Andhra Pradesh, under Chief Minister Jagan Mohan Reddy, is likely headed for a debt trap. This has earned AP the moniker of Runandhra (an amalgamation of the Telugu words for ‘debt’ and ‘Andhra’). While his fiscal profligacy is deeply worrying, it is Jagan's approach to governance that is the real problem. He is driven by image management rather than the need to achieve development outcomes for the state. This has worked well for him so far. But with Jagan’s poor handling of COVID-19, his failures are reaching a point where even shrewd PR cannot hide reality.
At the peak of the second wave, it was next to impossible to find a bed through the much-hyped 104 helpline. The reason? The AP government did not learn from the experience of the first wave to expand health infrastructures like bed capacity, oxygen supply linkages, and tele-medicine infra. Even the AP High Court pointed out that on the rare occasion an official responded to a call, no beds were available and no alternative solutions were offered. In early May 2021, out of 17,000 patients in Srikakulam, at least 5,000 required beds but only 1,700 patients were able to get them!
Similarly, the 108 helpline was so poor that by the time you got an ambulance, your destination would’ve changed from the hospital to the cremation ground. Jagan launched the 1902 helpline to clamp down on black marketing of medicines & excessive hospital charges. But black marketing of essential medicines continues to be rampant. The problem of hospitals levying excessive charges on patients got so bad that the AP High Court had to issue orders to the AP government on how to tackle this issue. When the judiciary goes out of its way to direct the executive on how to do its duties, it becomes yet another marker of governance failure at the highest levels.
For Jagan, the purpose of hype isn’t just to show him in a positive light, but also to hide skeletons in the closet, a phrase that is almost too apt for what follows. A recent Scroll.in article revealed that the AP government has been massively underreporting the true impact of the second wave of COVID-19. It uses official records to demonstrate that “the excess mortality reported by the state from January to May 2021 was 34 times the official COVID-19 toll.” This confirms the possibilities of underreporting by the AP government that news reports had alluded to earlier.
Since data informs policy-making, AP is handicapping itself and setting a bad precedent for the future by underreporting. It also gives rise to troubling questions. Is the AP government hiding a third wave? Is AP also similarly underreporting the true extent of the infection itself, especially in underserved rural areas where testing capacity and contact tracing is already weak?
This scale of underreporting is also ultimately a betrayal of the people’s trust. On one hand, the AP government is giving people a false sense of security which incentivises them to let their guard down on following COVID-19 protocols, putting them at risk again. On the other hand, underreporting allows the AP government to renege on its much-hyped promises like paying for funeral expenses, ex-gratia for kin of health care workers, children orphaned by COVID-19, etc. By under-counting covid deaths, the number of people availing these facilities also decreases. In other words, children orphaned due to COVID-19, won’t get the promised ex-gratia because their parents’ deaths haven’t been counted as COVID-19 deaths.
On the other hand, the author of the same article has also talked about the disruption of routine health services using data from the Health Management Information System (HMIS). Taking a cue from there, I looked at HMIS data for AP comparing the period of April-November in 2020 and 2019. What I saw was shocking evidence of state failure and apathy.
The provision of routine but essential health services across pregnancy care, infant & child care, immunisation, hospital treatments declined by 60-70%. For example, the number of fully immunised children (9-11 months) declined by 62%. The number of infants getting polio vaccine dropped by 68%. The number of pregnant women getting four or more checkups has dropped by 56%, with institutional deliveries having dropped by 65%. Comparing the data from rural areas for 2020-21 over 2019-20 or 2018-19 shows that inpatient treatment of serious diseases like Tuberculosis, Hepatitis, Malaria, Dengue, Typhoid, Asthma, etc has dropped by a mind-numbing 80%.
Whatever way you spin it, that data is damning. It shows that Jagan took the shortcut route of hiding data and merely reorienting the health system for COVID-19 instead of expanding its capacity. He ignored the fact that essential health services mustn’t be interrupted due to their time-sensitive nature. COVID-19 or not, newborns still need the polio vaccine. The disruption in such services will have long-term detrimental health effects on child and maternal mortality, incidence of major diseases and life expectancy. And since health gains made so far have been lost, future governments of AP will incur higher expenditures on public health.
That brings me to the crux of ṭhe problem with Jagan’s governance. He governs purely for the next election, not for the next generation. To that end, he is willing to declare fake victory over COVID-19 by severely underreporting. He is also willing to ignore the need for substantial expansion in the health infrastructure during this pandemic. But thanks to the pandemic, Jagan is being forced to confront the deep flaws in this myopic approach to governance. The question is — will he reconcile with this reality and course correct, or will he double down and lead AP deeper into an abyss?
Ram Mohan Naidu Kinjarapu is a two-time Member of Parliament from Srikakulam constituency and is a member of Telugu Desam Party. Views expressed are the author’s own.