Breathless India

In just the past month, India has officially recorded around 10 million Covid-positive cases and 100,000 Covid-related deaths. As the second wave of the pandemic spirals out of control, India’s healthcare system is facing a chronic shortage of oxygen, hospital beds, vaccines, and critical medicines. Last month, 62 patients died when three of New Delhi’s biggest private hospitals ran out of oxygen. Similar tragedies are unfolding across the country: in Mumbai, Amritsar, Gurgaon, Kurnool, Nasik, Moradabad, Jammu, and Goa. Here and elsewhere, hundreds of thousands of patients have found themselves stranded outside hospital buildings, gasping for one final breath or surviving on one rapidly depleting oxygen cylinder.

Last month, the crematoriums in New Delhi ran out of wood. Since then, they have also run out of funeral platforms and ash urns, and have recorded 20-hour long queues. Funeral pyres are now being lit in the parks and parking lots of the nation’s capital. Meanwhile, there is still no news of how the pandemic is affecting the vast swathes of rural India. A recent exposé by the journalists of Dainik Bhaskar, a popular Hindi daily, uncovered more than 2,000 dead bodies secretly buried along the banks of the Ganga in Uttar Pradesh. These half-buried, half-burnt bodies, some of them eaten away by kites and stray dogs, are a glimpse of the disaster currently unfolding across the Indian countryside. A new report by the Institute for Health Metrics and Evaluation (IHME) estimates that the actual number of Covid-related deaths in India is around 650,000, thrice the official number. It projects that by September India’s death toll is likely to surpass 1 million.

As the spectre of mass death looms, a dramatic political transformation is underway. A host of corporations have stepped in to play the role traditionally reserved for the Indian state. In the last month, Amazon, Paytm, and the Adani group, owned by India’s second-richest man, Gautam Adani, have airlifted and shipped in thousands of oxygen cylinders, BiPAP machines, ventilator units, cryogenic tanks, and portable oxygen concentrators and generators. In turn, the key industrial giants, including Reliance Industries, Tata Steel Ltd, ArcelorMittal Nippon Steel, and JSW Steel, have started producing and supplying medical-grade oxygen to various state governments and hospitals. Some of them, including Reliance, owned by Mukesh Ambani, the richest man in India and second richest in Asia, have also started setting up new healthcare facilities. 

The relief efforts of the government, by contrast, have been trifling at best, limited largely to coordinating the logistics of supply chains between different state governments. Even here, rather than fulfilling its responsibility, the BJP has blamed the individual states where it is not in power for the medical shortages they are facing. Its control of oxygen production has been even worse. A recent report revealed that it was only in October – by which time millions were already infected and thousands dead – that the tenders for building 150 oxygen generator plants were floated. Six months later, amidst the deathly clamour of mass breathlessness, the plants remain nowhere to be seen.

With the government now facing growing criticism, it is crucial to grasp that its failure is not simply a case of botched governance, the kind that stems from ‘poor planning’ and ‘bad policymaking’. The government has not so much failed as altogether refused to intervene in the current crisis. And this refusal is not a one-off. It is systemic in nature, part of a drastic neoliberal transformation where every such refusal is accompanied by a deepening dependence on corporations to fulfil the responsibilities of the state.

Consider, for instance, the annual budget presented by the finance minister Nirmala Sitharaman earlier this year. Given its pandemic-setting, it was widely hyped by political commentators; Sitharaman herself claimed that ‘the budget will be remembered for 100 years to come’. And yet, what ensued was merely the tragic repetition of a yearly farce: the privatization of yet more state-owned assets; continued cutbacks to the Mahatma Gandhi National Rural Employment Guarantee Scheme (by 34.5 percent) and the Ministry of Women and Child Development (by 18.5 percent); the reduction of the Corporation Tax/GDP ratio to such a low level (2.5 percent) that Indian citizens will pay more taxes than corporations; and so on.

This systematic withdrawal of the Indian state, particularly from the lives of the poor, is the reason why the Covid-relief efforts have been dependent upon corporate giants. As of 2018, the country had one doctor per 1,453 people and one hospital bed per 2,000, while over 70 percent of its hospitals were controlled by the private sector. And even though Sitharaman claimed a record 137 percent increase in the funds allocated to healthcare in the budget, this increase already included the ongoing Covid-relief efforts, and the actual expenditure amounted to only 0.34 percent of annual GDP. No amount of philanthropy can make up for this ruined infrastructure; in fact, insofar as this aid circulates within the bounds of a deeply iniquitous system, it will only serve to reproduce it.

Commentators have repeatedly underscored the immense scale and speed at which this crisis is evolving. Indeed, its all-pervading character is in stark contrast to other decidedly ‘local’ crises in the country, that have afflicted only specific sectors and groups: the privatization of farming and education; the anti-Muslim citizenship amendments; the settler-colonial violence against Kashmiris; the routine lynching of Dalits; the revocation of existing labour protections; the military-led dispossession of the tribes and Maoists in Central India. As this list of the ‘enemies of the Indian state’ continues to swell, the anti-fascist chestnut – in the morning they came for us, at night they will come for you – has become increasingly popular in the Indian public sphere. The warning is generally directed at the Hindu middle class, which overwhelmingly backs the government, and has enjoyed relative political stability in recent years. As the second wave builds, it seems the wolf of history has finally caught up with them. But it is not that someone­­ has come for them. Rather it is that no one has come to save them. No ambulances, no healthcare workers. Only the invisible hand of capitalist markets, which has shrunk the middle class by 32 million within a few months and is now swiftly choking them to death.

As thousands lie stricken outside hospitals, a black market has sprung up around them: oxygen cylinders and critical medicines are being sold for exorbitant prices while vans transporting oxygen to hospitals are getting stolen. And yet, for a Prime Minister who revels in instructing the millions of unemployed to become ‘self-reliant’– ‘fry and sell pakoras outside public offices’ – this ‘informal economy’ is presumably nothing to lament.  

Last year, during the first wave of the pandemic, Narendra Modi unveiled the Atmanirbhar Bharat Abhiyan, a grand national plan for self-reliance. This sparked a brief surge of panic in the business community, with many noting the uncanny echoes of Nehru’s ‘socialist’ vision of atmanirbharta. Fears of a return of ‘import substitution’ and ‘license raj’ though quickly subsided when the government announced plans to boost private sector investment in social infrastructure, and to open several other sectors, including defence, space, and mining, for private investment. Modi’s rhetoric was in fact only pastiche: it was not the country but the people who were to be made self-reliant, by systematically weaning them off their dependence on the Indian state, while, in turn, making the state itself more dependent on private corporations.

This neoliberal lockstep of ‘refusal’ and ‘dependence’ is perhaps most clearly embodied by last year’s relief package. The sudden imposition of a 75-day national lockdown rendered 450 million migrant workers jobless and homeless. After forcing them to walk thousands of miles back to their native villages, the government announced support measures that were among the lowest in the world – totalling a miserly 1 percent of the country’s GDP. In addition to a meagre 5kg of wheat or rice per month, its proposed financial support for a family of four amounts to only 4 Rupees per day per person, when the poverty line in rural and urban areas is 50 Rupees and 73 Rupees per person per day respectively.

A broad range of heterodox economists and social activists criticized these austerity measures. Some also proposed alternatives. The Heterodox Economists’ Collective called for the government to universalize the Public Distribution System in order to provide free cereals, pulses, and cooking oil to all for the next six months; to make cash transfers of 15,000 Rupees to the bottom 80 percent households to compensate for lost wages; and to guarantee 200 days of work to everyone including the migrants who were forced to return to their native villages. Others, including the leading development economist Jayati Ghosh, offered alternate blueprints designed to revive a faltering economy: both short-term measures to stimulate demand and long-term schemes funded by a range of fiscal and legislative measures, including temporarily suspending the Fiscal Budget Regulation Act, increasing corporation tax, and implementing a 2 percent wealth tax on the top 1 percent.

But the government has refused to even acknowledge these proposals. To put its intransigence in perspective: earlier this year, even the IMF, whose fabled touch is known to turn all things into a Structural Adjustment Program, urged its members to increase public spending, and to not worry about increasing their indebtedness. It would seem that the Indian government has successfully out-IMFed the IMF. Rather than increase public expenditure, it has chosen to hold fast to the ‘correct’ level of fiscal deficit, at a cost of hundreds of thousands of lives.

Even more striking is the lack of attention these entirely feasible counter-proposals have received in the public sphere. The less said the better, then, about actual utopian questions. (Why, for instance, must the wellbeing of the population be tied to the rate of return?) As the emergent mutual-aid networks struggle to survive the ever-expanding swirl of new viral strains and mutants, there has been growing agreement among liberal and left commentators that voting the BJP out of power is now a precondition for making democratic politics possible again. During the recent elections in West Bengal, the slogan ‘No Vote to BJP’ gained widespread popularity, especially among young urban voters, and proved remarkably successful in keeping the party out of power. Though fledgling in its national appeal, the slogan conveys something essential about the present conjuncture.

This rallying is of course an expression of the disgust that the BJP now widely inspires, directed into an emergency electoral measure. Anyone but the BJP will do. But the strategy remains freighted with pitfalls. For one, what if we simply lapse into a vacuous form of secular populism, which might offer a short-term term electoral alternative to the BJP, but not an alternative to the crisis-riven, neoliberal trajectory of the country? In five years’ time, that may well return an even stronger right-wing Hindutva to power. Given the longstanding decline of the parliamentary left – the CPM-led Left Front won a total of zero seats in the recent elections in West Bengal, a state where it ruled for 34 years, while many of its leaders, voters, and cadres defected to the BJP – the poverty of genuine political alternatives is an urgent question. Just anyone will not do.

Read on: N. R. Musahar, ‘India’s Starvation Measures’, NLR 122.