Preparedness could pertain to the domain of public health — identification of cases, healthcare facilities, methods to check the spread of the virus, research and communication.
The rapid spread of the coronavirus beyond China and the identification of a large number of cases in India raise questions about India’s preparedness to control, suppress or mitigate the pandemic. Preparedness could pertain to the domain of public health — identification of cases, healthcare facilities, methods to check the spread of the virus, research and communication. Aggressive policies to identify individuals with infections and those most vulnerable to the virus reduce the risk faced by the people at large and also slow down the spread of the infections so that severe cases do not overwhelm medical facilities. Aggressive social distancing measures, such as the lockdown that began in India on Wednesday, could also serve such a purpose.
A second set of “pandemic preparedness” issues is also important. These relate to India’s external relations, UN agencies, international NGOs, businesses, and other transnational actors. China’s management of external relations since early January — with the WHO, foreign governments, and the international media — shows the value of such preparation. Not having a health emergency diplomacy plan puts India at risk of losing control over a potential crisis and being overrun by foreign actors. It could place the country at a disadvantage in international negotiations.
What do effective external relations during a health emergency look like? Different strategies would apply if the outbreak started inside India versus if a pathogen came from outside. Even if a pathogen came from outside, India could become the epicentre of an outbreak. In a globalised world, such possibilities cannot be ruled out. The government needs to begin mapping the epidemiological risks India faces as well as the repercussions it could face externally, especially a dramatic reduction in trade and tourism. People of Indian or South Asian descent could face discrimination outside India as a result of being perceived as carriers. Many agencies — from the well-meaning to the self-interested — could begin information-gathering activities, research, and analyses. Such action could take place within an international order of global governance, which has been criticised by Shashi Tharoor and Samir Saran in their recent book, The New World Disorder and the Indian Imperative.
Tharoor and Saran use the case studies of war, sustainable development and cyber-space to show the inadequacies of the current global governance system and what they see as India’s inevitable leadership role in Asia and global governance. They, however, don’t go into how the global order creates and distributes health risks like COVID-19. The lack of health issues being taken seriously in global governance was also evidenced at the Raisina Dialogue in January: Impressive otherwise, it showed that international relations scholars and policymakers, deeply engaged in global economics and security issues, do not give much importance to transnational aspects of health. As almost everyone in the world now realises, because of COVID-19, our responses to health issues cannot just be a domestic issue: We need to learn how to globally govern biological contagion with as much dedication as we give to governing economic and security matters.
Unsurprisingly, PM Modi and his close advisors seem to have recognised the importance of global health diplomacy. On March 15, Modi organised a video conference with SAARC leaders to discuss and share models for responding to COVID-19. The full value of this meeting will only make sense in a few months’ time after the successes or failures of the Indian response to the pandemic are apparent. But, Indian health diplomacy during emergencies has to be much more than sharing a disease control model with other countries. Tharoor and Saran seem to argue that India’s manifest destiny is to take a leadership role in global governance in order to make global institutions fairer. If that is so, we must pay close attention to how global institutions, nation-states, and other actors deal with COVID-19 to see what needs to change. There could be more pandemics after this one.
The writer is associate professor, global health and philosophy, King’s College, London. This article first appeared in the March 26 print edition under the name 'An Indian health diplomacy'.