In the current crisis, of immediate concern are the disastrous omissions and commissions of the government concerning the building of health infrastructure, including, crucially, the problem with oxygen supplies and its recently announced vaccine policy.

George Floyd’s last words, “I can’t breathe”, resonated across the world to symbolize the brutal reality of a racist police force in the US. Today in India, there is a different context: these tragic words are whispered across homes and outside hospitals as Covid patients struggle to breathe, deprived of life-saving oxygen. “I can’t breathe”, symbolizing the arrogance of a chest-thumping central leadership of the government of India, a leadership that dismissed warnings of the coming Covid tsunami from experts, based on scientific research and concrete data, a leadership mesmerised by its own self-serving propaganda of being the vishwa guru who would save the world, a leadership which led the way in breaking every single rule of Covid-appropriate behavior and encouraged others to do so too, a leadership that promoted a platform of fake nationalism to hide its failures. And echoing the tone and tenor of the top two leaders of the present regime, the Prime Minister and the Home Minister, are their minions across the country who exist because they obey.

In the current crisis, of immediate concern are the disastrous omissions and commissions of the government concerning the building of health infrastructure, including, crucially, the problem with oxygen supplies and its recently announced vaccine policy. As far as the oxygen supply situation is concerned, much is being made of the data put out that there is no shortage of oxygen which is mainly used by industry, but of transportation. The bottom line is that because of lack of planning and execution, people are dying. A few days ago, the Prime Minister made a grand announcement that an additional 150 oxygen plants would be set up – with no explanation as to why the earlier decision taken a year ago to set up 162 oxygen plants is still not implemented. An investigation by the website Scroll showed that till April 2021, only 11 were installed and just three were functional. In response, the Health Ministry claimed that 33 were installed, an official admission nevertheless of the non-implementation of the decision. Take the case of Delhi, the capital of India, which has the highest number of deaths due to oxygen supply shortages. In its recent affidavit in an ongoing petition in the Delhi High Court, the union Health Ministry admitted that of seven oxygen plants to be installed in Delhi, only one oxygen plant had been installed. The government counsel could not say whether it was functional or not. If the central government had acted as it should have, many of the precious lives lost in the capital could have been saved.

By mid-March, there was an alarming rise in cases in Delhi. The central government had usurped all the powers of the elected government in Delhi through the amendments pushed through in the recent session of parliament. Having got the power, where were the central agencies at the time? Was the Lieutenant Governor waiting for instructions from the Home Minister, who was busy campaigning for votes? Why were no preparations made for the inevitable increase in infections and the need for hospitalization? If such assessments had been done, the emergency measures of bringing oxygen through tankers to Delhi would have been in place much earlier.

But equally importantly, the privatization of the health care system has taken its toll. Why do top private hospitals in the capital for example not have their own captive oxygen plants? They charge obscene amounts for medical treatment, including during Covid. Setting up oxygen plants would cut into their profits. Privatization of health care has been a key “reform” measure of successive government since the decade of the 90s. This is reflected in low budgetary allocations. India is paying the price today with the collapse of the system in almost all its states.

Kerala is an exception. For oxygen supplies, Kerala used to depend on other states; today, Kerala has been transformed into an oxygen-surplus state, helping others with oxygen supplies. From March 2020, its government was monitoring the use of oxygen and estimating requirements. The government had invested in state public sector undertakings to increase oxygen production capacity. The state-owned KMML set up an oxygen plant in October last year which produces 70 metric tons a day. Oxygen plants in the public and private sectors have been set up over the past two years which now have a production of 207 metric tons a day. Given the expected increase in oxygen demand with the fast-growing cases in the state, the government is preparing itself to deal with all emergencies. The key has been investment in public health infrastructure.

Just as in its failure to build health infrastructure, including oxygen plants, in the last year, the vaccine policy of the government is going to create havoc and lead to another disaster. The Cowin dashboard shows that from January 2021 till April 24, only 139 million doses of vaccines had been administered. Of these, only 22 million people had been administered their second dose. 117 million people had taken their first dose. This is much below the official first phase target of 300 million to be completed by July.

The current combined numbers of vaccine production is around 7.6 crore doses a month, which, according to recent announcements by manufacturing companies, will be increased to about 13 crore by the end of May. Taking the population as 140 crore people and a projected 60 per cent as eligible, the requirement is of 168 crore doses. Even taking the optimistic and unlikely projections of production as the base, and assuming the entire production will be for domestic use, it will take over a year to vaccinate the adult population.

The central government policy, while opening up the criteria for eligibility, has declared that it will be responsible for providing free vaccines only for those over the age of 45 years and will take control of over 50 per cent of the production for this purpose. States and private hospitals will have to make their own arrangements to divide the remaining 50 per cent between themselves at prices fixed by the companies. The country and indeed the world has watched with dismay and concern the tensions created between states to “capture” oxygen tankers passing through their territories marked for a different destination, the most recent example being that of UP and Madhya Pradesh. This will happen on a much larger scale for vaccines, given the shortage of supplies and the license given to the companies to decide their priorities. Only they will benefit, while India gets divided by a vaccine war initiated by the central government’s policy.

There is a two-fold solution. First, the central government has to withdraw this divisive, market-oriented policy of vaccine access and ensure a universal, free vaccination programme with a scientific method of distribution to each state. It is estimated that the entire cost will be less than one per cent of GDP.

Secondly, public sector vaccine units which were virtually destroyed by “reform” policies have to be swiftly revamped through urgent government investment and involved in the manufacturing of vaccines. Multiple PSUs producing quality vaccines is an urgent necessity. Patent monopolies used by big manufacturers to make super-profits cannot be permitted. It is important to emphasize that Covaxin was developed by the Institute of Virology, a public sector institution under ICMR, in collaboration with a private company, Bharat Biotech. Why did ICMR not include PSUs in this collaborative exercise? India had excellent facilities in at least seven public sector undertakings to produce vaccines which were the driving force behind India’s universal immunization programs for decades. Logically, given the intensity of the pandemic, the central government should have invested funds in these idle units to help them prepare for manufacture of vaccines as part of a private-public partnership. PSUs could have been used as critical platforms to ramp up vaccine supplies. Even today, there are provisions of compulsory licensing in the Patents Law which make transfer of technology to PSUs possible. Under Section 92, pursuant to a notification issued by the central government, if there is either a “national emergency” or “extreme urgency”, or in cases of “public non-commercial use”, such technology transfers are permitted. This clause can and must be used to include PSUs to ramp up manufacture vaccines. However, instead of showing the political will to reboot its approach and policy framework, the Modi Government has resorted to its default mechanism – suppress the facts, the truth, dissent in the name of spreading anti-national fake news.

The Modi-Shah regime has already sent out warnings to Twitter to delete posts which they describe as “fake news.” Critical views are equated with fake news and are being taken down. The RSS, through a statement by its second-in-command, warned of a “conspiracy “by” destructive and anti-Bharat forces (who) can create a feeling of negativity and mistrust” against the government. Veiled threats were made to be “more restrained and positive on social media.” This has been implemented in UP by an official warning from the Chief Minister and police officials that property would be seized, and the NSA and the Gangster Act used against those “spreading rumors and fake news.” An unnamed hospital that had reported a shortage of oxygen was cited as an example. The message is clear enough: suffer in silence, allow the court jesters the stage for their grotesque competitions in praise of the rulers, or face the consequences.

Truth telling is not a blame game. It is not “playing politics when people are dying.” When people die due to wrong policy decisions, then it is the patriotic duty of every citizen to point it out, to fight and resist it, to force change, to hold governments responsible for omissions and commissions which take people’s lives so as to save others.

(The author is a Politburo member of the CPI(M) and a former Member of the Rajya Sabha)