Class Struggle and the Pandemic

Kunal Chattopadhyay

THE GRAVITY OF the corona­virus pandemic should not be understated, nor should we exaggerate. There have been other, significant pandemics in the late 20th and early 21st centuries: Ebola, SARS in 2003, the H1N1 influenza pan­demic of 2009.

The 2009 case is important for one particular reason: It started in North America. On June 11, 2009 the World Health Organization (WHO) raised its pandemic level to the highest level, Phase 6, indicating widespread community transmission on at least two continents. The 2009 H1N1 virus contains a unique combination of gene segments from human, swine and avian influenza A viruses.  But it was never called “the North American swine flu.” This bears stressing given the aggressive racist attacks on China in connection with the coronavirus.

The gravity of the current case comes from other factors. By the first week of May, the number of confirmed COVID-19 cases worldwide has exceeded three million, with over 200,000 dead. The total is well over that because testing and reporting are so incomplete.

COVID-19 is transmitted more readily between humans than its closest relation, SARS. The virus has caused severe respiratory disease in about 20% of patients and killed more than three percent of confirmed cases. While the death rate is lower than for SARS (up to 10%), its transmission is wider.

Medical practitioners and specialists are warning of severe consequences. In several interviews Ramanan Lakshminarayan, Director of the Centre for Disease Dynamics, Economics and Policy, New Delhi, has suggested an estimate of as many as 300-500 million will be affected in India. Even if even one percent die, that would be three to five million. If the top estimate includes a number who are asymptomatic and never tested, and if the official figure is only 100 million, India might still end up with a million dead from COVID-19 in 2020.

To understand the gravity, look back at the “Spanish Flu” of 1918-20, which caused 100 million deaths, [So called because the Spanish press could cover it without wartime censorship — ed.] Compared with the bacteria-induced plague pandemic that resulted in the death of 12 million Indian people in the period 1896-1939, the Spanish Flu caused a similar number in two years’ time. So many people were dying that at one stage, disposal of the bodies proved impossible. The poet Suryakant Tripathi “Nirala” wrote about bodies lying along the Ganga riverside for lack of wood with which to burn them.

Then too, the government had attempted “social distancing” and some stress on alternative medicine. Then, as now, certain factors were understated. A key one was its social and economic dimension. Fatality must be measured not just in gross numbers but also in terms of distinct social layers — the class, the gender, and in India, the caste.

Fatality rates are hard to estimate in the early stages of an epidemic and depend on the medical care given to patients. For example, ventilators save lives by enabling people with pneumonia to breathe. Most experts believe the current fatality rate is exaggerated by serious under-diagnosis of mild cases.

Hypothetically, if COVID-19 affected half the world’s current population of seven billion over the course of a year with a one percent fatality rate, the death toll would be 35 million —- substantially increasing the number of annual deaths for all causes worldwide to 60 million.

This is where a key human intervention comes in. However, for the last three decades the world has been reeling under a deep right-wing economic offensive, which used to go under the name of neoliberalism, but under Trump, Modi, Johnson, Bolsonaro and others may be said to have gone beyond that.

Public Health and the Neoliberal Offensive

India’s public health expenditure has been rising somewhat over the decade 2009-2018, in order to meet its growing population. But by fiscal year 2018, the value of public health expenditures by states and the central government amounted to around 1.58 trillion Indian rupees ($22 billion), estimated to be 1.28% of the GDP. If we average this out, India spent $22 per person on healthcare that year.*

Additionally, a study by Sanika Dewanji, an author quite sympathetic to the Narendra Modi government, points out that the low public expenditure resulted in a sharp rise in private sector for-profit healthcare. Dewanji remarks that “Various programs like the Ayushman Bharat and the National Health Mission have already showed some success by providing the common man with an alternative to exorbitant healthcare costs and treatments.”(1)

Even by Modi’s level of “fakespeak,” this takes the cake. The Ayushman Bharat program has two components. One is the creation of 150,000 “health and wellness centers.” Its 2018-19 budget was the equivalent of about $1100 per center. All that would do is repaint existing health centers and decorate them with Modi’s picture.

The other component is the Pradhan Mantri Jan Arogya Yojana (PMJAY). Jean Drèze pointed out in an angry note that the previous Medical Insurance scheme was folded into the new program. The actual hike was just $140 million.

Drèze added that according to media reports, NITI Aayog (the premier policy think tank of the government, called the National Institute for Transforming India) experts anticipated the annual PMJAY budget to rise significantly over the next few years. But for the purpose of providing adequate health insurance, it is just chicken feed, amounting to an annual $2.80 for a family of five.(2)

This is not the picture of India alone, but of the Global South (the exploited, ex-colonial world). Neoliberal policy instruments such as privatization, marketization, commercialization and deregulation have led to the expansion of markets in economic and social sectors. In the public health sector this has meant restructuring by introducing market principles and reducing barriers for capital investment on for-profit services.

Several studies have identified the critical role played by global multilateral organizations like the World Bank and International Monetary Fund (IMF) in furthering neoliberalism through their Structural Adjustment Programs (SAPs).

In the case of India, however, a significant aspect was government negotiation, not simply World Bank coercion. This means that one cannot pass the buck on to “imperialist exploiters.” The intelligentsia played an essential role in shaping policy by legitimizing liberalization and privatization.

Several influential academics, policy and media analysts actively promoted these ideas, just as now a lot of them are whitewashing the Modi regime and the RSS (extreme Hindu-nationalist Rashtriya Swayamsevak Sangh — ed.). Advocates of all-out privatization held many key positions in finance, industry, education and health. Some already held senior positions in the World Bank, IMF and WHO prior to occupying influential positions in government.

There was a whole community of Indian experts, including diaspora Indians, pushing neoliberalism before 1991 and certainly during the period of formal changeover to a privatized system. Changes in the health sector began with the introduction of user fees, public-private partnerships, and greater commercialization.

In the last three decades health care, historically seen as a not-for-profit sector, has begun displaying a mind-set and a form of activity meant for profit-making enterprises. This has meant a massive widening of inequalities.

Health and health service inequities became global concerns a decade after the initial euphoria of neoliberalism. Several countries in Africa, Latin America and Asia that had taken loans under SAPs implemented health sector reforms; they were faced with the challenge of rising inequities. Even economists like Joseph Stiglitz, an advocate of neoliberalism, wrote on the discontents of globalization and highlighted the fault lines of liberalization and globalization across and within the developing and developed countries.

The policies of the World Bank and IMF reconfigured the role of non-governmental organizations (NGOs) in the health sector. For example, public–private partnerships became an important element in national disease control programs like HIV/AIDS, tuberculosis, malaria and leprosy.

Kapilashrami and McPake(3), in their study of the role of the Global Fund to fight HIV in India, observed that funding made available through these global initiatives created many distortions and fissures within the NGO community. It led to unhealthy competition in accessing resources. Two other scholars, Rama V. Baru and Malu Mohan, pointed out that the seemingly radical language employed by NGOs helped to delegitimize the role of the state and proving highly beneficial for the for-profit sector.

With the growing disengagement of the United States from United Nations and WHO funding, a financial crisis developed. The void was partly filled by a combination of big pharmaceutical corporations and philanthro-capitalist groups like the Bill and Melinda Gates Foundation (BMGF).

Global public–private partnerships were forged for several disease control programs and the production of vaccines. Consequently, the autonomy of WHO was compromised by the entry of big capital.(4) The BMGF, for example, spends more on global health than any government other than the United States. Receiving funding from the BMGF, WHO has had to modify its policies to follow their priorities.

Further, the BMGF played an important role in the formation of the H8, which is like the G8. The H8 consists of WHO, UNICEF, UNFPA (United Nations Population Fund), UNAIDS (United Nations Program on HIV and AIDS), the World Bank, the BMGF, the GAVI Alliance (Global Alliance for Vaccines and Immunization), and the Global Fund to Fight AIDS, Tuberculosis, and Malaria. The H8 holds closed door meetings that decide global health policies.(5)

Neoliberalism has extracted a greater amount of the surplus from working people, redirecting it to the already well off. At the same time, it has created aspirations, which turn into anxieties when they are not fulfilled. Moreover, the individualistic ideology of neoliberalism attempts to undercut all social solidarities.

Consumerism increasingly displaces the ideas of democracy and social justice. This leads to the exclusion of socially weaker or marginalized groups — women, oppressed castes, religious minorities, sexual minorities — from both public and personal spheres.

A Public Health and Reproductive Crisis

The rise of neoliberalism has also fuelled the rise of the religious right — in some cases fascist-like, in other cases fundamentalist — who share some similar traits while remaining distinct from country to country.  A key area where religious fundamentalisms operate through state policies is in women’s sexual and reproductive health, contributing to gender-based health inequities. As the coronavirus threat forces us to prioritize, several U.S. states have seized the opportunity to make abortions “non-essential,” i.e. delaying abortions because of the pandemic.

Accordingly, I am arguing that the coronavirus pandemic is a public health crisis created by capitalism. As the crisis unfolds, we are being told “now is not the time for politics.” On the contrary, now is above all the time for politics, since doing politics means fighting for alternative strategies.

Anyone in India watching television, reading newspapers, or receiving messages on WhatsApp or Facebook is aware that the aged (above 65), the very young (below five) and people in the medical profession are the most threatened. There is also special mention of people with risk factors such as asthma and diabetes. Yet few commentators in the mainstream media have talked about the class dimension.

If you are rich and have medical insurance, you can obtain treatment that is very different from that given to those who are poor or those who lack a minimum pension. Remember that in India, the bulk of the working class is unorganized and without retirement benefits.

At present there is no vaccine or medical cure for the coronavirus. The majority who get infected will have a fever, cough, and recover after some days. A minority will develop serious respiratory trouble. Between one and two percent will be more acutely affected. Deaths occur because their bodies will produce antibodies that are ineffective against the virus. Many will develop pneumonia.

Developing a COVID-19 vaccine takes time. Programs are underway in dozens of academic and private labs around the world, some under the auspices of the Oslo-based Coalition for Epidemic Preparedness Innovations (CEPI). The first results are expected this summer. However further tests will be necessary. No serious candidate is expected before early 2021; a faulty vaccine can kill more than it cures.

Treatment means supportive treatment, medical care, ICUs and ventilators when necessary, proper food. Respected cardiologist and chair of the 21-center Narayana Health chain, Devi Shetty, went on record in late March to say that in Bengaluru alone, he was staring at 80,000 testing positive for the virus. Some 15,000 might need hospitalization, with 2500 further care in ICU, requiring 1000 ventilators.

These issues are not confined to India but can be seen in other Asian countries, in Africa, in Latin America. The IMF, World Bank, regional agencies such as the African Development Bank, have all imposed cuts in health care spending over decades. There are now fewer personnel in the public hospitals.

Governments and Medical Responses

The Government of India responded in a shabby way for the first two-and-a-half months after the coronavirus was reported in early January. As we subsequently learned, the government called for all returning from abroad on or after January 1 to get themselves checked. But there was little seriousness in follow up.

At the beginning of March Rahul Gandhi, Congress Party leader (opposition), stated that he felt the government was underestimating the dangers of the virus. There was an immediate response, typical of the BJP (ruling party), who trolled him on Twitter and Facebook. Yet by the end of February, the WHO-issued guidelines clearly stated:

“The current global stockpile of PPE is insufficient, particularly for medical masks and respirators; the supply of gowns and goggles is soon expected to be insufficient also. Surging global demand — driven not only by the number of COVID-19 cases but also by misinformation, panic buying and stockpiling — will result in further shortages of PPE globally.”

PPE, or personal protective equipment, means gloves, masks, gowns or coveralls, and N95 respirators. Yet the Indian government waited until March 19 to prohibit the export of domestically manufactured PPEs or the raw materials necessary for their production. In fact, putting profits before people was the government’s systematic approach.

As early as January 31, 2020, soon after India’s first COVID-19 case was reported, the Directorate General of Foreign Trade issued an order prohibiting the export of all PPEs. But eight days later the government reversed itself, permitting the export of surgical masks and gloves.

On February 25, by which time there had been 11 reported deaths in Italy, a further relaxation was ordered, with eight more items added. Although the WHO had forecast the need for PPE kits, the government was doing nothing to obtain them. Prime Minister Modi was saying in early March that small measures would be enough to tackle the virus.

For the next month, the government was busy with the budget, ignoring what was happening globally except to welcome Trump and remain silent while BJP leaders organized the targeted anti-Muslim pogrom in Delhi.

The government finally imposed a temporary price freeze only after the price of masks and hand sanitizers skyrocketed 20-fold in online shopping platforms over an eight-day period. Meanwhile, in late March India sold and exported a planeload of vital equipment to Serbia.

Between late January and late March, the government’s Health Ministry, Textile Ministry and the government-owned HLL Lifecare Limited colluded in giving HLL a monopoly over the procurement of PPEs. HLL then sold them at a very high price. Since HLL does not manufacture the equipment, handing it a monopoly over procurement was just a mechanism to secure profits.

Vidya Krishnan, a health and related issues author, wrote in Caravan magazine that manufacturers told her they can produce PPEs at half of what they were being sold.(6) There is also a gross mismatch between the government’s orders and the potential requirements. While the All India Drug Action Network estimated that orders for coveralls could be as much as 500,000 per day by May, government orders are for a total of 750,000.

Until March 24 when Modi placed the nation under lockdown, the government was allowing only U.S. Food and Drug Administration or European Conformity certified kits in testing. Since none of the Indian test kits were being validated by the National Virology Institute (NIV), none could be used.

Why this madness? Why this short-sighted behavior?

It turns out there is just one Indian manufacturer with USFDA approval, Cosara Diagnostics. Based in Ahmedabad, it has a tie to a U.S. firm. CoSara Diagnostics, a joint venture of Synbiotics, a wholly owned subsidiary of Ambalal Sarabhai Enterprises and a U.S. firm CoDiagnostics, is a Gujarat-based molecular diagnostic company. Here is a case of prime minister Narendra Modi favoring a Gujarati (his home province) capitalist concern. In fact, the CEO of the company, Mohal Kartikeya Sarabhai, was part of the group welcoming Donald Trump to the Sabarmati Ashram on February 25.

The medical profession has reacted to this. As a result of the state-imposed terror over the past few years, not all have been too vocal, but many have made the point that they feel let down by the government. Modi appealed to people to gather on their balconies on March 22 at 5PM and bang metal plates, pots and pans to show appreciation of the doctors. But one doctor, gastroenterologist Manisha Bangar, wrote sharply in a Facebook post shared over 3200 times: “Dear Indians! pay no heed to ‘ghantologygyan’ of Modi-BJP. Please don’t clap for me!!” Dr. Mangar also wrote:

ldquo;I have been attending to patients with severe contaminating infections for two decades and will continue to do so in times of Corona but I don’t want anyone to clap for me on 22nd March. Instead, as responsible citizens who possess fundamental rights. I want you to demand and pressurize the Modi-led BJP government to do the needful:

• Spell out the allocation of disaster relief funds and medical aid strategy for all.

• Demand that Modi double the amount of funds required for the statue of Sardar Patel.

• Get Modi to tell corporates and his industrialists whom he let escape or bailed out with your money, that now it’s their turn to bail out the country from the crisis of their own making.

• Declare the tons of gold/silver/money looted, hoarded and now accumulated in temples of Tirupati Padmanabhan, Shirdi Siddhivinayak, Puri and many more, as being state treasure to be used in times of such crisis.”

She added: “We need… massive efforts to deploy testing kits… conversion of schools and stadiums into hospitals with adequate ventilators, financial help for those who are losing jobs…. States like Maharashtra and Kerala are doing a much better job than the Centre [central government — ed.] and it seems the BJP government wants to wash its hands of this massive expense…. The PM could have at least come out and said that unscientific claims like gaumutra (cow urine) curing the Corona virus infection or the banging of plates chasing away the virus are false…. On the contrary, social media handles supportive of the BJP have put out antiquated, religion-coloured ignorant thinking.”

According to The Telegraph, she received three death  threats after the post.(7)

Government response also needs to be seen at another level. Until March 24 the Indian Council of Medical Research (ICMR) claimed that there was no com­munity transmission. Meanwhile, ministers and BJP leaders flouted all norms. Yogi Adityanath, chief minister of Uttar Pradesh state and one of the most aggressive faces of Hindutva, had been insisting even after the spread of coronavirus on holding a large gathering at Ayodhya celebrating Ramnavami.

In West Bengal, Dilip Ghosh, state BJP president, alleged that the Chief Minister was unnecessarily exaggerating the problems; the state’s governor, an appointee of the central government, demanded that the Chief Minister follow the Prime Minister, who had remained silent.

We can multiply these examples manifold. Just one story should stand in for many. While the Shaheen Bagh protestors (opposing the new Hindu-supremacist immigration law — ed.) were being condemned, even though they had changed their mode of operation with just a small number of people in the sit-in and keeping safe distance from each other, the BJP organized a victory celebration in Madhya Pradesh. Having topped the Congress government, large numbers of BJP supporters gathered outside their party office in Bhopal. Inside, the party’s top leaders were photographed offering sweets to each other.

A few state governments were much ahead of the BJP and the central government. They included the governments of Maharashtra (Mumbai is one of India’s major international points of contact, so Maharashtra got a higher than average incidence), Kerala and West Bengal.

Maharashtra is ruled by a non-BJP coalition. West Bengal is ruled by the right-wing populist Trinamul Congress. Kerala is ruled by a coalition, the Left-Democratic Front, headed by the major parliamentary left party, the Communist Party of India (Marxist) or CPI(M).

The Kerala government, despite a limited budget, took early initiatives. In February, when three of the first cases were being treated, the government took prompt action, hospitalizing suspected cases. This led to a reduction of the spread. When the second wave hit, it organized a massive tracking exercise to identify who else had been infected. As a longer quarantine was imposed on the affected, they were kept in comfortable.

The government established call centers where those quarantined could talk to counsellors about the problems they faced living in isolation. The Kerala State Drugs and Pharmaceuticals Ltd, a public sector undertaking, went into mass production of sanitizers. Awareness campaigns were launched, including among migrant workers who speak different languages.

Yet when the parliamentary opposition raised the need to pass a financial package, the Modi government refused. Since Modi desires to keep the spotlight on himself, he announced his package in a television speech on March 24. This also enabled him to set the terms of what would be spent and how.

Modi announced a strict 21-day lockdown. Nobody can explain why 21 days, the most likely explanation being that — given 75 municipalities and four states including opposition-run governments in West Bengal and Kerala, were already in some form of lockdown — Modi supposedly trumped by announcing a longer one. He also announced that the government would spend the equivalent of $2.1 billion to buy more testing kits, increasing the number of ventilators, and stocking hospitals with more equipment and beds.

This financial commitment needs to be viewed alongside the government’s budget for non-performing assets for public sector banks, which lent money to big capital but will not get it back, is the equivalent of $35 billion.

This behavior of the central government contrasted not only with the Kerala state government, but also with West Bengal, where the government, after announcing a lockdown, took additional steps. These included converting a hospital in Kolkata into a coronavirus treatment hospital and providing for the poor and unorganized wage workers.

West Bengal chief minister Mamata Banerjee has earned much applause for announcing a step-by-step lockdown that gave people time to prepare. First came the closure of schools, colleges and universities. Then cinema halls were shut.

Banerjee assured people that basic services would be kept open and demanded that migrant workers be provided for wherever they had gone to work. She vowed not to let anyone to remain unfed. Community kitchens, alongside rationing, will ensure that food will reach everyone.

The Chief Minister has earned much applause for her populist ways, “leading from the front.” For example, she goes into the streets to draw chalk lines where people should stand when they are shopping.

What the state governments of West Bengal and Kerala are doing, was only to be expected. Fifty years ago, when the welfare state model was more widely accepted, this is how it would have operated. But neoliberalism has lowered expectations of how public funds are used even during a pandemic; since 2014 the economic performance of the Modi government has lowered expectations even more.

These models stand in contrast to Modi’s four-hour warning that there would be a lockdown without any assurance about maintaining supplies or a commitment to providing aid. Modi has shown how utterly inhuman he is, and how he can manipulate a pliant media to aid him in his juggling act. Instead, the Modi government’s program functions to siphon off money to his cronies.

At this point, we need to go beyond such comparisons and look at wider dimensions of the class struggle.

The Pandemic and Opportunities of Capitalism

The coronavirus pandemic is a natural disaster aggravated by environmentally unsound practices of production and consumption under capitalism. How the pandemic is tackled is a matter of capitalism, and its priorities.

This essay, written over several days, saw changes in how the Government of India moved. To begin with, as it admitted, since January 1 some 1.5 million people — including the farcical state visit with Trump — entered India. Yet no one was tested. The coronavirus arrived primarily through the rich, travelling back from jaunts abroad, or from tourists. The government bent over backwards to make them comfortable.

The Modi government’s opening act was on March 19, when the Prime Minister appeared on television and appealed to people to go out into the streets and bang pots and pans in support of doctors. Given the near total support for the current regime by the print media and television, and also the regime’s use of all its powers to ensure that its views are the ones that are communicated, this meant that for every handful of people questioning the action, far more would hail him for the “support” he was showing to the doctors.

“Twenty one days of lockdown is a long time but it is important to save you and your family, this is the only way we have,” Modi said on March 24, warning: “This is as good as a curfew.” But coming after a sustained neglect of advance preparation, the lockdown led immediately to the well-to-do and the middle class rushing to stock up as much as possible.

Essential services were exempted, including electricity, banks, ATMs, groceries, medical stores and of course hospitals. In the case of many shops, lack of staff (unless purely family run) led to closures. Those local stores that remained open ran out of oil, salt, and liquid hand wash within a few days. There was a run on the supermarkets as well. Obviously, neither the unorganized sector workers nor the lower middle class were in any position to stockpile.

Since Modi’s lockdown occurred as Delhi chief minister Kejriwal’s local lockdown was already in effect it meant that people were stuck. There was a panic, especially the next day when landlords evicted migrant workers or people felt they would not be able to sustain themselves and set out for home. Masses thronged to the Anand Vihar Bus Terminus, where there were no departing buses. In many different parts of the country, and out of sheer desperation, the migrant workers began to walk home.

Expressing sorrow that some people faced difficulties with the lockdown Modi, in his March 28 TV address, claimed it was his only option. Later that day, it was evident that orders had been sent to block people trying to get back home.

Caste and Class

During March, the dominant narrative in India has been either about the state enforcing the lockdown, or about “social distancing” — do not go out, do not mix closely with others, keep a six feet distance, work from home.

However, social distancing is not a value-free term. In India it has a firm caste implication. Brahmins in India have practiced social distancing for thousands of years, in a culture where even now a Dalit [so-called “untouchable” caste — ed.] taking water from a well used by upper castes can lead to lynching.

Writing from the Jhargram area, Mrinal Kotal, nephew of the late Chuni Kotal (the first woman graduate from the Adivasi or the so-called “tribal” community of Lodha Shabars, forced into suicide by her unpunished university teachers) appealed for help because Adivasis were not even getting one full meal a day. How does one tell people who live in these poor and densely packed neighborhoods that their priority should be social distancing, hand sanitizers and washing with soap for 20 seconds?

It has taken over a century of struggles by Dalit leaders and activists to generate a degree of awareness about how oppressed the Dalits are and why there is a need to make that a sustained battle for equality. But at each opportunity it gets, the upper castes, who are dominant within the ruling class, ensure that Dalit rights are pushed back. The whole strategy adopted by India ignores the class-caste dynamics of its population.

How can it be addressed? To start with, there was a need to recognize that social distancing cannot function for the vast mass of people. Additionally, we can’t ignore the underlying health and sanitation conditions that the unorganized workers and poor have. And certainly, hosing down with diluted bleaching powder — as was done to migrant laborers in Uttar Pradesh — is not an alternative to stemming the virus.

The capacity of the health system, including diagnostics, must be augmented to make it universally accessible. That means building, at the block level, temporary “Corona treatment units,” modelled along the lines of the Ebola treatment units in West Africa. Because so many have little access to health care, examinations and treatments should be comprehensive rather than focused on only the coronavirus.

Accredited social health activists, practitioners of alternative medicine (to whom many of the poor will go, having no other option) as well as nurses, should be trained in triaging or deciding the order of treatment for COVID-19. They also should be provided with the knowledge, training and supplies to manage the virus.

Considering the ecology of urban India, there must be decentralization with authority and funding moving downwards. Municipalities, block level institutions, district and middle-level Panchayat bodies, must be empowered to design locally suitable strategies for the heavily crowded poor and lower middle-class neighbourhoods, for homeless shelters and prisons.

What do we have instead? Kerala with its Social Democratic leadership has shown what can be done even within a capitalist set-up. It attempted to be relatively inclusive as it invited diverse religious leaders, local bodies, civil society activists, and NGOs to work with them. It saw that notices were put up in the languages people used. Prisoners were engaged in the production of masks.

On March 27 the central government announced what was supposed to be a huge package for the poor.(8) It includes insurance coverage for health workers. This is a positive announcement. But the principal beneficiary will be the insurance companies to whom the premium is paid. While the actual spending will depend on how many fall ill, the big question is why that there is no countrywide health care network, under state regulation and control. The answer is that governments have avidly run to adopt the patchwork and retrograde U.S. model of health care, and therefore determinedly withdrew from decent public healthcare.

A few proposals commit the government to some spending, although the plan was announced without any parliamentary discussion. Once again, every social, economic crisis is seen by the present government as an opportunity to whittle away at the powers of parliament.

For Modi, every event is seen primarily as an opportunity to build up his own cult. The periodic speeches by the Prime Minister on television — never a public and open press conference — serve only to focus attention on him personally.

This is connected to how the BJP-RSS has been stepping up its hollowing out of parliament as an institution. Repeatedly, bills have been passed just by vote, without referring them to select committees, without considering ideas from numerous social organizations or opposition parties.

The Modi government’s response starkly reveals its class interests. Trains were immediately cancelled along with long-distance buses that would carry the working class. Cancelling air traffic came later and even then there were exceptions for special flights and dispensation visas. True, the planes carried Indian citizens, or families of Indian citizens; they had a right to be home with their own. But they were people potentially bringing more of the contagion into India.

The Class Struggle on the Political Plane

Meanwhile working people, the people who clean cities, who work in the unorganized sectors, who travel hundreds of miles to work in some big city or other, were not in the vision of the Prime Minister, the Home Minister, or any of their minions. They, who have a right to be home with their own, were told by Modi: “Stay where you are.”

For tens of thousands, this meant staying at bus stations for buses that would not be plying their routes, or in empty railway stations, or on highways. Shrugging off government responsibility, the Prime Minister said that civil society organizations were taking care of the poor. Since they cannot afford an airplane ticket, he does not see these people as part of the citizenry.

Migrant workers in India always head home when they have no prospect of work, for at home they can survive better and expect kin support. This has been a pattern during any disruption, natural or man-made. In fact, during Modi’s tenure, migrant workers have left their place of work in droves more than once, most memorably when he announced demonetization, when much of the currency held by these workers became worthless overnight.

But now as establishments closed, construction ground to a halt and vendors and stall holders found few customers, they headed back to their towns and villages in the poorer states of the north and east. This time staying might mean the added threat of pograms that might cost them their lives.

But they were to be halted. On March 29 the Director General of Police, Haryana, informed all high-ranking police officers through a video conference that under the Disaster Management Act there must be no movement of people along the roads. Large indoor stadiums and other buildings should be turned into temporary jails.

The coronavirus pandemic is an ecological disaster created under conditions of aggressive global capitalism. This global capitalism seeks opportunities everywhere — the opportunity to make money but also the opportunity to carry out its political projects.

It is the case that in numerous countries an ultra-right, chauvinist, nationalist force is on the rise. They are pursuing all aspects of their agenda at the same time. We must not view the coronavirus crisis as a purely public health issue isolated from politics.

Right from the start the crisis has been linked to specific political projects. In India — and in other countries such as the Philippines — that has meant the increasing use of police and the legitimization of police violence in the name of disaster management. In West Bengal police treated the lockdown not as a medical issue, but as a kind of curfew. One young man was beaten to death when he went out to buy milk for his young child.

Due to the COVID-19 scare, courts closed; bail petitions were not heard. And as of March 20, prisoners were not allowed to meet their relatives. As a result, in the Dum Dum Central Prison violence broke out the following day. Angry prisoners apparently set parts of the prison on fire.

According to human rights activist Ranjit Sur, police fired on prisoners and there are rumours about the number of dead. The police, as usual in such cases, have denied that there was any firing, claiming they “only” teargassed the prisoners. Since the attempt by human rights activists to pursue court action failed, the government is left sitting pretty.

Activists sought to have parolled prisoners from several overcrowded jails. While the government has released on parole some 3018 prisoners, not one political prisoner is included. Yet according to the Association for the Protection of Democratic Rights (the oldest functioning civil rights organization in West Bengal) there are currently 71 political prisoners in West Bengal prisons, either accused or sentenced on antiquated charges of sedition, or of being members of the banned CPI (Maoist).

People who were arrested as early as 2010 are still awaiting trial. Sudip Chongdar, a former state secretary of the CPI (Maoist) died in prison. Patitpaban Halder died a few days after being released. Others too have died while in prison. Currently there are at least seven such political prisoners at least 60 years old, and others critically ill. Spondylitis, diabetes, glaucoma, depression and various skin diseases are common.

Not a Local but a Global Trend

The environmental crisis is linked to capital, which sees nature as something that has to “adjust” to constant growth. The rapid industrial growth in India and China have contributed to increasing pollution. Studies done by the World Health Organization in 2016 found that approximately 98% of cities in middle- to low-income countries have air quality that doesn’t meet the recognized WHO standards. In Delhi, the world’s most densely packed city, levels of dangerous particles in the air are far higher, seven times higher than in Beijing.(9)

Across the world, members of the ruling classes are concerned with how to exploit the COVID-19 virus for their goals. For Donald Trump, it was to go on an anti-China propaganda drive. At the same time, Trump attempted to minimize the threat, since keeping business running was his major goal.

Given their slow initial response, the capitalist class globally is now compelled to take some measures. But these measures begin by putting pressure on the working classes. Israel and Singapore have refined their already well-developed internal espionage systems.

Considering the specific ideological-political contexts, each country is moving to cut down the democratic and civil rights of working people and extend so called anti-terrorist measures. While this authoritarianism does nothing to slow down the virus, it gives an impression of a government hard at work. It also responds to a standard middle-class reaction of demanding “firm action.”

Meanwhile, workers are attempting to defend themselves. In Italy, workers struck after seeing that despite the massive spread of the virus, industrial production was continuing. In the USA, nurses and Amazon workers have demonstrated, demanding better personal protection equipment and other safety measures.

Of course, it will be argued that “we are all in the same boat.” But that is not how the ruling class sees it; and that cannot be the working-class response. Yet with the political blows struck at the working class in many countries, including India, to talk of a fightback is easier said than done. Nevertheless it remains essential.

We must not give up struggles for better wages, living conditions and quality public healthcare in the name of national unity. We must fight for international collaboration for better scientific research. We must fight for immediate state regulation of hospitals so that far greater numbers can be treated at low cost.

Unless militant actions are undertaken, workers will find more of their rights trampled in the name of fighting the coronavirus. Parties, trade unions, social movement organizations and networks of the working class and poor peasants must try to understand which measures constitute scientific methods necessary to fight the threat, and which are attacks by capital.

Notes

1. “Value of public health expenditure in India 2013-2018,” Published by Sanika Diwanji, Sept. 23, 2019, https://www.statista.com/statistics/684924/india-public-health-expenditure/
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2. Jean Drèze, “Ayushman Bharat trivialises India’s quest for universal health care,” https://idronline.org/ayushman-bharat-trivialises-indias-quest-for-universal-health-care/?gclid=CjwKCAjwvOHzBRBoEiwA48i6Avv-ttSq4rPZd6Dlql9xjnaeILI4aqtEM4ZKtHxtFIqPX0-j7SFKhhoCqG4QAvD_BwE
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3. A. Kapilashrami and B. McPake, “Transforming governance or reinforcing hierarchies and competition: examining the public and hidden transcripts of the Global Fund and HIV in India,” Health Policy and Planning, 2013 Sept. 28 (6): 626-35. doi: 10.1093/heapol/czs102. Epub 2012 Nov 11
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4. Baru, R.V., Mohan, M. “Globalisation and neoliberalism as structural drivers of health inequities,” Health Res Policy Sys 16, 91 (2018) https://doi.org/10.1186/s12961-018-0365-2
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5. Birn AE. “Philanthrocapitalism, past and present: the Rockefeller Foundation, the Gates Foundation, and the setting(s) of the international/global health agenda,” Hypothesis. 2014; 12(1):e8. https://doi.org/10.5779/hypothesis.v12i1.229
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6. Vidya Krishnan, “India did not stockpile COVID protective equipment for health workers despite clear WHO guidelines,” The Caravan, 22 March 2020. https://caravanmagazine.in/health/india-did-not-stockpile-covid-protective-equipment-health-workers-despite-clear-who-guidelines?fbclid=IwAR1uViOoQz_KSOMwlMb5LXR2HpZ0X5RxB8-RyaQdrDekfO0N6sd2PjA0fxs
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7. The Telegraph, Kolkata, 23/03/2020.
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8. “Coronavirus Lockdown: Govt to provide wheat at Rs 2/kg, rice at Rs 3/kg to 80 crore people,” https://english.jagran.com/india/coronavirus-lockdown-govt-to-provide-wheat-at-rs-2kg-rice-at-rs-3kg-to-80-crore-people-10010044
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9. https://cleanair.camfil.us/2018/03/14/developing-countries-struggling-air-pollution-can-reduce-emissions/; and https://abcmundial.com/en/2019/11/03/india/society/india-air-pollution-at-unbearable-levels-delhi-minister-says
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May-June 2020, ATC 206