resources for the creation of an expansive database of diseases and epidemic outbreaks. In 2004, the country’s disease surveillance transitioned into the Integrated Disease Surveillance Programme (IDSP), which was initiated under the World Bank’s financial assistance of $68 million. By 2012 the World Bank’s funding for the programme was stopped, after which the IDSP continued under the Twelfth Plan as part of the National Health Mission with a budget estimate of Rs.640 crore. The annual budgetary allocation from 2012-13 to October 2017 has varied from approximately Rs.33 crore to Rs.65 crore.

More than 15 years into its existence, the country’s “revamped” public health surveillance still lacks coordination, adequate resources, and is ridden with significant gaps in the monitoring of many infectious diseases. Even in the ensuing context of the COVID-19 pandemic, disease reporting under the IDSP has floundered as the Central and State governments have enforced singular focus on COVID-19. Out-patient department (OPD) services and surgeries were drastically reduced in March 2020 when there were only a few hundred cases of COVID-19 in the country, and disrupted public health-care services have persisted despite the realities of comorbidity and actual disease burden of the common masses.

Ironically, in a country reeling under malnutrition and delayed treatment of the sick, among other adverse effects of a lengthy and poorly managed lockdown, the IDSP has failed to trace the actual disease burden of the population, as is evident in its lack of reporting of disease outbreaks since March 22, 2020. The IDSP’s inadequacies are linked to the general limitations of the country’s public health policy and overburdened public health-care infrastructure. For one, centrally-implemented health programmes continue to focus on vaccine-preventable infectious diseases even as other infectious diseases fail to be systematically controlled. As noted in the Draft National Health Policy (2015), the communicable diseases that national health programmes seek to address represent less than 25 per cent of all the communicable diseases in existence and less than 6 per cent of overall reported fatalities.

This apart, the country’s disease monitoring is hampered by specific problems such as limited funding; a scattered and inadequate laboratory network; lack of trained manpower; insufficient use of ICT (information and communications technology) for data collection, analysis and transmission; existence of a number of parallel systems under various vertical health programmes; inadequate use of routine data; and limited use of non-specific health indicators or proxy measures like trends in drug sales, use of emergency services, etc., which some health experts consider as an important back-up to laboratory-testing surveillance.

In the IDSP’s own annual reports, the inadequacy of funds gets reflected in the diversion of funds from other accounts/heads to the IDSP and vice versa from the IDSP to other programmes under the National Health Mission. For example, in 2010-11 an additional grant-in-aid was extended by the IDSP to the north-eastern States by diverting Rs.5.40 crore from the Rural Family Welfare Services head, indicating a reallocation of resources from an equally fundamental civic welfare programme. The limited funds for what needs to be a much more expansive and vigilant disease monitoring system has resulted in inadequate strengthening or upgrading of laboratories that are linked to the IDSP network. To date only 114 laboratories at the district level have been strengthened for diagnosis of epidemic-prone diseases.

Needless to say, the practice of upgrading district public health laboratories in a “phased manner” has meant additional burdening of established laboratories of medical colleges and other major centres in the States/Union Territories. Of course, the focus on district public health laboratories also tends to overlook the need for vigilant community level disease monitoring, for which neither can primary health centres (PHCs) and community health centres (CHCs) be left out from the necessary upgradation process, nor can the existing training of overburdened front-line health workers such as auxiliary nurse midwives (ANMs), multi-purpose health workers (MPHW) and accredited social health activists (ASHAs) be considered adequate for extensive and accurate data collection. Upgraded PHCs and CHCs as well as adequately trained front-line health workers mean better equipped local level disease surveillance.

Importantly, studies have identified that the lack of adequately trained front-line health workers and technical staff clearly affects the alertness of the surveillance system. A 2014 study published in the Journal of Family Medicine and Primary Care examined 24 sub-centres that come within the rural field practice area attached to the Post Graduate Institute of Medical Sciences, Rohtak, Haryana. It was noted that 70 per cent of the staff could not expand the abbreviation “IDSP”; 91 per cent were unaware of trigger levels; 93 per cent were not aware of nil reporting; and only half the number of sub-centres were actually filing written records according to defined syndromes, indicating the lack of awareness among the staff about the utility of their reporting.

Lack of expertise

From the IDSP reports it is also evident that district laboratories themselves lack trained manpower, i.e. microbiologists, epidemiologists, technicians, laboratory assistants, and so on. This worrying lack of expertise is the fallout of the long-standing trend of inadequate state investment in the education sector which generates skilled human resources for the economy and society. The country lacks dedicated educational programmes and institutions that can produce trained epidemiologists, among other specialists, for data analysis of diseases and policy framing, which are crucial components of an efficient disease surveillance system. Since the launch of the IDSP under World Bank funding in the early 2000s, the acute shortage of epidemiologists has been met by appointing personnel with an educational background in public health, statistics, communicable diseases, and social work, who are then subsequently trained in the working of the IDSP. Usually medical graduates with a postgraduate degree or work experience in public health, preventive and social medicine or epidemiology are preferred for positions of epidemiologists.

The lack of dedicated educational programmes is aggravated by interdisciplinary rivalries between medical sciences on the one hand and public health and community medicine on the other. The Medical Council of India (MCI), for instance, recognises the Masters in Public Health (Epidemiology) course of solely two institutions in the entire country; namely, the National Institute of Mental Health and Neurosciences, Bengaluru (offering 10 seats), and the All India Institute of Hygiene and Public Health, Kolkata (offering seven seats). Meanwhile, a handful of other private and public-funded institutions that do not feature in the MCI’s database offer this particular master’s programme and a diversity of allied courses.

Overall, the existing structure hints at the serious lack of standardisation in the educational training of epidemiologists, which is detrimental to the growth of such expertise, especially when combined with the relatively low remuneration for epidemiologists. Recent news reports on the country’s ill-preparedness for tackling the COVID-19 pandemic have rightly highlighted that the lack of experts such as epidemiologists is linked to the IDSP’s preferred practice of recruiting for non-tenured positions. Such non-tenured positions allow for low-paying, unrewarding work conditions, and trigger the preference among qualified experts for employment in private pharmaceutical companies and global agencies.

Conclusion

Some experts have rightly emphasised the embedded proximity of several microorganisms to human life. In the case of disease-causing microbes or pathogens, this means that infectious diseases and their outbreak have been an intrinsic part of human civilisation. However, human society has increasingly learnt to liberate humankind from disease, and its corollary, death. Unfortunately, the endeavour is often compromised by systemic reasons and the biases integral to the dominant socio-economic system within which scientific research is carried out. We are constantly confronted by the lack of preparation in meeting the challenges posed by diseases and their outbreaks.

The ill-preparedness can be addressed by augmenting the health conditions of the common masses and the health-care facilities of the country. It is also imperative to question the existing parameters of disease monitoring, which is currently far from an objective exercise. Many diseases plaguing the working masses and backward regions are not even differentiated and identified by the existing scientific community. Even if a disease is discovered with a definitive aetiology, we find that the order of priority given to it and the launch of appropriate disease control are based on whether it has a certain signalling effect for the scientific community. In a large number of instances, it is only when there is a threat of transmission to the well-to-do sections of society or wealthier regions that the disease actually has such a signalling effect.

Science does not exist in isolation but is actively shaped by contemporary social dynamics. Professional scientists do not pursue research in a bubble, and their subjective biases negate the very idea of the self-sufficient character of science. Controlled by increasing specialisation and growing demands for funding and output, only a limited number of scientists build conceptual frameworks and pursue empirical research with an ear to the ground. It is thus imperative to bring the social question back into science for which we need greater interface between scientists and social scientists, as well as between the existing health-care establishment and people’s movement. These interfaces are crucial for delinking scientists from prevailing prejudices and for asserting the marked distinction between the “specialist and a real seeker after truth” (Albert Einstein, 1944). It is through these interfaces that we can lay bare the skewed relationship between social epistemology (ways of knowing) and epidemiology in order to build pressure on state agencies to take active cognisance of diseases and illnesses that they have been neglectful of.

Maya John teaches at the University of Delhi and is working on the history of epidemics and epidemiology.

COVID-19 strategy

COVID-19: Government gloating in defeat

T.K. Rajalakshmi the-nation

The Indian health establishment is sparing no effort to convince everyone that the government’s strategy to control the spread of COVID-19 infections has been a success, but the reality on the ground proves otherwise.

In the first week of August, almost a week after the third phase of a gradual unlocking was announced, Chief Ministers of at least two States reporting fairly large COVID-19 numbers tested positive.

While Shivraj Singh Chauhan in Madhya Pradesh and B.S. Yeddyurappa in Karnataka were the high-profile COVID-19 cases, at the Centre, Home Minister Amit Shah too was diagnosed with COVID-19. On August 2, Kamal Rani Varun, a 62- year-old Cabinet Minister in the Uttar Pradesh government, succumbed to the disease.

India today has the third highest number of COVID-19 infections after the United States and Brazil and the fifth highest number of deaths after the U.S., Brazil, Mexico and the United Kingdom.

During the period from July 5 to August 5, the daily number of confirmed cases more than doubled from 23,942 to 56,626. On July 25, the daily number of cases touched 50,000 for the first time and has been on the rise since then. A record 57,486 confirmed cases were reported on July 31, the highest in the month. By August 6, this figure had gone up to 62,000.

On two consecutive days, India even surpassed the U.S. and Brazil in the largest single-day spike of cases and deaths. With around 40,000 deaths so far, India can hardly boast of having controlled the spread of the virus.

On August 4, a day when 51,282 cases were reported, senior Health Ministry officials urged the media to look at the “biggest news”, which was that nearly two crore tests had been done till date and that more than six lakh tests had been conducted in the previous 24 hours.

The other “big news”, of daily infections crossing 50,000, was not mentioned at all. At a briefing on that day, Rajesh Bhushan, the newly appointed Health Secretary, told mediapersons that the total number of recovered cases was double that of active cases.

This line of presentation was nothing new; each time a briefing was held, media officials always talked about the high recovery rates. It was not mentioned that the total number of recoveries was the cumulative figure, that is from March onwards, while the number of active cases indicated those currently active, that is, in the past 14 days.

The two were not comparable metrics from any standpoint, yet in each press conference health officials were self-congratulatory about the recovery figures. The number of active cases was by no means small: it was over six lakh.

At the briefing on August 4, there was no reference to the two days when India recorded the largest number of cases and deaths in the world.

Testing methods

Of the 1,370 laboratories in the country, 698 were conducting tests using the gold standard Reverse Transcription Polymerase Chain Reaction (RTPCR) method. Of the 1,370 laboratories, 921 are run by the government and 449 are in the private sector.

Apart from these laboratory tests, the Rapid Antigen Tests (RAT) method was also used but considered less reliable than the RTPCR, which is known to have higher sensitivity and specificity.

Although some mediapersons had repeatedly made inquiries about the proportion of antibody tests to the total number of tests, the government issued a reply only on August 4. The Director General of the Indian Council of Medical Research (ICMR), who was present at the Health Ministry briefing, said that 30-40 per cent of the total tests were done using the RAT method.

This was interesting as the ICMR had, in guidelines issued in May, stated that rapid antibody or antigen tests should not be used for diagnostic purposes. This was also in line with the guidelines of the World Health Organisation (WHO).

The problem with this method is that a positive test would indicate exposure to COVID-19 but a negative test would not overrule the presence of the infection.

If there were false positives, then these tests would have to be followed up with the RTPCR method. Given that there are only 698 laboratories using the RTPCR method for a population of 1.3 billion, it is impossible for every false negative case to get tested again using the gold standard method.

Besides, if 30-40 per cent of the total of two crore tests were done using the RAT method, many possible carriers of the infection were going untested and undetected.

The government and the Health Ministry have been sensitive to the criticism regarding the low rates of testing. They have been at pains to convince critics that India was testing far beyond the WHO standard on the optimum number of tests that need to be done a day per million, which is 140, according to the Health Ministry.

However, the cases per million in most countries are well over 140, often running into thousands, so it was unrealistic that a mere 140 tests a day per million would suffice.

Rise in cases and deaths

On August 6, the Health Ministry announced that a new record had been set with 6,64,949 tests in the previous 24 hours and that it was the third consecutive day that the number of tests a day had crossed six lakh. The tests per million had also crossed 16,000, the Ministry said in a release. However, it did not mention that in the previous 24 hours, India had taken the top spot in the highest single-day spike of confirmed cases, touching almost 62,000 and surpassing even the U.S. and Brazil in daily numbers.

August 6 was a milestone as the 60,000 mark had been breached. It was apparent that as more tests were being conducted, the number of confirmed cases were also going up. Also, India topped in the number of COVID-related new deaths. A day before, it was in the second place. On August 6, as many as 888 people in India succumbed to the virus, compared with 829 in Mexico, 416 in the U.S. and 274 in Brazil.

According to Health Ministry officials, the case fatality rate—the number of deaths as a percentage of the number of people who have tested positive—was at its lowest since March. But they did not offer any explanation on why the number of fresh daily cases (61,000 plus) was far higher than those reported in the U.S. (22,858) and Brazil (10,543).

The positivity rate over the weekly seven-day average was close to 11 per cent, which was high, although the cumulative positivity rate was around 8.89 per cent. The positivity rate indicates the percentage of positive samples out of the total number of samples tested.

According to the WHO, a positivity ratio of less than five was desirable and an indication that testing was adequate. A high positivity rate showed that testing was not adequate and that the infection was being chased, which was the case in India. According to the government, the positivity rate was high because of some States.

The Health Ministry said that some 28 States and Union Territories were testing more than the WHO’s guideline of 140 tests a day per million. The all-India average was 479, which the government considers robust. However, several countries are testing far greater numbers on an average.

Goa, Delhi, Tripura, Jammu & Kashmir and Tamil Nadu had increased their testing capacity and were testing more than the nation’s average.

Although the daily testing numbers had gone up, it was clear that India had woken up rather late to the ‘test, treat and track’ approach, as a result of which infections were far ahead of testing capacities.

Maharashtra, Tamil Nadu, Andhra Pradesh, Karnataka, Delhi, Uttar Pradesh, West Bengal, Telangana, Bihar and Gujarat accounted for the bulk of the caseload, but there is hardly any State left where no fresh cases are being reported.

Uttar Pradesh, for instance, was at the bottom of the list of States contributing to the caseload for many months. With over one lakh confirmed cases, it is now in the sixth place.

Export of ventilators

On August 4, even as the Health Secretary declared that there had been a progressive decline in the case fatality rate since June, he also announced that the government had decided to lift the ban on the export of ventilators.

The formal decision came in the form of a notification from the Directorate General of Foreign Trade in the Department of Commerce, which stated that “all ventilators, including any artificial respiratory apparatus or oxygen therapy apparatus or any other breathing appliance or device” whose export was prohibited under the existing policy could now be exported.

The lifting of the ban defied logic given the rising number of cases and daily deaths.

The Health Secretary also gave a presentation on “Make in India” ventilators in which he said that India was now self-sufficient in the production and supply of ventilators.

The Indian ventilator market had grown from 8,510 units to 18,000, all of them domestically produced. They had been supplied to States and were being installed in more than 700 hospitals. The government had placed orders for the domestic production of a total of 60,000 ventilators, which was the projected demand during the pandemic, he said.

Two public sector units had been given the charge to produce 43,500 ventilators and Maruti Suzuki was to supply another 10,000.

The government has been in denial mode for a long time now. Its recent discovery of the merits of aggressive testing and contact tracing should be complemented with adequate health infrastructure and life-saving equipment.

Great Indian horbill and its habitat

The great Indian air show in the Western Ghats

THE great Indian hornbill, the enormous, bizarre bird of the rainforest with its striking wing pattern and imposing wingspan, is visually overwhelming and gorgeous in flight. Its neck and tail are white, while its face and wings are black. Each wing has two white bars, which are conspicuous when it flies. The horn-shaped, powerful, sharp bill has a cumbersome casque on top of it; both are yellow, and this distinguishes the bird from the other heavy-winged beauties of the jungles. The loud whoosh of its wings can be heard from a distance like a steam engine of old chuffing away.

Capturing this massive bird on camera when it deviates from its usual “gait” resulted in some rare and much sought-after photographs, said Shefiq Basheer Ahammed, a globetrotting wildlife photographer, passionate about wild tuskers, big cats and birds. He has encountered a few male great Indian hornbills in the lush green hilly tracts of Valparai (Tamil Nadu) and Nelliampathy (Kerala), which are both hornbill habitats in the Western Ghats.

Last year, when he was trekking in the mist-clad Nelliampathy jungles adjoining the Parambikulam Tiger Reserve in Kerala, he was able to take an incredible photograph in which the bird, with its wings raised, looked like a martial arts maestro warding off an attacker. It was a shot on the spur of the moment when he sighted the bird on a tall tree. “It was such an awesome sight. After my click, the bird flew away with heavy wingbeats,” he said.

In another shot, Shefiq captured the bird in the midst of the thick leaves of a fig tree with its yellow beak and casque shining in the sun. Another shot was just of the curved beak jutting out from the leaves. In one shot, it looked as if the bird was hiding from those who wanted to watch it. Its curved beak quickly grabbed the figs, which it sometimes ate right away or stored in its beak to deliver to the nest. During the peak fruiting season, flocks of hornbills attired the trees, providing a feast for the eyes, said Shefiq.

Sometimes, when a great Indian hornbill swoops down, its wings look like the leaves of a fan. Shefiq said he had seen such shots of the bird taken in Thailand by the globally acclaimed wildlife photographer Tim Laman of the United States. It takes years of patient waiting to take such shots, and they leave indelible imprints in one’s mind. Shefiq said that the more one watched the hornbill, the more irresistible was the temptation to follow the bird in jungles, which one had to do silently and patiently. The great Indian hornbill is sensitive to even the slightest disturbance. He recalled that in Valparai, which is a haven for the lion-tailed macaque, he once watched a great Indian hornbill suddenly slanting, then twisting or curving its wings, to impart an aerobatic vision in the air. In Nelliampathy, the bird stopped like a fighter aircraft, then looked wobbly but, amazingly, straightened and started gliding. It then perched on a tall tree. “Such incredible shows stirred me. I was fortunate to take such shots,”Shefiq said.

“In both places, I had to be patient. Often I thought the bird would come gliding or booming into view at any moment and put on one of its magnificent ‘air shows’, but that did not happen,” he said. Two days later, while Shefiq was trekking in Valparai, a bird suddenly appeared, with its audible heavy wingbeats and deep grunts. Shefiq, who was hiding behind a tree, swung his camera into action. Through his binoculars, he could see that the bird looked agitated.

There was a nest with a female and chicks inside nearby. After walking a little distance, Shefiq could see three honey collectors, members of a tribe who lived in the forest. They were looking at the high nest and talking. The male bird was alert and could hear them. It gets agitated at any sign of danger because its role is that of guardian angel, a scrupulous protector of the nest. It also feeds the female and the chicks. Hunters used to steal the chicks as they were delicacies, and if they got a chance they would kill the male bird for its casque as it was used as an ornament in dances on festive occasions. If poachers try to snatch the chicks, the male bird will attack them with its sharp beak and seriously injure them. Some tribal people still carry the deep scars of hornbill attacks on their bodies. But now the protection measures in the forest are effective. Poachers are caught red-handed and booked for forest offences. The Forest Department employs honey collectors to monitor and keep a watch over the hornbill nests.

Salim Ali

The late Salim Ali, the legendary birdman of India, meticulously observed the great Indian hornbill and other birds during his bird surveys in 1933. Birds of Kerala, his mammoth work, has inspired generations of naturalists in Kerala. This is his most romantic description of the hornbill: “Their deep harsh grunts, roars or barks, and loud resonant call tok-tok, etc., reverberate in the forest-clad valleys and are responsible for their Malayalam name [Malamuzhakki, meaning reverberations in the mountains].The flight, slow and heavy, is accomplished by deliberate beats of the broad wings, the tips of the primaries are upturned, and is punctuated by occasional short glides. The loud rasping sound produced on each downstroke is audible at considerable distance. The bird’s habit of smearing the white wing bands and foreneck feathers with the yellow oily exudation from its preen gland is remarkable.... I certainly think that one of the most thrilling and grotesque characters in Kerala is the great Indian hornbill.”

There are four species of hornbills in the Western Ghats. The prominent among them is the great Indian hornbill and the others are the Malabar pied hornbill, the common grey hornbill and the Malabar grey hornbill. The hornbill is present in India from the Himalayas to Kumaon to Assam and in Myanmar, the Malay peninsula, Thailand, Sumatra, and so on. Totally, there are 57 species in Africa and Asia with 10 in the Indian subcontinent. The International Union for Conservation of Nature has evaluated the great Indian hornbill as vulnerable on its Red List of Threatened Species. Habitat loss, deforestation, human interference, poaching and development activities in the forests are responsible for its decline. In Thailand, the helmeted hornbill is poached for its casque, which is, in fact, responsible for the decline in its numbers. Even poachers from China intrude into Thailand.

The globally renowned authorities on hornbills Pilai Poonswad (Thailand) and Alan Kemp (South Africa) and the photographer Morten Strange (Denmark) came out with Hornbills of the World: A Photographic Guide, an important and authentic work that covers all the 57 hornbill species in Asia and Africa. Tim Laman took most of the photographs on the two continents. Some hornbill names are quite interesting, for example,the brown-cheeked hornbill, the white-thighed hornbill; the silvery-cheeked hornbill and the black dwarf hornbill, all from Africa, and the white-crowned hornbill, the helmeted hornbill, the rhinoceros hornbill and the rufous-necked hornbill, all from Asia. The Narcondam hornbill is confined to Narcondam Island of the Andamans.

Hydroelectric project

Last month, the Kerala government gave nature lovers a rude shock by deciding to go ahead with a proposed 163 MW hydroelectric project that would involve building a dam on the Chalakudy river in Thrissur district. When the project was first mooted, environmentalists had warned that it would be disastrous for riparian forests, aquatic biodiversity and flora and fauna, including the hornbill population, and that the elephant corridor from Chalakudy to the Parambikulam Tiger Reserve would be seriously affected The proposal was put aside becauseof the public outcry, but suddenly the government has revived it again.

Prof. Amita Bachan, who has carried out detailed studies of the riparian forests in the area, observed that the unique ecosystem would be ruined if the dam was built. Low-level hornbill nests are found only in this region of the Western Ghats, which will bear the brunt of the project. However, environmentalists and nature lovers in Kerala are getting ready to confront the government on the issue.

Chalakudy-Vazhachal forest area

All those who read Salim Ali’sautobiography, Fall of a Sparrow, will be moved by his fond remembrances of the Chalakudy-Vazhachal forest area and the adjoining Parambikulam Wildlife Sanctuary, now a tiger reserve. He visited these rich and dense bird habitats in 1933 during his Travancore-Cochin bird surveys at the behest of the Maharaja of Travancore. The Cochin Forest Administration had built a tramway from Chalakudy to Parambikulam to move timber from the forests to Chalakudy, from where it was taken in lorries to Cochin harbour for export. Salim Ali had on occasion travelled on the tramway, which was dismantled in 1946, and watched birds, including hornbills. He called it a romantic tramway.

Whenever he visited Kerala, he recalled those days. He visited Kuriarkutty, a rich bird habitat, in 1986 in the company of his protege R. Sugathan,who is at present an ornithologist with the bird sanctuary in Thattekad, 60 km from Kochi city. On seeing Salim Ali, an old tribal man who had accompanied him on his bird surveys in the 1930s exclaimed: “Oh, you have come again Bombaywalla? You want to shoot and kill birds?”(At the time of those surveys, birds were shot down with tiny bullets for observation and study.) Salim Ali burst out laughing. He hugged the old man and exchanged pleasantries with him. Salim Ali was deeply moved at the sight of flocks of great Indian hornbills in Parambikulam.

He visited the Thattekad sanctuary in 1986 and was heartbroken when he found that all the tall trees had vanished. Hornbills need tall trees for nesting, and he wondered how they could survive without the trees. Salim Ali observed that successive governments and crooked politicians had carried out mindless vandalism on virgin forests to clear land for settlements or for so-called development projects such as dams and to extract raw materials for wood-based industries. Sugathan felt that his guru was weeping silently.

Ground-breaking research

In the past two decades, ground-breaking research has taken place in India on the behaviour and ecology of hornbills, and valuable information has been gathered. Scientists have undertaken excellent fieldwork, which has benefited from the advent of digital photography.

The scientists Divya Muddappa and T.R. Shankar Raman of the National Conservation Foundation, Mysuru, visited 45 locations in Maharashtra, Goa, Karnataka, Kerala and Tamil Nadu to carry out a detailed survey of the hornbills of the Western Ghats. They prepared a report titled “A conservation status of hornbills (Bucerotidae) in the Western Ghats, India”. It said that the Malabar grey hornbill was the most frequently sighted and widely distributed of the hornbill species followed by the great Indian hornbill and the Malabar pied hornbill. The scientists identified the following as the important hornbill conservation landscapes in the Western Ghats: Amboli-Goa-Dandeli, Anamalai-Parambikulam, Nilgiris, Wayanad, Someshwara-Mookambika, Neyyar-Peppara-Kalakkad Mundanthurai Tiger Reserve, Periyar Tiger Reserve and Nelliampathy.

The survey report recommended setting up a committee with local participation and a forest officer as a facilitator. It wanted an action plan to monitor and protect hornbills. The survey made the startling finding that there was very low awareness of the hornbill species even among the forest staff of protected areas. So, the scientists recommended that education and awareness programmes should go hand in hand with protection and conservation efforts.

Plantations have become common in many forest areas, for example,the coffee plantations in the Anamalai hills. Scientists from different scientific institutions have observed that the great Indian hornbill may adapt to modified habitats as long as the key attributes relating to foraging and nests are present. They have also carried out detailed studies on the tree species hornbills select for nesting and on tree density; plant density; food availability; nest cavities; and availability of insects, lizards, small snakes, and so on.

As Pilai Poonswad says: “Many details still need to be explored and documented about hornbills from the world’s most fascinating wild environments of Africa and Asia.”

G. Shaheed is Chief of Legal and Environment News Bureau of Mathrubhumi, Kochi.

Shefiq Basheer Ahammed, who has travelled widely in India and abroad, is a motor vehicles inspector in Kochi.

 

Film review

Malayalam film "Run Kalyani": Patriarchy in perspective

It is not always that other characters in a film also become a leading character, despite the film already having a leading character. Perhaps this is where the ‘what’s in a name’ idea turns out to be a major area for critique.

One of the famous texts that Kerala has produced is Nalacharitham by Unnayi Warrier, a Kathakali play or aatakatha. In it, the male protagonist is Nalan and the female protagonist is Damayanthi, both supposedly the major characters. However, when we delve deeper into the play, it becomes evident that without a messenger, it would not be a brilliant one. That messenger comes in the form of the ‘hamsam’ (a bird of passage).

Perhaps it is the indelible nature of the ‘hamsam’ that is seen in the character of Kalyani in the movie Run Kalyani directed by Geetha J. The movie has been critically lauded in several spaces, ranging from the Kolkata International Film Festival 2019 to the 20th edition (virtual) of the New York Indian Film Festival on July 24.

Giving a glimpse of the storyline that begins in an ‘agraharam’ (Brahmin street) in Thiruvananthapuram, Geetha said in an interview to The Hindu (November 14, 2019) that the film tracks Kalyani from the time she wakes up in her rented house in the ‘agraharam’ and makes her way to the high-rise apartment of a bachelor where she works as a cook. Then, she works in a house inhabited by a joint family. And, in the evening, she returns home.

“This goes on for three days, and on the surface, her day looks monotonous but no two days are the same. There are several interesting interactions with the members of the household, and there are visitors too. In the meantime, she also acts as a go-between, carrying poems written by Nirmala (Meera Nair), the young housewife in the joint family, to the resident (Ramesh Varma) in the flat. The complexities go on increasing subtly every day till it all explodes on the fourth day. It is a pattern film about people keeping hope alive in oppressive circumstances, a realistic theme that focuses on the romance of everyday living, of grief and grit,” she said.

Although this happens to be a major plot in the film, as explained by the director, for a viewer there are multiple plots that can be deciphered and delved into through difference and repetition.

Humankind has been the subject and object of a history that has always been confronted with the most mechanical and the most stereotypical repetitions, inside and outside. Although we try to endlessly extract from them little differences, variations and modifications, the realisation of women also being part of the workforce has remained far away from the idea of representation in a patriarchal society.

Run Kalyani  is a glimpse into the daily life of the female workforce. This is a movie that takes one into varied realms of toil, class relations, and, most importantly, an identification of what it means to be a human amidst all the bourgeois ailments that populate the environment we live in.

In other words, the movie is a documentation of how to lead one’s life along with the ‘other’. Here, the ‘other’ need not necessarily be a character; it can even be an imaginative force that stimulates the self to work for others. It can be an illusion that just keeps someone up and running.

This agency, which functions through living a life characterised by an extreme, deep-seated, far-reaching responsibility for others before oneself, is what Run Kalyani tries to portray.

Portraying repetitive differences

Garggi Ananthan, who plays Kalyani in the movie, uses her theatrical training to brilliantly establish relations with the other characters in the film by conveying things that are not always verbal.

Garggi has put her body and soul into the role. It is not always that one can express the toil one undergoes without speaking, but Garggi has perfected this with utmost diligence.

The true success of a hidden talent is when repetitions are perfected. In a traditional artistic sense, one may call it ‘sadhakam’. Garggi as Kalyani in the movie has perfected this ‘sadhakam’ in portraying these repetitions very differently but with precision. The viewer is convinced that the other characters are also equally leading characters when the film succeeds in portraying the ‘repetitive difference’ of the characters. All the actors who are part of this film have achieved perfection in portraying this repetitive difference.

It is also this repetitive difference which is the major signifier employed in the film throughout. This is because the run is for a need and the need marks the limits of a variable present. The variable present for Kalyani has always been repetitive. This is because repetition is essentially inscribed in need, and it coincides with the duration of contemplation. All the characters in the film are in a way objects and subjects of Kalyani’s contemplation owing to her forced circumstances that have been repetitive in nature.

As Gilles Deleuze said: “Novelty passes to the mind which represents itself: because the mind has a memory or acquires habits, it is capable of forming concepts in general and of drawing something new, of subtracting something new from the repetition that it contemplates.”

It is perhaps this repetitive nature that creates a stage of novelty for Kalyani also to stay up and running.

Romantic poetry in acting

Run Kalyani  is yet another cinematic vehicle that wonderfully documents the brilliance of Ramesh Varma’s acting. A trained theatre artist, Ramesh Varma’s very involvement in this film is yet another example of romantic poetry, which he embodies both in his acting as well as in life. This romantic poetry in his acting seems to be getting more and more immanent at the same time aesthetically hidden as time and reel passes by. There is a particular scene in the film where he philosophises the beauty of ‘nothing’. The scene is minute and lasts only a few seconds, but the very articulation of saying the word ‘nothing’ when a girl asks him is a larger symbolic representation of every human in this world who has his/her heart firm in their beliefs.

Meera Nair in the film becomes an epitome of a spiralling staircase. Though the steps are spiralled, the ultimate arrival is at a larger world of flying without boundaries. A world that is bereft of a containment zone. Meera Nair’s acting is definitely a slap on the face of patriarchy and perhaps no one has ever immersed in a character to realistically portray living trauma to such an extent.

The trauma inside manifests not just as silence but also as actions, and these actions are a punch to the face. In a society still weighed down by the burden of historical patriarchy, Run Kalyani comes as a redeemer that questions the past.

Henry Wadsworth Longfellow once wrote: “The heights by great men reached and kept were not attained by sudden flight, but they, while their companions slept, were toiling upward in the night.”

Men as spectators

Kalyani and the film represent a toil wherein men remain mere spectators. The representation of women as labourers remains in the shadows even today. The reason for this is what the classical Marxist from Kerala, Dr T.K. Ramachandran, called an ‘ultra-conservative backlash’. This backlash marks the majority of the society we live in today.

He said that this society can be a representation of the unabashed idealisation of the feudal past, its belligerent apolitical posturing, its unconcealed male chauvinistic and sexist bias, its pathological dread of people’s movements and its strident revivalist rhetoric.

Run Kalyani goes against this ultra-conservative backlash by positioning Kalyani as an achiever who is optimistic, hardworking, determined and a fellow being who is always there for the ‘other’.

For this courageous attempt, Kalyani and the film have been rewarded with success, but as Geetha. J put it, this is the beginning of a larger beginning.

The movie was available on the site nyiff.moviesaints.com, NYIFF’s screening partner, until August 2.

Sankar Varma is a research scholar with Christ University (deemed to be), Bengaluru.

Works Cited 

https://www.thehindu.com/entertainment/movies/geetha-js-run-kalyani-revolves-around-the-life-of-a-young-cook/article29971252.ece

Ramachandran, T.K. (1995): “Notes on the Making of Feminine Identity in Contemporary Kerala 

Society”, Social Scientist.

Deleuze, Gilles (1994): Difference and Repetition, Columbia 

University Press.

Lukacs, Georg (1972): History and Class Consciousness, MIT Press.

Seroprevalence of COVID-19

COVID-19: Indian population still far from herd immunity

R. Ramachandran the-nation

In the last 10 days of July, Delhi, Mumbai and Ahmedabad, three of India’s major cities, released the results of COVID-19 seroprevalence surveys that their respective municipal corporations had conducted in association with research institutes. In the absence of any published countrywide sero-survey results, these studies, notwithstanding their limitations, are the only ones that give us information about the prevalence of COVID-19 infection in the general population of these cities, and possibly also give us some insight into the infection prevalence in typical urban Indian populations.

It should be borne in mind that sero-surveys, by testing for IgG antibodies to the infection that form around two weeks after infection, identify people who had been infected in the past and would have since recovered. So, such surveys identify only infected people who have circulating antibodies and only give an estimate of the prevalence of infection about two weeks before. Also, migrant workers, who constitute a good chunk of the population in Indian cities, possibly get missed out in these surveys as they are likely to have left for their hometowns during the lockdowns.

As reported earlier (“COVID cover-up” and “Chinks in the armour”, Frontline, July 3 and 17 respectively), the Indian Council of Medical Research (ICMR) conducted a nationwide cross-sectional sero-survey in mid May that covered over 70 districts, including only the containment zones of the 10 cities reporting the highest number of cases as of April 25, and tested over 26,000 individuals. Although the results of this national survey are yet to be published, the ICMR stated in a press briefing that the seroprevalence rate found among the general population, that is, excluding the hotspot zones of the 10 cities, was only 0.73 per cent. Since this survey was conducted in mid May, it gives the seroprevalence rate of April-end.

On the basis of leaked information, some news reports said in June that the ICMR study had found over 30 per cent prevalence in the cities. The actual findings, however, remain unknown as the ICMR has not made the results public. In the absence of the ICMR data, these city-specific surveys conducted in June-July, give us a more recent picture of seroprevalence in these three cities. This article discusses the data released by these surveys and also looks at, for what it is worth, the nationwide seroprevalence data gathered by the private diagnostics company Thyrocare Technologies Ltd. Neither the scientific community nor the Ministry of Health and Family Welfare has taken note of this private effort as it falls well short of being a properly conducted survey.

Delhi

In a press release dated July 21, the Health Ministry said it had commissioned the seroprevalence study for Delhi as a follow-up to the sero-survey the ICMR carried out in the containment zone of Delhi’s South East district. The National Centre for Disease Control (NCDC), an institution under the Ministry, in collaboration with the Delhi government carried out the community-based cross-sectional sero-survey in all the 11 districts of Delhi between June 27 and July10. The IgG antibody tests were done using the ICMR-approved indigenous COVID KAVACH IgG ELISA (enzyme-linked immunosorbent assay) kit.

Following a “multistage sampling study design”, 21,387 sera samples were collected. The results of this seroprevalence study (Figure 1) show that the (population-weights adjusted) average infection prevalence across Delhi (from mid June to the third week of the month) was 22.86 per cent. According to the Ministry, a large number of infected people were asymptomatic. Given the current population of Delhi (over 20 million), this means that about 4.6 million people were infected in mid to end June. However, the official data for the number of confirmed cases in Delhi for that period was 43,000 to 82,000.

While this clearly indicates a gross failure of the testing strategy, the Ministry, however, in its usual self-congratulatory style, said: “Nearly six months into the epidemic, only 23.48 per cent [unweighted average] of the people are affected in Delhi, which has several pockets of dense population. This can be attributed to the proactive efforts taken by the government to prevent the spread of infection including prompt lockdown, effective containment and surveillance measures, including contact tracing and tracking,…”

In an article in The Financial Express (August 1), Padam Singh, a former head of the ICMR’s medical statistics division and former Additional Director General at the ICMR, and Davendra Verma, former Director General of the Central Statistics Office of the Ministry of Statistics and Programme Implementation, wrote a severe critique of the sampling design and survey methodology even as they gave some additional data about the Delhi survey that had not been made public. The survey had found that the seropositivity rate (SPR) among females (24.2 per cent) was higher than among males (21.63 per cent) and that the SPR among the younger age group (<18) was 23.13 per cent, while that among the higher age group (>18) was 22.86 per cent. They also expressed surprise at the large variation in the SPRs between districts, ranging from 12.95 per cent to about 28 per cent.

While remarking that the above data were somewhat strange and unlikely, the authors pointed out that the SPRs found would actually be underestimates because the the detection kit used had a low sensitivity of 92.1 per cent, and the NCDC data analysis had not accounted for this. In the main, Padam Singh and Davendra Verma criticised the survey for its faulty four-stage sampling design. They pointed out that the inclusion of dispensaries as the primary sampling units in the third stage appeared to be basically because of administrative convenience. The selection of individuals at the fourth stage, which was left to the dispensaries, was, therefore, not random. “Thus, there is no sampling of wards and obviously there was no multistage sampling. The question is how dispensaries became part of the primary sampling units if they were not part of the sampling frame,” they wrote.

Meanwhile, despite this erroneous sampling methodology, the second round of sero-surveillance in Delhi has already begun.

A more sound survey in Mumbai

The design and conduct of the Mumbai survey was perhaps technically more sound as it involved many front-ranking research institutions and a larger group. Its limitation was its relatively (as compared with Delhi and Ahmedabad) smaller sample size as it covered only three of the city’s 24 wards, though this choice was made with some scientific rationale. It is also the only one among the three surveys whose summary report with all the relevant data has been made public.

This sero-survey, which used the random sampling methodology, is the first stage of a bigger project undertaken by a joint venture between the Tata Institute of Fundamental Research (TIFR), Mumbai; the Translational Health Science and Technology Institute (THSTI), Faridabad, Haryana; the University of Chicago, United States; Duke University, North Carolina, U.S.; A.T.E. Chandra Foundation, a Mumbai-based philanthropic organisation; Kasturba Hospital, Mumbai; and the IDFC Institute, a Mumbai-based public policy think tank. The project, which was launched on June 29, aims to conduct the survey at two time points to infer the trajectory of the epidemic in the city. The NITI Aayog, the Brihanmumbai Municipal Corporation (BMC) and the TIFR jointly conducted the initial stage of the survey from June end up to mid July.

The strengths of the study are the use of chemiluminescence immunoassay (CLIA) IgG antibody detection kits with high specificity (100 per cent) and high sensitivity (93 per cent). To gain insights into seroprevalence, the data captured was stratified in terms of slum/non-slum areas, age (in four groups: 12-24 years, 25-39 years, 40-60 years and over 60 years) and gender. In particular, the sampling methodology took into account the number of reported cases and population sizes in each of the wards and, significantly, for slums and non-slums separately. Sampling included people who had been symptomatic but recovered at the time of the survey or were asymptomatic without distinction. The sampling did not include active containment zones. The larger study also includes a survey of health care workers, assessment of the impact of risk factors on prevalence and determination specifically of the presence of neutralising antibodies (as against binding antibodies). These components of the study are still ongoing.

The selection of the wards was based on the following criteria: coverage of city and suburban areas, east, west and north areas and representation of localities with low to high caseload as on June 2. The selected wards were R North (Dahisar region, low), M West (Chembur region, average) and F North (Matunga region, high). Significantly, the chosen wards did not include the Dharavi slum, which lies close to F North and is supposed to be the largest slum in Asia.

“We chose 3 wards out of 24 for many reasons,” said Sandeep Juneja of the TIFR. “Our sampling budget was somewhat limited. It made sense to focus on geographically limited diversity so that our estimates given the sample sizes are more meaningful. Further, this way we make better conclusions about the differential in population density (slums and non-slums) leading to different prevalence rates. There is a large set-up cost involved in going to each new ward. So, from the logistics point of view, this was more manageable.”

Out of an estimated sample size of 8,670 individuals, the first round could gather only 6,936 samples because, strangely, while the participation from slums was 100 per cent, the turnout from non-slum areas was only 70 per cent (Table 1). “Nonetheless,” says the survey report, “the sample size relative to the prevalence is adequate to draw statistically meaningful conclusions.” Sample analyses were done at Kasturba Hospital and the THSTI.

The study has estimated an average prevalence of 56.5 per cent in slums and 15.5 per cent in non-slums in the three wards selected (Tables 2 (a-c) and 3 (a-c)). Assuming that 42 per cent of Mumbai’s population lives in slums, this works out to an overall seroprevalence rate of about 33 per cent for the entire city, which is significantly higher than the value of about 23 per cent found for Delhi. Also, according to the report, the seropositivity for females was marginally higher than for males, but the age-wise prevalence in both males and females was comparable. However, since the data have not been corrected for the lower sensitivity of 93 per cent of the CLIA kits, these figures represent a conservative lower estimate, notes the report.

On the basis of the results, as in the case of Delhi, the authors of this study too have inferred that asymptomatic infections are likely to be a high fraction of all infections. While the higher prevalence in slums could be due to the higher population density and shared common facilities such as water points and toilets, the lower prevalence in non-slums points to better adherence to physical distancing, wearing protective masks and access to better hygiene and sanitation coupled with the other non-pharmaceutical interventions by the BMC. On the basis of the survey-estimated prevalence in the three wards and the BMC’s records of reported deaths, the infection fatality rate (IFR) has been estimated to be a low 0.05-0.1 per cent as against the case fatality rate (CFR) of 5-6 per cent. The low IFR is perhaps a reflection of active measures the BMC has taken to isolate symptomatic cases immediately.“These results,” says the report, “will be valuable to learn more about herd immunity. Although it is still unclear what level of prevalence leads to herd immunity, our findings indicate that at least in slums this could be attained sooner [rather] than later, if the immunity exists and persists in a significant proportion of the population.” It is even likely that slum pockets may have already attained herd immunity. If, as mentioned in COVID-19 literature, we assume that R-nought (the average number of people that an infected person can pass on the infection to) to be 2 to 3, a near 60 per cent SPR would be close to the required value to achieve herd immunity. It is interesting to note that at the time of the Mumbai survey, Dharavi (which was not included in the survey) was already seeing a rapid downward trend in its caseload, and as Juneja concurs, Dharavi may indeed have a higher SPR than the other slum areas surveyed.

Second round of survey

According to Juneja, the planned repeat survey (the second round) is expected to begin in one or two weeks’ time. “Since the intent is to measure change in prevalence, we will be going to the same wards,” he said.

Analysing the Delhi and Mumbai sero-survey data for theWire.in, Murad Banaji, a mathematician from Middlesex University London, wrote: “Limitations aside, the data suggest two things: that the virus has spread wide and the fatalities have been relatively low.” According to Banaji, when the epidemic in London and New York City (NYC) was in its downward trend, the seroprevalence rates in the two cities had been estimated to be 17.5 per cent and 23 per cent respectively. An SPR of about 23 per cent for both Delhi and NYC works out to about 4.4 million and 1.9 million infections respectively shortly after the respective surveys. However, the fatalities in the two cities were drastically different: 3,200 in Delhi and 15,000 in NYC. If you compare the IFRs calculated from this data, it means that COVID-19 was 10 times deadlier in NYC than in Delhi, says Banaji.

Similarly, following Banaji, if you compare Mumbai and London, which had recorded a similar number of deaths (of 5,500) at the time of the surveys, their respective SPRs of 33 per cent and 17.5 per cent work out to 4.5 million and 1.6 million of infected people. On the basis of this data, the rough values of IFRs for the two cities work out to 0.12 per cent and 0.34 per cent respectively. So, the virus was three times deadlier in London than in Mumbai. Of course, it must be pointed out here that Banaji has not accounted for the demographic difference in the cities being compared, with Indian populations being skewed in favour of younger age groups. One of the important factors in the COVID-19 pandemic is that younger people are not affected as severely by the virus as the elderly are. If you take that into account using age-stratified data, the differences should reduce significantly.

A politically motivated survey?

The Ahmedabad Municipal Corporation (AMC) claimed that the sero-survey conducted in the city was the world’s largest, but it released only just as much information about the results as the Delhi survey. In fact, the AMC did not even share the identity of the research institution/laboratory with which it had associated to carry out the survey. According to the AMC press release, the survey was conducted from June 16 to July 11 and 30,054 samples that were “fully distributed [sic]” among the seven zones of the city were collected. For a city with a population of 6.3 million, this works out to a sample-to-population ratio of 4,770 per million. Comparing this with the Spanish sero-survey whose ratio was 1,302 per million and a U.S. study in six of its States whose ratio was 255 per million, the release claimed that this was the most extensive sero-survey study in the world so far.

Alongside this claim, the release also seemed to take a swipe at the ICMR, whose as-yet-unpublished sero-survey of May, which was conducted with just 496 samples from containment zones only, had a “minuscule” ratio of “just 79 per million”. It was rumoured in early July that the ICMR had not been allowed to release its sero-survey results for political reasons because its survey had found a very high SPR in Ahmedabad, something that would not have been palatable to the powers that be. Thus, the Ahmedabad survey and the tenor of its press release smack of a politically motivated study, especially when even the institution involved in the study has not been named.

According to the information put out by the AMC, the SPR in Ahmedabad (during June) was 17.61 per cent. The release further said: “Some sections of media have reported about a study by ICMR showing around 49 per cent seropositivity in Amdavad.... [The ICMR study] is not at all representative of [the] actual existing situation and cannot be relied upon for any conclusion (the AMC’s latest study is 60 times larger).”

Like in Delhi, the AMC survey too seems to have found variations in the SPR between different zones of Ahmedabad, with the Central Zone having the highest SPR (28.43 per cent), followed by the North Zone (27.42 per cent) and then the North-West Zone ( 6.43 per cent). Significantly, like in Delhi and Mumbai, this study too found that the SPR among females (17.98 per cent) was a little higher than among males (17.29 per cent), but the release noted that “the difference is not statistically significant”.

Private ‘sero-survey’

Thyrocare Technologies Ltd has been collecting seroprevalence data since the beginning of July and has made this data public through tweets of A. Velumani, its chairperson and founder, who is a scientist-turned-entrepreneur. Although this cannot be termed a proper study because it is not a randomised survey, nevertheless, one has to accept that the data collection strategy was novel and innovative, the data collation and its classification too was pretty quick and the dissemination of information immediate.

Velumani offered antibody tests at a very low cost and, using the vast network of Thyrocare diagnostic laboratories across the country, gathered seroprevalence data from corporate houses, apartment buildings and individuals who came to have themselves tested in more than 600 pin codes across the country. “We have not chosen whom to test; we have only tested those who wanted it. Eighty per cent was the requirement of the corporates, 15 per cent was the requirement of residential societies and 5 per cent was the demand of individuals. We covered pin codes from Nariman Point to Jamshedpur, so big and small cities are all covered,” Velumani told the online news website thequint.com in an interview.

So, in that sense, the sampling is not random at all; it is highly biased and leaves out the large number of people from the lower strata of society to whom the survey did not offer the test. In fact, there is no statistical sampling at all because there is no defined sampling frame to begin with. Therefore, statisticians and medical experts, perhaps, would not even give this survey a second look. Nevertheless, the data from this private survey (which seems to be ongoing), given in age- and gender-stratified form, does perhaps offer some insight into infection prevalence across the country that is most recent.

As of August 4, Thyrocare had tested 1,51,588 individuals (across all age groups), of which 28,347 were seropositive for IgG antibodies. This works out to a crude SPR of 18.7 per cent, albeit in a significantly biased population, across the country. Of course, this should not be immediately taken to mean that 240 million people of the country were infected, but it probably gives a very rough idea of prevalence. The data of July 29 shows that more males (about 2.5 times more) got themselves tested than females. Interestingly, even this biased survey found a higher SPR among females than males, 20.02 per cent compared with 17.62 per cent. Also, if you look at the SPRs for the three cities discussed above, Thyrocare’s figures are roughly in the same ballpark, notwithstanding the much smaller numbers it tested in these cities compared with the population sizes that were sampled in the sero-surveys. If there is something significant in these numbers, it is for the experts to glean from them.

What the city sero-surveys, at least, tell us is that about one out of four to five individuals in major cities has been infected, but this is still far removed from what is required for herd immunity to set in. However, if any part of a city is to become “herd immune”, it will be the slums first, as the Mumbai survey shows. And, it is quite likely that Dharavi may have already achieved herd immunity given its recent caseload trend. Asymptomatic infections seem to constitute a significant proportion of all infections. All surveys seem to indicate that seropositivity in women appears to be higher than in men. This may be an interesting aspect for virologists, medical experts and epidemiologists to look into.

Rajasthan Assembly crisis

Over to Assembly in Rajasthan

Political developments in Rajasthan have rarely been as interesting as the drama that has been onin the last one month. The saga of the rebellion within the State unit of the ruling Congress, which had threatened to split the party and bring down the government, is not over as yet. At the moment, the focus is on an unusual Assembly session scheduled to be held on August 14.

The session comes in the backdrop of an intense factional fight between Chief Minister Ashok Gehlot and Sachin Pilot, former Deputy Chief Minister and erstwhile president of the party’s State unit. The dramatis personae in this entire saga also include the supporters of Gehlot and Pilot, apart from the office of the Governor and the courts.

The office and powers of Rajasthan Governor Kalraj Mishra became a talking point when he repeatedly turned down Gehlot’s request to convene an Assembly session. It took three letters to the Governor and a dramatic sit-in protest by Gehlot and his legislators on the lawns of the Raj Bhavan to force Mishra to convene an Assembly session.

The Bharatiya Janata Party (BJP), which has all along denied any role in the crisis, sharply criticised Gehlot for his “language” and actions against the Governor. Mishra finally relented after much prevarication and it was mutually agreed that the Assembly would convene on August 14, although Gehlot had stated July 31 as his preference. As soon as the date was announced, Gehlot, who had housed his supporters in a hotel in Jaipur to prevent poaching, shifted them to Jaisalmer. Pilot and his faction stayed put in a hotel in Haryana, where they had moved to in July.

There were some indications from the Pilot camp that they would attend the Assembly proceedings. Pilot also congratulated Govind Singh Dotasara who replaced him as Pradesh Congress Committee president.

In the 200-member State Assembly, the undivided Congress has 107 legislators; the opposition BJP 72; the Rashtriya Loktantrik Party (RLP) three; the Bharatiya Tribal Party (BTP) and the Communist Party of India (Marxist) two each; and the Rashtriya Lok Dal (RLD) one. There are 13 independent MLAs, 12 of whom supported the Congress—along with the BTP and the RLD—in the Rajya Sabha elections.

Genesis of crisis

Turmoil began in the Congress after the party accused Pilot and his supporters of conspiring against the government in collusion with the BJP, a charge the rebels denied.

The party issued show-cause notices after the rebels stayed away from two successive meetings of the Congress Legislature Party (CLP) that were convened to discuss the charges of conspiring to topple the government. The conspiracy, according to the Gehlot camp,had been brewing since the Rajya Sabha elections.

The party sent notices to all the legislators with the warning that not attending the CLP meetings without justification would invite action under Constitutional statutes.

The Rajasthan Police had already initiated inquiries against several people in the government, including Pilot and the Chief Minister, to investigate a conspiracy against the government. The impartiality of the move was questionable as Gehlot is also the Home Minister and the police report to him. For Pilot, this was the last straw.

Matters came to a head when Pilot and his supporters refused to reply to a notice issued on July 13 by the Chief Whip directing them to attend the CLP meeting on July 14 or to the show-cause notice from Speaker C.P. Joshi subsequently under Article 2(1)(a) of the Tenth Schedule of the Constitution.

In the notice of July 13, Chief Whip Mahesh Joshi said that “in view of the exigencies of the prevailing political situation in the State on account of repeated defections and to discuss and draw out a political strategy”, a CLP meeting had been called at Hotel Fairmont on July 14.

The letter also expressed displeasure with the absence of some legislators at a similar meeting called the same day. The letter made it clear that absenteeism without valid and adequate reasons would be interpreted as evidence of their “intention to dissociate from the Indian National Congress and its ideology” and would invite action as per the relevant statutes of the Constitution of India.

When Pilot and his 18 supporters abstained once again, the Chief Whip filed a complaint under Paragraph 2(1) (a) of the Tenth Schedule and petitioned the Speaker claiming that 19 legislators had tried to topple the government. He added that by doing so, they had voluntarily given up membership of the Congress party, which was actionable under the anti-defection law. The Speaker promptly issued disqualification notices to the 19 legislators, asking them to reply by July 17.

Audio controversy

There was further drama as some audio clips with controversial content surfaced. They involved three persons, one of whom wasallegedly a BJP Union Minister from Rajasthan and another a Congress legislator close to Pilot.

The All India Congress Committee removed Pilot from the posts of State president and Deputy Chief Minister. Two of his Cabinet colleagues were also removed.

The 19 rebels then petitioned the High Court on July 16. Their lawyers argued that the Chief Whip’s complaint was full of surmises and assumptions and that it lacked factual ground to support the apprehensions. They added that none of the MLAs had declared their intention to leave the Congress or voluntarily give up their party membership and that there was no utterance that indicated they were out to destabilise the government.

The lawyers also said that just because an elected representative sought to express disagreement with policies, it did not tantamount to acting against the interests of the party or the government.

According to them, not attending two party meetings or voicing a difference of opinion outside the House could not be brought under the purview of the Tenth Schedule. They added that no reasons were recorded in the show-cause notice.

The lawyers pointed out that a complaint alleging defection by Bahujan Samaj Party (BSP) legislators was made in September 2019 but no action was taken by the Speaker. The rebel MLAs also said that they had apprehensions that the Speaker, without following the procedure of law, would disqualify them under pressure from the Chief Minister.

The matter was first heard by a single Bench, which referred it to a double Bench after amendments were made to the original petition whereby the constitutionality of the anti-defection law was challenged on grounds that it was against the “basic structure of the Constitution”.

The basic structure referred to in this context was the right to freedom of speech and expression, which the petitioners claimed they had. The counsel representing the Rajasthan government vehemently opposed the inclusion of the additional parts, stating that the basis for incorporating the parts had been rendered untenable by the Supreme Court itself.

The writ petition was also non-maintainable as it was a qua timet (an action or injunction against an apprehended act) action, which was not allowed as per the judgment of the Constitution Bench in the Kihoto Hollohan vs Zachillu & Ors (1992) case.

There were also no provisions in the Rajasthan Legislative Assembly (Disqualification) Rules that stated that the Speaker had to record reasons in a disqualification notice.

Court directions

Meanwhile, the High Court directed the Speaker to defer the proceedings against the rebel legislators as the matter was being heard in court.

As there were repeated deferments, the Speaker moved the Supreme Court with a plea that he should be allowed to proceed with the disqualification notices, but the Supreme Court turned down the request on the grounds that the High Court was yet to give a verdict.

On July 24, the High Court ruled that the status quo would prevail on the disqualification notices issued by the Speaker but declined to give a fresh date to hear the challenge to the constitutionality of the Tenth Schedule.

The double Bench framed a series of 13 questions pertaining mostly to Paragraph 2(1)(a) of the Tenth Schedule, queries similar to those raised in the amended petition of the 19 legislators.

The Speaker withdrew his petition from the Supreme Court and it appeared that the Congress would fight it out politically, considering it had received two setbacks consecutively, first when the Supreme Court declined to stay the High Court’s proceedings and second when the High Court restrained the Speaker from proceeding on the disqualification notices.

Back to court

Things took a fresh turn on July 29 and 31 when both the Speaker and the Congress’ Chief Whip in the State approached the Supreme Court separately challenging the High Court order of July 24.

In a special leave petition (SLP), the Speaker said that the High Court’s order was unconstitutional and was “a direct intrusion into the domain exclusively reserved for the Speaker under the Tenth Schedule of the Constitution”.

He also said that the order was in contravention of the settled legal position with a reference to the order in Kihoto Hollohan vs Zachillhu, which held that a judicial review could not be made available at a stage prior to the decision made by the Speaker or Chairman and qua timet action would not be permissible, nor would interference be permissible at the interlocutory stage of proceedings.

The only exception, as per the Kihoto order, was when the Speaker passed an order disqualifying or suspending a member. In his SLP, the Speaker said that he had only issued a notice and not passed any adverse order.

The High Court did not give any reasons for passing the order. The effect of the order was to “efface Para 2(1)(a) of the Tenth Schedule from the Statute book”, he said.

He submitted that “a mere challenge to the validity of the constitutional provision could not result in the provision itself being inoperable till the court decided the same”.

The SLP also stated that the High Court had acted in “gross judicial indiscipline” and impropriety by reopening issues that were settled by a Constitution Bench of the Supreme Court.

In the Kihoto Hollohan judgment, it was settled that the Tenth Schedule did not violate the basic structure or the freedom of speech and expression.

The petitioners were, therefore, “seeking to achieve indirectly” what they could not achieve “directly”, the SLP said. The High Court had granted “extraordinary indulgence” to the petitioners by listing the writ petition on a day to day basis. The SLP said that only the Speaker could settle the issue of whether the conduct of the legislators was “democratic dissent” or was tantamount to crossing over.

The 13 questions framed by the Division Bench of the High Court were already settled in law, the SLP said, with a prayer to the Supreme Court to ensure that all Constitutional authorities including the judiciary exercised their jurisdiction within their “Lakshman rekhas”.

Chief Whip’s petition

In his SLP, similar to that of the Speaker, the Chief Whip contended that the High Court order had the “effect of emasculating the provisions of para 2(1)(a) of the Tenth Schedule of the Constitution itself”.

Under the Tenth Schedule, para 2(1)(a) allows for disqualification proceedings against a person who has voluntarily given up membership of his political party.

The Chief Whip petitioned the Supreme Court to declare the High Court order ex facie (on the face of it) illegal and unconstitutional. The High Court had “exceeded its jurisdiction in issuing a status quo” on the disqualification proceedings, the Chief Whip said in the SLP, adding that the “exclusivity of the Speaker’s power under the Tenth Schedule” had been upheld in the Keisham Meghachandra Singh vs Speaker of Manipur Assembly (2020) judgment, wherein it was held that interlocutory orders by courts interdicting the Tenth Schedule proceedings were not permissible.

This judgment had also referred to the Kihoto Hollohan case, where the Constitution Bench had made it amply clear that no judicial review was available at a stage prior to the making of a decision by the Speaker either by a qua timet action or by interlocutory orders.

Among other things, the petition said that “grave and sinister attempts” were made to break the ranks of the Congress party and topple the elected government. It said that the legislators had deliberately absented themselves from two crucial meetings despite numerous reminders and notices and that they had, through the media, demanded a floor test and alleged that the Congress had cheated the people.

It also said that the rebel MLAs had become inaccessible and incommunicado and, despite repeated requests, did not return to the parent State or meet the leadership in Rajasthan or Delhi.

It also mentioned the audio conversations with references to bribes and allurement.

Apart from referring to the Kihoto Hollohan order, the Chief Whip’s petition alluded to recent Supreme Court judgments in Shrimanth Balasaheb (2020), Ravi S. Naik vs Union of India (1994), and Jagjit Singh vs State of Haryana (2006), all of which upheld the Speaker’s decision pertaining to various disqualification orders.

In Ravi S. Naik, the SLP said, the Supreme Court had ruled that even in the absence of a formal resignation from membership, an inference could be drawn from the conduct of a member that he had voluntarily given up membership of the political party he belonged to.

“By directing the status quo, the High Court has done indirectly what it could not have done directly, that is, staying the operation of the Tenth Schedule 35 years after it was inserted vide the 52nd Constitutional Amendment Act in 1985,” the SLP stated. The High Court order had disregarded the “presumption of the constitutionality of the statutes” and had “impinged on the domain of the legislature” despite the protective shield of Article 212, which expressly laid down that courts were not to inquire into the proceedings of the legislature. The High Court order helped the respondents secure “relief over and above their original grievance that the Speaker did not give them seven days of time”, it added.

The petition also said that the substantive questions related to the interpretation of the Constitution, that is, whether the Tenth Schedule violated the basic structure of the Constitution, could only be heard by a five-judge Bench of the Supreme Court and the court was was the ultimate arbiter.

Crucial Assembly session

The proceedings of the Assembly session on August 14, and the conduct of the rebel legislators in particular, will indicate the political future of the Congress government. If Pilot and his 18 supporters decide to oppose the government on the floor of the House either by voting against a Bill or staying away or even break away, the Congress’ effective strength will comes down to 89. It will need the support of 12 MLAs to prove a simple majority.

As things stand, Gehlot seems to have the backing of 12 independents, one MLA from the RLD and two legislators each from the BTP and the CPI(M). The BJP along with its ally, the RLP, has the support of 75 legislators and one independent, taking its support base in the Assembly to 76.

However, it is not only a question of Gehlot saving his government; Pilot too would have to think of his political future outside the Congress if the differences fester. The legal battle is also an issue that needs some settlement.

The overall indecision on the part of the Congress central leadership has only made matters worse. The political situation continues to be as fluid as it was in mid-July.

NEP 2020

Decoding the agenda of the new National Education Policy

Anil Sadgopal cover-story

The Union Cabinet’s approval of National Education Policy (NEP) 2020 on July 29, was preceded by significant moves by the Government of India, which revealed the ideological framework of the policy.

On May 1, Prime Minister Narendra Modi reviewed NEP 2020 and declared that online education would constitute the core of the education policy because it would improve the quality of education and enable India’s education to reach global standards. Two related questions arise. First, is there any credible evidence that online education increases the quality of education? On the contrary, there is ample evidence that without human agency of the teacher and student-student interaction learning levels deteriorate. Second, what are these global standards and who has set them? It is taken for granted that India’s higher educational institutions (HEIs) should be ranked among the top 100. This ranking is done by marketing agencies that apply parameters rooted in market fundamentalism, which are not related to the social purpose of education or its transformative role or constitutional values.

Against this background, the Prime Minister’s call for raising the level of India’s education to the so-called world class is far from a settled matter. Yet, the NEP does not raise these concerns; instead it promotes the notion of world-class education uncritically. Then why this compulsion to push for online technology? Shortly after the Prime Minister’s announcement, Google’s chief executive officer (CEO) announced a major investment in Mukesh Ambani’s Reliance Industries. This was followed by a marketing agency report that online education would have a market worth $15 billion in the next four years. Clearly, the push for online education is not motivated by education but by the need to resolve the crisis of neoliberal capitalism.

The Prime Minister gave a call on June 11 to build atmanirbhar Bharat. Within a short span of time, on June 24, the Human Resource Development (now Education) Ministry signed an agreement with the World Bank inviting its intervention in school education in six States of India. If India, the self-assumed ‘Vishwa Guru’, does not know how to organise its school education, then how will it create an “atmanirbhar Bharat”? More significantly, in doing so, the Government of India ignored the history of the World Bank’s District Primary Education Programme (1993-2002), or DPEP, in almost half of India’s districts, which led to the dismantling of the primary education system and the consequent creation of a vast market for private schools, which was the core objective of the World Bank. In 2001-02, when the World Bank intervention was at its peak, its loan constituted merely 1.38 per cent of the total expenditure on education incurred by the Central and State governments together. The second intervention of the World Bank was in the Sarva Shiksha Abhiyan (SSA), from 2002 to date, which led to a multilayered school system rooted in discrimination and failure to achieve the SSA’s mandated goal of universalising elementary education (Class I to VIII) by 2010, a goal that has since been eroded by the national political agenda.

Why then invite the World Bank for a third intervention? Is it because India lacks resources? Like in the case of the DPEP, the World Bank loan for its STARS (strengthening teaching-learning and results for States) programme would comprise only 1.4 per cent of the total public expenditure incurred on education. Clearly, this decision is motivated by neoliberal capitalist forces to create space for non-state private actors (such as non-governmental organisations and edu-tech companies) and a market in elementary education for almost 20 crore children.

On July 6, the University Grants Commission (UGC) issued a notification ordering all State governments and universities to hold final undergraduate and postgraduate examinations online latest by September, least concerned about the impact of COVID-19 on students. Ironically, a few weeks earlier, the UGC had given the State governments freedom to decide whether to hold university examinations or not on the basis of local conditions. In the process, the UGC overruled the decision of seven State governments against holding examinations, as if the States did not matter. The cynical assault by the Central government on the federal structure, sanctified by the Constitution, is now an integral feature of the NEP. The greed of edu-tech companies for the huge market that online examinations would open fits with the Central government’s alignment with neoliberal capital, not the people of India.

The aforesaid three examples foreground the neoliberal coordinates that define the government vision of education. The additional ideological orientation of the Rashtriya Swayamsewak Sangh (RSS)-Bharatiya Janata Party (BJP) regime of Hindu Rashtra will be revealed as we further decode the NEP. Brahmanical Hegemony

The NEP’s incomplete and misperceived framework of the “rich heritage of ancient and eternal Indian knowledge and thought” reveals its historical prejudices. While it accords adequate attention to the Brahmanical traditions and sources of knowledge, the non-Brahmanical contribution to knowledge and pedagogy of debate and questioning by the Buddha and Mahavira and their challenge to social stratification and hierarchical social order stand ignored. The materialist philosophical treatises of Charvaka or Lokayata rooted in observation, empiricism and conditional inference as sources of knowledge are not just undervalued but entirely erased from the NEP’s historical memory. The Brahmanical view failed to accommodate both the rich Tamil literature and its treatises as part of India’s rich heritage until there was a protest from Tamil Nadu in mid 2019. The same prejudice is extended to deny its due space to the contributions of Syrian Christians who settled on the Kerala coast in the first century A.D. and became part of the subcontinental socio-cultural landscape. The NEP further sidelines the entire medieval period when Islamic traditions interacted with Hindu traditions to create syncretic Sufism and infused new dynamism in India’s pursuit of knowledge in various scientific fields, governance, commerce, literature, music and arts. Similarly, the epistemic contributions of the tribal people of central and eastern India as well as those of the north-eastern States to agriculture, forestry and management of natural resources are not recognised as part of the so-called “mainstream” Indian heritage. This skewed perception can only mislead educational planning for the youth of the 21st century India.

Caste and Patriarchy

The NEP fails to recognise the hegemonic role caste and patriarchy continue to play in circumscribing access to and participation in education, acquisition and production of knowledge and opportunities for socio-economic mobility through higher education. The NEP also ignores the rich legacy of the anti-caste discourse from Savitribai-Jyotirao Phule, Chhatrapati Shahu Maharaj and Dr B.R. Ambedkar (Maharashtra); C. Iyothee Thass, Singaravelar and ‘Periyar’ E.V. Ramasamy (Tamil Nadu); Narayana Guru and Ayyankali (Kerala); Kandukuri Veeresalingam Pantulu and Gurajada Apparao (undivided Andhra Pradesh); Kudmul Ranga Rao and Krishnaraja Wadiyar IV (Karnataka); and, finally, the historic debate between Mahatma Gandhi and Ambedkar on the question of caste in the 1930s. This lack of recognition is reflected in the NEP’s flawed understanding of these twin historically embedded issues, when it tries to see caste and patriarchy through the lens of the so-called “merit” and gender sensitisation respectively. Reservation has no space in the NEP, in violation of Article 16 and as denial of all gains made through the struggles for social justice since Independence.

The twin anti-caste and anti-imperialist legacies of the freedom struggle that inspired the defining framework of the Constitution stand cynically replaced by the World Bank-sponsored United Nations Sustainable Development Goals-4 (STD-4). Even a cursory comparison between the two documents will reveal that the constitutional imperatives constitute a far more empowering framework for educational and other related social rights than the SDG-4. This is why the NEP prefers to rely on STD-4 and undervalues the Constitution. Ambiguity, internally contradictory positions, conceptual blurring of ideas and duplicity mark the NEP. It would refer to fundamental duties but maintains silence on fundamental rights, a practice adopted during the National Democratic Alliance (NDA)-I rule (1999-2004). The concept of ‘free’ education stands replaced by ‘affordability’, thereby allowing private institutions to increase the fees as they wish; the distinction between education and literacy-numeracy and similarly between ‘informal’ and ‘formal’ education is blurred. The constitutionally legitimised terms of Scheduled Castes (S.C.), Scheduled Tribes (S.T.), Other Backward Classes (OBCs) and religious and linguistic minorities are substituted by “socio-ec onomically disadvantaged groups (SEDGs)” or “under-represented groups”, thereby trivialising the historic oppression and exploitation of the Bahujans over centuries.

Article 1(1) of the Constitution states, “India, that is Bharat, shall be a Union of States”. While presenting the Constitution to the Constituent Assembly on November 25, 1949, Ambedkar, as the Chairperson of the Drafting Committee, declared, “The basic principle of Federalism is that the Legislative and Executive authority is partitioned between – the Centre and the States. . . . The States under our Constitution are in no way dependent upon the Centre for their legislative or executive authority. . . Centre cannot, by its own will alter the boundary of that partition.” The 13-judge Constitutional Bench of the Supreme Court in the Kesavananda Bharathi case (1973) held that the “federal character of the Constitution is the basic structure”. Yet, the NEP proposes to over-centralise all key decision-making “from ECCE [early childhood care and education] to higher education” through a spectrum of new central agencies and mechanisms to be constituted/instituted; for example, the Higher Education Commission of India, the National Research Foundation, the National Curricular and Pedagogical Framework for ECCE, the General Education Council, the National Testing Agency, National Professional Standards for Teachers, and so on. In the process, all the powers and responsibilities of the State/Union Territory governments relating to education as well as those devolved to the Tribal Councils under the Fifth & Sixth Schedules and to village panchayats/zilla parishads and municipalities/municipal corporations by various Acts are destined to be either substantially compromised or withdrawn altogether. This paradigm shift in the constitutional framework calls for a nation-wide democratic debate and for placing NEP 2020 for a thorough scrutiny by Parliament.

The NEP provision that has won acclaim from the media and academia alike is the ECCE provision for the 3-8 year age group. ECCE for the 3-6 age group had been included in all previous policy documents and, since 1974, the Integrated Child Development Scheme (ICDS), popularly known as the Anganwadi programme, has been implemented all over the country. However, it basically remained a nutrition-health care programme, without making provisions for pre-primary education. The Right to Education (RTE) Act, 2009, did not include children in the 3-6 age group. Hence, the NEP’s addition of pre-primary education and combining it with the first two years of primary schools (Class I-II) to create a foundational literacy and numeracy programme has attracted public attention. Let us decode the intent and content of the proposal.

Starting from ECCE to senior secondary schools, the NEP proposes an informal role for “trained volunteers from both the local community and beyond, social workers, counsellors and community involvement” in the school system. Who are these people and what is their eligibility for being invited to undertake informal tasks in anganwadis or schools?

The RSS has publicly claimed that most of its “demands” have been incorporated in the policy. It is obvious that the RSS cadre would be assigned the aforementioned informal roles which would be supported by public funds. RSS-allied education-related organisations have been for long advocating that the most effective way of preparing Hindu Rashtra cadre is to instill Hindutva ideas and “ethical” values (read myths, prejudices and superstitions) in the subconscious mind of the 3-6 year age group during which more than 80 per cent of the mind develops, thereby making them integral elements of the future generation’s thinking and social behaviour. And this explains why the NEP is insisting on merging the three years of ECCE with the first two years of primary education since it builds a plausible basis for absorbing the new RSS entrants into the permanent primary school cadre itself.

Languages and Medium of Education

The question of making “mother tongue/home language” the medium of instruction at the primary level or even beyond has been debated ever since Mahatma Jyotirao Phule extolled the significance of the mother tongue being the medium of education before the Hunter Commission (1882) – an idea that has been endorsed by educationists and linguists globally and practised in all economically advanced countries. Both Gandhi and Rabindranath Tagore were ardent advocates of the mother tongue as the most potent cognitive medium for acquiring knowledge as well as for laying the foundation for learning any other language proficiently, including English. This rational and internationally accepted principle is rejected in India by the narrow interests of the upper castes and classes. It is nobody’s case that children should not learn fluent English. What is being debated is whether English or any other alien language is best learnt by using it as a medium of education or learning it as a subject on the strong foundation of the child’s mother tongue. According to a 2017 British Council study, “There is little or no evidence to support the widely held view that EMI (English as Medium of Instruction) is a better or surer way to attain fluency in English than via quality EaS (English as Subject) . . . A move to EMI in or just after lower primary, commonly found in South Asia and Sub-Saharan Africa, yields too shallow a foundation of English to sustain learning across the curriculum from the upper primary years onwards. Early introduction of EMI is thus viewed as impairing learning in the formative years and limiting educational attainment.”

The NEP’s proposal on the mother tongue/home language issue is not just deliberately ambiguous and confusing; it also overburdens the child with the language curriculum, which includes the emphasis on learning a classical language (read Sanskrit) at all stages of education, including higher education, even as classical and rich languages such as Tamil, Pali and Persian are accorded step-child status. Nor does the NEP take any stand against Brahmanical Sanskritisation of Indian languages – a phenomenon that is partly responsible for the massive exclusion of the Bahujan children constituting 85 per cent of the child population.

Higher Education

The NEP’s higher education proposals imply:

(a) Starving government degree colleges and State universities of funds, forcing them to become indebted to the market, eventually leading to their closure;

(b) Incrementally handing over higher education institutions (HEIs) to private capital under the pretext of promoting philanthropy, which is yet another neoliberal excuse to pass on public funds to India Inc. under the modified PPP, that is, Public Philanthropic Partnership;

(c) Exacerbation of the present rate of exclusion of Bahujans and the disabled (even higher rate for girls in each of these sections) from higher education by not just giving freedom to the HEI to hike up their fees but also by essentially withdrawing the social justice agenda, especially reservation, and distortion of the concept of scholarships/fellowships by linking it to the so-called

“merit” which sociologically implies “privileges, rooted in class, caste and patriarchy, on the one hand and linguistic and metropolitan hegemony” on the other;

(d) Reducing knowledge to mere skills under the pretext of vocational education from “ECCE to higher education”, despite the repeated claims of “no hard separation between . . . academics and vocational education”, thereby diverting Bahujan students from academics to parental caste-based occupations and other low-wage skills; viewing critical thinking, creativity and scientific temper as mere skills; distorting knowledge-related parameters to those of Skill India’s notions (Section 18.6);

(e) Demolishing the research-based knowledge production in HEIs by over-centralisation of the research agenda through the National Research Foundation, that is, taking away the excitement of research; and

(f) Establishing the hegemony of online education to homogenise knowledge as per market requirements; reducing knowledge to mere skills – both low-wage earning (as in the unorganised sector) and high-wage earning (as in Silicon Valley/National Aeronautics and Space Administration), the latter category being entirely enslaved to the global market framework; and dehumanising education by eliminating human interaction both between teacher and students and among students themselves, thereby also depoliticising the education system.

Inviting Foreign Universities

The obsession of the ruling elite with “foreign universities” does not permit them to see the “satya”. The joint document of the World Bank and UNSECO (The Task Force, 2000) reported “There are prestigious universities from developed nations offering shabby courses in poor and developing countries, using their renowned names, without assuring equivalent quality.” The great universities of North America and Europe have earned their reputation by building upon their rich intellectual legacy over 100 to 150 years. It would be naive to assume that this inherent epistemic legacy can be just mechanically transposed to their Indian campuses. The only option for us, denied by the NEP, is to build our own intellectual legacy, just like several of our post-Independence universities have been able to do and win laurels globally, despite being discredited by the present regime.

Problematic Areas and Issues

i) The NEP fails to commit itself to a common school system based on neighbourhood schools for all children, irrespective of their socio-economic status;

ii) It has no plan to do away with the discrimination-based multi-layered school system;

iii) It does not commit to replace contract and ad hoc teachers with dignified service conditions; nor does it take a stand against their deployment in census, election (from village panchayat to parliament},, and disaster-relief duties;

iv) It does not call for amending the RTE Act, 2009, to include children in the 3-6 and 14-18 age groups, thereby denying statutory status to both ECCE and secondary-senior secondary;

v) It refuses to ban commoditisation of knowledge and trade in education; and

vi) It takes no stand against the intervention of the World Bank in school education and the World Trade Organisation’s regime in higher education.

In this background, it would be justified to surmise that “neoliberal capital is riding piggyback on the Hindu Rashtra forces in order to loot India’s natural and human resources!” India needs Ambedkar, Gandhi and Shaheed Bhagat Singh today more than ever before.

Anil Sadgopal is founder-member of the All India Forum for Right to Education and former Dean, Faculty of Education, Delhi University.

Education&Social Equity

NEP 2020: High on rhetoric

T.K. Rajalakshmi cover-story

At a time when all educational institutions remained practically shut because of the still raging COVID-19 pandemic, the Union Cabinet on July 29 approved National Education Policy 2020. Prime Minister Narendra Modi tweeted that it was a long-overdue and much-awaited reform in the education sector and would transform millions of lives. “The era of knowledge, where learning, research and knowledge are important, the new policy would transform India into a new knowledge hub,” he tweeted. The draft policy, according to Ramesh Pokhriyal, Union Human Resource Development Minister, had received over 2.25 lakh suggestions after it was put in the public domain. He tweeted that the policy was “in line with” the Prime Minister’s vision of making India a global knowledge superpower.

Modi’s tweet said that the NEP was based on “pillars of access, equity, quality, affordability and accountability”. “May education brighten our nation and lead it to prosperity,” he added, like a prophet. However, a close look at the policy belies his claim.

The 66-page policy document is a slim version of the voluminous draft prepared by a committee headed by K. Kasturirangan, former chief of Indian Space Research Organisation (ISRO). The last education policy was framed in 1986 and updated in 1992. This policy was left untouched in the first tenure of the National Democratic Alliance government under Atal Bihari Vajpayee, though many changes were made in the school textbooks, especially history textbooks. The exercise to prepare a new policy was initiated in 2016, during Modi’s first tenure as Prime Minister. The late T.S.R. Subramaniam, who was also a former Cabinet Secretary, was made the chairperson of a “Committee for the Evolution of a New Education Policy”. The Ministry prepared an initial draft based on the committee’s report. A new committee, headed by Kasturirangan, finalised the draft in May 2019. This was placed in the public domain and inputs and suggestions were invited.

In essence, the policy is top-down in character. Its proposals range from a single regulator for higher education institutions, multiple entry and exit options in degree courses, discontinuation of M.Phil programmes, setting up of school and university complexes, multidisciplinary universities, online school and college education and common entrance examinations for universities. Any policy aimed at universal quality education must also make education affordable, but the new policy has little to say on this aspect. The policy envisions education as “a key to India’s continued ascent and leadership on the global stage”, whereas the aim of education should be promotion of critical thinking and furthering of social and economic equality. The goal of “cultural preservation”, as listed at the outset, points to the Sangh Parivar’s agenda of cultural nationalism. The underlying “politics” of the policy is apparent in the long paragraph on the glory of ancient India where everything was picture perfect and where “seamless accessible knowledge” was available to all.

A key aspect of the new policy is the disproportionate focus on “high quality” educational opportunities for the individual’s growth. It is the process by which quality education is sought to be provided that is questionable.

‘Complete reconfiguration’

On the face of it, the policy seems to have been drafted with the objective of achieving the educational goals laid down in the agenda for the 2030 Sustainable Development Goals. According to the policy, a “complete reconfiguration” of the education system is needed to reach these goals. It identifies multiple challenges at the global level, including the need for skilled labour, and advocates multidisciplinary institutions and courses. The policy presupposes a new “knowledge and an employment landscape” for which Indian education must prepare itself and where “how to learn” is more important than “what to learn”. The policy is replete with meaningless statements put together. For instance, education will have less content but must also promote critical thinking and help people to solve problems and be creative.

It says the gaps between objective and outcome need to be bridged with reforms, but there is no critical assessment of what leads to these gaps. The policy speaks of revising and revamping all aspects of education structure, though its key emphasis is on removing existing regulatory aspects.

The policy talks about recruiting teachers and encouraging the best and the brightest to enter education. Teachers are to be the “centre of the fundamental reforms, in the education system”, it says. The policy promises to secure teachers’ livelihoods and ensure their dignity and autonomy and at the same time make sure that there is quality control and accountability. Yet, there is no acknowledgement that thousands of teachers work in ad hoc capacity at both school and university levels, all recruited over the past several years, even in States ruled by the Bharatiya Janata Party (BJP). Notwithstanding the rhetoric on the “dignity, respect and autonomy” of teachers, this government paid scant heed to concerns raised by teachers’ associations and federations regarding the holding of examinations by September-end. The government also completely ignored the concerns that the teachers raised about the difficulties and ethical issues involved in online and open-book examinations.

The policy lists 22 apparently harmless fundamental principles. These include a focus on “extensive use of technology in teaching and learning”, a “light and tight regulatory framework”, “rootedness and pride in India and its rich diverse ancient and modern culture, knowledge systems and traditions” and “investment in a strong vibrant public education system” accompanied by encouragement of “true philanthropic, private and community participation”. The emphasis on the use of technology has led to genuine apprehensions that the government wants to push online education as a dominant method of teaching and learning. In the allusion to the rich heritage of India, the medieval period has been conspicuously omitted.

State: trimmed responsibility

The document observes that quality early childhood care and education is not available to crores of children. But nowhere does the policy recommend that it is the state’s responsibility to fulfil the mandate of quality, affordable and accessible education for all. The delivery of early childhood care envisaged in the policy is problematic. Under the policy, the Integrated Child Development Scheme (ICDS) centres or anganwadis will be developed as nodal institutions for achieving universal early childhood care. The policy gives little thought to the already existing work that the ICDS is entrusted with—providing nutritious food and care to children between three and six years of age. There is no thought on the workers and helpers of these centres, who get a meagre honorarium for the crucial services that they render. There is no effort to address the proliferation of private child care centres or private schools in small towns and rural areas. In short, the vision of the new policy does not encompass a common school system where children from all social and economic backgrounds receive the same quality of education. Children attending schools in anganwadis or those attached to anganwadis are definitely at a disadvantage in comparison with privileged children in towns and cities.

The policy says that in tribal areas early childhood care and education will be introduced in “ashramshalas”, the Sanskrit term for schools and learning centres. Why tribal areas with their distinct local and cultural traditions (and tradition is a hobby horse of this government) should have schools called ashrams defies logic. But, of course, it is commensurate with the Sangh Parivar ideology.

Further, the suggestion of peer tutoring in order to meet the gaps in attaining universal literacy and numeracy in effect frees the state from any financial or other responsibility. The policy talks about achieving 100 per cent gross enrolment ratios in primary and secondary stages of schooling, but it liberalises the requirements and standards for schools. Rather than bridge the schism between economic and social classes and adopt the principle of “taking the school” to the child, the policy openly advocates non-formal systems of schooling for those who are unable to attend a “physical school”. The policy describes forms of schooling as “multiple pathways” to learning.

The policy recommends reducing the “curricular content”, a goal that all National Democratic Alliance governments pursued in varying degrees. Each subject will only have “core essentials” in order to “make space for more holistic-based, inquiry based, discovery based and analysis-based thinking”.

The policy’s latent bigotry is revealed in the section on languages. India’s languages, it says, “are among the richest, most scientific, most beautiful and most expressive in the world with a huge body of ancient as well as modern literature (prose and poetry), film and music written in these languages that help form India’s national identity and wealth”. The exclusion of the medieval period and its contributions to language, arts, music and aesthetics is clearly deliberate, as is the exclusion of Urdu from the list of classical and regional languages that the policy purports to offer as an option in schools. In the list of foreign languages, Mandarin does not feature but Russian, French, Spanish, Japanese, Portuguese, German, Korean and even Thai are included. While the policy steers clear of mentioning Hindi as one of the three languages in its proposed three-language formula for school education, the insistence on Sanskrit as one of the three languages has raised the hackles of some governments, especially of States that follow the two-language formula and States where Sanskrit is not the “base” language.

The policy has outlined big plans to revamp the curricular framework for school education prepared and designed by the National Council of Educational Research and Training (NCERT). In the section on curricular integration, a sub-section on “Knowledge of India” says that knowledge from ancient India and its contributions to modern India will be included in the curriculum. The policy once again leaps from ancient to modern India without any reference to the medieval period and its contribution to knowledge systems. It proposes to include a course on “Indian Knowledge Systems” that will include “tribal knowledge and indigenous and traditional ways of learning” which will be used as pedagogical tools for various subjects ranging from mathematics to engineering to linguistics, throughout the school curriculum.

On higher education, the policy begins by taking away the role that universities and university faculty have in the examination system right from the stage of framing questions for the university entrance examinations for undergraduate and postgraduate courses. Aiming to reduce the burden on students, teachers and universities, the policy aims to set up a National Testing Agency (NTA) that will have a common aptitude test. It will conduct examinations for undergraduate and graduate admissions and for grant of fellowships in higher educational institutions. Universities, it says, will be free to use the NTA assessments for admissions.

Push for private/philanthropic sector

The policy makes a case for promoting education in the private sector. While it proposes a centralised examination system for admissions to undergraduate and graduate course, it is also sharply critical of the Department of School Education, which deals with governance and regulation of all schools. According to the policy, the present system has led to “conflicts of interest, excessive centralised concentration of power, inefficient management of the school system”. It says the current regulatory regime has failed to check the commercialisation of education and economic exploitation of parents and has also “inadvertently discouraged public spirited/ private philanthropic schools”. The policy says that there was “therefore far too much asymmetry between the regulatory approaches to public and private schools”. The policy lays bare its intent to “encourage the private/philanthropic school sector” to enable them to play a significant role. This is the first time that an education policy has so brazenly advocated the private school system.

Online is the way

The policy aims to make all higher educational institutions (HEIs) multidisciplinary by the year 2040 with enrolment running into thousands. Single-stream institutions will be phased out. But for enrolment to run into thousands, the gross enrolment ratio for students in secondary and higher education levels will also have to be in thousands. Perhaps realising that there was a long way to go before such a goal is reached, the policy says that “as the process would take time, HEIs will firstly plan to become multidisciplinary by 2030 and then gradually increase student strength to the desired levels”. The aim will be to increase the gross enrolment ratio in higher education from 26.3 per cent (2018) to 50 per cent by 2035. In a bid to push online teaching, higher educational institutions will be encouraged to promote open distance learning and online programmes.

The policy aims to increase online learning in school and higher education, thereby creating more categories of educational access that will not necessarily bridge the social and economic divide the policy claims to address. Instead of offering universal and undifferentiated access to education, the policy aims to create multiple streams—formal, non-formal, mainstream, alternative, online and offline education. It proposes to encourage higher educational institutions to offer freeships and to set up a “fee determining mechanism” that would enable “reasonable recovery of cost while ensuring that HEIs discharge their social obligations”.

The proposal of online training of teachers completely ignores the digital divide that exists in India, more so in the tribal and remote parts. Like health, education in India is hugely privatised. Nearly 45.2 per cent of college enrolment is in private unaided colleges, while 21.2 per cent of enrolment is in private aided colleges. More than 60 per cent of enrolment in professional courses is in aided and unaided private institutions. Earlier, public institutions used to dominate university enrolment.

In a discussion on a television channel on the National Education Policy, an academic described as a representative of the “Right” let on that the government had “committed itself to the World Trade Organisation” and that the NEP proposals were in line with that commitment. The philosophy that informs the new policy views education as a commodity rather than as a service.

NEP 2020

Education at the mercy of the market

Madhu Prasad cover-story

It is an intriguing but by now a hardly surprising fact that on June 24, the Human Resource Development (HRD) Ministry finalised a loan with the World Bank as the culmination of a process allowing for its third and final intervention (the earlier ones were the District Primary Education Program (DPEP) 1993-2002 and the Sarva Shiksha Abhiyan (SSA) since 2002) in determining the structure, content and governance of the entire system of school education from pre-nursery to Class 12 through its Strengthening Teaching-Learning and Results for States (STARS) programme. Barely one month later, on July 30,  HRD Minister Ramesh Pokhriyal revealed through a PowerPoint presentation at a press conference in New Delhi that the Central Cabinet had “passed” for immediate implementation the long-delayed New Education Policy (NEP 2020).

Both events occurred under conditions of the still surging coronavirus pandemic across the nation. The long lockdown, which even now continues intermittently in affected States, districts, cities, towns and urban localities, has brought the economy to a halt.

Lakhs of migrant workers, deprived of even the barest incomes, returned to their hometowns and villages in the most atrocious conditions. Schools, colleges and universities have been closed since March and examinations have either not been held or are being held or threatened to be held online, creating confusion and panic among the majority of students in the universities. The last thing one would have expected was that the Cabinet would pass the NEP without presenting and debating it  in Parliament at a time when the people are concerned only with getting their lives back on track and coping with the  unprecedented health and economic crisis. If the Prime Minister has little more than Atmanirbharta to offer the people under these circumstances, surely the NEP 2020 could have waited.

Reforms during pandemic

However,  the Government of India (GOI) has been utilising the COVID-19 crisis to great advantage by passing several of its “reform” programmes without observing democratic niceties or permitting any democratic resistance.  It has allowed doing away with protective labour laws and collective bargaining, disinvesting the public sector including the Railways, privatising the electricity sector, reorganising banks, and clearing environmentally sensitive projects at break-neck speed. So why should the education system be spared?

The NEP 2020 states that its priority, like that of the World Bank,  is ensuring that quality education be made accessible to all children from pre-nursery to Class 12. So we would be justified in assuming then that the World Bank must be providing a hefty grant or at least a loan to the GOI to assist in realising this laudable goal. However, the finalised loan constitutes a mere 1.4 per cent of the total investment required for the SSA of which the STARS programme is a part. The Central and the State/Union Territories governments would be  contributing the remaining 98.6 per cent.%! Yet, the STARS programme will focus on the “whole school approach” and teacher education in the SSA in the selected “high performance States” of Kerala, Himachal Pradesh and Rajasthan and the “learning States” of Madhya Pradesh, Maharashtra and Odisha. It will,  thereby, allow the World Bank to acquire an overarching role in:

    • influencing the teaching-learning content, practices and outcomes of the entire system of school education from ECCE onwards;

    • training and  monitoring faculty for implementing it;

    • setting up “merit-based” learning assessment systems to measure achievement based on the above; and

    • formulating and implementing governance reforms to cover, on the one hand, the training of educational officials and, on the other, function as an extensive outreach to train parents to participate in implementing the programme.

This raises the next obvious question. Is the World Bank an international educational institution? If not, then why is it being asked to design such a comprehensive programme for quality school education in India? Further, what has been the experience of the bank’s  earlier interventions in India’s school education system?

The World Bank as an international financial institution creates, regulates and safeguards markets for advancing the interests of international finance capital. It is neither equipped nor concerned with the educational rights and pedagogical concerns of providing quality education to the majority of India’s children who are deprived of the benefits of such education.

From the 1980s onwards, the World Bank has concentrated, particularly in the former colonial countries, on persuading governments to withdraw public resources from education and encourage the entry of private investors and a variety “non-state actors”. As the NEP 2020 itself advocates, this omnibus term may include multi-national corporations and corporate investors, NGOs, civil society/charitable/religious organisations and even “volunteers”. Under the garb of the new nomenclature of being “philanthropic” rather than merely “private” partners, the NEP promotes and commends their initiatives and role in sharing resources as well as in synergising the interaction between the public system and private agencies. “To further enhance cooperation and positive synergy among schools, including between public and private schools, the twinning/pairing of one public school with one private school will be adopted across the country, so that such paired schools may meet/interact with each other, learn from each other, and also share resources, if possible. Best practices of private schools will be documented, shared, and institutionalised in public schools, and vice versa, where possible" (NEP, 7.10).

However, it has become more than evident that with the collaboration of these “players”, governments can neither be held effectively accountable nor remain responsible for the state of the education system. The experience of the DPEP, designed and sponsored by the World Bank, should have made this clear already. Implemented in 18 States and almost half of India’s districts, it incorporated “low-cost” solutions in government schools to fill the need for greater accessibility and quality. The rapid deterioration of state-funded primary schools (Classes I-V) and the loss of credibility among those who depended most on the system, the Scheduled Castes(S.Cs), Scheduled Tribes (S.Ts), Other Backward Classes (OBCs), Muslims and other impoverished sections, resulted in the privatisation and commercialisation of school education, with the mushrooming of low-budget fee-charging private schools at a faster pace than ever since Independence.

This damaging experience was systematically ignored and the bank’s intervention in the SSA from 2002 onwards only carried it further. The Right to Education  Act, 2009, which legislated an “at least 25 per cent” quota for the Economically Weaker Section (EWS) in admissions to private schools functioned as a “Trojan Horse” that set up privately funded school education as a “desireable” option and failed to emphasise its inherently defective pedagogical character, which fused quality in education with the capacity to pay. Yet, the third intervention has now been transacted with the World Bank.

Exclusion of the marginalised

Therefore, the  present government’s claim to have embarked on a path-breaking direction 34 years after the 1986-92 New Education Policy, is in fact entirely misplaced. It is  advancing the same strategy as previous governments which followed the perspective and approach of the World Bank model after the adoption of the neoliberal reforms policy in 1991. Public-private partnership (PPP) strategies, which lie at the core of the World Bank’s approach, do not provide better quality education. They increase the exclusion of the deprived and the marginalised, exploit a highly discriminatory multi-track system of education which is promoted by the play of market forces and divert from the constitutional goal of establishing a nation-wide system of quality education for all.

Although the NEP states that “the aim of the public school system will be to impart the highest quality education so that it becomes the most attractive option for parents from all walks of life for educating their children," (NEP, 8.9) and the present document opens with the assertion that "substantial investment in a strong, vibrant public education system as well as the encouragement and facilitation of true philanthropic private and community participation" will determine government  policy, the hackneyed solutions offered in the NEP 2020 belie the claim:

    • “To facilitate learning for all students, with special emphasis on socio-economically disadvantaged groups (SEDGs), the scope of school education will be broadened to facilitate multiple pathways to learning involving both formal and non-formal education modes. Open and Distance Learning (ODL) programmes offered by the National Institute of Open Schooling (NIOS) and State Open Schools will be expanded and strengthened for meeting the learning needs of young people in India who are not able to attend a physical school. NIOS and State Open Schools will offer the following programmes in addition to the present programmes: A, B and C levels that are equivalent to Grades 3, 5, and 8 of the formal school system; secondary education programmes that are equivalent to Grades 10 and 12; vocational education courses/programmes; and adult literacy and life-enrichment programmes. States will be encouraged to develop these offerings in regional languages by establishing new/strengthening existing State Institutes of Open Schooling (SIOS)” (NEP, 3.5).

    •  “...various successful policies and schemes such as targeted scholarships, conditional cash transfers to incentivise parents to send their children to school, providing bicycles for transport, etc., that have significantly increased participation of SEDGs in the schooling system in certain areas...must be significantly strengthened across the country”  (NEP, 6.4).

    • “To make it easier for both governments as well as non-governmental philanthropic organisations to build schools, to encourage local variations on account of culture, geography, and demographics, and to allow alternative models of education, the requirements for schools will be made less restrictive. The focus will be to have less emphasis on input and greater emphasis on output potential concerning desired learning outcomes” (NEP, 3.6).

Does the much-needed inclusion of the Early Childhood Care and Education (ECCE) programme as an integral part of the school system offer any new directions? For universal access to ECCE, we are offered the old idea of “strengthening” anganwadi centres and equipping them with high-quality infrastructure, play equipment, and well-trained anganwadi workers/teachers. State governments would be responsible for training those educated upto 10+2 for six months while those with “lower” educational levels would receive training for one year. Anganwadis would be fully integrated with school complexes (NEP, 1.5.). Again, there is nothing new here, for they would continue to remain under several Ministries (Education; Women & Child Development; Health) as at present. Their separate functions are still not conceived of as integral parts of a significant and cohesive stage of the education system.

An unexamined proposal for establishing ashramshalas and “alternative schooling” for tribal areas earmarks them for “targeted attention”. The plan for “Special Educational Zones”, mentioned here only once but not elaborated, is confusing. Are these zones with large populations of the “underrepresented” (a euphemism for the deprived/marginalised) sections going to be merely separated from the rest of the system or will they receive special attention and support?

Serving corporate interests

The World Bank’s strategy since 1994 has been based on the promotion of:  i) a model of knowledge adjusted to the requirements of corporate  job markets; and ii) a market model of education delivery that involves the privatisation, commercialisation and corporatisation of education.

The latter model places the entire burden of education on the individual family and fee-paying parents or students. They are the  “consumers” who make it profitable for the investor/provider to enter the education market. PPP strategies encourage the transition to a “market” where edu-businesses strengthen their hold over public assets through government reimbursement and voucher schemes.

Governments indirectly further the process by starving and dismantling state-funded education systems through budgetary fund cuts and the subsequent “rationalisation”  proposals for the merger/closure of the crisis-ridden schools. NEP 2020 repeatedly endorses these strategies, which will continue to lead to a  massive exclusion from education of Bahujans, who constitute almost 85 per cent of the population. These strategies leave neither access nor agency for the SCs/ STs/ OBCs/ Muslims/ Denotified Tribes and girls, transgenders and the disabled within these already disempowered categories. The proposed creation of “Inclusion Funds” for them will neither change the commercialised character of the system nor even provide meaningful relief to individual recipients. 

The NEP 2020 also shares the main features of the World Bank approach to the model of knowledge. It approves of and promotes a perspective that is detrimental to establishing an equitable system of quality education in India as the contemporary “merchandisation” of education not only requires it to conform more closely to the needs of the job market but also to initiate its own transformation into a new and highly lucrative market.

Knowledge as a resource for critically comprehending the contemporary world, societies and value systems is now treated as being “too heavy” for current teaching-learning methodologies and curricula to handle. The “skills approach”, a functional assembly of performance-oriented qualities that signal their own desired level of achievement,  now defines the basic unit, module, topic of learning.

The “learning outcome”," too, is predetermined. The teaching-learning process is reduced to acquiring procedural competencies which can be “appropriately” graded for different levels. NEP 2020 is firmly committed to  classroom transactions shifting “towards competency-based learning and education. The assessment tools (including assessment “as”, “of”, and “for” learning) will also be aligned with the learning outcomes" (NEP, 4.6). The proposal for multiple exit and entry points from pre-nursery to Class 12, which begins early with the re-introduction of examinations at Classes 3, 5 and 8, is based on the identification of skill levels. “Specific sets of skills and values across domains will be identified for integration and incorporation at each stage of learning, from pre-school to higher education” (NEP, 4.4).

However, depriving students of the “content” of formal learning which not only develops fundamental disciplines, critical thinking and the creativity to innovate but also to  conceptualise opposition to social injustices and forms of discrimination, makes a mockery of all learning as it cultivates conformism in thought and produces persons fit only for being cogs in the economic and technological machine.

Regulatory centralisation

Approaching the  section on Higher Education, where regulatory centralizstion as achieved through the Higher Education Commission of India (HECI), has been a long-standing demand of private investors, and the loss of democratic freedoms and academic autonomy with supreme authority being granted to Boards of Governors of institutions that must compulsorily become autonomous, is a painful and largely meaningless exercise. A regime which neither countenances nor respects the right of scholars to freedom of thought and expression can hardly expect to have its “official” policy statements taken seriously. When poets, academicians, public intellectuals and students, irrespective of their age, gender and physical condition, are incarcerated  on trumped-up and heinous charges of sedition and being a threat to “national security”, when universities are vandalised and scholars brutally beaten not only by the storm-troopers of the regime but also by the security forces, what else is left to be said about the government’s attitude towards higher education.

‘Idea of India’

The “vision” of NEP 2020 is “to instill among the learners a deep-rooted pride in being Indian, not only in thought, but also in spirit, intellect, and deeds, as well as to develop knowledge, skills, values, and dispositions that support responsible commitment to human rights, sustainable development and living, and global well-being, thereby reflecting a truly global citizen." To this end,  the entire “curriculum and pedagogy, from the foundational stage onwards, will be redesigned to be strongly rooted in the Indian and local context and ethos...in order to ensure that education is maximally relatable, relevant, interesting, and effective for our students” (NEP, 4.29).

In fact such exhortations are repeatedly invoked throughout the policy document, but the “idea of India” and the Indianess that is endorsed appear to be quite distinct from what we usually associate with the plurality and diversity of India. Being open to absorbing and negotiating with philosophical, religious, cultural and technological knowledge from other parts of the world was what India was once identified with. 

However, NEP 2020 states that the “Knowledge of India will include knowledge from ancient India and its contributions to modern India and its successes and challenges, and a clear sense of India’s future aspirations....”(NEP, 4.27). Completely missing from this leap across centuries are the changing experiences of numerous tribal communities; the powerful anti-caste cultural ideologies, monotheistic movements and  cults; the philosophical contestations within the various sects of what  later came to be referred to as Hinduism.  The political, cultural and technological impact of the exposure to central Asia, the arrival of Islam and the richness and complexity of its intellectual, cultural and sociological consequences which surround us in our daily lives are also absent. Equally surprising is the neglect of the period of colonial domination and the decades-long struggle of the Indian people, united through this struggle into a ‘nation’, surviving the tragedy of the Partition, and emerging out of the experience as an independent constitutional republic.

“India” is far greater, far more expansive, far richer in detail and far deeper in its experience of inequality and oppression than NEP 2020’s clumsy attempt to confine it to “Sanskrit knowledge systems" (NEP, 4.17), theory and literature. However much one may value the classical character of this tradition and its persistence over time, the failure (and it is an enormous failure)  to recognise the worth of the totality of our sub-continental history, culture and lived experience, immeasurably diminishes the very idea of “India”. An education policy that is unable to reflect this sweep of history does itself and the youth of India a grave injustice.

Madhu Prasad is with the All India Forum for the Right to Education.

Social Issues

‘The fight for reservation is not over’

ON July 27, the Madras High Court created history when it ruled that there was no impediment, constitutional or legal, for extending the benefit of reservation to Other Backward Classes (OBCs) under the all-India quota (AIQ) of seats in State government-run medical and dental colleges in Tamil Nadu. It asked the Centre to constitute a committee to arrive at the percentage of seats and address other issues relating to the OBC quota from the next academic year. The Medical Council of India (MCI) argued against reservation in AIQ seats, relying on a rather strange logic that since the Supreme Court had created the AIQ in 1984, only it could give an order in the matter.

The significant verdict was delivered by Chief Justice Amreshwar Pratap Sahi and Justice Senthilkumar Ramamoortrhy, on a batch of writ petitions filed by the State government, the ruling All India Anna Dravida Munnetra Kazhagam (AIADMK), the Dravida Munnetra Kazhagam (DMK), the main opposition party in the State, and a host of others. The prayer was uniform: 50 per cent reservation for OBCs in 15 per cent of undergraduate and 50 per cent of postgraduate seats in the AIQ in State-run government colleges.

Tamil Nadu’s has a long history of fighting for and providing reservation. Both the DMK and the AIADMK, which have ruled the State alternately for over five decades now, have been in the forefront of the fight for reservation in jobs and education as a measure to ensure social justice. The State has taken steps to create reservation within the reserved quota in some cases. It is a pioneer in extending reservation to the OBCs, Most Backward Classes (MBCs), Backward Classes (B.Cs) and other special categories of people. These measures were based on the socio-economic conditions of the people and have helped contribute to the development of a social fabric whose fundamentals rest on equity in education. The Supreme Court laid down in Indira Sawhney vs Union of India (1992), or the Mandal judgement, that the total quantum of reservation should not exceed 50 per cent, but Tamil Nadu had been approaching the apex court every year since then for a breather—and had obtained it—to protect 69 per cent reservation in the State. Later, a constituional amendment gave legal sanctity to this.

Thangam Thennarasu, DMK leader and former Education Minister, who is well-versed in theoretical and contemporary issues facing the State, said the High Court verdict was a victory for the DMK and its leader, M.K. Stalin, as the party had been raising the issue ever since the AIQ came into force. A Member of Legislative Assembly representing Tiruchuli constituency, he said that whenever a problem arose with regard to reservation in any sphere, particularly education, the DMK had always been the first political party to take up the issue and ensure that the rights of the oppressed and the backward classes were established. Thennarasu, who was Minister for School Education in the erstwhile DMK government, said the fight for reservation was in a continuous mode because the forces opposed to it were constantly trying to undo the gains made for the people by the DMK. He said that despite several differences, most of the political parties in Tamil Nadu had steadfastly remained on the same page with respect to the issue of reservation when it mattered. Thennarasu, who is DMK’s Virudhunagar North district secretary, said the party remained extremely vigilant in the case of reservation, and that was why Stalin directed that a caveat be filed before the Supreme Court. In this interview to Frontline, he traces the history of reservation in Tamil Nadu and places the current court battle in context. Excerpts:

In the OBC quota case, what was the main contention of the DMK and other political parties that demanded reservation in the AIQ for medical seats?

The Supreme Court permitted reservation in the AIQ, “including” reservation for Scheduled Caste/Scheduled Tribe, in the Abay Nath case on January 31, 2007. The line of judgments in Pradeep Jain and thereafter on AIQ stands modified by Abay Nath & Ors vs University of Delhi & Ors. While this is the reality, the Central government, using the 2006 Central Act, implemented 27 per cent reservation for OBC, 10 per cent for the economically weaker sections [EWS] and 5 per cent for persons with disabilities [PwD] in AIQ seats contributed by Central educational institutions without approaching the Supreme Court in view of the order in the Abay Nath case before the 2019 Lok Sabha election. But, the position of the government changes only in the case of OBC reservation. In the Gulshan Prakash case [2009] the Supreme Court held that the Abay Nath case’s clarification relating to reservation applied to seats in AIQ only. The ratio laid down is that the State has complete control over reservation and Central reservation does not apply to seats surrendered by the State. This is the most important issue that had to be raised.

The four MCI and Dental Council of India [DCI] notifications enabled application of State-specific reservation in medical and dental seats. Hence, the State reservation of 69 per cent under the TN Reservation Act 45 of 1994 shall stand automatically applied. The regulations never categorised seats as ‘All India Quota seats or States filled up seats’ for the purpose of reservation. The Director General of Health Services [DGHS], under these regulations, is to hold counselling for AIQ and is an agent /trustee to handle seats contributed by the State to AIQ. The DGHS has just that role and cannot dictate to a State government or the Central government in the matter of reservations or reduce or deny the same after enabling MCI and DCI regulations granting State-specific reservation in all seats without any demarcations.

The problem here is the DGHS overstepping its remit. Although the DGHS is not applying the 50 per cent OBC reservation formula to the seats contributed by the State to the AIQ, contrary to the orders of the Supreme Court in the Gulshan Prakash case, it has been currently applying a wrong reservation scheme to State-surrendered seats in Tamil Nadu insofar as reservation to S.C./S.T./PwD is concerned. Such wrong application of reservation by the DGHS is illegal and against the MCI and DCI regulations and the State’s reservation policy.

What was the crux of the argument of the DMK and other parties?

The total reservation granted by the Central government in Central educational institutions is as follows: S.C. 15 per cent; S.T. 7.5 per cent; OBC 27 per cent and EWS 10 per cent. After the EWS category was added (and there is a long discussion on the whys and ifs of this), the total in the reserved quota exceeded the 50 per cent mark and now stands at 59.5 per cent. Thus, when Central government grants more than 50 per cent of reservation, it is not proper to dictate terms to the State government to restrict all reservation to 50 per cent. Such a stand of the Central government runs counter to the principles of natural justice, is certainly against the letter and spirit of the federal structure established under the Indian Constitution, and is in violation of the MCI and DCI regulations. It has to be remembered that medical and dental education seats are State resources. The principle of reservation as per the Tamil Nadu Act applies to the seats surrendered by the State to the AIQ. It is a fact that the State seats do not get de-reserved merely because it is in the hands of the DGHS while it is handling the AIQ as these seats are filled in State educational institutions only. In fact, if the State-contributed seats are not filled up by the DGHS after the second round of counselling , it comes back to the State to be filled up by it. Hence, the character of the seat as the State seat is not lost merely because it is handled by the DGHS under a scheme because there is no law that dereserves the seat in the hands of the DGHS. Such an interpretation is against the letter and spirit of Article 15 and is impermissible in law. Reservation is a means to achieve equality. Social justice is a fundamental right and equally economic empowerment is a fundamental right to the disadvantaged people of India. Right to reservation backed by reservations laws is certainly a fundamental right. The Central government gave 10 per cent reservation for the EWS category while for OBC candidates, for the past four years, it is not abiding by its own affidavit filed before the Supreme Court.

The High Court has ordered the formation of a committee to look into the issue of granting reservation from next year. Is the issue settled now?

We will be watchful. If there is an appeal on the part of the MCI, then we will have to again fight it in the Supreme Court. It is easy to settle this issue right here in the High Court, if the AIADMK and the BJP want to. The BJP government just needs to direct the MCI to not go in for an appeal.

Is there any difference in stance between the AIADMK and the DMK on the issue?

On the question of reservation, both parties have been on the same page. But in this case, it was clear that the AIADMK had some hesitation in taking on the issue at hand, possibly because it is beholden to the BJP. This is the issue of a State’s rights. The AIADMK, which runs the government, should have been the first one to fight for it in all fora possible—courts, legislature and even the streets—when the need arose. Take NEET for example. They did not fight. In this [AIQ] case, it was Stalin who took the issue seriously and fought all the way and finally got this verdict. Like all other issues, this is not a single day’s battle, and the fight is not yet over. Every time there is an assault on the rights of the State, we need to stay together and fight as one. The problem in this case was some political parties thought that it was better to fight for 27 per cent reservation, instead of Tamil Nadu’s right of 69 per cent. This is a wrong approach; 69 per cent is what we have arrived at after a long fight stretching over decades. Why should we settle for anything else? We see the fruits of this move in society, and we need to preserve it because of what it has achieved for Tamil society.

Both the DMK and the AIADMK accuse each other of politicising this issue. Why does this happen when they are largely on the same page?

The problem here is the BJP. If the BJP so wishes, there was no need to go to court. When we filed a writ, the BJP could have said that this was a fact and agreed to implement the reservation. What is the MCI? Or the DCI? Are these bodies outside the control of the Central government? No, right? When that is the case, why is the Central government not directing both the bodies to implement the reservation as it exists in each State? What stops the BJP? This is clearly a case of double standards of the BJP.

The AIADMK is an ally of the BJP. The Chief Minister, the Deputy Chief Minister and others routinely meet the Prime Minister and several other Ministers of the Union Cabinet. Why is it that they are unable to press this issue, though they keep saying that they will preserve reservation? This is actually the problem with the AIADMK. They adopted the same stand on NEET. Finally, they let down the entire State.

Tamil Nadu has a long history of fighting for reservation. The Communal Order of 1921 and the subsequent attempts at affirmative action are public knowledge. Where and when does the struggle begin? Why is it important? And where is it now?

This has been a long-drawn-out fight and it still continues. Tamil Nadu’s struggle for reservation is spread over three centuries and pre-dates our independence struggle—19th century, 20th century and the current struggles in the 21st century. Each generation has a major history and context of why the fight happened and how it progressed. The first recorded instance of a fight is in 1854. A survey at that time found that one community, which constituted about 3.5 per cent of the population, was occupying all positions of power. There are instances where members of one family occupied all positions of government power in a given geography. In 1854, a government order, numbered 138, was issued, which directed that key positions in a district should be distributed among communities. You can say that the seeds of the concept of reservation were sowed at that time. The Census of 1871 reaffirmed these facts.

Subsequently, there were efforts to distribute government positions on the basis of the ratios of the populations of communities. In 1891, Iyothee Thassa Pandithar, the pioneering anti-caste activist, managed to highlight the problems faced by the S.Cs, and set in motion a thought process on the need to address the issues of those who were ostracised in society. All this crystallised in 1916, when Sir P.T. Theagarayar, one of the founders of the Justice Party, brought out the non-Brahmin manifesto when the party was formed. This was the first time that a formal demand for reservation was voiced.

The Justice Party was the precursor of the Dravidian movement. In 1920, the first Justice Party government was formed. Soon after, the first legal attempt at reservation was made via the communal G.O. The G.O. held that students from the oppressed sections should be given reservation in educational institutions. In 1928, again, after Justice Party came to power, Muthiah Mudaliar was responsible for consolidating all the thoughts and actions of the movement until then, and a comprehensive communal G.O. No. 1021 was brought for reservation in jobs, too. This G.O. was in operation until India attained freedom. In 1950, this G.O. was struck down by the Supreme Court, with the ruling that the Indian Constitution did not provide for reservation on the basis of caste.

A large section in the Indian National Congress backed this move. After the reservation was denied to the oppressed classes, a massive agitation was launched by the pioneers of the Dravidian thought and movement. ‘Periyar’ [E.V. Ramasamy] launched an agitation and gave a call to observe August 14 as ‘vaguppurimai naal’ [reservation rights day]. C.N. Annadurai [the founding father of the DMK, who later became Tamil Nadu Chief Minister] wrote on the issue and began a campaign on how rights of the oppressed classes were snatched away.

At this time, Congress leader K. Kamaraj, endorsed the struggle, which became a shot in the arm for the movement. So, on one side, there was a powerful campaign launched by Periyar and Annadurai, and on the other, there was a section within the Congress that endorsed the stand of these two leaders. The series of agitations attracted the attention of New Delhi and a constitutional amendment was enacted in 1951 for reservation on the basis of caste. In independent India, this was a major turning point. Soon after Kalaignar [M. Karunanidhi] assumed office as Chief Minister, the Sattanathan Commission was constituted to study the situation of the B.Cs and make appropriate recommendations. On the basis of the Commission’s report, the government increased the reservation quota of the B.Cs in educational institutions and government employment from 25 per cent to 31 per cent and for the S.Cs from 16 to 18 per cent. Karunanidhi appointed, for the first time, a Minister for Backward Classes.

The M.G. Ramachandran [MGR] government, which succeeded the DMK government, changed the community-based reservation into economic status-based reservation. MGR capped the upper income limit at Rs.9,000 per annum for reservation. But after his party lost the 1980 Lok Sabha election, many in the party claimed that the change in the reservation policy was responsible for the defeat. MGR took this view seriously and increased the reservation to 50 per cent for the B.Cs. Representatives of some communities approached the court, and the court directed the State to appoint an independent body to study the order. The independent body, headed by an Indian Administrative Service officer, gave a report in favour of the government.

To cut the long story short, there were two developments at this juncture. One is the demand for implementation of the Mandal Commission recommendations, and two, the Vanniyar agitation in Tamil Nadu, led by Dr S. Ramadoss. MGR passed away [in 1987] and the Kalaignar [Karunanidhi] Ministry took charge in 1989. Kalaingar [Karunanidhi] as the Chief Minister introduced 20 per cent reservation for the MBCs. Later, during the chief ministership of J. Jayalalithaa, the total percentage of reservation was increased to 69, which was challenged in the court. Finally, because of combined efforts, a constitutional amendment was moved to secure 69 per cent reservation. This is not there in any other State. Only people of Tamil Nadu have the privilege of this provision. Here, B.Cs enjoy 26.5 per cent reservation, MBC 20 per cent, Muslims 3.5 per cent, S.Cs 18 per cent and S.Ts 1 per cent. Within the S.C. reservation, Kalaignar provided 3 per cent reservation to the Arundhadhiyar community—who are among the most backward among the S.Cs. Now, there is a new criterion, the EWS, for whom there is a 10 per cent reservation.

Why are political parties opposed to the creamy layer concept?

Economic prospects change with time but the social status of a person does not change. Economic indicator fluctuates. MGR brought a criterion of Rs.9,000 annual income for reservation in 1980. This was opposed because economic situation can never be a measure. You can only have a classification for socially and educationally deprived sections.

The word ‘economic’ was sought to be included during Jawaharlal Nehru’s time. It was rejected then. We have had this debate since then. I am exasperated; how many times and across how many decades should we have the same arguments over and over again. Taking into account all the recent policies of the Centre on education—EWS reservation, the New Education Policy [NEP] and NEET—do you think the government is serious about upholding the hard-fought gains of reservation and education for the deprived sections?

It does not appear so. In the NEP for example, there is simply no mention of reservation. Why is this? I can only conclude that this is because the BJP is not concerned about social justice or uplift of the depressed and poorer sections of society. If you do not have any interest in social justice, then any policy that is drawn up will not benefit the backward and depressed classes.

Communalism

Christians as target during the lockdown

Ziya Us Salam the-nation

At least two reports by Christian organisations in India say that life has been precarious for the members of the minority community during the lockdowns imposed because of COVID. They were ostracised, threatened, intimidated, harassed, and in some cases fatally assaulted, the reports say. There were even instances of prayers being disrupted.

According to a report released in mid-July by the Religious Liberty Commission of the Evangelical Fellowship of India (EFI), there were 135 cases of attack against Christian houses, churches and individuals until June this year. The EFI, founded in 1951, is an umbrella body of more than 65,000 churches across the country.

The incidents include lynching, social boycott and attempts to hinder worship. The report states: “A lynching, community ostracisation, concerted attempts to stop worship and gospel-sharing mark the 135 cases registered by the EFI in the first half of 2020.”

Says Vijayesh Lal, its general secretary: “We thought attacks on Christians would die down during the lockdown when businesses, markets, schools and colleges were closed. When nobody would venture out. But we were mistaken. The attacks on Christians increased during the lockdown. There were 33 attacks in March and 21 in June. There has been a further increase in July.”

A few days after the EFI released its report, Persecution Relief, an organisation that aims to protect the right to worship guaranteed by the Constitution, released its half-yearly report stating that hate crimes against Christians in India had risen by an alarming 40.87 per cent in spite of the nationwide lockdown. It records 293 cases of hate crimes against Christians, including five rapes and six murders, compared with 208 incidents last year.

According to Shibu Thomas, founder of Persecution Relief, the aim of the report is to draw attention to the “intensifying hostility against the Christian minority in India which has become progressively common. The cases chronicled in this report are only a fraction of the actual violence perpetuated and reported on the ground.”

According to Thomas, six murders, “influenced by religious bigotry”, were recorded in Jharkhand, Chhattisgarh and Odisha in the last three months. He says hate crimes have been committed against Christians in as many as 22 States in the country.

Uttar Pradesh fares worst

According to the Persecution Relief report, the maximum number of attacks against Christians (63) has been in Uttar Pradesh. That is, every fifth incident of attack on Christians in the country happened in Uttar Pradesh. Tamil Nadu came second with 28 cases, including two hate crimes resulting in death, and the burning of a church structure. Chhattisgarh accounted for 22 cases, including a rape and the murder of a widow, and Jharkhand closely followed with 21 cases and one murder. Karnataka recorded 20 cases of attacks against Christians in the first half of 2020.

The report mentions 51 hate crimes of heinous nature against women and children, of which five were rape cases. There were 37 cases of boycott and ostracisation, rendering many Christian families homeless and forcing them to hide in jungles or stay at temporary shelters or safe houses. There were 130 cases of harassment, threats and intimidation and 80 incidents of physical assault, according to the Persecution Relief report.

“Over the past seven years, India has risen from No. 31 to No. 10 in the ‘Open Doors’ World Watch List, ranking just behind Iran in persecution severity. As of 2020, the USCIRF [the United States Commission on International Religious Freedom] has listed India as a CPC (Country of Particular Concern),” says Thomas. Open Doors, its website says, is an outreach to persecuted Christians in the most high-risk places. The World Watch List is an annual report prepared by its research team.

‘Impunity in administrative apparatus’

Condemning the targeted violence against the community, the EFI has sought the immediate arrest of the purveyors of hate violence. It turned down as false the allegations of coercive conversion, which is often cited as the reason for the violence.

The EFI report states: “The absolute sense of impunity generated in the administrative apparatus of India by the lockdown during the COVID pandemic, and the consequent absence of civil society on the streets, has aggravated the environment of hate and violence against Christians in major states and the National Capital Territory.”

Cases under-reported

The reports suggest that crimes against Christians are under-reported. The police are not willing to register complaints in some cases and when they do so, the incidents seldom get reported in the media, the reports say. “With the courts being virtually closed and the police failing to record all complaints, the access to justice is severely restricted,” the report says.

Significantly, the EFI did not regard the much-reported custodial death of Bennicks and Jayaraj in Tamil Nadu in June as a case of targeted killing of Christians as propagated in some quarters. The organisation also did not read communal motives into the murder of pastor Balwinder Singh in Ferozpur in Punjab in July end.

Incidentally, both reports claimed that the most number of attacks against Christians took place under Yogi Adityanath’s rule in Uttar Pradesh. The EFI report put the number of attacks against Christians in the State at 32. In early July, one Vikash was assaulted in Azamgarh at the residence of Sunita Maurya during a prayer service. Last year, Sunita Maurya was herself subjected to physical abuse, with a hot cup of tea poured on her allegedly at a police station.

“It is difficult to control attacks these days. The poison has reached very deep, right up to the grass-roots level. Until a few years back, there was only the Bajrang Dal whose members were often involved in such attacks. Now new bodies have mushroomed,” says Lal. Apparently, groups like Abhinav Bharat, Modi Sena, Amar Sena, and Dharm Sena have a crucial role in many of the recent incidents. Their volunteers go to almost every lane, every village, and speak about conversion to whip up an anti-minority atmosphere.

The atmosphere of hatred generated by these groups, says Lal, has resulted in attacks on not just Christian houses and churches but in the disruption of private prayers too. Says Lal: “The RSS [Rashtriya Swayamsewak Sangh] has percolated to the grass-roots level. Until 1990 or so, the term conversion was not heard of in everyday life except maybe in the Sangh circles. But today, a mere mention of the word Christian evokes images of conversion. It is due to sustained indoctrination over a long period of time. The lockdown attacks are a manifestation of that indoctrination.”

The worst manifestation of hatred came on June 4, when a group of people crushed to death with a stone a 14-year-old boy at Odisha’s Kenduguda village in Malkangiri district and then chopped the body to pieces before burying them in several places. In the first information report (FIR), the police noted that the victim and his family had adopted Christianity three years ago and that since then, a few villagers had been harassing them. He had been attacked in February this year.

Jharkhand and Chhattisgarh

The EFI suggests that the increase in number of anti-Christian violence in Jharkhand and Chhattisgarh is because of the greater confidence among the minorities to report the crime thanks to the change in political dispensation in these States. “In Chhattisgarh, now at number three from its earlier sixth position (in the crime list), the rise is attributed to Christians more willing to report violence in the Bastar region where there had been so far a blanket of fear of both underground militant Maoist forces and the armoured police,” the EFI report says.

According to it, Chhattisgarh saw six documented cases of targeted violence against Christians in April alone. This happened after Christians who were summoned to village meetings refused to participate in religious rituals against their conscience. They were apparently under pressure to recant, and when they refused to do so were assaulted.

In three separate incidents on May 5, May 7 and May 18, in Bastar and Dantewada districts, Christians faced stiff opposition to bury their dead. They were told that since they had not followed village religious rituals, they could not bury the dead there. “There have been 15 such confirmed incidents in these districts since 2019,” according to the EFI report.

Things were worse in neighbouring Jharkhand, which had earlier reported a spate of lynching incidents targeting Muslims. During lockdown this year, Christians were at the receiving end. The EFI report says: “Jharkhand saw four major assault cases in May alone. Though no one was killed, women were molested. On May 25, local authorities had banned Christians in Pundiguttu village from getting ration from the government outlet. In Jharkhand too there were cases of Christians being socially ostracised. The Pundiguttu village panchayat in May ordered the Christian converts to rejoin their parent faith at pain of being denied water from the community well and other penalties.”

The Pundiguttu case brings to memory the attempted Ghar Wapsi incident in Agra in 2014 when some Muslim families were sought to be lured to Hinduism with sacks of wheat and rice.

Increasing violence

The attacks on Christians are becoming increasingly common. In 2014, Bajrang Dal activists attacked 12 pastors in Greater Noida in western Uttar Pradesh during a private meeting. At the local police station they were advised to discontinue the meeting. In 2017, goons attacked a Christian woman putting her kids to sleep after prayer in Dalli Rajhara in Chhattisgarh and asked her not to pray.

“While the churches have often been attacked in the past, now it is becoming increasingly difficult even to offer prayers even in private. There are objections to Sunday prayers at home. The malaise is much deeper in the interiors and tribal areas. Even a regular prayer is considered a step towards conversion. First a prayer is attacked. Then a social boycott follows,” says Lal, adding that “most of the attacks are by local people. They are mostly OBCs [Other Backward Classes] who have been brainwashed by self-styled outfits like the Abhinav Bharat and the Modi Sena, besides the Bajrang Dal.”

‘Government in denial’

Activist and veteran journalist John Dayal puts the findings of the various Christian bodies in perspective: “Five murders of Christians in the COVID-impacted first six months of 2020 mark a new high in the viciousness of targeted hate against the community. Not since the pogrom in 2007-08 in Kandhamal district of Odisha have so many people died for professing the Christian faith. That they include pastors, young boys and women adds to the tragedy. The half-yearly reports by Persecution Relief and Evangelical Fellowship of India spell out the gravity of the targeted violence against Christians in India. The government is not just in denial, but positively on the side of the assailants, it would seem. The ruling party’s cadres where it is in power enjoy immunity, but surprisingly even where other ideologies govern States, the Sangh and its groups are aggressive and seem to defy the law. The international organisations, including the UN bodies, seem helpless in the face of government obduracy and the ruling party using the nationalistic rhetoric and sovereignty argument to insulate itself from all international inspection and exhortation.”

According to Dayal, the data “as reported by the Religious Liberty Commission of the Evangelical Fellowship of India, the Alliance Defending Freedom, the Morning Star News and the Persecution Relief” carry authenticity to the numbers reported.

Lal says there have been instances when policemen have asked peaceful worshippers, including pastors, not to go ahead with their religious meeting, saying it is not allowed in “Hindu Rashtra”. “Are we still ruled by the Constitution or the mob which attacked houses, desecrated churches, objected to gospel-sharing even during the lockdown?” he asks.

Controversy

COVID ventilators: Who cares?

“Never let a good crisis go to waste.” This quote, attributed to Winston Churchill’s motivational public engagements during the Second World War, has once again come into wide circulation against the background of the COVID-19 pandemic in India. The bon mot has been repeated with diverse emphases in different contexts. But sections of the Indian business class, officialdom and political apparatus seem to have taken it to heart in a totally mercenary manner and exploit the health crises caused by the pandemic to enhance their financial resources through means that are legal, extralegal or even illegal. Several key public health initiatives of the government, such as the Prime Minister’s “special package” to reduce dependency on imported APIs (active pharmaceutical ingredient) and drug intermediates and “allotments from PM CARES Fund to expedite the purchase of ventilators required for critical care of acute patients”, seem to have been tainted by questionable financial deals. Notably, many of these deals seem to have been done without due diligence and appropriate processes and the deciding factor appears to be the proximity of the business class beneficiaries of the schemes to the political leadership, including Prime Minister Narendra Modi (see “A scam in the making”, Frontline, July 31, 2020).

The Frontline expose showed how B.R. Shetty, a business tycoon based in the United Arab Emirates and a self-proclaimed “blind diehard follower and disciple” of Prime Minister Modi, was the closet beneficiary of the private-public partnership scheme to reduce dependence on imported APIs and drug intermediates, which was launched amidst the pandemic. Some discrepancies with regard to the purchase and deployment of ventilators had already come out in the open, particularly in relation to the ventilators that were procured for the Ahmedabad General hospital from Jyoti CNC Automation Ltd, a Rajkot-based firm, whose owners are close to both Prime Minister Modi and Gujarat Chief Minister Vijay Rupani. However, a perusal of the details of the purchase of ventilators at the national level makes it clear that the Ahmedabad story may well be just the proverbial tip of the iceberg. Using the Right to Information (RTI) Act and other means, social activists and independent investigators have sought clarifications on the ventilator deals. The responses from several government and quasi-government agencies to these queries have been marked by systematic denial of information, indicating a possible cover-up.

The procurement story

The national level procurement and deployment of ventilators was done on the basis of the recommendation of the “Special Empowered Group” (SEG), which the Union government set up in the third week of March under the chairmanship of NITI Aayog CEO Amitabh Kant, to urgently procure ventilators in the months of May and June. When the SEG was set up, it was estimated that over two lakh ventilators would be required by mid May, whereas only 19,398 high-end ventilators were available. The Union government cited this shortfall when it earmarked Rs.2,000 crore under the PM CARES Fund to procure some 60,000 ventilators. On March 27, the SEG floated tenders for the procurement of 20,000 ventilators, one-third of the total number identified as needed urgently.

The SEG’s frame of reference had the clear objective of developing collaborations with the private sector, non-governmental organisations (NGOs) and international agencies and overseeing and guiding cross-sectoral dialogue on production of health equipment and personal protective equipment (PPE). HLL Lifecare Ltd was eventually designated as the sole agency to carry out ventilator procurement. By the last week of April, however, the estimate for the total number of ventilators to be bought was revised to 60,884. Additional tenders for as many as 40,884 ventilators were issued separately; this includes a tender issued on April 18, 2020. At the end of all this, on May 1, HLL Lifecare Ltd placed orders to procure 60,884 ventilators, of which 59,884 ventilators were to be ordered from Indian manufacturers.

The following Indian companies were also among those that got orders to manufacture ventilators: joint venture of Bharat Electronics Limited (BEL) and Skanray Technologies Private Limited, Mysuru, Karnataka, for 30,000 ventilators; joint venture of AgVa Healthcare and Maruti Suzuki Limited, for 10,000 ventilators; Andhra Pradesh MedTech Zone (AMTZ), a medical devices manufacturing initiative of the government of Andhra Pradesh, for 13,500 ventilators; Allied Medical Limited (AML), Gurugram, Haryana, for 350 ventilators. The deadline for delivery was June 30. However, only AML had supplied the full order of 350 ventilators by the first week of July.

In response to an RTI query filed by the social activist Saket Gokhale, BEL stated on June 15 that it had produced 4,000 BEL-Skanray ventilators against an order of 30,000. However, in a press note on June 23, the Prime Minister’s Office stated that only 2,923 ventilators had been manufactured until then. BEL-Skanray’s claim in the last week of June was that 15,000 of the order for 30,000 ventilators had been delivered. As of the first week of July, AgVa Healthcare and Maruti Suzuki Limited delivered 1,500 of the order for 10,000 ventilators. Details of deliveries by AMTZ are not available.

Significantly, AML has a track record of having supplied more than 2,000 ventilators to many State governments and hospitals in the public sector, including Army hospitals, over a considerable period of time. The BEL-Skanray collaboration and the AgVa Healthcare-Maruti Suzuki association were stitched up after the COVID-19 outbreak. According to technology specialists focussing on the clinical equipment industry, AgVa and AMTZ have no prior experience in manufacturing high-end ventilators. These experts, who did not wish to be named, pointed out that manufacture of high-end ventilators was time-consuming and that the government had either misjudged the capacity of these companies to deliver or had misrepresented facts about them deliberately.

Even more significantly, of the ventures that received the orders, only AML seems to fulfil the certification and accreditation requirements specified in the tenders floated for the ventilator contracts. Certification bodies in India are accredited by the National Accreditation Board for Certification Bodies (NABCB). Globally, accreditation is done by a member of the International Accreditation Forum (IAF). An important requirement in the tender was that the ventilators must be certified by the United States Food and Drug Administration (FDA) or they must have European Union standard of CE marking. (CE marking is a certification mark that indicates conformity with health, safety and environmental protection standards for products sold within the European Economic Area (EEA). The CE marking is also found on products sold outside the EEA that have been manufactured to EEA standards. Governments within the EEA framework as well as outside periodically insist on CE certification. There are authorised agencies that can provide this certification.) No Indian manufacturer has an FDA-certified ventilator, though AML has ratified CE certification. Medical equipment specialists and researchers at different levels have questioned Skanray’s claims about having CE certification. AML’s director, Aditya Kohli, has also expressed doubts on Skanray’s claims.

Problems in the tender and certification

Separately, KEN, the niche portal primarily focussing on technology issues, pointed out in early July that apart from non-compliance of these firms with the specific parameters mentioned in the tender, there were fundamental problems with the tender itself. According to KEN, the open tender released by HLL was based on the specifications of AgVa’s ventilator. KEN claimed that that the minutes of an HLL meeting that it had obtained proved this. The portal further pointed out that the tender specifications were released in the public domain a full 18 days after they were decided. “So, while AgVa sat pretty, nailed on to win the tender, other manufacturers were at a disadvantage,” the KEN article said. KEN said that HLL did not respond to questions sent by email.

The portal has pointed out other issues related to certification. AgVa apparently has a certificate from a third-party company that says it is FDA-compliant. The portal says: “There are two problems with this. The FDA doesn’t certify companies, just products. And the FDA compliance can only be issued by the FDA itself. In 2018, AgVa was certified by Unitas Certification Services, a company with a UK-based address. Unitas, incidentally, doesn’t appear to exist beyond its website. As recently as last month (June), AgVa received an IEC 6,0601 compliance certificate from NFI Certifications Ltd, another UK-registered entity, which appears to be a shell company. According to company filings, it has assets worth £1 ($1.25). AgVa did not respond to questions sent by email.” The KEN article went on to add that the absence of relevant laws had not just led to a rise in the importance of accreditation bodies but had also spawned an entire industry of opportunistic and unscrupulous certification companies (https://the-ken.com/story/ventilator-procurement-problems).

Unanswered questions

Saket Gokhale’s pointed RTI queries on the pricing of ventilators elicited obfuscatory responses from these entities, including BEL. Gokhale had sought information on the number and price of ventilators bought with funds from PM CARES and asked for copies of invoices. BEL rejected the query saying that the request was “non-specific with regards to time”. Saket Gokhale pointed out that the PM CARES purchase was billed as a one-time order to be delivered by June 30. Gokhale had also asked how many BEL-Skanray ventilators were bought between March 25 and June 18 at what cost and which hospitals these were supplied to. This question was not answered on the grounds that “giving this info would harm the competitive position of BEL”. Gokhale wonders how a “a public authority” can argue about harming its competitive position. He says that BEL is not in the ventilator business and that the ventilators it is manufacturing along with Skanray constitute only a COVID-related government project funded by PM CARES. More importantly, he notes, a government-owned company cannot suppress information on the prices at which it sells to the government.

On pricing, too, Saket Gokhale has raised pertinent questions. He points out that PM CARES has allocated Rs.4 lakh for every ventilator. According to the company’s own publicised claims, AgVa Healthcare ventilators are priced at Rs.1.5 lakh. The designer of BEL-Skanray ventilators, Dr Hiremath, said on record that their price was under Rs.1 lakh. “So, where is the extra money going?” asks Saket Gokhale.

Amidst all this, new advisories by the Union Ministry of Health and allied agencies are underplaying the importance of ventilators in treating COVID patients. According to the findings of some of these agencies, most patients in India require only simple oxygen delivery through nose prongs, using non-invasive ventilation (NIV) or BiPAP mode. Only 5 per cent of COVID patients need ventilators for invasive ventilation, they claim.

In the light of this new understanding, estimates for the number of ventilators required are set for a drastic revision from the original estimate of two lakh instruments. Even so, questions on the pricing, certification, underproduction and inadequate delivery of ventilators remain, as do questions on their quality and functional efficiency. Doctors at the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, rejected, in the last week of July, 10 ventilators delivered to the institute. The machines, bought with PM CARES funds, were found to be “not effective” and “faulty”.

Sources at the institute revealed that a total of 20 ventilators were sent to two health care facilities in Chandigarh. Ten were given to Government Medical College and Hospital and the other 10 were sent to PGIMER for its COVID-care hospital. Sources at the hospital said that a team of doctors—pulmonologists, anaesthesiologists and intensive care experts—carried out regular and mandatory checks on the ventilators. The majority opinion of the team was that the ventilators were not up to the mark. “We cannot use these substandard machines and put patients, especially COVID patients, at risk,” a senior doctor said.

A couple of weeks earlier, doctors at Ahmedabad General hospital had rejected many of the ventilators bought from Jyoti CNC Automation Limited for the same reason.

These rejections highlight the flagrant violations, mismanagement and suspected underhand dealings in the procurement and deployment of ventilators funded by PM CARES. An investigation seems to be in order. However, the Prime Minister and his government have steadfastly ruled out any sort of inspection of PM CARES funds and what it spends on.

The ventilator story gets curiouser and curiouser.

Sheetal P. Singh is a freelance journalist and social activist. He is co-founder of the Satya Hindi web portal.

Prisons

Prisons become breeding grounds for the coronavirus

Divya Trivedi the-nation

As early as May, the International Legal Foundation, which has two decades of experience in protecting detainees impacted by infectious diseases, warned that it was not a question of if, but when, COVID-19 would overwhelm incarceration facilities.

When 57 girls became COVID-positive in a shelter home in Kanpur, and seven of them were found to be pregnant, it shook the administration’s complacency and turned the spotlight on the spread of the virus in closed facilities such as detention centres.

A number of prisons across India have emerged as COVID-19 hotspots. These include prisons in Delhi, Jaipur, Puzhal Central Prison Chennai, Cuddalore Central Prison, Rajamahendravaram Central Prison Kakinada, Warangal Central Prison, Sangli District Prison, prisons of Behrampur circle, Rourkela Jail, Agra Central Jail, Jhansi Prison, Ballia district jail, Arthur Road Jail Mumbai, Nagpur Central Prison, Yerwada Central Prison, Guwahati Central Jail, the district jail in South Kashmir's Anantanag, Pratapgarh Jail in Udaipur, the Vadodara Central Prison and Bareli sub-jail of Madhya Pradesh. The Delhi Prison has 16 jails spread across three complexes in Tihar, Mandoli and Rohini; more than 220 inmates and staff members of Delhi Prison have tested positive.

Unsanitary conditions, overcrowding, poor nutrition, co-morbidities and a shortage of hygiene products in these confined spaces have rendered inmates vulnerable to disease outbreaks even in normal times. Indian prisons are overcrowded by upto an average of 150 per cent, which makes social distancing impossible to maintain. Legal researchers have pointed out that in some prisons, there is not enough space for all the prisoners to even sit comfortably, let alone sleep at the same time.

On June 16, large-scale violence broke out inside Delhi's Tihar Jail. Apparently, foreign inmates were protesting against an order that prevented them from getting interim bail. Such protests have increased in the months after the pandemic erupted, but the authorities quickly suppress them. The June 16 incident came to light when Pinjra Tod (an autonomous collective of women students) member Natasha Narwal alleged that inmates were prohibited from getting in touch with family members via videoconferencing because of the violence. Narwal is one of several student activists arrested during the lockdown for her role in the anti-Citizenship Amendment Act (CAA) protests.

At a time when prisons are being decongested the world over in view of the pandemic, and even the Supreme Court of India has ordered the release of prisoners, Indian investigating agencies are working overtime to fill prisons with more arrestees.

Several States have introduced punitive measures for citizens who fail to comply with lockdown rules. United Nations High Commissioner for Human Rights Michelle Bachelet expressed deep concern that some countries were threatening to impose prison sentences on those who failed to maintain physical distancing. Such actions were likely to exacerbate the grave situation in prisons and would do little to halt the disease’s spread. “Imprisonment should be a measure of last resort,” she said.

The prison population is not static. Though prisons are opaque facilities, there is a considerable traffic of people entering and exiting them. Every week thousands of people are arrested and released and transferred between jails, creating a floating pool of prisoners. Moreover, the cumulative number of staff employed by the prison-industrial complex is also substantial. Prison administrations across India have stopped meetings between prisoners and their friends or families (mulaqats). But there is still frequent movement of prison staff, visitors, vendors, service providers and prisoners that threatens to endanger communities inside and outside prisons.

COVID deaths

In June, Kanwar Singh, 62, who did not have any symptoms, died in his sleep at the Mandoli Jail in Delhi. He was later found to be COVID-positive. A judge of the Karkardooma District Court who examined his body for inquest proceedings had to go into home quarantine. The senior citizens’ barrack where Kanwar Singh had been lodged had 29 other inmates. All of them were tested after Kanwar Singh’s death, and 17 of them tested positive. One of them was Mahender Yadav, 70, a former Congress MLA, who developed symptoms and succumbed to the infection soon after. His family alleged that the police did not inform them of his hospitalisation after he tested positive. The Supreme Court had refused to entertain a plea for interim bail on the grounds that Mahender Yadav was in intensive care (ICU) after testing positive.

Mahender Yadav’s was the sixth reported COVID death in an Indian prison. Four deaths were reported from prisons in Maharashtra, the worst affected State. So far, 2,191 COVID-19 cases have been identified in prisons across India. But the actual numbers of cases sand fatalities are suspected to be much higher, according to the Commonwealth Human Rights Initiative (CHRI).

A legal expert speaking on condition of anonymity spoke of how intertwined communities inside and outside prisons were with each other. “It is all the more reason why policymakers should take care of the prison population. If not from the angle of humanitarian concern, then at least out of self-interest,” the legal expert said.

The case of Guwahati Central Jail

The situation is especially bad in Guwahati Central Jail, where as many as 435 inmates have been infected. The entire prison was declared a containment zone in the second week of July. Soon after, a letter written in Assamese by an inmate describing conditions in the jail was thrown outside prison gates from a bus that was transporting COVID-positive prisoners to another facility. The writer, who identified himself as Dudul Das, claimed that though 95 per cent of the inmates were infected not all of them were tested. “Even after we tested positive, nothing has been done regarding treatment or diet...Both positive and negative patients are staying together. Two people are sleeping in a two-feet space. More than 50 inmates have been made to sleep in a single room...When asked, the jail authorities said they knew nothing [about it]…” he wrote. The letter concluded in English, “Please save us, we are also human being and not a bluddy [sic] ghost!”

Dissatisfaction among prisoners was high even before this call for help surfaced. In the last week of June, almost all inmates of Guwahati Central Jail went on a two-day hunger strike after several letters to the jail authorities demanding better health-care facilities went unanswered. They demanded that new inmates be quarantined before they were assigned cells to share with existing inmates. They also demanded regular supply of clean drinking water and visiting rights for lawyers and others to be restored with COVID-19 protocols.

Political prisoners

Several political prisoners, including Krishak Mukti Sangram Samiti (KMSS) leader Akhil Gogoi, his associates Bittu Sonowal and Dhaijjya Konwar and Jawaharlal Nehru University student Sharjeel Imam, are incarcerated in the same prison as Dudul Das is. All of them have reportedly tested positive for COVID. Sharjeel, who was to be brought to Delhi by the Special Cell of Delhi police, will now not be transported until he is cured of the infection. Manas Konwar, president of the student wing of the KMSS, who was released on bail, told the press that the prison conditions were deplorable. In December 2018 the prison had an occupancy rate of 93.5 per cent, but the inmate population had surged in the past two years. It currently operates at more than 100 per cent of its capacity, which is for 1,000 inmates.

Eight of the 12 accused in the Bhima Koregaon case– Mahesh Raut, Anand Teltumbde, Sudhir Dhawale, Vernon Gonsalves, Arun Ferreira, Surendra Gadling, Gautam Navlakha and Rona Wilson–are in Taloja Jail in Mumbai where a thousand inmates have reportedly displayed COVID-like symptoms. Professor Hany Babu, who is currently in NIA custody, is expected to be transferred to Taloja Jail. But in the absence of systematic testing and information sharing with the lawyers, family members of the accused are a worried lot.

On March 23, the Supreme Court directed the States and Union Territories to constitute a high-powered committee to determine the categories of prisoners to be released on interim bail, parole or furlough to reduce overcrowding in prisons. While Assam said it would release 3,550 prisoners in order to decongest, it had released only 722 prisoners until July 23, according to CHRI.

Sanjoy Hazarika, who is CHRI’s International Director, took up the issue of the delay in arranging medical help for human rights defenders, including Akhil Gogoi and Varavara Rao in Maharashtra. He said: “Both had known existing ailments and co-morbidities and were hospitalized only after they tested positive. Till that time, they had been held inside prisons without adequate precautions. This is part of a larger wave of infections affecting other prisoners, who are similarly placed and continue to be at risk of contracting COVID-19. Factors like confined space, overcrowding, poor health and sanitary conditions, underlying health conditions like TB, HIV, hepatitis make the prison population extremely vulnerable to contracting and spreading the virus.”

Prof. G.N. Saibaba, who is lodged in Nagpur Central Prison, informed his family that despite preventive measures undertaken by the prison authorities, there had been an uncontrolled outbreak of COVID-19 with hundreds of prisoners, both convicts and undertrials, and even jail guards getting infected. His family was quoted in the media as having said that the infection was widespread and that “barrack after barrack” was infected. The family also reportedly said that one prisoner tested positive after all 20 prisoners of the jail’s “Anda” cell were tested on July 8. The family says that it is only a matter of time before Saibaba gets infected. Saibaba was convicted in 2017 for having Maoist links.

The National Platform for the Rights of the Disabled (NPRD), a non-governmental organisation, sought the National Human Rights Commission's intervention to shift Saibaba to a hospital for treatment. NPRD general secretary Muralidharan said in a letter to the NHRC that Saibaba, who was 90 per cent disabled, was highly susceptible to the virus and that a COVID infection might prove dangerous and fatal for him.

Experts’ opinions

Dr Lokendra Dave, a pulmonologist from Bhopal, said prisoners in general did not enjoy good health because of undernutrition. “Tuberculosis, respiratory diseases like asthma and COPD [chronic obstructive pulmonary disease], diabetes and cardiac issues are widely prevalent in the prison population. Mental issues like depression and suicidal tendencies and poor immune response of the body are also common. It is important that their nutritional needs, co-morbidities and immune status are addressed, apart from overcrowding, in order to curb the pandemic in jails,” he said.

He proposed that the following steps should be taken: a daily record of prisoner health should be maintained; CBNAAT (Cartridge Based Nucleic Acid Amplification Test) laboratory facilities should be installed on prison premises to ensure fast testing; pool sampling should be applied for tests; a diet high in proteins and Vitamins C and D should be provided to prisoners; co-morbidity analysis should be undertaken for inmates and safety protocols such as physical distancing, wearing of masks and washing of hands should be enforced. (In pool sampling, samples from a group of people are tested together in a single tube; the samples need to be individually tested only if the result is positive.)

Dr Gagan Shrivastava, a cardiac anaesthetist from Fortis Hospital in Delhi, echoed these views and said that barracks should be regularly cleaned and prisoners should be asked to sleep head to toe rather than mouth to mouth. Periodic health check-ups of prisoners with regular monitoring of their health status should also be undertaken by the prison authorities, he said. While it was nearly impossible to maintain social distancing or hygiene measures as ordered by the government or World Health Organisation, it was important to segregate new entrants for ten to 14 days before allowing them to mingle with other prisoners, he said.

Prison administrations are taking standard precautionary measures, but these are inadequate. Dr Gagan felt that preventive measures such as stopping the mulaqat altogether further compromises prisoners’ mental well-being. Not allowing prisoners visits by their lawyers or loved ones creates anxiety, especially in a situation of confinement. Dr Gagan suggested that visiting hours could be specified and the meetings regulated with certain protocols in place, he said.

After the Supreme Court’s directive on the decongestion of prisons, States such as Chhattisgarh, Goa, Haryana, Kerala, Karnataka, Punjab, Uttar Pradesh and Delhi took proactive steps to address the issue. But some States, Bihar for instance, did not act on the directive. The prison administration in Bihar created sub-jails to isolate new entrants.

CHRI and the Madhya Pradesh Prisons & Correctional Services organised a “virtual” national consultation on “Prisons and Ensuring an Effective Response to Covid-19”. Prison administrators from 15 States shared their strategies and challenges on combating the virus. Restricting or altogether stopping the mulaqats, spraying disinfectants, providing kaadha (ayurvedic drink) and homoeopathy medicines and mass screening (in Punjab) were some of the steps taken by them.

Pravin Kumar Sinha, Additional Director General of Prisons, Punjab, said that social distancing could not be maintained in prisons. “The only way to control the pandemic was to chase the virus,” he said. Sandeep Goyal, Director General of Prisons, Delhi, said that the pandemic had showed that the concept of barracks was now obsolete and it was time to think of single cells for prison inmates.

APPEAL, a non-profit organisation dealing with legal issues, has demanded temporary or early release of prisoners convicted of non-violent offences whose appeal applications have passed the single judge screening stage (via bail); prisoners on remand charged with non-violent offences; prisoners aged over 70; prisoners with pre-existing serious health conditions, including heart or lung disease, diabetes; immuno-suppressed prisoners suffering from cancer, HIV, or autoimmune diseases; pregnant women prisoners; prisoners in Mother and Baby units; and all prisoners in Category D minimum security open prisons with staff deployed to other prisons to boost capacity.

According to India Justice Report 2019, much of the overcrowding in prisons is on account of the presence of undertrials. If anything, the pandemic makes a strong case for the Indian justice system to review its prison policies and release low-risk prisoners who pose no threat to society.

Interview: K. Srinath Reddy

‘Swinging from lockdown to laxity’

T.K. Rajalakshmi the-nation

The continued upward trajectory of COVID-19 infections in India is a matter of concern. After the United States and Brazil, India has the third largest number of confirmed cases in the world. On August 3, India’s daily COVID-19 count surpassed that of the U.S. and Brazil. Even though the fatalities as a percentage of the confirmed cases are low, the alarmingly high positivity rate is an added cause of concern. The lockdown period was an opportunity to aggressively test, track and treat and fill the gaps in public health infrastructure, but that opportunity seems to have been frittered away. Professor K. Srinath Reddy, a public health expert and member of the Indian Council of Medical Research’s (ICMR) high-level technical expert committee on COVID-19, spoke to Frontline on India’s contribution to the global pool of knowledge on COVID-19, the reasons for the virus extending to new territories and the lessons learnt. He underscored the need for doubling India’s health expenditure and for a drastic reduction in out-of-pocket expenditure from its current levels. He also said there was a serious shortage of personnel at all levels of care and that investing in expansion of the health workforce was both a health system imperative and an economic opportunity for job creation. Excerpts from the interview:

What explains that even after a long period, India continues to have an upward trajectory of confirmed and active cases? Why is it that India has not able to reverse this trend as has happened in several other countries?

Our story has been one of the pendulum swinging too widely from lockdown to laxity. The COVID-19 virus exploits every weakness in containment measures. It is active again even in countries that had achieved good control earlier. This is now evident from Spain to Germany and Hong Kong to Japan. This sends a clear message that we cannot take this virus for granted and must maintain vigil for several months more.

The weakness of our public health systems came to the fore after we opened up. Early detection of cases, through symptom-based syndromic surveillance of households, prompt testing and isolation of suspected cases and close contacts, accompanied by vigorous contact tracing, are measures that are essential components of a sound surveillance and containment strategy. These have not been implemented adequately as a full package. The virus was also given ample opportunities to spread. Large gatherings were allowed for social or religious reasons. Masks came in late and have not always been worn properly, failing to prevent effective transmission.

However, it must also be noted that India is a vast country with a large population. The roll-out of the epidemic here has geographic and time dimensions that differ from [those of] a small country. If each of our States had acted with alacrity and efficiency from early on, rather than being dependent on Central directives, we may have seen more vigorous control. Within the States, district-level decision- making would have been needed from the very beginning, given the size of our districts. Even now, that is the level at which the response must be shaped, with monitoring at the State level and support from the Central level.

When is this likely to change and what would be the additional measures needed to achieve this?

The virus is now extending its presence to new territories even as those affected earlier are battling it out. So we will see different calendars for the epidemic in different parts of the country, with a landscape of many peaks and undulating hills portraying the infection.

We need to vigorously contain the transmission within the already affected urban zones while we energetically block passages of entry into villages and small towns. We have to step up the frequency of primary healthcare personnel-led household surveillance of symptomatic persons and close contacts for early testing and isolation, followed by energetic and extensive tracing of all named or indicated recent contacts. Citizen volunteers and elected local bodies can add to the strength of the formal primary healthcare system in performing these functions. Mild cases may be isolated, cared for and monitored at home, while persons with moderate or severe illness must be hospitalised without delay.

We need to develop integrated data systems that combine socio-demographic profile, emerging epidemiologic information, health workforce availability, healthcare facility capacity and readiness, supply chain status and transport data to quickly profile local area challenges and resources for a swift and contextualised response. While such data may be transmitted to higher levels of district, State and Central administration, village and ward-level data must be readily available to local implementers for responding without undue delay. So, people-partnered public health and decentralised data-driven decision-making must become the main engines of our epidemic response from now on.

Spread in south India

Within India, the number of cases were low in the southern States (except for Tamil Nadu) earlier, but are now accelerating. What explains this trend, especially as the lockdown and the easing of lockdown happened uniformly across the country.

More travel, into and within, these States, is a likely cause. The virus hitch-hikes with asymptomatic or pre-symptomatic travellers and spreads to more people in new areas. It is also possible that reports of good control in these States gave both the administrators and the public a false sense of assurance that the epidemic has ended locally, leading to a lowering of the guard. Bengaluru is a classic example of how public health failure has been snatched from the jaws of victory. If you give this virus an inch, it will take a yard. I do hope, however, that the well-earned reputation of the southern States for efficient administration will help them to quickly course-correct and regain control over the virus.

Are we clear about the reasons for the spread to new areas?

The virus moves with people and celebrates with crowds. Initially it entered via the international airports. Now it moves through road, rail and air to other parts of the country. If asymptomatic and pre-symptomatic persons are carrying the virus as they travel, neither do they know this nor can thermal screening detect it as they start their journeys. Physical distancing and masks can help cut the transmission but they are not universally followed. During travel, physical distancing becomes difficult. However, crowded events should certainly be avoided. Unfortunately, they have not been prevented in several areas.

Given the Indian experience, what have we contributed to the global pool of knowledge on the virus, treatment and so on?

We could have done more by way of organised research on clinical manifestations, outcomes and their determinants in different age groups. Our vaccine development efforts have been quite successful and clinical trials have begun to assess safety and efficacy. Characterisation of the virus strains and some mutations have been reported by Indian scientists. India is part of the World Health Organisation’s ongoing Solidarity trial on treatments, and other treatment trials, too, are under way in different parts of India.

This experience reinforces the need to build good epidemiological and clinical research capabilities in medical colleges across India. Presently, we depend only on a few elite medical colleges and research institutes. Many government and private hospitals are out of this circuit. The ICMR, State Health Departments and the National Board of Examinations (which affiliates private hospitals providing post graduate medical education) must build countrywide capacity for collaborative research and develop protocols which can be quickly implemented.

Among COVID-19 patients who have died, there are those who have not had any co-morbidity. What does this imply?

There are several possible explanations for this. First, several of them may have been repetitively exposed to a very high viral load under stressful conditions which sap immunity. This applies to healthcare providers and other frontline workers who come into contact with many patients and also to family members who have been in close and unprotected contact with a sick person. Second, several persons with co-morbidities may not have been diagnosed earlier. It is well recognised that many persons with diabetes, hypertension or coronary heart disease in population surveys are unaware of their condition. Third, risk factors such as high blood sugar and high blood pressure have a continuous relationship with blood-vessel damage and cause some harm even below the cut-off levels used for clinical diagnosis. This results in sub-clinical co-morbidity. Pre-diabetes, for example, has been found to be widely prevalent and carries the risk of vascular and renal disease. Fourth, high levels of air pollution may have already damaged many lungs. Fifth, malnutrition may have compromised immune status. Sixth, delays in diagnosis, transport, admission and treatment contribute to preventable deaths. The contribution of each of these factors would probably vary across different locations in India.

Acquired immunity

Earlier we were told that once infected, a person was not likely to contract it again. What is the current status of evidence from India about how long does immunity last among people who have recovered from the infection?

Acquired immunity, arising from infection, has two components. “Humoral immunity” is conferred by antibodies produced in response to viral invasion. “Cellular immunity” is conferred by thymus-derived T lymphocytes which mount additional defence. It has been recently reported that the anti-COVID-19 antibodies produced by an infected person decline by three months. However, it is believed that T cell-mediated immunity lasts longer. Since this is a novel virus, the extent and duration of immunity conferred by each of these pathways are still under investigation. Some stray cases of clinically manifest re-infection have been reported internationally but these appear to be very few. Most of the reports of positive viral tests in recovered persons have been attributed to “dead viruses”. It is possible that persons with low immune status could get reinfected. The Indian experience of such cases is very limited.

The ICMR sero-surveillance in May had suggested that 0.73 per cent of the population had been exposed to the infection. Since then the number of cases has multiplied manifold. Delhi’s surveillance data show 23 per cent exposure. What percentage of the population now is likely to have been exposed?

The ICMR report was on district-level surveillance data, reflecting rural and small-town populations surveyed in mid May. The Delhi survey was from June to July and covered a large city. So, differences are bound to be there. The sampling methods of each survey will have to be carefully examined to assess both internal validity and comparability. In general, the rates of viral exposure will vary across the country, being the highest in the big cities and the lowest in the villages as of now.

It must be recognised, though often not adequately publicised, that antibody tests can yield “false positive” test results too. This is because other coronaviruses, including those which cause common cold, can contribute cross-reactive antibodies. We do not know to what extent they are prevalent in our population at different times of the year. For statistical reasons, these false positive results get amplified when the test moves from a laboratory or hospital setting, where its accuracy was assessed in clinically proven cases, to the field setting, where the prevalence of infection is lower. So the 23 per cent positivity rate in Delhi is likely to be an overestimate of the true prevalence. Even if we think it will be 15 per cent instead of 23 per cent, that is a high number. So the virus has spread with ease. The good news is that most of the persons found positive were asymptomatic. The sobering news is that even at 20 per cent, Delhi will be below the herd immunity threshold, variably estimated to be at 50-70 per cent. The need to observe public health measures for containment is still very high.

India’s testing rate

Has India’s testing rate grown too slowly? Has it ended up chasing the spread of the infection or helped us to get ahead of the infection and help control its spread?

Our testing rates have varied over time. Low testing rates in the beginning were both due to operational constraints of testing kit availability and low numbers of people meeting the criteria for test eligibility. The testing rate picked up as kits, labs and eligible persons rose in number. They were still considered inadequate by international comparison, though there is no correlation between different testing rates and mortality rates per million population in any geographic zone of the world. Otherwise, the U.S. should have had far fewer deaths than most countries.

The need for increased testing is for quickly identifying cases and contacts for isolation. Since the real-time polymerase chain reaction (RT-PCR) test has only around 60 per cent sensitivity, it should be complemented with clinical and contact information for making decisions on isolation. It should not be assumed that a negative RT-PCR test rules out infection. Such expanded case definitions were not followed in practice. As criticism of low testing rates mounted, antigen tests were introduced. They had even lower sensitivity than RT-PCR and would miss more than half the infected persons. While testing rates went up and test positivity rates came down with these tests, the numbers of missed cases rose. We need to judiciously combine information from clinical data, contact history and RT-PCR or antigen tests to guide our strategy for identifying infected persons for isolation. Case identification must also lead to efficient contact tracing. The media, the public and even some policymakers are too fixated on testing numbers alone to recognise this composite template. That blinkered view, too, is as unhelpful as low testing rates.

Should the lockdown period not have been used to ramp up testing faster than we did? Did we lose an opportunity there?

During the full lockdown period, testing numbers were less important than preparing for larger scale testing as the lockdown ended. This is because the principal purpose of testing is to identify cases and isolate them as well as their close contacts. In the first 21 days of strict lockdown, this purpose was served even at low levels of testing as all potential cases and contacts were already isolated at home and symptomatic cases reached healthcare facilities. It is when that phase ended that testing and contact tracing should have been ramped up.

There were shortages of testing kits initially, in India and even globally, but the lockdown period gave time to fill those gaps. If symptom-based syndromic surveillance of households was routinely conducted by primary healthcare teams and citizen volunteers, more suspected cases would have been identified for testing.

Stigma and fear also kept people reporting for testing. Efficient and empathetic primary healthcare services would have countered that hesitancy too.

It must be recognised that a testing strategy must not merely chase numbers and do haphazard testing. It must be based on clear criteria. Once those are defined, all those who meet those criteria must be tested through active search strategies. Lag times in these could have been cut down through stronger primary healthcare services. Lamentably, our urban primary healthcare services are mostly absent or very feeble. Different States pursued different strategies for identifying persons to be tested, leading to missed cases and contacts.

Given that there is no specific “cure” for the virus, and many therapies are listed as investigational therapies, what is your opinion on whether there should be a definite treatment protocol or whether it should be left to the discretion of the individual clinician?

It bears repeating that this is a new virus and large clinical trials are still under way to identify which drugs can effectively reduce deaths in infected persons with different levels of clinical severity. So far, dexamethasone has been shown to reduce deaths in patients who require oxygen or mechanical ventilation. Others are still being evaluated for their impact on mortality. Some drugs have shown effects on the viral load or the duration of hospital stay, but not on mortality. Until we are better informed by ongoing clinical trials, clinicians will use their best judgement to manage patients under their care, by choosing among the various options available. It is too early to lay down a single evidence-based protocol for all clinical situations. Research in this area is still in a fluid state and science has not yet crystallised in the form of definitive recommendations.

As the number of cases are growing and the demand on the health system is increasing, do we not have a problem of inadequate personnel? While beds and infrastructure can be ramped up, are there not constraints even now regarding the availability of healthcare professionals?

We do have a serious shortage of trained personnel at all levels of care. From contact tracers in the field to intensive-care doctors, nurses and technicians who can confidently provide ventilatory support, we have the challenge of low numbers and low skill levels. This is where our long neglect of the need to build a sizeable, multi-layered and multi-skilled workforce is biting us now. Investing in expansion of the health workforce is both a health system imperative and an economic opportunity for job creation. We should learn this lesson at least now and start investing in creating an adequate health workforce which is also well distributed across the country.

From the COVID-19 experience in India, do you think that it is appropriate that such a large proportion of its healthcare facilities should lie in the private sector and that there should be significantly greater public investment in health?

I believe that a strong public sector should lead the way, even in a mixed health system that has grown by default rather than by design. This applies to all levels of care but is especially essential in primary and secondary care where most of the healthcare needs of the population must be met. Such transformation calls for higher levels of public financing for health, by both Central and State governments.

Whether for effectively combating public health emergencies like COVID-19 or for efficiently delivering universal health coverage, a strong public sector has to lead the way. It will not happen with only 1.2 per cent of the gross domestic product being spent on health. We need a doubling of that figure in three years and a further steady annual rise until we can reduce out-of-pocket expenditure on health to less than 20 per cent from the present 62 per cent. These additional resources must be used for strengthening both rural and urban primary healthcare, district hospitals, medical college hospitals and government laboratories.

Disease Surveillance

How the poor die

Maya John the-nation

For the human race that has seen approximately 100 billion of its species die in the past 50,000 years, death is an inescapable reality. What has changed now is its enhanced ability to systematically track down death to specific causes. With its national-level tracker for COVID-19 deaths, India has perhaps for the first time launched a daily tracker for deaths caused by a disease. However, the current conjuncture reveals an unsettling fact: while certain diseases gain singular prominence by attracting funds for exhaustive scientific research and treatment, many others are neglected as “ordinary”. In this light, the actual disease burden of a population is highly underexplored because several ailments and illnesses fail to be identified as specific diseases with a definitive cause (aetiology). Given the darkness surrounding many illnesses, it is essentially symptomatic treatment that is administered to patients.

Conspiracy theories

The identification of diseases and the spread of old as well as new diseases requires robust disease surveillance and expansive public health-care facilities. Unfortunately, there are systemic problems with the existing disease surveillance. Piecemeal disease surveillance often paves the way for conflicting assessments and opacity about the origins of disease outbreaks so much so that conspiracy theories soon take root. It is in this regard that even certain reactions to the COVID-19 outbreak may be contexualised.

For instance, shortly after the United States saw a spurt in COVID-19 cases earlier this year, President Donald Trump unleashed a bitter volley of accusations against China that it had concealed information about the novel coronavirus outbreak in Wuhan (China). In some quarters, COVID-19 has been projected as an engineered outbreak and the virus as one that has been produced in a laboratory. Considering that this is the U.S. presidential election year, many political commentators have labelled Trump’s accusations as part of an unsavoury attempt at jingoistic politics and to divert attention from his mismanagement of the COVID-19 outbreak in the country.

The allegations were accompanied by Trump’s formal announcement about ending the U.S.’ membership in the World Health Organisation (WHO) and withdrawal of $450 million it grants to the WHO as financial support. Accusing the WHO of being “controlled” by China, the U.S. government claims it will channelise its funds towards other global public health organisations. Such aggressive posturing by the U.S. conveniently sidesteps the important contribution of the Chinese disease surveillance system in identifying the new disease. What if China had not identified the virus strain and derived a definitive aetiology for the new disease from amidst a host of symptoms that are common to other known contagious and severe respiratory diseases?

Moreover, it is important to recognise the most recent compromises the U.S. government has made with respect to disease monitoring, such as a two-third deduction in funding for the country’s Global Health Security Agenda, which was introduced in 2014 with the aim of setting up an early-warning system for infectious diseases across the world. Likewise, the Trump administration almost discontinued the $200 million epidemiological research programme, PREDICT, that is funded by a grant from the United States Agency for International Development (USAID), but the COVID-19 pandemic compelled it to extend funding temporarily for six months beyond March 2020.

By then the damage had been done, with many scientists, including those researching in China, been laid off just before the Wuhan outbreak. Set up in 2009, PREDICT, with its focus on locating viruses with the potential to cause human disease and pandemics, has been engaged in regions like the Amazon Basin, South and Southeast Asia, and the Congo Basin. All these recent measures stand to affect not only the American population but also weaken ongoing intergovernmental disease monitoring tie-ups across poorer regions of the world.

Class, region and other social dynamics are crucial factors that steer the thrust of disease monitoring/surveillance across the world. The adverse medical conditions prevalent among the labouring poor and the less-wealthy regions do not get adequate attention because of their insufficient signalling effect on private pharmaceutical companies, and also because governments do not assign priority to the general health care and diseases of the poor. The profit-oriented pharmaceutical industry controls the lion’s share of funding for scientific research. Its funding priorities determine the quantum of funding and thereby shape the scientific community’s interest in certain diseases over others, stunting in the process the potential and quality of research carried out by the majority of scientists. In other words, the pharmaceutical industry tends to set the health agenda for intergovernmental agencies and influence the institutional priority of governments with respect to the scope and direction of scientific research.

This unfortunate reality is best captured by the growing dominance of the vertical model of health intervention wherein powerful donors (internationally recognised foundations), intergovernmental agencies and pharmaceutical companies, eager to promote certain drugs, dictate what constitutes as health exigencies for a country. The vertical health model propagates a surgical mode of intervention on a singular disease, leaving the collateral damage unaddressed, i.e. increasing fatality rates of numerous other debilitating diseases and illnesses prevalent within a population, which only horizontal health intervention or an expansive public health-care system can resolve. The fallout of this is that while some diseases gain singular prominence and are declared epidemics/pandemics by the scientific community, scores of infectious diseases and illnesses affecting largely the poor are brushed aside as “ordinary”. As the U.S.-based medical practitioner Siddharth Mukherjee aptly puts it in his award-winning book, The Emperor of All Maladies, “A disease must win politically to win scientifically.”

Narrow focus

Given the increasingly narrow focus on specific communicable diseases and the consequent skewed channelisation of resources, the process of neutral discovery of a disease rarely unfolds. For one, a significant number of clinical cases that can be captured by a disease surveillance system are not even made out, considering that the infected poor and marginalised people do not necessarily report their condition to certified doctors; they fall prey to quacks who are more easily accessible to them.

The dismal scenario with respect to fake doctors was exposed in a 2016 WHO report, which claimed that 57 per cent of the allopathic “doctors” in India in 2001 did not have any medical qualifications. The report further said that 31 per cent of the allopathic “doctors” in urban India were educated only till Class 12, while rural India had access to only 18.8 per cent allopathic doctors with proper medical degrees.

Even when infected persons report their ailments to public health institutions, an overburdened system often averts the essential testing of their blood/serum, throat swab, sputum, stool, urine, and so on, and restricts diagnosis to symptomatic treatment. If clinical cases lead to microbiological or cytological investigations, the tendency for pathology laboratories to categorise diseases on the basis of pregiven classification and parameters is so predominant that differentiating and separating pathogens on the basis of variations in groups, subgroups, and strains in genotype is minimal.

This way many pathogens are wrongly categorised into existing classificatory schemes, and the specific cause behind numerous diseases and ailments fail to be identified and differentiated. Many ailments are then simply clubbed together under catch-all categories such as “Respiratory Tract Infection”, “Urinary Tract Infection”, “Fever of Unknown Origin”, and “Acute Febrile Illness”. Some of these diseases are on the rise, and many are more contagious and fatal than diseases that gain prominence. However, given the incomplete diagnosis, it is at the most symptomatic treatment that is made available to the common masses, leading to the persistent spread of the disease and continuous heavy loss of life.

TB, an undeclared silent epidemic

Even when the aetiology of a contagious disease and its treatment are well known, the disease’s prevalence does not generate adequate reaction among the people concerned. Tuberculosis (TB), a disease generally associated with the poor, is an apt example. Sources highlight that every 10 seconds a person contracts TB, pointing to a very high R0 (basic reproduction number) for the disease. With four to five lakh persons succumbing to the disease every year in India and with more drug-resistant cases being reported yearly, TB has had not only a higher mortality rate than COVID-19 so far, but is clearly an undeclared persistent silent epidemic. Furthermore, there is an urgent need to recognise the issue of comorbidity, that is, the possible combination of preexisting medical complications with diseases that plague the majority of Indian people. Expectedly then, an eventuality of the ongoing pandemic is dying with rather than of COVID-19. The other eventuality is the neglect of coexisting diseases, which points to a situation where many poor people, if not succumbing to COVID-19, are dying from the rising fatality rates of other diseases. Evidently, the Indian population is falling prey to the sinister synergy between coexisting diseases and the vulnerability fostered by the overall functioning of our socio-economic system.

Considering the social dimensions impacting scientific inquiry and the resulting prevalence of undifferentiated and downplayed diseases, what could have unfolded if the Chinese disease surveillance system failed to tap the outbreak of the novel coronavirus and differentiate the aetiology of the outbreak? Among the most probable consequences would have been the misidentification of the disease’s symptoms and aetiology with existing severe and acute respiratory diseases that otherwise trigger mass hospitalisations and a significant number of deaths in many parts of the world. Case studies from Italy and the U.S. highlight that the COVID-19 death toll has been predominantly confined to elderly persons of the same age group who usually succumb to influenza (flu), pneumonia and similar diseases. For a typical flu season, COVID-19 nonetheless quickly caught the attention of governments in the West mainly because the population that was infected initially turned out to be well-to-do travellers. If this had not been the case and if China had not identified and differentiated COVID-19 from a host of similar diseases, COVID-19 would have in all probability gone under-reported as a somewhat unusual long spell of flu or pneumonia deaths.

The Surat outbreak

Outright non-identification, mistaken or undifferentiated identification of diseases, and downplaying of disease outbreaks are the ingrained reality of the existing disease surveillance systems. In turn, the opacity bred by mainstream epidemiology and disease surveillance systems allows for marked contestation. We have seen this in the context of recent and older disease outbreaks. The so-called “pneumonic plague” outbreak in Surat, Gujarat, in September 1994 is an important instance of the ambivalence that accompanies disease analysis and the conflicting interests that play themselves out in disease outbreak reporting.

The Surat outbreak reflected the frictions that exist between member-states and the WHO. At that time, the WHO was carving out a new role for itself in the context of the growing dominance of economic liberalisation policies which pushed for less public involvement in health-care services, the shrinking of the WHO’s traditional funding sources, and the competition posed by well-funded health programmes of the World Bank and the United Nations Children’s Fund (UNICEF). Through a somewhat unprecedented interventionist role in Surat, triggered by the pressure mounted by India’s affluent trading partners, the WHO sought to make an example of the epidemic and assert the importance of enhanced disease surveillance at the global level. Interestingly, WHO officials maintained a relatively ambivalent position on the cause of the outbreak. The WHO Team Executive Report claimed: “Yersinia pestis is the likely causative agent of the Surat outbreak…. [However] the identification of plague as cause of the outbreak cannot be established in the absence of confirmed isolation… from clinical materials….” Meanwhile, the National Institute of Communicable Diseases, New Delhi, confirmed that the outbreak was the plague whereas the Gujarat Chief Minister denied the plague thesis, claiming that it was more likely to be pneumonia.

The Indian government interpreted the WHO’s intervention as the undermining of the sovereign realm of state authority. It set up its own Technical Advisory Committee (TAC) that ran a parallel investigation to that of the international team constituted by the WHO on October 7, 1994. The TAC attributed the aetiology of the so-called pneumonic plague to Yersinia pestis, although it had to also acknowledge that its assessment was based on preexisting and contaminated cultures. It also sought to establish that the genetic mutation indicated the external origin of the strain, thereby projecting the emergence of a new disease whilst challenging the notion of poorer countries being the sites of disease and contagion. The outbreak was consequently connected to the enhanced mobility of disease vectors in a highly globalised world of trade, business and commerce, as well as to a possible act of bioterrorism. The politics of locating the origins of the outbreak stemmed from the Central government’s preoccupation with regional tensions involving hostile South Asian neighbours, who were allegedly antagonised by India’s bid to integrate with the globalised world economy.

The Gujarat government tabled a different assessment. The Gujarat Expert Plague Committee’s report questioned the Indian government’s assessment of the plague diagnosis and attributed the origin of the outbreak to internal issues of hygiene, unplanned industrialisation and social deprivation. Interestingly, conflicting assessments allowed for the labelling of over 6,000 cases as plague cases whereas they were actually due to other diseases. Taken together, the diversity of views revealed the ambivalence surrounding the origins of the disease outbreak and the inadequacy of sample data, both of which highlighted the acute need for a more robust disease surveillance system. Not surprisingly, the Surat outbreak became a crucial example worldwide and compelled the TAC itself to acknowledge the need for a new, integrated surveillance and response network in the country.

Challenges of disease surveillance

A dedicated disease surveillance programme in India was established in 1997 under a pilot project known as the National Surveillance Programme for Communicable Diseases (NSPCD), which started off in five districts and was later expanded to 101 districts by 2004. The nodal agency of the NSPDC was the National Centre for Disease Control (NCDC), New Delhi, and the implementing agencies were States/Union Territories. The programme was based on weekly reporting of outbreaks of epidemic-prone diseases (including nil reporting) directly from districts to the higher centres. However, the NSPCD failed to give a complete picture of disease burden in the country, given its limited coverage of districts and inadequate resources for the creation of an expansive database of diseases and epidemic outbreaks. In 2004, the country’s disease surveillance transitioned into the Integrated Disease Surveillance Programme (IDSP), which was initiated under the World Bank’s financial assistance of $68 million. By 2012 the World Bank’s funding for the programme was stopped, after which the IDSP continued under the Twelfth Plan as part of the National Health Mission with a budget estimate of Rs.640 crore. The annual budgetary allocation from 2012-13 to October 2017 has varied from approximately Rs.33 crore to Rs.65 crore.

More than 15 years into its existence, the country’s “revamped” public health surveillance still lacks coordination, adequate resources, and is ridden with significant gaps in the monitoring of many infectious diseases. Even in the ensuing context of the COVID-19 pandemic, disease reporting under the IDSP has floundered as the Central and State governments have enforced singular focus on COVID-19. Out-patient department (OPD) services and surgeries were drastically reduced in March 2020 when there were only a few hundred cases of COVID-19 in the country, and disrupted public health-care services have persisted despite the realities of comorbidity and actual disease burden of the common masses.

Ironically, in a country reeling under malnutrition and delayed treatment of the sick, among other adverse effects of a lengthy and poorly managed lockdown, the IDSP has failed to trace the actual disease burden of the population, as is evident in its lack of reporting of disease outbreaks since March 22, 2020. The IDSP’s inadequacies are linked to the general limitations of the country’s public health policy and overburdened public health-care infrastructure. For one, centrally-implemented health programmes continue to focus on vaccine-preventable infectious diseases even as other infectious diseases fail to be systematically controlled. As noted in the Draft National Health Policy (2015), the communicable diseases that national health programmes seek to address represent less than 25 per cent of all the communicable diseases in existence and less than 6 per cent of overall reported fatalities.

This apart, the country’s disease monitoring is hampered by specific problems such as limited funding; a scattered and inadequate laboratory network; lack of trained manpower; insufficient use of ICT (information and communications technology) for data collection, analysis and transmission; existence of a number of parallel systems under various vertical health programmes; inadequate use of routine data; and limited use of non-specific health indicators or proxy measures like trends in drug sales, use of emergency services, etc., which some health experts consider as an important back-up to laboratory-testing surveillance.

In the IDSP’s own annual reports, the inadequacy of funds gets reflected in the diversion of funds from other accounts/heads to the IDSP and vice versa from the IDSP to other programmes under the National Health Mission. For example, in 2010-11 an additional grant-in-aid was extended by the IDSP to the north-eastern States by diverting Rs.5.40 crore from the Rural Family Welfare Services head, indicating a reallocation of resources from an equally fundamental civic welfare programme. The limited funds for what needs to be a much more expansive and vigilant disease monitoring system has resulted in inadequate strengthening or upgrading of laboratories that are linked to the IDSP network. To date only 114 laboratories at the district level have been strengthened for diagnosis of epidemic-prone diseases.

Needless to say, the practice of upgrading district public health laboratories in a “phased manner” has meant additional burdening of established laboratories of medical colleges and other major centres in the States/Union Territories. Of course, the focus on district public health laboratories also tends to overlook the need for vigilant community level disease monitoring, for which neither can primary health centres (PHCs) and community health centres (CHCs) be left out from the necessary upgradation process, nor can the existing training of overburdened front-line health workers such as auxiliary nurse midwives (ANMs), multi-purpose health workers (MPHW) and accredited social health activists (ASHAs) be considered adequate for extensive and accurate data collection. Upgraded PHCs and CHCs as well as adequately trained front-line health workers mean better equipped local level disease surveillance.

Importantly, studies have identified that the lack of adequately trained front-line health workers and technical staff clearly affects the alertness of the surveillance system. A 2014 study published in the Journal of Family Medicine and Primary Care examined 24 sub-centres that come within the rural field practice area attached to the Post Graduate Institute of Medical Sciences, Rohtak, Haryana. It was noted that 70 per cent of the staff could not expand the abbreviation “IDSP”; 91 per cent were unaware of trigger levels; 93 per cent were not aware of nil reporting; and only half the number of sub-centres were actually filing written records according to defined syndromes, indicating the lack of awareness among the staff about the utility of their reporting.

Lack of expertise

From the IDSP reports it is also evident that district laboratories themselves lack trained manpower, i.e. microbiologists, epidemiologists, technicians, laboratory assistants, and so on. This worrying lack of expertise is the fallout of the long-standing trend of inadequate state investment in the education sector which generates skilled human resources for the economy and society. The country lacks dedicated educational programmes and institutions that can produce trained epidemiologists, among other specialists, for data analysis of diseases and policy framing, which are crucial components of an efficient disease surveillance system. Since the launch of the IDSP under World Bank funding in the early 2000s, the acute shortage of epidemiologists has been met by appointing personnel with an educational background in public health, statistics, communicable diseases, and social work, who are then subsequently trained in the working of the IDSP. Usually medical graduates with a postgraduate degree or work experience in public health, preventive and social medicine or epidemiology are preferred for positions of epidemiologists.

The lack of dedicated educational programmes is aggravated by interdisciplinary rivalries between medical sciences on the one hand and public health and community medicine on the other. The Medical Council of India (MCI), for instance, recognises the Masters in Public Health (Epidemiology) course of solely two institutions in the entire country; namely, the National Institute of Mental Health and Neurosciences, Bengaluru (offering 10 seats), and the All India Institute of Hygiene and Public Health, Kolkata (offering seven seats). Meanwhile, a handful of other private and public-funded institutions that do not feature in the MCI’s database offer this particular master’s programme and a diversity of allied courses.

Overall, the existing structure hints at the serious lack of standardisation in the educational training of epidemiologists, which is detrimental to the growth of such expertise, especially when combined with the relatively low remuneration for epidemiologists. Recent news reports on the country’s ill-preparedness for tackling the COVID-19 pandemic have rightly highlighted that the lack of experts such as epidemiologists is linked to the IDSP’s preferred practice of recruiting for non-tenured positions. Such non-tenured positions allow for low-paying, unrewarding work conditions, and trigger the preference among qualified experts for employment in private pharmaceutical companies and global agencies.

Conclusion

Some experts have rightly emphasised the embedded proximity of several microorganisms to human life. In the case of disease-causing microbes or pathogens, this means that infectious diseases and their outbreak have been an intrinsic part of human civilisation. However, human society has increasingly learnt to liberate humankind from disease, and its corollary, death. Unfortunately, the endeavour is often compromised by systemic reasons and the biases integral to the dominant socio-economic system within which scientific research is carried out. We are constantly confronted by the lack of preparation in meeting the challenges posed by diseases and their outbreaks.

The ill-preparedness can be addressed by augmenting the health conditions of the common masses and the health-care facilities of the country. It is also imperative to question the existing parameters of disease monitoring, which is currently far from an objective exercise. Many diseases plaguing the working masses and backward regions are not even differentiated and identified by the existing scientific community. Even if a disease is discovered with a definitive aetiology, we find that the order of priority given to it and the launch of appropriate disease control are based on whether it has a certain signalling effect for the scientific community. In a large number of instances, it is only when there is a threat of transmission to the well-to-do sections of society or wealthier regions that the disease actually has such a signalling effect.

Science does not exist in isolation but is actively shaped by contemporary social dynamics. Professional scientists do not pursue research in a bubble, and their subjective biases negate the very idea of the self-sufficient character of science. Controlled by increasing specialisation and growing demands for funding and output, only a limited number of scientists build conceptual frameworks and pursue empirical research with an ear to the ground. It is thus imperative to bring the social question back into science for which we need greater interface between scientists and social scientists, as well as between the existing health-care establishment and people’s movement. These interfaces are crucial for delinking scientists from prevailing prejudices and for asserting the marked distinction between the “specialist and a real seeker after truth” (Albert Einstein, 1944). It is through these interfaces that we can lay bare the skewed relationship between social epistemology (ways of knowing) and epidemiology in order to build pressure on state agencies to take active cognisance of diseases and illnesses that they have been neglectful of.

Maya John teaches at the University of Delhi and is working on the history of epidemics and epidemiology.

COVID-19 strategy

COVID-19: Government gloating in defeat

T.K. Rajalakshmi the-nation

The Indian health establishment is sparing no effort to convince everyone that the government’s strategy to control the spread of COVID-19 infections has been a success, but the reality on the ground proves otherwise.

In the first week of August, almost a week after the third phase of a gradual unlocking was announced, Chief Ministers of at least two States reporting fairly large COVID-19 numbers tested positive.

While Shivraj Singh Chauhan in Madhya Pradesh and B.S. Yeddyurappa in Karnataka were the high-profile COVID-19 cases, at the Centre, Home Minister Amit Shah too was diagnosed with COVID-19. On August 2, Kamal Rani Varun, a 62- year-old Cabinet Minister in the Uttar Pradesh government, succumbed to the disease.

India today has the third highest number of COVID-19 infections after the United States and Brazil and the fifth highest number of deaths after the U.S., Brazil, Mexico and the United Kingdom.

During the period from July 5 to August 5, the daily number of confirmed cases more than doubled from 23,942 to 56,626. On July 25, the daily number of cases touched 50,000 for the first time and has been on the rise since then. A record 57,486 confirmed cases were reported on July 31, the highest in the month. By August 6, this figure had gone up to 62,000.

On two consecutive days, India even surpassed the U.S. and Brazil in the largest single-day spike of cases and deaths. With around 40,000 deaths so far, India can hardly boast of having controlled the spread of the virus.

On August 4, a day when 51,282 cases were reported, senior Health Ministry officials urged the media to look at the “biggest news”, which was that nearly two crore tests had been done till date and that more than six lakh tests had been conducted in the previous 24 hours.

The other “big news”, of daily infections crossing 50,000, was not mentioned at all. At a briefing on that day, Rajesh Bhushan, the newly appointed Health Secretary, told mediapersons that the total number of recovered cases was double that of active cases.

This line of presentation was nothing new; each time a briefing was held, media officials always talked about the high recovery rates. It was not mentioned that the total number of recoveries was the cumulative figure, that is from March onwards, while the number of active cases indicated those currently active, that is, in the past 14 days.

The two were not comparable metrics from any standpoint, yet in each press conference health officials were self-congratulatory about the recovery figures. The number of active cases was by no means small: it was over six lakh.

At the briefing on August 4, there was no reference to the two days when India recorded the largest number of cases and deaths in the world.

Testing methods

Of the 1,370 laboratories in the country, 698 were conducting tests using the gold standard Reverse Transcription Polymerase Chain Reaction (RTPCR) method. Of the 1,370 laboratories, 921 are run by the government and 449 are in the private sector.

Apart from these laboratory tests, the Rapid Antigen Tests (RAT) method was also used but considered less reliable than the RTPCR, which is known to have higher sensitivity and specificity.

Although some mediapersons had repeatedly made inquiries about the proportion of antibody tests to the total number of tests, the government issued a reply only on August 4. The Director General of the Indian Council of Medical Research (ICMR), who was present at the Health Ministry briefing, said that 30-40 per cent of the total tests were done using the RAT method.

This was interesting as the ICMR had, in guidelines issued in May, stated that rapid antibody or antigen tests should not be used for diagnostic purposes. This was also in line with the guidelines of the World Health Organisation (WHO).

The problem with this method is that a positive test would indicate exposure to COVID-19 but a negative test would not overrule the presence of the infection.

If there were false positives, then these tests would have to be followed up with the RTPCR method. Given that there are only 698 laboratories using the RTPCR method for a population of 1.3 billion, it is impossible for every false negative case to get tested again using the gold standard method.

Besides, if 30-40 per cent of the total of two crore tests were done using the RAT method, many possible carriers of the infection were going untested and undetected.

The government and the Health Ministry have been sensitive to the criticism regarding the low rates of testing. They have been at pains to convince critics that India was testing far beyond the WHO standard on the optimum number of tests that need to be done a day per million, which is 140, according to the Health Ministry.

However, the cases per million in most countries are well over 140, often running into thousands, so it was unrealistic that a mere 140 tests a day per million would suffice.

Rise in cases and deaths

On August 6, the Health Ministry announced that a new record had been set with 6,64,949 tests in the previous 24 hours and that it was the third consecutive day that the number of tests a day had crossed six lakh. The tests per million had also crossed 16,000, the Ministry said in a release. However, it did not mention that in the previous 24 hours, India had taken the top spot in the highest single-day spike of confirmed cases, touching almost 62,000 and surpassing even the U.S. and Brazil in daily numbers.

August 6 was a milestone as the 60,000 mark had been breached. It was apparent that as more tests were being conducted, the number of confirmed cases were also going up. Also, India topped in the number of COVID-related new deaths. A day before, it was in the second place. On August 6, as many as 888 people in India succumbed to the virus, compared with 829 in Mexico, 416 in the U.S. and 274 in Brazil.

According to Health Ministry officials, the case fatality rate—the number of deaths as a percentage of the number of people who have tested positive—was at its lowest since March. But they did not offer any explanation on why the number of fresh daily cases (61,000 plus) was far higher than those reported in the U.S. (22,858) and Brazil (10,543).

The positivity rate over the weekly seven-day average was close to 11 per cent, which was high, although the cumulative positivity rate was around 8.89 per cent. The positivity rate indicates the percentage of positive samples out of the total number of samples tested.

According to the WHO, a positivity ratio of less than five was desirable and an indication that testing was adequate. A high positivity rate showed that testing was not adequate and that the infection was being chased, which was the case in India. According to the government, the positivity rate was high because of some States.

The Health Ministry said that some 28 States and Union Territories were testing more than the WHO’s guideline of 140 tests a day per million. The all-India average was 479, which the government considers robust. However, several countries are testing far greater numbers on an average.

Goa, Delhi, Tripura, Jammu & Kashmir and Tamil Nadu had increased their testing capacity and were testing more than the nation’s average.

Although the daily testing numbers had gone up, it was clear that India had woken up rather late to the ‘test, treat and track’ approach, as a result of which infections were far ahead of testing capacities.

Maharashtra, Tamil Nadu, Andhra Pradesh, Karnataka, Delhi, Uttar Pradesh, West Bengal, Telangana, Bihar and Gujarat accounted for the bulk of the caseload, but there is hardly any State left where no fresh cases are being reported.

Uttar Pradesh, for instance, was at the bottom of the list of States contributing to the caseload for many months. With over one lakh confirmed cases, it is now in the sixth place.

Export of ventilators

On August 4, even as the Health Secretary declared that there had been a progressive decline in the case fatality rate since June, he also announced that the government had decided to lift the ban on the export of ventilators.

The formal decision came in the form of a notification from the Directorate General of Foreign Trade in the Department of Commerce, which stated that “all ventilators, including any artificial respiratory apparatus or oxygen therapy apparatus or any other breathing appliance or device” whose export was prohibited under the existing policy could now be exported.

The lifting of the ban defied logic given the rising number of cases and daily deaths.

The Health Secretary also gave a presentation on “Make in India” ventilators in which he said that India was now self-sufficient in the production and supply of ventilators.

The Indian ventilator market had grown from 8,510 units to 18,000, all of them domestically produced. They had been supplied to States and were being installed in more than 700 hospitals. The government had placed orders for the domestic production of a total of 60,000 ventilators, which was the projected demand during the pandemic, he said.

Two public sector units had been given the charge to produce 43,500 ventilators and Maruti Suzuki was to supply another 10,000.

The government has been in denial mode for a long time now. Its recent discovery of the merits of aggressive testing and contact tracing should be complemented with adequate health infrastructure and life-saving equipment.

Seroprevalence of COVID-19

COVID-19: Indian population still far from herd immunity

R. Ramachandran the-nation

In the last 10 days of July, Delhi, Mumbai and Ahmedabad, three of India’s major cities, released the results of COVID-19 seroprevalence surveys that their respective municipal corporations had conducted in association with research institutes. In the absence of any published countrywide sero-survey results, these studies, notwithstanding their limitations, are the only ones that give us information about the prevalence of COVID-19 infection in the general population of these cities, and possibly also give us some insight into the infection prevalence in typical urban Indian populations.

It should be borne in mind that sero-surveys, by testing for IgG antibodies to the infection that form around two weeks after infection, identify people who had been infected in the past and would have since recovered. So, such surveys identify only infected people who have circulating antibodies and only give an estimate of the prevalence of infection about two weeks before. Also, migrant workers, who constitute a good chunk of the population in Indian cities, possibly get missed out in these surveys as they are likely to have left for their hometowns during the lockdowns.

As reported earlier (“COVID cover-up” and “Chinks in the armour”, Frontline, July 3 and 17 respectively), the Indian Council of Medical Research (ICMR) conducted a nationwide cross-sectional sero-survey in mid May that covered over 70 districts, including only the containment zones of the 10 cities reporting the highest number of cases as of April 25, and tested over 26,000 individuals. Although the results of this national survey are yet to be published, the ICMR stated in a press briefing that the seroprevalence rate found among the general population, that is, excluding the hotspot zones of the 10 cities, was only 0.73 per cent. Since this survey was conducted in mid May, it gives the seroprevalence rate of April-end.

On the basis of leaked information, some news reports said in June that the ICMR study had found over 30 per cent prevalence in the cities. The actual findings, however, remain unknown as the ICMR has not made the results public. In the absence of the ICMR data, these city-specific surveys conducted in June-July, give us a more recent picture of seroprevalence in these three cities. This article discusses the data released by these surveys and also looks at, for what it is worth, the nationwide seroprevalence data gathered by the private diagnostics company Thyrocare Technologies Ltd. Neither the scientific community nor the Ministry of Health and Family Welfare has taken note of this private effort as it falls well short of being a properly conducted survey.

Delhi

In a press release dated July 21, the Health Ministry said it had commissioned the seroprevalence study for Delhi as a follow-up to the sero-survey the ICMR carried out in the containment zone of Delhi’s South East district. The National Centre for Disease Control (NCDC), an institution under the Ministry, in collaboration with the Delhi government carried out the community-based cross-sectional sero-survey in all the 11 districts of Delhi between June 27 and July10. The IgG antibody tests were done using the ICMR-approved indigenous COVID KAVACH IgG ELISA (enzyme-linked immunosorbent assay) kit.

Following a “multistage sampling study design”, 21,387 sera samples were collected. The results of this seroprevalence study (Figure 1) show that the (population-weights adjusted) average infection prevalence across Delhi (from mid June to the third week of the month) was 22.86 per cent. According to the Ministry, a large number of infected people were asymptomatic. Given the current population of Delhi (over 20 million), this means that about 4.6 million people were infected in mid to end June. However, the official data for the number of confirmed cases in Delhi for that period was 43,000 to 82,000.

While this clearly indicates a gross failure of the testing strategy, the Ministry, however, in its usual self-congratulatory style, said: “Nearly six months into the epidemic, only 23.48 per cent [unweighted average] of the people are affected in Delhi, which has several pockets of dense population. This can be attributed to the proactive efforts taken by the government to prevent the spread of infection including prompt lockdown, effective containment and surveillance measures, including contact tracing and tracking,…”

In an article in The Financial Express (August 1), Padam Singh, a former head of the ICMR’s medical statistics division and former Additional Director General at the ICMR, and Davendra Verma, former Director General of the Central Statistics Office of the Ministry of Statistics and Programme Implementation, wrote a severe critique of the sampling design and survey methodology even as they gave some additional data about the Delhi survey that had not been made public. The survey had found that the seropositivity rate (SPR) among females (24.2 per cent) was higher than among males (21.63 per cent) and that the SPR among the younger age group (<18) was 23.13 per cent, while that among the higher age group (>18) was 22.86 per cent. They also expressed surprise at the large variation in the SPRs between districts, ranging from 12.95 per cent to about 28 per cent.

While remarking that the above data were somewhat strange and unlikely, the authors pointed out that the SPRs found would actually be underestimates because the the detection kit used had a low sensitivity of 92.1 per cent, and the NCDC data analysis had not accounted for this. In the main, Padam Singh and Davendra Verma criticised the survey for its faulty four-stage sampling design. They pointed out that the inclusion of dispensaries as the primary sampling units in the third stage appeared to be basically because of administrative convenience. The selection of individuals at the fourth stage, which was left to the dispensaries, was, therefore, not random. “Thus, there is no sampling of wards and obviously there was no multistage sampling. The question is how dispensaries became part of the primary sampling units if they were not part of the sampling frame,” they wrote.

Meanwhile, despite this erroneous sampling methodology, the second round of sero-surveillance in Delhi has already begun.

A more sound survey in Mumbai

The design and conduct of the Mumbai survey was perhaps technically more sound as it involved many front-ranking research institutions and a larger group. Its limitation was its relatively (as compared with Delhi and Ahmedabad) smaller sample size as it covered only three of the city’s 24 wards, though this choice was made with some scientific rationale. It is also the only one among the three surveys whose summary report with all the relevant data has been made public.

This sero-survey, which used the random sampling methodology, is the first stage of a bigger project undertaken by a joint venture between the Tata Institute of Fundamental Research (TIFR), Mumbai; the Translational Health Science and Technology Institute (THSTI), Faridabad, Haryana; the University of Chicago, United States; Duke University, North Carolina, U.S.; A.T.E. Chandra Foundation, a Mumbai-based philanthropic organisation; Kasturba Hospital, Mumbai; and the IDFC Institute, a Mumbai-based public policy think tank. The project, which was launched on June 29, aims to conduct the survey at two time points to infer the trajectory of the epidemic in the city. The NITI Aayog, the Brihanmumbai Municipal Corporation (BMC) and the TIFR jointly conducted the initial stage of the survey from June end up to mid July.

The strengths of the study are the use of chemiluminescence immunoassay (CLIA) IgG antibody detection kits with high specificity (100 per cent) and high sensitivity (93 per cent). To gain insights into seroprevalence, the data captured was stratified in terms of slum/non-slum areas, age (in four groups: 12-24 years, 25-39 years, 40-60 years and over 60 years) and gender. In particular, the sampling methodology took into account the number of reported cases and population sizes in each of the wards and, significantly, for slums and non-slums separately. Sampling included people who had been symptomatic but recovered at the time of the survey or were asymptomatic without distinction. The sampling did not include active containment zones. The larger study also includes a survey of health care workers, assessment of the impact of risk factors on prevalence and determination specifically of the presence of neutralising antibodies (as against binding antibodies). These components of the study are still ongoing.

The selection of the wards was based on the following criteria: coverage of city and suburban areas, east, west and north areas and representation of localities with low to high caseload as on June 2. The selected wards were R North (Dahisar region, low), M West (Chembur region, average) and F North (Matunga region, high). Significantly, the chosen wards did not include the Dharavi slum, which lies close to F North and is supposed to be the largest slum in Asia.

“We chose 3 wards out of 24 for many reasons,” said Sandeep Juneja of the TIFR. “Our sampling budget was somewhat limited. It made sense to focus on geographically limited diversity so that our estimates given the sample sizes are more meaningful. Further, this way we make better conclusions about the differential in population density (slums and non-slums) leading to different prevalence rates. There is a large set-up cost involved in going to each new ward. So, from the logistics point of view, this was more manageable.”

Out of an estimated sample size of 8,670 individuals, the first round could gather only 6,936 samples because, strangely, while the participation from slums was 100 per cent, the turnout from non-slum areas was only 70 per cent (Table 1). “Nonetheless,” says the survey report, “the sample size relative to the prevalence is adequate to draw statistically meaningful conclusions.” Sample analyses were done at Kasturba Hospital and the THSTI.

The study has estimated an average prevalence of 56.5 per cent in slums and 15.5 per cent in non-slums in the three wards selected (Tables 2 (a-c) and 3 (a-c)). Assuming that 42 per cent of Mumbai’s population lives in slums, this works out to an overall seroprevalence rate of about 33 per cent for the entire city, which is significantly higher than the value of about 23 per cent found for Delhi. Also, according to the report, the seropositivity for females was marginally higher than for males, but the age-wise prevalence in both males and females was comparable. However, since the data have not been corrected for the lower sensitivity of 93 per cent of the CLIA kits, these figures represent a conservative lower estimate, notes the report.

On the basis of the results, as in the case of Delhi, the authors of this study too have inferred that asymptomatic infections are likely to be a high fraction of all infections. While the higher prevalence in slums could be due to the higher population density and shared common facilities such as water points and toilets, the lower prevalence in non-slums points to better adherence to physical distancing, wearing protective masks and access to better hygiene and sanitation coupled with the other non-pharmaceutical interventions by the BMC. On the basis of the survey-estimated prevalence in the three wards and the BMC’s records of reported deaths, the infection fatality rate (IFR) has been estimated to be a low 0.05-0.1 per cent as against the case fatality rate (CFR) of 5-6 per cent. The low IFR is perhaps a reflection of active measures the BMC has taken to isolate symptomatic cases immediately.“These results,” says the report, “will be valuable to learn more about herd immunity. Although it is still unclear what level of prevalence leads to herd immunity, our findings indicate that at least in slums this could be attained sooner [rather] than later, if the immunity exists and persists in a significant proportion of the population.” It is even likely that slum pockets may have already attained herd immunity. If, as mentioned in COVID-19 literature, we assume that R-nought (the average number of people that an infected person can pass on the infection to) to be 2 to 3, a near 60 per cent SPR would be close to the required value to achieve herd immunity. It is interesting to note that at the time of the Mumbai survey, Dharavi (which was not included in the survey) was already seeing a rapid downward trend in its caseload, and as Juneja concurs, Dharavi may indeed have a higher SPR than the other slum areas surveyed.

Second round of survey

According to Juneja, the planned repeat survey (the second round) is expected to begin in one or two weeks’ time. “Since the intent is to measure change in prevalence, we will be going to the same wards,” he said.

Analysing the Delhi and Mumbai sero-survey data for theWire.in, Murad Banaji, a mathematician from Middlesex University London, wrote: “Limitations aside, the data suggest two things: that the virus has spread wide and the fatalities have been relatively low.” According to Banaji, when the epidemic in London and New York City (NYC) was in its downward trend, the seroprevalence rates in the two cities had been estimated to be 17.5 per cent and 23 per cent respectively. An SPR of about 23 per cent for both Delhi and NYC works out to about 4.4 million and 1.9 million infections respectively shortly after the respective surveys. However, the fatalities in the two cities were drastically different: 3,200 in Delhi and 15,000 in NYC. If you compare the IFRs calculated from this data, it means that COVID-19 was 10 times deadlier in NYC than in Delhi, says Banaji.

Similarly, following Banaji, if you compare Mumbai and London, which had recorded a similar number of deaths (of 5,500) at the time of the surveys, their respective SPRs of 33 per cent and 17.5 per cent work out to 4.5 million and 1.6 million of infected people. On the basis of this data, the rough values of IFRs for the two cities work out to 0.12 per cent and 0.34 per cent respectively. So, the virus was three times deadlier in London than in Mumbai. Of course, it must be pointed out here that Banaji has not accounted for the demographic difference in the cities being compared, with Indian populations being skewed in favour of younger age groups. One of the important factors in the COVID-19 pandemic is that younger people are not affected as severely by the virus as the elderly are. If you take that into account using age-stratified data, the differences should reduce significantly.

A politically motivated survey?

The Ahmedabad Municipal Corporation (AMC) claimed that the sero-survey conducted in the city was the world’s largest, but it released only just as much information about the results as the Delhi survey. In fact, the AMC did not even share the identity of the research institution/laboratory with which it had associated to carry out the survey. According to the AMC press release, the survey was conducted from June 16 to July 11 and 30,054 samples that were “fully distributed [sic]” among the seven zones of the city were collected. For a city with a population of 6.3 million, this works out to a sample-to-population ratio of 4,770 per million. Comparing this with the Spanish sero-survey whose ratio was 1,302 per million and a U.S. study in six of its States whose ratio was 255 per million, the release claimed that this was the most extensive sero-survey study in the world so far.

Alongside this claim, the release also seemed to take a swipe at the ICMR, whose as-yet-unpublished sero-survey of May, which was conducted with just 496 samples from containment zones only, had a “minuscule” ratio of “just 79 per million”. It was rumoured in early July that the ICMR had not been allowed to release its sero-survey results for political reasons because its survey had found a very high SPR in Ahmedabad, something that would not have been palatable to the powers that be. Thus, the Ahmedabad survey and the tenor of its press release smack of a politically motivated study, especially when even the institution involved in the study has not been named.

According to the information put out by the AMC, the SPR in Ahmedabad (during June) was 17.61 per cent. The release further said: “Some sections of media have reported about a study by ICMR showing around 49 per cent seropositivity in Amdavad.... [The ICMR study] is not at all representative of [the] actual existing situation and cannot be relied upon for any conclusion (the AMC’s latest study is 60 times larger).”

Like in Delhi, the AMC survey too seems to have found variations in the SPR between different zones of Ahmedabad, with the Central Zone having the highest SPR (28.43 per cent), followed by the North Zone (27.42 per cent) and then the North-West Zone ( 6.43 per cent). Significantly, like in Delhi and Mumbai, this study too found that the SPR among females (17.98 per cent) was a little higher than among males (17.29 per cent), but the release noted that “the difference is not statistically significant”.

Private ‘sero-survey’

Thyrocare Technologies Ltd has been collecting seroprevalence data since the beginning of July and has made this data public through tweets of A. Velumani, its chairperson and founder, who is a scientist-turned-entrepreneur. Although this cannot be termed a proper study because it is not a randomised survey, nevertheless, one has to accept that the data collection strategy was novel and innovative, the data collation and its classification too was pretty quick and the dissemination of information immediate.

Velumani offered antibody tests at a very low cost and, using the vast network of Thyrocare diagnostic laboratories across the country, gathered seroprevalence data from corporate houses, apartment buildings and individuals who came to have themselves tested in more than 600 pin codes across the country. “We have not chosen whom to test; we have only tested those who wanted it. Eighty per cent was the requirement of the corporates, 15 per cent was the requirement of residential societies and 5 per cent was the demand of individuals. We covered pin codes from Nariman Point to Jamshedpur, so big and small cities are all covered,” Velumani told the online news website thequint.com in an interview.

So, in that sense, the sampling is not random at all; it is highly biased and leaves out the large number of people from the lower strata of society to whom the survey did not offer the test. In fact, there is no statistical sampling at all because there is no defined sampling frame to begin with. Therefore, statisticians and medical experts, perhaps, would not even give this survey a second look. Nevertheless, the data from this private survey (which seems to be ongoing), given in age- and gender-stratified form, does perhaps offer some insight into infection prevalence across the country that is most recent.

As of August 4, Thyrocare had tested 1,51,588 individuals (across all age groups), of which 28,347 were seropositive for IgG antibodies. This works out to a crude SPR of 18.7 per cent, albeit in a significantly biased population, across the country. Of course, this should not be immediately taken to mean that 240 million people of the country were infected, but it probably gives a very rough idea of prevalence. The data of July 29 shows that more males (about 2.5 times more) got themselves tested than females. Interestingly, even this biased survey found a higher SPR among females than males, 20.02 per cent compared with 17.62 per cent. Also, if you look at the SPRs for the three cities discussed above, Thyrocare’s figures are roughly in the same ballpark, notwithstanding the much smaller numbers it tested in these cities compared with the population sizes that were sampled in the sero-surveys. If there is something significant in these numbers, it is for the experts to glean from them.

What the city sero-surveys, at least, tell us is that about one out of four to five individuals in major cities has been infected, but this is still far removed from what is required for herd immunity to set in. However, if any part of a city is to become “herd immune”, it will be the slums first, as the Mumbai survey shows. And, it is quite likely that Dharavi may have already achieved herd immunity given its recent caseload trend. Asymptomatic infections seem to constitute a significant proportion of all infections. All surveys seem to indicate that seropositivity in women appears to be higher than in men. This may be an interesting aspect for virologists, medical experts and epidemiologists to look into.

Sports

East Bengal Football Club: 100 not out

“Rarely does the fan say, ‘My club plays today.’ He says, ‘We play today’. He knows it is ‘player number 12’ who stirs up the winds of fervour that propel the ball when she falls asleep, just as the other eleven players know that playing without their fans is like dancing without music.”

− Eduardo Galeano (Soccer in Sun and Shadow)

She sells lozenges in stadiums at football matches, and this is her only source of income. Every time East Bengal Club wins, she forgets about selling the lozenges and distributes them among the club’s fans. “I scatter them around. I have no idea where they go.” She claims she has never missed an East Bengal match, wherever it may be. Her name is Jamuna Roy, but for the millions of supporters of the football club, she is simply “Lozenge Maashi” (aunty). Jamuna, 56, has been a supporter of East Bengal since her childhood. “East Bengal is in my veins. Wherever I may have been born, East Bengal is in my very being… When East Bengal loses, the pain I feel is almost physical,” she told Frontline. Over the years, in her red-and-gold East Bengal jersey, she has become a mascot for the club. In the 2018 India Super Cup in Bhubaneswar, in which East Bengal was the runners-up, the team defender Eduardo Ferreira handed over his medal to Lozenge Maashi, who had landed up in Bhubaneswar to support her team.

It is not really about how many trophies a football club wins, or even the records it holds. Essentially, it is about what the club means to its supporters, the unflinching loyalty it inspires among its followers, and the unconditional love it gets from its fans. In that regard, an East Bengal supporter could very well call her club the greatest football club in the history of the game. On August 1, the iconic club turned 100. The only other club in the country that is over a hundred years old and has played in the top league throughout its existence is Mohun Bagan (1889). Mohammedan Sporting (1891) is at present relegated to the Second Division in the national order.

But as congratulations pour in from VIPs including Prime Minister Narendra Modi and Chief Minister Mamata Banerjee, as memories of tears, triumphs and trials come gushing forth through fading old scrapbooks and preserved magazines long out of print, the fan is also acutely and painfully aware that her club is possibly facing the toughest period ever in its illustrious history. In April this year, the team’s main sponsor, Quess Corp Ltd, announced a premature cessation of its professional contract with the club. Its traditional rival Mohun Bagan, after being taken over by ATK FC, the R.P. Sanjeev Goenka-owned football club, has secured a berth for itself in the Indian Super League (ISL). But East Bengal remains out in the wilderness. This year the All India Football Federation has designated the ISL as the top league of the country. East Bengal, for the first time in its history, faces the possibility of being left out from playing in the top league. But even as it faces its worst ever crisis, its fans have no doubt that the club will turn around. Arjun Das, an assistant in a grocery shop, feels nothing can keep his club down. “This situation will only make it come back stronger and invincible. It is a club whose legacy was created by blood and sweat,” he said.

This fierce loyalty may perhaps be traced back to the driving force behind the formation of the club a hundred years ago—the need for an identity and an emblem for a proud, rebellious people hailing from the land on the eastern bank of the Padma, once known as East Bengal, now Bangladesh. A common language notwithstanding, there was a pronounced schism in dialect, culture, tradition, cuisine, food habits and attitude between the two Bengals. Mohun Bagan, East Bengal’s traditional foe and also paradoxically its soul brother, was a “Calcutta” club, a “Ghoti” (a term describing the traditional inhabitants of Bengal’s western districts) institution controlled by Calcutta’s moneyed babus and even named after a lane in north Calcutta. East Bengal represented the largely marginalised “Bangals”, that is, people from East Bengal. There was little love lost between these two peoples, and the rivalry between the two clubs and their supporters is the stuff of legend. Even today, an insult to the club one is loyal to cannot go unanswered. It would not be an exaggeration to say that love affairs have foundered and ties of friendship and even marriage have been severely tried over respective loyalties to the two clubs.

But the rivalry kept football alive in the country even as sponsors piled crores on cricket. Back in 2003, when East Bengal created history by becoming the first club to win an international championship by beating Thailand’s BEC Tero Sasana, 3-1 in the Asean Club Championship final in Jakarta, the late great Chuni Goswami, one of the greatest legends of Mohun Bagan and Indian football, told Frontline: “We [East Bengal and Mohun Bagan] are complementary to each other, not contradictory. For over 80 years this rivalry and fierce loyalty of the fans have kept football alive and kicking in Kolkata.” For all their animosity towards East Bengal, Mohun Bagan fans did not refrain from celebrating the historic win, which came 92 years after their club carved out its name in letters of ever-shining gold by beating the British York Regiment 2-1 in 1911. In the 369 derby matches between East Bengal and Mohun Bagan, East Bengal has won 129, while Mohun Bagan has won 119; 121 matches were drawn.

For the people of East Bengal, the need for an identity became more acute than ever after the 1947 Partition. As millions started leaving their erstwhile homeland in what was now East Pakistan and tried to rebuild their lives in West Bengal, the legend of the East Bengal football club began to take shape. It ceased to remain just a football club and assumed the identity of a rallying point for the diaspora of a displaced people. Like its supporters, the club, too, has had to struggle every bitter inch of its way to glory. It rebelled against the establishment, fought against injustice and back-room machinations of rivals, and never once surrendered or sought an easy way out. Refugees from East Pakistan saw in East Bengal’s struggles a reflection of their own, and the club and its supporters rejoiced in and drew inspiration from each other’s triumphs – on the football field and outside. No matter what station in life a person may occupy, wherever she may be in the world, the call of the club will always bring her home.

It has been nearly 73 years since East Bengal as a region ceased to exist. (What was, roughly, East Bengal became East Pakistan after Partition, and was renamed Bangladesh after the liberation war of 1971.) Yet, the fans of East Bengal Club have continued to grow with every succeeding generation. Allegiance to the club is perceived to be a valuable legacy handed down from one generation to the next. Debanjan Chakrabarti, Director of the British Council, East and Northeast India, put it succinctly: “Supporting East Bengal was a family legacy I inherited from my mamabari [mother’s family]. My grandparents are from Bogra in Rajshahi division of what is now Bangladesh. My maternal uncles nurtured this fandom for me and my many cousins. East Bengal for me is a deep emotion that runs beyond just football. It’s about my identity—the red of the club colours depicts that for me—as someone whose family history is linked to the greater story of this subcontinent. On the other hand, the yellow of East Bengal’s colours and the emblem of the torch exhort me and my generation of East Bengal supporters to look ahead and go forward.” Chakrabarti has passed down his love for the club to his 14-year-old daughter Debashmi.

A memorable journey

Established on August 1, 1920, East Bengal Club was born out of a clash of egos within the Jorabagan football club over the inclusion of a player in a match against Mohun Bagan. Jorabagan’s vice-president and noted industrialist Suresh Chandra Chaudhuri walked out of the club and set up a new club with Sailesh Bose, Ramesh Chandra Sen and Aurobindo Ghosh. The club was named East Bengal, after the region from which its founders hailed, and its chief patron in its early years was Manmatha Nath Roy Chowdhury, the Maharaja of Santosh, after whom the Santosh Trophy is named. The club made its debut in the 1920 Hercules Cup, a seven-a-side competition, which it won, and subsequently entered the Indian Foot Ball Association (IFA) league’s Second Division and immediately announced its arrival by finishing third.

In 1924, East Bengal became joint champions of the Second Division with Cameroon B, but it still found itself unable to enter the First Division because of an unfair rule laid down by the British-controlled Governing Body of the IFA that no more than two Indian clubs would be allowed to play in it. Mohun Bagan and Aryans were already in the elite league. But in 1925, the club’s relentless efforts to change the oppressive IFA rule paid off. Not only did it break into the First Division, but it beat arch rival Mohun Bagan in the very first match that the two played against each other. In their next meeting, Mohun Bagan avenged its loss, and thus began one of the greatest and longest-lasting rivalries in sports history.

However, in 1928 East Bengal was once again relegated to the Second Division. And once again it clawed its way back into the First Division, by dint of merit, by 1932. That year, East Bengal could have been the first Indian team to win the Calcutta Football League (CFL) but for sheer bad luck. It was poised to head the league if it could beat the British regimental side Durham Light Infantry. However, with the injury of its defender Paritosh Majumdar, it had to play with one player short for the second half of the match (the substitution rule did not exist at that time). Durham managed to hold East Bengal to a 3-3 draw, and the club’s dreams of creating history went up in smoke. Though East Bengal won the title eventually in 1942, it was Mohammedan Sporting that had the honour of being the first Indian team to lift the crown, in 1934. However, at the end of the day, it is East Bengal that has won the largest number of CFL titles, becoming champions 39 times.

According to Kushal Chakrabroty, a well-known chronicler of the club, East Bengal’s history can be divided into two phases—the first 50 years until 1970, and the next 50 years until the present day. “The first 50 years were marked by the struggle to establish itself and overcome all the hurdles thrown in its way. After that, it was the time for glory and to change the face of Indian football forever. Until 1970, it had won the CFL eight times, and in the next 50 years it won it 31 times,” Chakraborty told Frontline.

But that does not mean that the club’s heroics in the field in its first 50 years were by any means insignificant. In 1951, East Bengal became the first Indian team to win the IFA Shield three times in a row (1949 to 1951). For this achievement, the English FA annual almanac of 1951-52 adjudged East Bengal the best Indian soccer club. Between 1949 and 1953, playing a five-forward set-up, comprising the legendary combination of P. Venkatesh, Appa Rao, K.P. Dhanraj, Ahmed Khan, and P.B. Saleh—collectively known as the Pancha Pandavas—East Bengal won 11 trophies, including three CFLs, three IFA Shields, two consecutive Durand Cups (1951, 1952), two DCM cups, and one Rovers Cup (1949). In the years between 1949 and 1953, East Bengal scored 387 goals, of which 260 were shot by the Pancha Pandavas.

It had one of the best records against foreign teams and in 1948 defeated the Chinese Olympic XI (2-0); in 1951, the Swedish FC Gothenburg, (1-0); in 1956, the Chinese Olympic XI again (3-1); and in 1970, PAS Tehran FC (1-0) in the IFA Shield Final. At the end of the 1970 final, the entire Eden Gardens stadium was lit up by the burning torches of 80,000 East Bengal supporters. Until 1970, the club won a total of 45 trophies. In the next 50 years, it would go on to win 116 more.

East Bengal Club won the CFL for a record six times in a row between 1970 and 1975; four of these wins were under the legendary P.K. Banerjee. This record was to remain until East Bengal itself broke it by winning the league eight times in a row from 2010 to 2017. It has won the IFA Shield 20 times, including five times in a row between 1972 and 1976. In the 1975 final against Mohun Bagan, East Bengal won 5-0—the biggest victory margin in the IFA Shield’s history. Forty-five years later, Mohun Bagan supporters are still smarting from the result.

East Bengal Club went on to win the Durand Cup 11 more times, the Rovers Cup six times, DCM three more times, and the Bordoloi trophy four times. On July 26, 2003, it created history by winning the Asean Club Championship in Jakarta, and becoming the first Indian club to win a continental crown. Though East Bengal won the National Football League only three times (2000-2001, 2002-2003, 2003-2004), Kushal Chakraborty pointed out that it had played all the NFL/I-League seasons, had the best cumulative record in terms of total points, registered the largest number of wins and scored largest number of goals. “East Bengal’s presence in the top National League is like Brazil’s presence in the World Cup,” said Chakraborty.

Among the great features of the club were its iconoclastic nature and its ability to break barriers and take risks. At a time when the club’s unspoken rule was that it would play only Indian players, there came Fred Pugsley, the great Anglo-Indian player from Burma (Myanmar), at their gate, seeking asylum. East Bengal let him in, and he proceeded to rule the field with his magic in the 1940s. Bhaichung Bhutia, one of the greatest Indian football players ever, remembers how East Bengal “took a chance with a 17-year-old boy from Sikkim” in 1993, “and that is how my life began”. Bhutia went on to become the highest scorer for East Bengal with 148 goals.

East Bengal was also a pioneer in bringing in foreign players through international transfers. There were the Nigerian David Williams in 1979; the two Iranian wizards Majid Bishkar and Jamshed Nassiri in the 1980s; the Brazilians Junior and Douglas De Silva; World Cuppers Emeka Ezeugo of Nigeria, Johnny Acosta of Costa Rica and Suley Musa of Ghana; and many others from different corners of the world, who will always be welcome in Kolkata.

In every decade, the club has thrown up superstars, each of whom has represented an era—Majid in the 1930s; Pugsley and the Pancha Pandavas in the 1940s; Tulsidas Balaram in the 1950s; Mohammad Habib in the 1960s; Subhash Bhowmik, Gautam Sarkar, Shyam Thapa, Sudhir Karmakar, Surajit Sengupta and others in the 1970s; Krishanu De, Tarun Dey, Bikash Panji, Manoranjan Bhattacharjee in the 1980s; Bhaichung Bhutia in the 1990s and 2000s; and so many others. They all live on in the collective memory of the club’s supporters. The legacy of the players, too, is handed down from one generation to another. When Majid Bishkar, the man the Kolkata crowd hailed as “Badshah”, left the country quietly and in disgrace to go back to his home in Iran, many might have thought his memory would fade away with time. Yet, when he returned after more than 30 years at the invitation of East Bengal in 2019, there were thousands waiting for him outside the airport. Chants of “Badshah” filled the air as he appeared. The majority of those present were not even born when he ruled the football pitches of Bengal. An unknown in his own country, Badshah will always be a superstar wherever there is an East Bengal supporter.

Even in its darkest hour, it is inconceivable for East Bengal supporters to think that their club will not rise again as it has done so many times in the past. One is reminded of a story about the great middleweight boxer Stanley Ketchel (1886-1910). When he died, his manager is rumoured to have said, “Tell them to start counting ten over him. He’ll get up.”

The faith that East Bengal supporters have in their club is no different. With the COVID situation in the State getting out of hand, they could not be at the club grounds this year. But wherever they were, they put on their jerseys, shook off the dark clouds threatening to gather in their minds, and prepared to meet the future head-on. And with every jersey worn, the flame of the club burnt a little brighter.

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Oct 9,2020