Shankkar Aiyar is a senior Indian journalist and author of Accidental India: A History of the Nation’s Passage Through Crisis and Change and, most recently, The Gated Republic: India’s Public Policy Failures and Private Solutions.
The Gated Republic looks at how despite the tremendous successes of the Indian state, it has also failed to deliver on a number of fronts – water, health, security – that many see as fundamental to the very idea of a government. The book offers an important glimpse into the gap between intention and outcome and lays bare some of the truly disturbing failures of independent India.
Scroll.in spoke to Aiyar about state capacity during the crisis and what this might mean for policy going forward.
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Would you say the Covid-19 crisis and its effects (the migrant crisis, the economic crash) have only heightened the “Gated Republic” trend, with well-off citizens retreating into their safe, comfortable enclaves while others have had to take to the roads or grapple with hunger?
It has indeed. The pandemic has widened the fault lines of India’s political economy. Covid-19 has aggravated risks to life as both access to health care and affordability is constrained. Covid-19 has impacted livelihoods. The quest to flatten the curve, which essentially is about shifting it to the right to buy time and build capacity, has bludgeoned the economics of those most vulnerable.
One of the points of the book, in some ways, is the gap between what India thinks it can do, as discussed in commissions and panels and five-year-plans, and what it can actually accomplish. Do you see a parallel with how the lockdown played out, with an assumption of higher state capacity than the Centre could actually offer?
The capacity of the state to shut down or lockdown is not in doubt. It has a parade of colonial laws for just this. The capacity of the state to deliver on essentials though is severely incapacitated – both in the Centre and in the states. For decades, states have chosen to invest in electorally profitable expenditure and neglected health, water, education and other public services as investigated and illustrated in The Gated Republic.
The many tragedies witnessed are about incapacity and insufficiency of institutional thinking. NT Rama Rao used to say the Centre is a conceptual myth. Beyond the hyperbole fact is every square kilometre is ruled by states and therefore the design of the lockdown would have been better designed at the state level as is being done now. Ideally Kerala with its robust system and experience in dealing with epidemics should have led the ideation and draft of policy.
The Covid-19 crisis has brought into even starker focus the perils of a private sector-led healthcare system, which you cover in one of the book’s chapters, with the government taking the lead despite much more capacity in private hospitals. Ajay Shah has argued that policymaking needs to do a better job of incentivising private healthcare to play a role (witness the battles over private testing). What do you make of how this has played out?
The perils brought into focus by the pandemic illuminate the failure of regulation as much as the profiteering tendency of private enterprise. At a macro-level if we look around the world we know the countries which have done well are those with public healthcare systems such as Germany, Canada, Taiwan and New Zealand.
Investment in preventive and primary healthcare is both a moral and economic imperative. This does not mean there is no role for private providers. A public healthcare system can be paid for by the government and serviced by the private service providers under a transparent PPP model with built-in incentives allowing government to harness private sector efficiencies.
Do you have any hope that this moment might prompt states or the Centre to alter their approaches towards providing services that ought to be delivered by the government – say if more seek to learn and emulate the Kerala model – or do you expect things to simply revert to the norm as the pandemic passes?
The Kerala public healthcare model has been around for decades but other states have not been persuaded to adopt the best practices. Tamil Nadu has crafted its own model of welfare politics. Himachal Pradesh has a very successful community engagement model. Yet these are not shared practices.
The pandemic could be a wake-up call – for the Centre to create the incentives to make change happen – but whether it will be a wake-up call depends on public opinion and pressure. Think about it. Will healthcare be an issue in the forthcoming assembly polls Bihar – which has less than 50,000 doctors for a population of 110 million!
What does everyone – the media, the public, even other experts – get wrong about the idea of Indian state capacity and India’s ability to deliver public goods?
Transformation is a process, not an event, and demands consistent commitment and needs champions for the cause. India’s success stories are all driven by champions. For instance, the milk revolution needed a Verghese Kurien, the green revolution needed a C Subramaniam, and the space programme needed a Vikram Sarabhai.
In India electoral expediency has riveted a strong political consensus for weak reforms enshrined by weak public pressure for accountability. Every year a million people die of air pollution related ailments, malnutrition kills a hundred children every hour, nearly eight crore children don’t go to school. The situation persists because the politicos do not find it electorally profitable to attend to these issues. Worse, they don’t see it as politically damaging either.
Q: What was one thing you didn’t know before or surprised you during the research for The Gated Republic?
The fact that a system would collect data on schools without teachers – there were 6,000 of them in 2003 – and not do anything about it for decades was blood curdling.
Q: What three books/podcasts/papers/articles should we read on the current moment or on the subject in general?
I would recommend Albert Hirschman, Lant Pritchett, and, for the current context, Michael Osterholm.