New Delhi: Vidya Kaushal, 22, trained for six months as a beauty entrepreneur before she set up her own salon, ‘She’, in her hometown of Jagdishpur in central Uttar Pradesh’s Amethi district. Kaushal, who graduated last year, could have become a teacher as her family wanted, but chose instead to become an independent entrepreneur.

It cost her Rs 50,000 to set up the salon, which she rented at Rs 5,000 a month. Jagdishpur, once an industrial hub nurtured by the Gandhi family, has seen factories shut and employment dry up over the last decade, but Kaushal’s parlour saw a steady stream of customers when it opened in early March 2020.

Two weeks later, India went into a nationwide lockdown to deal with COVID-19. With strict social distancing rules in place, the beauty business became untenable. ‘She’ had to shut and Kaushal had to disband her two-member team. The parlour reopened in July once the lockdown lifted but it now gets few customers, Kaushal said, though she ensures hygiene and physical distancing.

“On a good day, five people will come; on most days, it’s less. People are really scared. I have suffered losses for months and if I raise prices, clients refuse to pay. It’s also difficult to run the parlour all by myself,” she said. She is hopeful that the ongoing wedding season will revive her business.

Among women, it is not only entrepreneurs who are struggling to survive, we found in our reporting across several districts of Uttar Pradesh including Lucknow, Allahabad, Sitapur and Amethi. In cities, women employed as domestic help, at construction sites and call centres, and in handicraft and retail units, have lost jobs. In villages, women’s participation in public employment schemes has dipped as men who returned from cities during the lockdown have replaced them.

Early research on the impact of the lockdown on women’s employment confirms what anecdotes showed: The drop in employment is not gender-neutral. “Given the large pre-existing gender gaps in employment, in absolute terms, more men lost employment than women. However, conditional on being employed pre-lockdown, women were roughly 20 percentage points less likely to be employed than men who were employed pre-lockdown,” said a report by Ashwini Deshpande, professor of economics at the Ashoka University, who investigated data from the Centre for Monitoring Indian Economy, a business information company.

In a three-part series, IndiaSpend is examining the impact of the COVID-19 crisis on work and livelihoods across India. In the first part, we looked at workers who stayed back in villages, concentrating on southern Rajasthan. In the second part, we investigated the return of Odisha’s migrant workers to Surat and other migrant destinations, and the work and living conditions they have returned to. In this, the third and concluding part, we explore how the lives of women in India’s workforce, urban and rural, have been impacted by the pandemic. We focus on Uttar Pradesh, which also reports a high gender skew in employment.

Even before the pandemic, women’s participation in India’s workforce was low due to social and cultural reasons, as IndiaSpend reported in its series Women@Work. At just 24%, according to the Economic Survey 2017-18, India’s rate is among the lowest in South Asia.

The states with the lowest rates for female employment were Bihar (2.8%), Uttar Pradesh (9.4%), Assam (9.8%), as per state-wise analysis of the Periodic Labour Force Survey (2017-18) by the Ministry of Statistics and Programme Implementation.

Slump hits women-run businesses

Vidya Kaushal’s business is one of many built on the back of the consumption boom in small- town India that goes back a decade. Micro-businesses like hers, 20% of which are owned by women, have been hit hard by the ongoing crisis, data show.

Representatives of India’s beauty and wellness industry, mostly micro, small and medium enterprises (MSME), had demanded government support from MSME minister Nitin Gadkari during the lockdown. They reported that seven million jobs were at stake in this category of businesses where two of three employees are either women or migrant workers.

The sectors most affected in the pandemic crisis--restaurants, retail, beauty, tourism, education, domestic work, and carework for the young and elderly--have high female employment, said Gayathri Vasudevan, chairperson for Labournet, a social enterprise that works on enabling livelihoods.

Kaushal, who started her business with her family’s savings, does not expect any support from the government. “All businesses around me have been destroyed and we will have to survive on our own,” she said.

Upto 73% of women entrepreneurs have dealt with setbacks caused by the lockdown and the pandemic, with 21% witnessing near wipe-out of revenues, said a report by Bain & Company, a management consultancy that interviewed women business owners of solo and small enterprises across Indian cities. Upto 35% of the women interviewed reported a significant decline (25%-75%) in business revenues. Women were affected even more than men because of the need to take on additional domestic work during the lockdown, the report said.

Crafts units shut

The lockdown and the resulting economic downturn have aggravated gender inequities, several reports have shown (here, here and here). Women have lost jobs and livelihoods, many are on the frontlines fighting the pandemic as health and social care workers, while also shouldering increased domestic workload.

Paid work for women in India is concentrated in low-growth, low-productivity sectors, mainly agriculture or home-based, informal work. It is estimated that there are 250,000 chikankari and zardozi workers in Lucknow--crafts that need fine embroidery skills. Most of these craftspersons are women, and with demand dwindling during the lockdown, most have lost jobs and earnings. Rani, 35, whose story we share later, is an expert zardozi worker whose unit shut during the lockdown. But with four young children and costs of food and education, she cannot afford to put away her needle yet, she said.

“This work has completely stopped since the lockdown. These women support their families, but they are invisible,” said Arundhati Dhuru, an activist from Uttar Pradesh and convener with National Alliance of People’s Movements, an NGO collective.

Given that in 2018 women’s participation in India’s workforce had fallen to its lowest since Independence--18.6%--as per the Periodic Labour Force Survey 2018-19, the pandemic could have serious repercussions on female employment in India, said experts.

“Women have been affected the most, so far as the socio-economic toll of the pandemic is concerned,” said Vibhuti Patel, former professor at Advanced Centre for Women’s Studies, Tata Institute of Social Sciences. “This is not just because of increased care work, it is also because of entitlement--whenever the unemployment rate is high, men get prioritised [for jobs] as they are seen as breadwinners and women as homemakers. In times of economic prosperity, women are hired last, and during a crisis they are fired first and are the last to be hired.”

‘As soon as men enter job market, women are thrown out’

In a state like Uttar Pradesh, which has social and cultural restrictions on women’s mobility, the effects of the current crisis are bound to be even more gender-skewed, experts said. In 2017-18, only 8.2% women were in the state’s labour force in urban areas and 9.7% in rural areas. When compared to the corresponding national average, the LFPRs for women in rural and urban areas were lower by eight and nine percentage points respectively.

In May this year, the Uttar Pradesh government announced measures to address the issue of women’s employment under the State Rural Livelihood Mission. One of these was a scheme to appoint ‘Banking Correspondent Sakhis’ (friends) to act as links between banks and female customers in all the 58,000 gram panchayats of the state. Other projects involved self-help groups in mask-making, manufacture of personal protective equipment and tailoring of school uniforms.

“Uttar Pradesh has been one of the lowest performing states for women’s participation in work. We don’t have [recent] numbers but we expect there must be a drastic drop since the lockdown,” said Dhuru of the National Alliance of People’s Movements.

Dhuru travelled across the districts of Sitapur, Hardoi and Unnao for an informal assessment of what the lockdown was doing to women’s participation in the Mahatma Gandhi National Rural Employment Generation Scheme (MGNREGS). She found that women who worked under the scheme have been displaced by their husbands, migrant workers who returned from cities in the millions during the lockdown. “As soon as men enter the market, women are thrown out,” she said.

With over 2.1 million migrant workers returning home to Uttar Pradesh, there was an unprecedented demand for MGNREGS jobs this year. According to state government figures reported in June, it topped the list of states offering employment under the scheme--5.7 million workers. The maximum numbers came from Sitapur district, right after capital Lucknow--about 191,000.

Most MGNREGS jobs go to men, said Richa Singh of Sangtin Kisan Mazdoor Sangathan, a Sitapur-based collective, who has been working on the issue of women’s rights and livelihood in Sitapur district. “Despite the provision for 33% reservation for women, the proportion of women workers in MGNREGA in our district used to be the lowest in the country, close to 5%. It’s now improved and is close to 20%. It’s not easy for women to work in this region. There is no acceptance for it,” she said.

In 2006, when the scheme was launched in India, Rambeti, 46, of Sitapur district was among the first women to demand work in her village. Most families from her village, Alipur, had started migrating to cities for work but she stayed on with her husband and four children. The family sustained itself by cultivating its seven bighas (around 1.4 acres) of land and taking on MGNREGS work. Rambeti gets an average of 10-12 days of MGNREGS work a month. When IndiaSpend contacted her one morning a few days before Diwali, she was working at a MGNREGS site outside her village.

“Once you leave for the city, it’s not easy to work in the village. You have to fight for your right to work with the panchayat. You have to walk long distances and stand under the sun and do hard labour,” said Rambeti, who mobilises women in her village to work in MGNREGS as part of Sangtin Kisan Mazdoor Sangathan. 

One of the women that Rambeti has mobilised is Sunita Devi, who returned to Alipur from Jaipur in July when her husband lost his job in a private company. She has three children aged 10, seven and two years, and this is the first time in her life that she has taken on paid work. “I find it very difficult to dig and to work with mud, but I don’t have a choice. Our children need to study and my husband has not got his job back,” she said. The family has two bighas (0.4 acres) of land on which they cultivate wheat and groundnut. “There isn’t enough water as the soil is dry and the yield is low. It’s not enough,” she said.

Women doing subcontracted work lose income 

Women who work from home in India are underpaid, invisible, but vital parts of domestic and global supply chains. They are in the lowest rungs of India’s labour chain, as IndiaSpend reported, performing subcontracted work in the textile and garments industry, for instance, for which they are paid on a piece-rate basis. Other home-based work includes making papads and agarbattis and rolling bidis. There are over 37 million home-based workers in India, most of them women. These women, who eked out an average of Rs 40-50 a day before the pandemic, have been pushed further into the margins.

An assessment by the Self-Employed Women’s Association, a union of 1.5 million women working in India’s informal economy, between March and July suggested that incomes of women working in the handicrafts, services and finance sectors shrank as enterprises either completely shut down or reduced capacity to less than 50%. “The role of collectives in supporting informal women workers is more crucial than ever. Those who were in collectives found a cushion in this crisis,” said Salonie Muralidhara Hiriyur, senior coordinator at SEWA. 

Rani was only eight when she learned how to do zardozi work and started supporting her family. This year she put down her needle for the first time in 15 years. The zardozi work of Lucknow has a Geographical Indication tag, but there is no value to the work, she said.

“I would work for seven hours and get paid Rs 150. My eyes have been ruined since the work is so intricate and laborious, I can hardly do it anymore,” she said. She hopes that the market will revive next year so she can open a workshop.

(Kumar is a Delhi-based independent journalist. She writes on social justice and gender.)

We welcome feedback. Please write to respond@indiaspend.org. We reserve the right to edit responses for language and grammar.

New Delhi: Abishek Muthian, a startup coach from Coimbatore, runs a blog on which he has uploaded many hours of phone conversations and several emails with call centre and back-office agents of Indian insurance companies. The anxiety over high healthcare costs during the COVID-19 pandemic prompted him to seek out medical insurance. But company after company declined to sell him a policy.

Muthian, 34, lives with dwarfism. Since late March, he tried to buy medical insurance from five leading companies--Royal Sundaram General Insurance, ICICI Lombard General Insurance, HDFC Ergo, Bajaj Allianz and Max Bupa. All five declined his request on grounds of his disability. This, despite various government circulars directing firms that people with disabilities must not be denied medical insurance.

The COVID-19 pandemic has exposed several faultlines in our health systems: Private healthcare is expensive while public healthcare can be inadequate. IndiaSpend has reported on various aspects of this issue in The Price of COVID series.

Health insurance could be a relief for anyone who needs to access private hospitals. But as IndiaSpend has reported, many with valid health insurance were not able to claim it for their COVID-19 treatment during this pandemic. Insurance companies offered many reasons for rejecting claims ranging from over-charging by hospitals to telling claimants they had not needed hospitalisation.

In our ninth investigation of the series, IndiaSpend attempts to document the challenges faced by people with disabilities in buying medical insurance and how they were routinely denied policies by India’s leading insurance companies. The pandemic has brought new anxieties and reinforced old ones for people with disabilities: Would they be able to afford treatment and healthcare, for COVID-19 or anything else, without medical insurance? 

Disability liability?

On his blog, he chronicles his experiences with various companies. He has documented how Royal Sundaram wrongly listed his disabilities and health parameters. The company did not give him a copy of his medical reports until after repeated complaints. Those reports certified him as healthy, yet the company did not issue him a policy. HDFC Ergo told him they could not insure people who had had accidents. Muthian has not had any accidents. The company also automatically rejected his application after he filled up a form online and declared truthfully that he had a disability. ICICI Lombard declined citing his pre-existing “illness”, even as Muthian told them that that is against the government guidelines. All three companies had initially accepted payment from Muthian for a policy but never issued him one, refunding the money after several emails and complaints, Muthian told IndiaSpend.

Copy of one of the rejections received by Muthian, for medical insurance, citing his dwarfism as a ground for denial

“My disability is not among those listed as permanent exclusions by the Insurance Regulatory and Development Authority of India (IRDAI). IRDAI guidelines ask people to honestly declare their ‘pre-existing illness’ and ask that insurance companies not deny people coverage due to this. I have always honestly declared my medical condition. Several insurance companies also claim to offer insurance to people with pre-existing illness and disabilities. Yet, I have not managed to buy medical insurance,” he said.

A person should not be denied insurance because of their disability or pre-existing illness, IRDAI guidelines state. The guidelines say that if need be, their particular disease can be excluded from coverage with a longer waiting time (upto a maximum of four years), but the rest of their bodies would still be eligible to be covered by medical insurance. After this waiting period, even the particular disease could be covered by the insurance policy.

However, in reality, the experiences of people with disabilities across India show that this had not been the case for them before the pandemic and it was not the case for them now.

“Insurance companies should make a distinction between disabilities that compromise on the healthiness and life of the person and ones that do not,” said Sanjay Datta, ICICI Lombard’s chief of underwriting and claims division. “For example, blindness or an orthopedic disability may not actually be affecting all other organs or the life of a person and so these people should be considered for insurance. But for someone with an auto-immune disease… this is a difficult risk for our industry to take on. But all people with disabilities should not be lumped together,” he added.

An insurance executive, who did not wish to be quoted, cited the example of the scientist Stephen Hawking. “He had a degenerative motor neurone disease. It would be difficult to insure him,” he said and went on to recount the story of British general Lord Nelson, who led the British to victory against Napoleon in the Battle of Trafalgar in 1805. "Nelson was said to be blind. When his troops came to him fearing defeat, the story goes that he put a telescope to his blind eye and reassured them of what was ahead... a disability like blindness, need not be a hindrance in the performance of the person and a reason to exclude them [from insurance] in any way.”

“Health insurance should be given to people with disabilities without bias,” said S. Prakash, managing director, Star Health and Allied Insurance. But, he added, the industry in India often does not approach people with disabilities with “medical wisdom” and thus treats all disabled people as unhealthy. “This apprehension in the mind of the insurers is mostly not correct.”

Insurance companies are not actively denying policies to people with disabilities, said G Srinivasan, director, National Insurance Academy, Pune. “It would not be correct if they are doing this as the regulator has also made this clear. There might be problems at the initial level, but not if people complain to the companies. So people should push for it and try to get insurance.” 

Muthian has raised multiple grievances with IRDAI for each of the companies who have denied him insurance and also complained directly to the insurance companies. Nothing has worked for him yet. He is tired, he said, but in one last-ditch attempt he wants to try and file a case at a consumer court.

“But if insurance companies are going to keep denying people with disabilities from policies, do we all have to go to court, one by one, to buy a policy?” asks Muthian.

No data

Some 26.8 million Indians, or 2.2% of the population, live with disabilities, according to Census 2011. These include persons with visual, hearing, speech and locomotive disability, mental retardation, mental illness, multiple disability and any other disabilities. Disability is higher in rural areas (2.3%) than urban (2%) and higher in men than women (2.4% versus 1.9%), according to the National Sample Survey 2018.

While the IRDA publishes large amounts of data, especially about the amount of money paid and number of claims cleared by insurance companies, it does not divulge how many policies are denied.

In 2018-19, 20.68 million health insurance policies were sold and 472 million people were covered by health insurance in India, according to IRDAI data (TABLE 72). But no breakdown is given of how many applications insurance companies received, and how many they rejected.

These data become more significant because, in 2019, the IRDAI had asked all insurance companies to make public their “underwriting philosophy” for people with disabilities, mental illness and HIV/AIDS. Many companies, as mentioned above, have posted articles on their websites saying they provide insurance cover to people with such medical conditions.

Insurance company executives told IndiaSpend that the IRDAI has not asked them to capture these data. Muthian says that if IRDAI asks companies to collect these data, just this mere requirement could make them give out more policies to people with disabilities, so that this shows up in their data.

“They claim they will provide insurance to us, but our applications are rejected outright. Is this not a false promise and fake advertising by these companies?” said Muthian referring to such articles. “If this is not false, then companies should release this data.”

IndiaSpend contacted grievance officers of 50 insurance companies listed on the IRDA website asking them for data on the number of applications from people with disabilities/pre-existing illnesses and how many had been rejected or granted a policy. We have also emailed IRDAI with queries about its audit, if any, of insurance companies’ compliance with its guidelines on inclusion of people with disabilities. We will update this report when they respond.

Term insurance? Yes. Medical? No.

“There is a need to encourage all insurance agencies to cover persons with disabilities without exception,” declared India’s National Policy for Persons with Disabilities in 2006. That policy said that the Life Insurance Corporation of India (LIC) provided insurance to people with specific disabilities.

That was what 35-year-old Prabhu, who goes by one name, was trying to find out recently when he filed a Right to Information (RTI) request with the LIC asking what types of insurance were available to people with disabilities for COVID-19 treatment. But in its reply, LIC said they could offer term insurance to cover the event of death of a person with disability due to COVID-19, but did not clarify if they offered any medical insurance for the same person.

Prabhu is a practising doctor at Tirunelveli, Tamil Nadu, and filed the RTI because his friend, a 34-year-old dentist, in Coorg, Karnataka, had asked him if there were any insurance policies that she could buy. Both Prabhu and his friend have physical disabilities in their lower limbs.

Copy of RTI reply received by Prabhu in Tamil Nadu, regarding insurance for people with disabilities by LIC

“During this pandemic, I got worried that my parents should have some insurance if something happens to me… COVID-19 is a risky disease,” the dentist said. She enquired at her local State Bank of India branch about their insurance policies for people with disabilities. “I was told I would have to get a medical check-up in Mysore. They wanted me to travel over 100 km away for this. I feel this particular condition was set in order to dissuade me from availing the insurance.” Her entire family is precariously placed on the issue of insurance. Neither she nor her elderly parents have any medical insurance.

Why government jobs are key

One source of security for people with disabilities are government jobs: they bring access to free government healthcare for themselves and their families. India has 4% reservation for people with disabilities in government jobs, according to the Rights of Persons with Disabilities Act, 2016.

The security of government jobs and healthcare is how many people with disabilities have been managing, explained Danish Mahajan, 32, a junior clerk with the Punjab government.

Mahajan, who also runs an online radio station as a hobby, is blind. His wife is blind as well. With anxiety over the pandemic playing on his mind, he decided to buy medical insurance and approached Aditya Birla Health Insurance in October. “They simply denied me and my wife a policy- They did not ask us to do a health check up and the only documents we submitted were the disability certificates of our blindness... I am blind but the rest of my body is fine. Why can I not get medical insurance?” said Mahajan, who had been declined insurance earlier too -- by HDFC Ergo in 2019.

“Since I have healthcare from the government, I did not pursue this too much. But now this year I have complained to the commissioner for people with disabilities about being denied a health insurance policy,” he said.

Like thousands of others, he is waiting for a reply.

(Bhuyan is a special correspondent at IndiaSpend.)

We welcome feedback. Please write to respond@indiaspend.org. We reserve the right to edit responses for language and grammar.

New Delhi: India will not only meet its climate commitments but is also set to overachieve, Prime Minister Narendra Modi said on November 22, 2020, speaking at a side event at the 15th summit of the G20 countries.

The announcement came just days after the United States, the world’s second largest emitter, elected Joe Biden as its next President, who has avowed net-zero carbon emissions by 2050. Biden promptly appointed John Kerry--a former diplomat instrumental in getting the US to sign on the Paris Agreement back in 2015--as his climate envoy. Just weeks ago, China, the world's largest emitter, had announced that it would achieve net-zero emissions by 2060. [What is net-zero carbon emissions? See box]

This has turned the spotlight on India--the world’s third largest emitter of climate change-inducing carbon dioxide (CO2).

PM Modi's speech was underwhelming for some climate researchers, who saw it as yet another proof of India’s hesitation to aim high. India’s global climate strategy has always been about under-promising and over-delivering, said Vaibhav Chaturvedi, fellow with the think-tank Council on Energy, Environment and Water (CEEW). “We knew back in 2017-2018 that India is going to overperform on its climate commitment of reaching 40% renewable energy in its electricity mix by 2030,” he said.

Other experts point out that India is in no position to set an economy-wide net-zero target if it wants to sustain economic growth, pull millions out of poverty and provide power to the millions still underserved. At best, it can aim for net-zero emissions in select sectors such as power and transport, in which it has access to effective technological solutions.

Declaring net-zero targets in sectors that are ready would, in fact, be a good move, experts believe--it would send out strong policy signals to businesses to act against pollution.

What is ‘net-zero’?

Being ‘net-zero’ or ‘climate neutral’ on GHG emissions means taking out of the atmosphere the GHGs that are put in. A country would have to reduce its emissions across sectors and remove the remaining emissions from the atmosphere through various strategies such as creating carbon-sinks (by increasing forest cover, e.g.) or using technological solutions. Some countries, however, limit this neutrality to just carbon emissions, not other harmful GHGs. The ideal scenario is ‘zero emissions’ when all GHGs have been reduced.

Look at the chart below for other climate terms:

Source: Bloomberg NEF

Global efforts, and India’s

In all, more than 120 countries have announced plans for net-zero emissions by 2050, including China, Japan, South Korea, South Africa and Canada.

To cap global warming between 1.5°C-2°C, more than 200 countries had signed the Paris Agreement in 2015 that requires them to voluntarily and aggressively cut their carbon emissions. The world will have to cut human-caused CO2 emissions by 45% by 2030 from 2010 levels, and reach net zero by 2050 if it wants to cap the global heating at 1.5°C, the United Nations’ Intergovernmental Panel on Climate Change (IPCC), the world’s authoritative body on climate science, declared in October 2018.

This means that countries have a decade until 2030 to stop irreversible damage that rising global temperatures are already causing. Yet, GHG emissions that should be starting to reduce have instead soared.

Between just China and the US, aggressive climate measures can help the world limit end-of-century global warming to 2.3-2.4°C, compared to the earlier prediction of 2.7°C, according to an assessment by Climate Action Tracker’s (CAT), an independent body of climate scientists and experts. If other large CO2 emitters such as India make similar cuts by mid-century, the Paris Agreement goal of limiting global warming to 1.5°C-2.0°C becomes more real, CAT’s analysis showed.

Reaching net zero has imminent benefits: India is highly vulnerable to disasters caused by climate change--exceptional heat waves scorched northern India while intense cyclones battered its coastal areas between January and June 2020. In the same period, the rest of the world too has dealt with the fallouts of global temperatures of 1°C above pre-industrial levels: In Siberia, temperatures have been 5°C above average between January and June; Australia and the state of California in the United States have seen massive wildfires in 2020.

“I don't see the alternative [to a net-zero pathway] for India, which has so much to lose from climate change,” said Ulka Kelkar, director of the climate programme at the World Resources Institute, India (WRI). Ambitious targets can become self-fulfilling prophecies, she said, because they send out a signal to society, different sectors and government departments to work towards policies and measures to reach these targets. They also indicate the state’s intent to regulate polluting businesses, catalysing them into planning and implementing practices for a cleaner trajectory, she added.

India, Kelkar believes, is in a better position than developed economies to work toward net-zero emissions. “We are talking about cleaner trajectories for the infrastructure that has not yet been built; houses and buildings that have not yet been constructed; industrial growth that has not yet come into effect; power generation that is still ahead in the future,” she explained. “I would argue that a cleaner trajectory and an ambitious target would be less painful for a country like India than for other countries, which are already locked into a path of high fossil fuel use in the infrastructure sector and need to, in fact, phase it out.”

India’s climate actions are critical to the global climate campaign. But unlike the US and China, India is still working on building the wherewithal for rapid economic growth--for example, it plans to build houses for every citizen by 2022 and its per capita power consumption has considerable room to grow despite government claims of 100% electrification--and much of its polluting and carbon emitting work lies ahead. This partly explains why India’s environment minister, Prakash Javadekar, said in an October interview that India would resist pressure to promise more ambitious climate targets than what it aims to achieve through actions it has already committed to. Although India is a high emitter, its per capita emissions are still nearly a tenth of the US’ a fourth of China’s.

An economy-wide net-zero emission target would not work for India, said Thomas Spencer, an expert on energy transition in India's electricity and industry sectors and a fellow at Delhi-based think tank, The Energy and Resources Institute (TERI), at a webinar on November 18.

China waited to strong growth trajectory before pledging to reach net-zero emissions but India is about 15-20 years behind China in terms of development--India is still a developing country with high levels of poverty, its gross domestic product (GDP) is almost a third of China’s and its level of infrastructure development is far lower, Spencer pointed out. For example, trade, aviation and industrial production are growth sectors where India will be uncertain about its potential to reduce emissions.

If China is targeting to go net zero by 2060, India which has a long journey of development ahead, is unlikely to promise net zero any earlier than 2060, though that would be too late to help the world meet the under-1.5°C warming target, said Parth Bhatia, senior research associate at Centre for Policy Research (CPR) Initiative on Climate Energy and Environment (ICEE). 

However, we should be careful not to get too focused on the long-term target and take our eye away from implementation in the present, he added.

Ideal sectors for emissions cuts

Here are the sectors that experts say India should focus its efforts on:

Power:

It is feasible for India to peak its electricity sector emissions within the next 15 years, Spencer said. This would allow India to keep emissions margins for the sectors that still experience a very strong demand: industry, aviation and freight transport, he said.

Led by large-scale solar plants, India’s transition towards clean electricity has been rapid ever since the country promised the world, in 2015, to quadruple its installed renewables capacity for electricity generation to 175 gigawatt (GW) in five years. Renewables now account for nearly a quarter of India’s total installed power generation capacity, up from 13% in 2014, IndiaSpend reported on May 5.

Much of the movement away from coal is because renewables grew to become highly competitive in terms of prices and sustainability, largely in the past five years. Current solar tariffs in India are hovering at Rs 2 per kilowatt-hour (1 unit of electricity). IndiaSpend had earlier reported that solar tariffs have stabilised at rates about 20-30% below the cost of thermal power in India, and up to half the price of new coal-fired power.

“There is a tremendous potential in rooftop solar that is untapped,” said Kelkar of WRI. “In India, land is always scarce [large-scale solar requires swathes] and also ecologically rich and supports livelihoods.”

Of 175 GW of renewables in India’s climate pledge, 40 GW was to come from rooftop solar. But the rooftop sector has been unable to build pace--subsidies were offered then rolled back because of high demand, IndiaSpend reported in August 2018. To give rooftop solar a big push, India needs to make a few changes in its approach: first, stabilise incentives for rooftop solar, Kelkar said, and second, create awareness among the public about its financial benefits.

India’s entire renewable energy transition is dependent on technology imports from other countries. For example, its annual domestic solar module manufacturing capacity is only about 15% of the country’s requirement of 20 GW--the rest it imported, as IndiaSpend reported on July 29. The primary reasons are India’s late entry into the manufacturing space for these inputs as well as the tough competition to reduce prices (and thereby tariffs), which impedes domestic manufacturing, Apurba Mitra, head, climate programme, WRI-India, told IndiaSpend.

Prime Minister Narendra Modi had declared in July that as part of India’s Aatmanirbhar Bharat campaign, a movement towards self-reliance, India will aim to end dependence on solar equipment imports including panels. Directed procurement or safeguarding duties for reducing import could move India towards self-reliance in manufacture of solar equipment, Mitra said, adding that India's research and development spending on solar technologies is picking up after decades of stagnation but must move faster in segments such as battery technologies to avoid long-term dependencies.

Battery or storage technologies could be breakthroughs for India’s renewables revolution by allowing renewable energy to overcome its ultimate draw-back over coal: intermittence, or the erratic nature of the electricity it produces dependant on when the sun shines or the wind blows, e.g. Yet, despite the progress in renewables, India is still trying to push for more coal, as part of its recovery measure from the economic slump caused by the COVID-19 pandemic, IndiaSpend reported on June 5.

Central to this discussion on net-zero balance in the power sector is an assessment of when this sector is likely to peak its emissions--it requires the country to retire its coal power plants--which are young with an average age of 12 years and their usual working age is 40-45 years, argued Bhatia of ICEE. Retiring the oldest and most inefficient plants would still leave about 100 GW of plants that have just been built in the last decade. “It will be very challenging to retire them anytime soon,” he said.

Chaturvedi of CEEW, however, is of the view that India’s political economy is the biggest hurdle to decarbonising the power sector: Cheap electricity for residential consumers (cross-subsidised by industrial and commercial consumers) remains an electoral issue, debt-ridden electricity distribution companies believe that renewables will disrupt their business; and coal provides millions of jobs and revenues in coal-bearing states.

Transport:

To decarbonise its transport sector, India must improve its cars’ energy efficiency and eventually stop using fossil fuels to run them. This is an ambitious goal that India has been tip-toeing around for the first few years with several changes in its policies related to electric vehicles.

“International projections show that India will remain one of the biggest off-takers of oil for at least another decade and a half,” said Bhatia. India’s policy U-turns on the electrification of its passenger vehicles have been closely watched by the world and the country cannot now make a promise it cannot follow through, he added.

India being in the early stages of planning its transportation infrastructure has the opportunity to lock in green pathways, Kelkar said: “It can promote non-motorised vehicles, make cities bicycle-friendly, invest in pedestrian infrastructure, increase and electrify public transport and personal vehicles, etc.”

These changes--especially electric vehicles--will immediately impact the air quality of Indian cities and have good health impacts, Kelkar said. Electric vehicles powered by green electricity will cut the sector’s emissions further, she added. But if there is no rapid transitioning from coal-power plants to renewable sources, electric vehicles will only end up changing the source of emissions.

A lot of emission savings can also come from transitioning back to railway freight and avoiding road cargo that relies on diesel-fed trucks, she said.

Manufacturing:

Historically, most climate actions to cut carbon emissions focussed on the electricity sector by increasing the share of renewables, said Spencer of TERI. But the three Asian countries that have recently promised a net-zero trajectory--China, South Korea and Japan--are industrial powerhouses, he pointed, together accounting for almost a third of the global production of industrial value added. For them, net-zero targets had to mean transformation of the industrial sector to low-carbon modes.

Manufacturing industries,construction and industrial processes account for about 25% of India’s total carbon emissions in 2014, according to India’s Second Biennial Update Report submitted to the UNFCCC in December 2018.

Although modern steel and cement plants in India are highly energy efficient, and others are attempting to be efficient through retrofitting, new technologies and fuel options have become imminent for India’s industrial sector to reach net zero in the long run, wrote Shubhasis Dey, programme lead, energy efficiency, Shakti Sustainable Energy Foundation, a think-tank. The examples he cited include the use of hydrogen as a new fuel, electrification of processes and re-use of materials.

Decarbonising India’s manufacturing sector would be tough, experts agreed--it would not only need technologies that increase energy efficiency but also policies that promote electrification, as per Chaturvedi of CEEW.

For energy, Indian industries’ reliance on electricity is less than 20%; most of it comes from fossil fuels, such as coal, which are cheaper than electricity, according to Chaturvedi of CEEW. This is because energy policies have kept electricity rates for industries high to cross-subsidise residential consumers, said Chaturvedi. “Why would an industry pay Rs 10 for each unit of electricity, when it can get coal at much cheaper prices?” he said, adding that India must prioritise electrification of industries by offering affordable power.

(Tripathi is an IndiaSpend reporting fellow)

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Bengaluru and Delhi: India’s national nutrition-specific programmes reach various social groups nearly equally, data show, and differences between uptake and delivery for all groups are small too. Yet more people from Scheduled Tribe and Scheduled Caste communities remain undernourished, as successive National Family Health Surveys have shown.

During the ongoing COVID-19 crisis, the link between social identities and access to health services has been well documented in the United States and Brazil--the two countries most affected besides India--with socially vulnerable groups such as blacks and indigenous peoples having been disproportionately affected.

In India, caste is a dominant aspect of an individual’s social identity and can similarly determine access to crucial health and nutrition services. But official sources such as the National Family Health Survey (NFHS) reports do not provide these details. Details showing outcomes of nutrition programmes for individual social groups--including scheduled castes and tribes--at the national, state and district levels, are not provided in a readily readable or usable format.

If such disaggregated data were made available--say, if we knew how much access Scheduled Caste groups in a particular district have to safe drinking water and sanitation, or how many women from Scheduled Tribe communities in a given district were anaemic--policy-level reforms could be implemented, such as increasing the number of Anganwadi centres in SC- and ST-dominated districts, or employing more Anganwadi workers from SC and ST communities.

In this first story in our series on gaps in public data, we examine how the lack of social identity information in the NFHS’s nutrition reports makes it difficult for policy makers and development partners to optimally design and implement nutrition programmes to target the marginalised groups that have the worst nutrition indicators. It also prevents scrutiny of these shortfalls, especially crucial to address the disproportionate impact of the global nutrition crisis created by the COVID-19 pandemic on socially disadvantaged groups.

Undernutrition and inequity

Months prior to COVID-19, traveling across a few districts in central and western Odisha to understand how accessible state-run nutrition services are, we visited numerous tribal hamlets where the first thing we noticed was the lack of National Rural Health Mission (NRHM) Anganwadi centres close to where people lived. Some centres were as far as 8 km from people’s homes.

In the course of our conversations, we found that pregnant and lactating ST women rarely received maternal healthcare services on Village Health Nutrition Days, given the distances that Anganwadi workers would have to travel. Several SC families narrated stories of discrimination against women and children, making their experience of accessing nutrition very unpleasant, despite NRHM “guarantees” of “better health outcomes” especially for “those belonging to marginalised and vulnerable communities”.

Both immediate (‘nutrient-specific’) factors such as access to nutrient-rich food and caregiving practices and underlying (‘nutrient-sensitive’) factors such as poverty and access to health services determine undernutrition and nutritional inequities, which are well explained in the Global Nutrition Report 2016 that covered 193 countries.

India’s largest and official nutrition survey, the National Family Health Survey (NFHS), however, does not publish data on several immediate and underlying factors disaggregated by social groups--such as caste, tribal or religious identities--at the national, state or district levels. Where such data are collated, they are not made public in a usable format, preventing closer examination that could reveal inefficiencies and improve reach to disadvantaged communities.

Nutritional disparities 

SC and ST communities remain worse off in nutrition outcomes than other groups, the latest NFHS-4 conducted in 2015-16 found, as had NFHS-2 (1998-99) and NFHS-3 (2005-06). SC and ST children show stunting and underweight levels and ST children wasting levels higher than children of all groups taken together, according to NFHS-4. More SC and ST women are anaemic than women of all groups.

It is well established that nutrition interventions for mothers and children in the first 1,000 days after birth are critical. The NFHS assesses levels of stunting (low height-for-age) in children, an indicator of chronic undernutrition, reflecting inadequate nutrition over a long period; wasting (low weight-for-height), an indicator of acute undernutrition reflecting inadequate nutrition in the period immediately before the survey; and underweight (low weight-for-age), a composite index of height-for-age and weight-for-height which assesses both acute and chronic undernutrition in children.

SC and ST children show stunting levels of 42.8% and 43.8%, respectively, while all groups taken together record a lower 38.4%, according to NFHS-4. Similarly, a greater proportion of SC (39.1%) and ST (45.3%) children are underweight compared to all groups (35.8%). SC children show levels of wasting (21.2%) just above all groups at 21%; ST children show 27.4%.

For maternal nutrition outcomes such as anaemia among women, SC and ST groups show much higher levels at 55.9% and 59.9%, respectively, compared to all groups at 53.1%.

Marginal difference in coverage of nutrition interventions

Tackling undernutrition requires a focus on both immediate (nutrition-specific, such as micronutrient and food supplementation, and treatment of childhood diseases) and underlying (nutrition-sensitive, such as women’s literacy levels and age at marriage, access to health care, safe drinking water and sanitation) causes, said a 2013 report in The Lancet medical journal.

India’s national nutrition-specific programmes--such as for micronutrient and food supplementation and treatment of childhood diseases--reach various social groups nearly equally, according to NFHS-4. Differences between uptake and delivery for all groups are small too.

For instance, the proportion of all mothers who took iron and folic acid (IFA) tablets for at least 100 days in 2015-16 was 30.3%, according to NFHS-4, versus 28.6% for SC women and 26.8% for ST women. Supplementation of Vitamin A was 59.5% for children from all groups against 60% for SC children and 59.4% for ST children.

The proportion of children who had diarrhoea and received oral rehydration salt (ORS) was 50.6% overall, compared to 51.1% for SC children and 55.3% for ST children. Further, the uptake for supplementary nutrition programmes was higher among SC and ST women and children compared to all groups, NFHS-4 data on food supplementation for both women and children show.

Despite these small differences in uptake between various social groups, higher levels of undernutrition persist among SCs and STs, indicating failure to address the underlying nutritional determinants such as access to health care and safe drinking water.

Inadequate data

The underlying determinants of health and nutrition--the main reference point for policy makers and practitioners when designing nutrition interventions--include food security, women’s literacy levels and age at marriage, and access to healthcare and safe drinking water and sanitation. 

Our analysis of NFHS-4 data shows a six- to 15-percentage-point difference in literacy levels of women from different social groups, with SC (62%) and ST (53%) women seeing lower levels than women from all groups (68.4%). There is also a seven-15-percentage point difference between women with at least 10 years of education from different social groups, with SC (28.2%) and ST (20.2%) women at much lower levels than women from all groups (35.7%).

However, NFHS reports do not provide data disaggregated by social groups at the all-India level for some of the other underlying factors, including women’s access to maternal health services and household employment status, poverty level and access to electricity, drinking water and sanitation facilities.

While the NFHS does collect such data, it does not present them in its published reports. The raw data collated and made public require specialised, costly software and technical ability to access, preventing wider scrutiny to detect problems that result in poor nutrition outcomes among disadvantaged groups.

*Not availableSource: National Family Health Survey-4, International Institute for Population Sciences 2017
Note: Figures in percentage

Caste a dominant social identity but data caste-blind

In India, caste is a dominant aspect of an individual’s social identity, and can also determine access to crucial health and nutrition services. Our field experience in Odisha indicated that caste-based discrimination limits SC/ST communities’ access to government services.

Several studies including this 2009 report based on NFHS-3 findings point to caste-based discrimination in access to public health services and schemes related to food security of school children, leading to worse nutrition, health and mortality indicators among children from disadvantaged castes. In some cases, among children with similar education and standard of living, the health status of children from SC and ST communities is lower than that of their counterparts from higher castes.

The risk of anaemia is higher in disadvantaged castes and caste is an independent determinant of childhood anaemia, another study based on NFHS-3 findings suggests. The top 10 districts in India with the highest prevalence of stunting have a sizeable population of SCs or STs, indicating a correlation between social identity and prevalence of under-nutrition, a study based on NFHS-4 data found in May 2018.

India’s official data, however, do not adequately prioritise the role of social identity in achieving health and nutrition equity. Most robust datasets are either not asking the key questions around disaggregation or not releasing respondent or household level data in time, a research paper found in June 2014. The National Sample Survey, for instance, collected social identity data, i.e. on SCs and STs, on nutritional outcomes in its 68th round conducted between July 2011 and June 2012, but did not present the caste-disaggregated data in its survey report, the research paper noted.

Bureaucrats, nutritionists and planners have remained oblivious of caste-based barriers and other such social variables in nutrition, wrote Veena Shatrugna, former deputy director of the National Institute of Nutrition, a central government research institute in Hyderabad. She pointed out that the National Nutrition Monitoring Bureau (NNMB) report until 1990 was caste blind. When caste data first appeared in 1994, it did not provide a complete explanation for the nutritional status of SCs and STs.

Our own analysis of literature on the impact of social identity, specifically caste, revealed that the lack of data disaggregated by social group, e.g. religion and caste, constrains understanding of nutrition levels and their determinants among these groups.

Disaggregated data and COVID-19

The disproportionate impact of the COVID-19 pandemic on populations vulnerable on the basis of race across various countries was examined in a paper published in the International Journal for Equity and Health in June. The perspective from India, however, refers only to economic vulnerability to COVID-19, not inequality due to social identities such as caste.

The COVID-19 pandemic has induced a global nutrition crisis, straining healthcare systems and diverting resources from regular nutrition services (such as antenatal care, micronutrient supplementation and management of acute malnutrition) towards tackling COVID-19. Ensuring the availability and affordability of a nutrition-rich diet has become more difficult, with household incomes having fallen and more people pushed into poverty. In low and middle-income countries such as India, the pandemic’s effect on health and nutrition services could cause more maternal and child deaths, and greater prevalence of wasting, a study published in The Lancet in July cautioned.

(Saigal and Shrivastava are development consultants with IPE Global; their work focuses on improving nutrition equity and accountability.)

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Bengaluru: Workers in India’s rural jobs programme, the Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS), faced numerous delays and hurdles in accessing their wages, a three-state survey by transparency project LibTech India has found. Delayed payments had become so normal for workers that they did not see month-long delays to be a violation of their rights under the scheme, the survey noted.

MGNREGS workers’ perspectives on the nature of hardships faced in accessing wages, awareness of banking norms, access to information, grievance redressal under the scheme, transparency and accountability were captured in the ‘Length of the Last Mile’ survey of 1,947 workers in one block each of Andhra Pradesh and Rajasthan and two blocks of Jharkhand between September and November 2018. The report based on the survey was released on November 18, 2020.

Respondents had to make multiple visits to and wait for long hours at different disbursement agencies, spending between Rs 6 and Rs 67 on travel for each visit, said the survey. The multiple trips and long waits imply that workers had to forego further earnings in order to collect their MGNREGS dues.

Nearly 13% of surveyed workers reported rejected payments and most were unaware of the reason for rejection, meaning future wage payments to these individuals would continue to be rejected, according to the survey report. Yet only about 6.3% of workers whose payments were rejected registered a written complaint, of which nearly 60% said their complaint was not resolved satisfactorily, or at all. A robust grievance redress system could fix this, experts told IndiaSpend.

The 15-year-old MGNREGS scheme, which guarantees 100 days of unskilled work a year to every rural household, has about 140 million active workers. In a year of heightened rural distress, with abrupt job losses in the informal sector stemming from the nationwide COVID-19 lockdown, MGNREGS is falling short in helping residents tide over the economic distress, IndiaSpend had reported in August. Around 4.2 million rejected wage transactions in the current financial year remain pending for resolution.

Multiple visits and costs incurred over ‘the last mile’ to payment

Four types of MGNREGS wages disbursement agencies, i.e. banks, customer service points (CSPs; kiosks where customers access limited banking services), business correspondents (BCs; who travel with point-of-sale machines for small banking transactions) and ATMs were used by respondents. CSPs and BCs both require customers to authenticate transactions through Aadhaar-based biometrics. In Andhra Pradesh, workers could also withdraw wages from post offices.

Almost half of the respondents had to visit each type of disbursement agency multiple times to receive wages. Two in five workers had to make multiple visits to CSPs or BCs, which accounted for the least number of visits; 45% had to make multiple visits to banks. Making withdrawals from ATMs were the most bothersome, with more than half (55.3%) of respondents having to make multiple visits due to insufficient cash in ATM machines.

More than half of Andhra Pradesh respondents had to make multiple visits to any of the disbursement agencies, the most among all three states, with nearly three in four having to revisit CSPs or BCs for assistance due to biometric failure.

With each failure leading to increased visits, costs of accessing wages rose. The cost of travel to and from agencies was Rs 6 to the post office (in Andhra Pradesh), Rs 31 to visit a bank, Rs 11 to a CSP/BC and Rs 67 to an ATM, on average.

Similar issues of access for workers were noted in a February 2020 report by the Karnataka Evaluation Authority (KEA), when evaluating the impact of wage and material payments to MGNREGS beneficiaries through the electronic fund management system for five years to 2018-19 in eight districts. Problems of access increase the cost of transactions for workers, the KEA report had noted. “To add to the hardship the workers would often take the trouble to go by foot, or a vehicle to a kiosk only to find that ‘the [ATM] machine is out of order,’ ‘no cash available,’ ‘no electricity or power supply’, or that wage has not been credited,” said the KEA report.

“With postal payment banks, one can think of the benefits of accessibility of post offices for workers,” Sakina Dhorajiwala, co-author of the LibTech India survey report, told IndiaSpend. But there were many cases of post offices in Andhra Pradesh hoarding the money for disbursal for long periods, she said. While the cost incurred by workers to access wages from post offices seems to have been low, despite the multiple visits required, this mode also requires biometric authentication which posed the same problems of biometric failure as with the CSP model, Dhorajiwala added.

Long hours at various wage disbursement agencies

Among the 1,204 workers of the 1,947 surveyed who are bank users, it took more than four hours to access wages for about 42% of workers in Jharkhand and 38% in Rajasthan. This was significantly less in Andhra Pradesh, at just 2% of workers. Further, it took more than five hours to access wages from banks for 30% of workers in Jharkhand.

Banks are usually located at the block headquarters and thus tend to be crowded, the survey noted. Despite the long hours taken, around 80% of bank users surveyed preferred banks as these were felt to be more secure, coupled with offering the full range of banking services, such as updation of passbooks.

Less time was taken for transactions at CSPs or BCs, and there was less crowding than at banks, the survey found. However, most workers still had to wait for at least an hour at CSPs and BCs. In Andhra Pradesh, 50% of CSP and BC users took more than an hour to access wages, while those in Jharkhand and Rajasthan took more than two hours to access wages. The experience was worse for around 30% of respondents in Jharkhand and Rajasthan, who took more than three hours to access wages at CSPs and BCs.

The multiple visits coupled with long hours taken at disbursement agencies imply that workers had to forego more work and wages to withdraw their dues. The MGNREGS wage rate for Andhra Pradesh, Jharkhand and Rajasthan at the time of the survey in 2018-19 was Rs 205, Rs 168 and Rs 192, respectively. This was revised to Rs 237, Rs 194 and Rs 220 in 2020-21.

Systemic problems in rural banking affecting MGNREGS payments

After 2014-15, MGNREGS workers’ Aadhaar numbers were seeded with their job cards and bank accounts to transfer wages, with Aadhaar-based biometric authentication needed for withdrawals at some disbursement agencies, as mentioned.

This created technical challenges for some workers in accessing wages, including missing names in muster rolls, mismatch of names in job cards and bank accounts or Aadhaar numbers, said Sunny Bhagat, an independent researcher who works on MGNREGS-related issues in Jharkhand. “In 2016, large numbers of Aadhaar linkages [to bank accounts] were made as per [Jharkhand] state government’s norms, which led to errors of such nature [mismatch of names],” Bhagat told IndiaSpend.

Around one in three respondents in Rajasthan said they had faced difficulty getting their Aadhaar number linked with their bank account, as did one in five in Jharkhand and one in 14 in Andhra Pradesh. About 40% of CSP and BC users reported having faced biometric authentication failure at least once in the last five transactions.

Such banking-related hardships are not restricted to the three states surveyed by LibTech India. In 2018, all MGNREGS workers did not yet have bank accounts linked with their job cards, and less educated or less informed workers depended on “Banking Middlemen, to assist them to make a transaction in the bank or at the ATM kiosk”, the KEA report had noted.

Privately-run Common Service Centres (CSCs) that provide online government services including banking for a fee across rural India, are also failing to deliver, according to a survey in Jharkhand, IndiaSpend reported in November 2019. CSCs tend to overcharge customers for services such as banking through Aadhaar-enabled payment systems, we reported. Here too, workers needed to make multiple visits due to biometric failure, lack of network connectivity and electricity.

These problems with rural banking have not changed much since the LibTech India survey in 2018, and COVID-19 lockdown restrictions have only exacerbated the situation in banks that were already crowded, said Dhorajiwala.

In 2014, a Reserve Bank of India-appointed committee had recommended that electronic payment access points be made available for all within 15-minutes’ walking distance by 2016. The “urgent need to increase bank branches in rural India” was also highlighted in the LibTech India report in 2018. Yet around 40% of Jan Dhan account holders could not access the government's COVID-19 relief, IndiaSpend reported in June, with limited access to banks in rural areas cited among the most common gaps in last-mile connectivity.

Payment rejection and lack of accountability

A total of Rs 7.19 lakh remained unpaid to 249 respondents (nearly Rs 2,900 per worker, on average) due to rejected payments at the time of the LibTech India survey. About 89% did not know the reason for rejection of their wage payments, and thus did not know how to rectify it. Without rectification, however, future MGNREGS payments to these workers would continue to be rejected, according to the report.

Workers must receive payments within 15 days of the closure of muster rolls under MGNREGS guidelines, but the process of resolving rejected wage payments is unclear and may take months to be fixed, said the LibTech India report. Further, “the onus of identification of the problem and rectification falls entirely on the worker for no fault of theirs”, said the survey report. Field functionaries such as assistants at the panchayat level and other MGNREGS field staff “did not seem to have clarity about” rejections, the report added.

In the five years to July 2020, about Rs 4,800 crore worth of payments were rejected and about Rs 1,274 crore worth were still pending to be paid to all MGNREGS workers, the report noted. As of November 30, 98.2% of payments have been made within 15 days for financial year 2020-21, per government data.

Rejected MGNREGS payments consist of approved ‘fund transfer orders’ (FTOs) to workers’ accounts that have failed due to technical errors in the payment system. These include data entry errors by the local administration (incorrect bank account or Aadhaar number entered), bank account-related issues (dormant, joint or closed accounts), Aadhaar-related (delinking of Aadhaar from bank account due to mismatch of names, etc). Each type of error throws up a particular error code in the MGNREGS Management Information System (MIS). The total rejected FTOs pending resolution in 2020-21 are 4.2 million.

Computer operators at the block level understand the meaning of different error codes displayed in the MGNREGS MIS, according to the survey. With the move to digitisation, however, “computer operators [have] become quite powerful making it hard for workers to reach out to computer operators”, said the report. Often, one computer operator at the block level is shared between multiple panchayats, which creates a human resources problem, Padma Bareddy, project manager, Anode Governance Lab told IndiaSpend. Computer operators also have to escalate some of the issues to a higher level, as there are different MIS user roles at the state, district and panchayat levels, added Bhagat.

Technology does not work in silos and is enabled by the principles used in its design, said Dhorajiwala, adding that agencies that design Aadhaar-centric platforms, for instance, are not accountable to people. “These platforms are opaque and do not consider the context of the state--like electricity and network challenges,” she said.

Most panchayat functionaries who oversee MGNREGS work and wage payments are not capable of resolving technical issues on their own due to lack of training, Bhagat told IndiaSpend. “They tend to escalate technical problems to the MGNREGS cell [at the state level in Jharkhand] or other relevant authorities. Ideally, these issues should be resolved at the panchayat level,” he added. “If panchayats are provided adequate resources and training, they are capable of taking ownership,” said Bareddy.

There are also non technical reasons for delayed MGNREGS payments and arrears. Wage payments were frozen in 19 states in the past due to delayed audits and approvals by governments, IndiaSpend reported in November 2017, the year preceding the LibTech India survey. “The absence of signatories in office when required, mismatch between the account particulars and what was stated in the wage bills, and the delay in preparation of wage bills by the team leaders” were also noted by the KEA report in 2018.

Delays ‘normal’ for workers, grievance redressal inadequate

Of 1,947 workers surveyed, 546 communicated complaints and 79% of these related to pending wages or partial wages received, said the LibTech India report. Here too, added costs of making follow-up trips to the panchayat to resolve complaints were incurred by some workers. About 94% of complaints were made verbally, for instance to panchayat officials, and 6% were filed in writing. Only about 6.3% of workers surveyed whose payments were rejected registered a written complaint, and nearly 30% said they had a complaint but did not register it. Nearly 60% of those who had complained said it was not resolved satisfactorily, or at all. Verbal complaints, however, have “no official bearing and therefore it is equivalent to not filing it at all”, the report noted.

One problem in registering grievances is that delayed payments have become so normal for workers that they do not see months-long delays to be a violation of their rights under MGNREGS, the report noted. Given that workers do complain verbally, there is reason to believe that if a robust and working grievance redress system is created, more workers would file complaints, said Dhorajiwala.

Often the people who implement MGNREGS are the same people who have to be approached to address the problem, making for a weak grievance redressal system, according to the report. For instance, if a worker is not provided employment within 15 days of receipt of application, they are entitled to a daily unemployment allowance, according to the 2019-20 annual master circular for MGNREGS. The compensation, if delayed, can be “recovered from the functionaries/ agencies responsible for the delay”, says the circular. “If the block has to pay unemployment allowance from their pockets, it is unlikely that they will ever approve the claims of MGNREGS workers for unemployment allowance,” Dhorajiwala cautioned.

Governments must ensure that workers are made adequately aware about their rights from work demand to payments at the panchayat level, the report said in recommendations on the way forward, and also pushed for MGNREGS information system design that is “worker centric”. Pointing to a need to make all agencies that design and develop technological solutions for MGNREGS accountable for delays, all “payment intermediaries like Unique Identification Authority of India [manages Aadhaar], National Payments Corporation of India [manages digital payments and settlement], Public Financial Management System [tracks funds released under all central government plan schemes] and Common Service Centres must be brought under the ambit of social audits as a start”, said Dhorajiwala.

(Paliath is an analyst with IndiaSpend.)

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Bengaluru: “It is more about the changes in the ‘social contract’ between the farmers and the Union government that is the root cause of fear,” said Sukhpal Singh, professor and former chairperson, Centre for Management in Agriculture at the Indian Institute of Management, Ahmedabad, on why farmers from Punjab and Haryana, among others, are protesting the three new farms laws passed by India’s Parliament.

The Farmers’ Produce Trade and Commerce (Promotion and Facilitation) Act, 2020 (FPTC), the Essential Commodities (Amendment) Act, 2020, and the Farmers (Empowerment and Protection) Agreement on Price Assurance and Farm Services Act, 2020 (FAPAFS) were passed during the monsoon session of parliament during the COVID-19 pandemic.

Thousands of farmers are at the outskirts of the national capital as they march to Delhi to demand the repeal of these laws. One of the reasons farmers are protesting is because they think that they were not consulted before making these far-reaching changes and that the central government is governing issues that are under the states’ domain, said Singh.

Farmers think these laws may affect the procurement of foodgrains under the minimum support price (MSP), which guarantees a minimum price for some of the agricultural produce bought by the government, Singh said. The government procures large quantities from Punjab and Haryana. But making MSP a ‘legal right’ isn’t the solution, according to Singh. Such a law will “kill” the agricultural market in a state because if private buyers are mandated to buy at a government-set MSP, they might look for cheaper costs elsewhere, Singh explained. 

What is needed, instead, is a range of pre-production support (like seeds, fertilisers, credit, machinery) and post-production aggregation (marketing and selling through farmer collectives), he said. The government must also invest in warehousing and cold storage to reduce forced sales because of a lack of storage. 

Singh was a member of the working group on disadvantaged farmers and the working group on agriculture marketing infrastructure of the erstwhile Planning Commission in 2011. He was also a member of Punjab’s expert committee to formulate policy for development and promotion of Farmer Producer Organisations (FPOs)--producer organisations where primary producers like farmers are members. 

In an interview, Singh spoke to IndiaSpend about the impact of the new laws,  Agricultural Produce Market Committees(APMC), issues with contract farming, the problems with an MSP for private players and the power of arhtiyas or commission agents within an APMC. Edited excerpts:

Farmers from across the country, led by those from Punjab and Haryana, are protesting against the three farm laws. Why is there such a strong opposition from farmers, particularly in these two states? What are the main issues?

First, there was perhaps inadequate consultation with stakeholders, i.e. farmers, traders and policy experts, as ordinances were brought in and then Acts were passed during the pandemic. 

Second, in some states, there is a feeling that the Centre is trampling on the domain of states by making laws on state subjects particularly with respect to contract farming, which has more to do with farming [which is on the state list] and less with marketing [since activities such as production, trade, supply and distribution of raw agricultural produce are on the concurrent list, governed by both the states and the Centre]. It seems that the Centre was not able to convince states to open up agricultural markets as quickly and as much as it had planned to, since the early 2000s, else it would not tread into a matter that was in the states’ domain. States were reluctant to make reforms, and therefore this route was taken.

Thirdly, Punjab will lose revenue (6%, including 3% mandi fee and 3% rural development fund cess) as no tax can now be imposed on farm produce transactions in new trade areas outside the APMC or mandi. Punjab has been earning nearly Rs 4,000 crore annually from mandi taxes and cesses.

Fourth, commission agents or arhtiyas in Punjab get 2.5% commission, which is around Rs 1,500 crore annually. Once new trade areas develop, the market may not require the commission agents. Even if buyers go through these agents, their commissions will fall drastically.

More importantly, in Punjab, Haryana and some of the north Indian states, there is an interlocking of the credit and produce market, where arhtiyas lend to farmers and recover [the loan] from the sale of [the farmer’s] produce. The state government has been facilitating this because payments by procurement agencies like the Food Corporation of India (FCI) are made (in Punjab) to arhtiyas, and not directly to farmers. Direct payments to farmers instead of routing them through these agents has been an issue in the state for more than a decade now. Central agencies were keen to pay [the farmers] directly but the state government did not support it. It is only during this kharif season, for the first time, that the CCI [Cotton Corporation of India] has bought cotton directly from farmers and has not not paid commission to arhtiyas. Even under the amended state Agriculture Produce Marketing (Regulation) Act, 2017, for which rules were framed in 2020, [the government] makes payments to farmers only indirectly through the arhtiyas. The act also allows some cash payments [upto Rs 10,000] to farmers by the arhtiya.

Further, farmers are agitated about these Acts due to their potential procurement and MSP linkage. The fear comes from some previous documents like the Shanta Kumar Committee report and the Commission for Agricultural Costs & Prices (CACP) reports, which suggested reduced procurement to cut down costs of the FCI and an end to open-ended procurement from states like Punjab where most of the grains are bought by the FCI. It is feared that the FCI itself may start procuring directly from the new trade area to cut down its buying costs like market fees and arhtiya commission. It is more about the changes in the ‘social contract’ between the state’s [Punjab’s] farmers and the Union government that is the root cause of fear.

There is a fear that Farmers' Produce Trade and Commerce (Promotion and Facilitation) Act, 2020, would expose farmers to price fluctuations of the open market. There is also a demand for a law in the country to make MSP mandatory. Farmers have long been demanding that the MS Swaminathan Committee recommendations on the MSP be implemented. How does the new law impact MSP, and is it possible to make a law on the MSP mandatory?

States like Punjab do not get many private buyers as the government procures most of the produce (wheat and paddy). Farmers feel that if the FCI moves out of the APMC to avoid paying commission to the arhityas and the market fees/cesses to the state mandi board, mandis will collapse as arhtiyas would also move out of mandis.

The demand for legal backing to MSP comes due to the fact that the government has been announcing MSP for 23 crops but procurement is limited to a few crops and a few states only, and farmers in most states (with the exception of Punjab and Haryana) end up selling below MSP, even major crop produce like paddy and wheat. Also, CACP in one of its reports in 2017-18 (kharif) suggested that “to instill confidence among farmers for procurement of their produce, a legislation conferring on farmers ‘The Right to Sell at MSP’ may be brought out”.

I am not convinced about the demand for MSP as a legal right. If a private player decides that they will not buy at MSP and rather import agricultural produce, and the FCI decides to not procure for various reasons mentioned above, where will the farmer sell? Punjab’s amendments to the farm acts making MSP mandatory are ill-advised, as this law will kill their own market, and discourage private buyers from buying.

Even though Punjab has made a law against selling wheat and paddy below MSP, how does the state know if a farmer has been forced to sell below MSP? It is difficult to enforce such a law. Agricultural markets cannot be run through such diktats. A farmer is desperate to sell and does not want to/cannot store produce or take it back after bringing it to the market yard. So, he would end up consenting to selling at below MSP.

Currently, selling in the private market is the last option for farmers, where public procurement does not take place, and by creating stringent rules (fine or imprisonment), the government [of a state] may create a situation where no sale can be made of the farm produce by the farmer. Maharashtra made a similar provision in 2018 in their APMC Act but had to reverse it after protests by traders.

It is important to realise that MSP is a political or administrative promise, or decision, made by the government to farmers. Why should a private player be tied to it and be penalised?

On the other hand, when the government is trying to liberalise and open the market to encourage private buyers, then it cannot at the same time mandate at what price they should buy (not below MSP in this case).

The FPTC Act 2020 allows farmers to trade outside of mandis. Can you explain, historically, how the mandi system, meant to protect farmers, ended up in a state that experts like yourself have said that “it is a ripe time to abolish the system of arhtiyas”?

Currently you have many stakeholders, such as cooperatives, primary agricultural credit societies, farmer producer companies etc., who can step in and help farmers sell to state and private agencies and there is no need to rely on arhtiyas for it. Madhya Pradesh had abolished the arhtiya system in the 1980s itself and buyers have been buying directly from farmers since then.

Overnight, after these new Acts, arhtiyas are being called service providers. Some others term them as a ‘necessary evil’. Arhtiyas became powerful because of the high cost of modern agriculture when institutional credit and finance was not adequately available to small and marginal farmers. Even now, 30-35% of farm loans are from informal sources like arhtiyas, especially for many small and marginal farmers. Due to this, there has been an interlocking of the credit and the produce market. At the same time, some reports suggest, in states like Punjab, there is over-financing of the farm sector.

The arhtiyas only get a license to facilitate purchase and sale of agricultural produce, and other aspects of their business like lending are informal and illegal. There is no monitoring of their activity. In some states, they overprice inputs, underprice produce and charge high interest on loans. Many not only have a license to buy produce but also have large agro-industrial interests beyond APMCs but tied to the APMC. Unless farmers are provided institutional finance access adequately, they will depend on these agents. Therefore, solutions to their marketing problems lie outside of markets.

How do you assess the role of APMC and what impact do you see due to the new law?

Madhya Pradesh has reduced the mandi tax to lower the buyer’s cost of purchase, and government bodies (like the Niti Aayog) have advised the same to other states so that buyers continue to buy from APMC mandis. But, in a state like Punjab, where buying costs are high, mandis will find it difficult to compete with new trade areas. Buyers, and even government agencies, may move out to new trade areas if buying charges are not reduced.

The APMC will lose if there is no level playing field. So, arhtiyas are up in arms and farmers are protesting around MSP procurement. Arhtiya interest should not really matter to policy if the intention is to help farmers realise better prices. Arhtiyas have other businesses to rely on and would find new roles sooner rather than later in new trade areas or other market channels.

With contract farming, although the farmers are allowed to engage with private players, how strong is the grievance/dispute redressal mechanism for the farmers? Can farmers take on big agricultural conglomerates independently given that clauses of the FPTC Act 2020 stipulate that the cultivator be paid within three days of the trade? Is it practical to approach a district magistrate for dispute resolution? What is the ideal mechanism when disputes arise?

Contract farming, as practised in India, across crops and regions, has shown that marginal and small farmers are generally excluded and there are many malpractices against farmers. These include one-sided (pro-contracting agency) contract agreements, delayed payments, quality-based undue rejections and outright cheating, besides poor enforcement of contract farming provisions by state governments. Therefore, a robust contract farming act to regulate it was needed.

In the 2003 model APMC Act, the APMC was supposed to resolve disputes. This was a better system because the farmer knew and was familiar with the Committee members and functionaries. Further, when a license is given to a trader or commission agent, there is a counterparty risk assurance. If there is an issue with payment to farmers, the committee takes note and tries to resolve it.

In states like Karnataka, Gujarat and Maharashtra, there are elections for office bearers of the APMCs. Representatives of traders, commission agents, farmers, cooperatives and the government stand for elections. So, the argument that mandis are a monopoly and exploitative is not entirely true. At the same time, Punjab has not had an election for APMCs in nearly 40 years. They only nominate chairpersons and members.

Now, in the new trade area [that the law will create], there is no authority to provide counterparty risk. Anybody with a PAN card can buy agricultural produce, which seems to be a free-for-all situation.

I think the government must go back to the 2003 Model APMC Act, which had a model contract agreement with mandatory and optional provisions in a contract. The way production agreement is defined in the new Act is leading to fear among farmers about contract farming being more about corporate farming. This is despite the Act clearly saying that farmland cannot be leased, mortgaged or bought by the contracting agency. Farmers are also worried because the law does not discuss what happens when companies cancel contracts or there is delay in deliveries by farmers, etc.

The other problematic aspect of the Farmers (Empowerment And Protection) Agreement on Price Assurance and Farm Services Act is that it says the sponsor would also pay, besides the minimum guaranteed price, a premium or bonus which will be linked to the APMC or e-trading price. This goes against the very concept of contract farming. The contract price should be left to the contracting parties to decide. Further, if the understanding is that mandis are not discovering prices well, then why peg contract price to such a price? The contract farming Act leaves out many sophisticated aspects of contract farming.

How would these new “liberalisation” laws affect the small and marginal farmer?

Unfortunately they are not part of contract farming as contracting agencies do not find them attractive enough to be engaged. The policy should have created a provision for group contracts and incentivised it. Further, the Act has defined FPOs [Farmer Producer Organisations] as farmers, which restricts them to supply side only. This has given a rudimentary treatment to FPOs instead of ensuring that they can also take up contract farming (which some FPOs are doing in any case). Hardly any FPO is into farm production. So, treating them as farmers is not a good aspect of this Act.

For small and marginal farmers, the mandi was the last resort for sale. If APMCs are reduced in importance, they will lose more rather than gain unless more of them are organised into FPOs and become attractive to private agencies for contract farming or direct purchase.

A 2019 study by the National Council of Applied Economic Research in Bihar noted that despite abolishing the APMC Act in 2006, there was lack of private investment in the creation of new markets, and strengthening of facilities in the existing ones, “leading to low market density”. What happened there?

Investments do not come due to a change in law, but due to incentives. Bihar only deregulated the market instead of reforming. Incentives are about infrastructure and supporting policies, which did not happen [in Bihar]. There could have been more investments in APMC and private markets even in public-private mode and better governance of APMCs to allow new buyers to procure directly. The APMC structure has collapsed in the state with procurement and purchase centres falling. Farmers are paying a commission in privately held mandis unlike in a regulated market. Farmers have not benefited from it other than the fact that the new local, private, informal markets are closer to farmers but not necessarily likely to stick around for long.

The prime minister has said that “new rights have begun to ameliorate the woes of our farmers”, but the farmers are agitating against the three laws. What revisions would you suggest to improve the farm laws? How can India achieve better incomes for farmers?

There are many provisions in both the acts [the FPTC and FAPAFS] like the definition of a trader and an FPO, dispute resolution and creation of temporary structures on farmer land, additional contract price linkage to APMC price and such other provisions which need to be reconsidered to protect farmer interest in the Contract Farming Act so that both parties find it smooth to transact and deal with each other as per rules.

To double farmers' income, farmers need to be collectivised (like in FPOs). This is the only way small and marginal farmers can deal with modern, large buyers. We do not need to meddle with production aspects as small farmers are quite efficient. We need pre-production (like seeds, fertilisers, credit, machinery) and post-production aggregation [marketing and selling through FPOs, etc]. The government needs to invest in warehousing and cold storage to reduce distress sale as we have warehouse receipts Act under which they can get loans against stored produce.

(Paliath is an analyst with IndiaSpend.)

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The new farm laws that aim to double farmers’ income in two years by deregulating agricultural markets may further widen the inequalities in the sector, shows our analysis of similar legislations from the past. By weakening the government’s price guarantee system, the laws may end up hurting small and poor farmers, who form 80% of the sector and 23% of those who live below the poverty line, say critics.

The privatisation of the sugarcane industry in 1998 and the deregulation of Bihar’s Agriculture Produce Market Committee (APMC), the state-regulated marketing board, in 2006 removed licensing barriers to agricultural markets. But, as we explain later, this privatisation led to no significant changes--the sugarcane farmers are still agitating for fair and timely payment of dues and Bihar’s agricultural infrastructure has not seen any sizeable private investment.

The ongoing agitation in Delhi by farmers and farmers’ unions from across India, especially from Punjab and Haryana, seeks to pressure the Centre to withdraw the laws. Their primary demand is for a statutory minimum support price (MSP), and their main objection is to the opening up of agricultural sales and marketing beyond regulated APMC mandis (government-approved wholesale markets). This, they believe, will kill the mandis and allow exploitative private players to set the terms of purchase from farmers.

The weakening of the established mandi system could further weaken the already floundering system of assured procurement at MSP set by the government, farmers argue, since only two crops--wheat and rice--are procured at MSP by government agencies (and 21 others for which the government announces an MSP are not).

These changes will affect the small farmers the most because their low output does not allow them any bargaining power. Small and marginal farmers tend to get lower prices for their produce than big agriculturists. The income of the farmers with the largest land-holdings rose from seven times that of those with the smallest land-holdings in 2002-03 to nine times in 2012-13, a 2015 study by NABARD showed.

The lack of land reforms and unassured markets were some of the major reasons for farm distress in India, said the 2006 Swaminathan committee report. Without land reforms to reduce the widespread disparities in land holdings, the new laws will not help remove income inequalities.

By contrast, China profited from liberalising its market starting in 1978, by taking small steps: first by reducing control on agri products and simultaneously maintaining control on other farm input institutions; transferring land rights to farmers; bringing in price and market reforms; and setting up rural credit cooperatives.

Farmers’ concerns

The three laws are aimed at enabling barrier-free trade in agriculture and empowering farmers to trade with buyers of their choice, said Narendra Singh Tomar, the Union agriculture minister. They are: the Farmers' Produce Trade and Commerce (Promotion and Facilitation) Act, 2020, The Farmers (Empowerment and Protection) Agreement of Price Assurance and Farm Services Act, 2020 and The Essential Commodities (Amendment) Act, 2020.

The new laws affect the farmers of Punjab and Haryana more because over 65% of wheat (2019) is procured from these states at MSP by the Food Corporation of India (FCI), the nodal government agency, along with other state agencies. These states and their farmers benefit the most from the current system. (The government declares MSP for 23 crops, and government agencies procure wheat and paddy at MSP. Crops such as lentils, cotton and oilseeds do have MSP, but they are not procured by government agencies. The prices of other crops are determined by domestic and international demand-supply factors.)

It is the farmers who bank on the APMC-MSP model who are most affected by the new laws. For them, the removal of barriers takes away all protections--of an assured price, of dealing with licensed agents, and of dispute settlement by the mandi. Mandis also provide important services such as storage and soil-testing facilities.

“Even with an MSP, the prices received are always less because the produce is sold to middlemen or private players,” said Rajesh Kumar, 54, who raises mustard, lentils and other vegetables on a 3.5-acre plot in Hathras in western Uttar Pradesh. With the entry of the private sector in agricultural markets, the small farmers’ limited knowledge of price dynamics can be easily exploited, he said.

A free market in agriculture could be problematic on multiple counts, according to V.M. Singh, convenor of the All India Kisan Sangharsh Coordination Committee. Farmers growing crops under the contract farming model, for instance, complain that private buyers make unfair and unrealistic demands on quality, often paying less or rejecting entire lots using quality issues as an excuse. Also, fragmented landholdings skew the game against small farmers, Singh said.

On the other side are farmers growing non-MSP crops, such as Manish Pandey, 45, who raises vegetables on his 24-acre farm in Haryana’s Fatehabad district, for whom the new laws mean little. He sells his produce to corporate and cooperative chains such as Reliance Retail, Mother Dairy and Udan Agri Retails. Under earlier laws, these companies had to secure a mandi license to procure his products, but under the new farm laws, that will not be necessary.

Corporate buyers have welcomed the changes. For example, before the legislation came into play, the wood from plantation crops such as Eucalyptus, Subabul and Casuarina was liable to a 1-3% mandi cess by the central government. This has been abolished under the new laws. This reduction in cess and handling/ transportation cost--buyers can now pick up their consignments directly from the farmer--will benefit both farmers and industries, said Suneel Pandey, vice-president of ITC-Paperboard and Speciality Paper Division, who procures plantation wood from farmers through aggregators.

Supporters of the new laws say the APMCs have a poor presence across the country, and they procured only 13.5% of the paddy harvested in 2013, as per the 70th Round of the NSSO (National Sample Survey Office) Survey on the Key Indicators of Situation of Agricultural Households. Only 6% of all farmers in the country gained from selling wheat and paddy directly to any procurement agency, noted the Shanta Kumar Committee Report on reorienting the role and restructuring the FCI in 2012-13.

Lessons from the past: Sugar

India’s sugarcane industry was delicensed in 1998, paving the path for private establishments to increase exports of sugar and overcome shortcomings such as low production and productivity even in favourable weather conditions. Sugarcane’s contribution to the agricultural GDP has risen from about 5% in 1990-1991 to 10% in 2010-2011, but deregulation did not result in any significant rise in the farmers’ incomes. Productivity levels are still not optimal: The current average sugarcane productivity is around 70 tonnes per hectare--lower than in Brazil, Colombia and China, e.g.,--with huge geographical variations, leaving much scope for improvement.

Sugarcane farmers have long agitated for better price realisation and timely payments. Also, the contribution of private sector sugar mills to public infrastructure development remains low due to their pursuit of profit, research has documented.

Fair and Remunerative Price (FRP) is a minimum price that farmers get from the sugarcane procurement agency of their region. The Commission for Agricultural Costs and Prices (CACP, a body that makes recommendations for MSPs), in association with the state governments, and in this case, sugar mill owners and traders, calculates and recommends the FRP. Apart from this price, state governments also announce a State Advisory Price (SAP). This has not worked very effectively, and the mills blame poor quality cane for lower prices.

“The privatisation of the mills has not secured us the right price of the sugarcane. Even with the FRP in place, we are either paid late or less,” said Vibhuti Narayan, 26, who assists his father on a seven-acre sugarcane farm in Amethi village of Lakhimpur Kheri district in eastern Uttar Pradesh. Sugarcane is the primary source of income for most farmers in Narayan’s village.

At traders’ mercy in Bihar

In a state-led attempt to liberalise the agricultural market, APMCs were deregulated in Bihar in 2006. By 2010, farmers in the state were facing high transaction charges from private buyers and were hamstrung by the lack of information about the right prices, a committee of state ministers reported that year.

Businesses tend to undertake buying only when it is profitable, as P. Sainath, journalist and founder of People's Archive of Rural India, explains in this video on why privatisation of Bihar’s agricultural markets has not increased farmers’ income or improved infrastructure.

The private sector did not develop the infrastructure necessary for the procurement of agricultural produce in the state and with time, existing public sector facilities deteriorated, according to a November 2019 report by the National Council of Applied Economic Research. This reduced the density of mandis and left the farmers at the mercy of private traders who often fixed low prices.

Bihar’s agro-processing industries do not have enough infrastructure--warehouses, for example, which are few and expensive. Due to unstable crop prices and a weak market structure, crop diversification is poor--three crops (paddy, wheat and maize) constitute over 70% of the total cropped area in the state.

A Niti Aayog task force report on agriculture in Bihar, released in 2015, described the abolishment of its APMC mandis as a “bold” move, but one undertaken without setting up adequate cold storage facilities. It had also left farmers in the area with few options than to sell to private buyers, the report said. The Standing Committee on Agriculture (2018-19) recommended that the six states that do not have APMC markets should create the infrastructure for better price realisation. This would include provision of inputs, machinery and cold storages; better banking and credit services as well as price information; roads and transport facilities to encourage agricultural trade; weather updates, and so on.

How farm reforms could be done right

The farm laws have been supported by economists such as Ashok Gulati, who has compared their initiation to the liberalisation of the Indian economy in 1991, which opened up the economy for the private sector and for foreign investors. Competition would result in more market options for farmers, he says.

But there is conclusive evidence, such as in this report, that liberalisation has led to increased inequalities. The increase in the income of the top 1% of Indians is significantly higher than that of the bottom 50% in the country’s income index. A sharp increase in wealth concentration from 1991 to 2012, particularly after 2002, is commented on by Thomas Piketty, scholar and author of Capital In The 21st century.

There are lessons from India’s past experience of deregulating the farm sector. “Investments do not come due to a change in law, but due to incentives,” Sukhpal Singh, professor and former chairperson of the Centre for Management in Agriculture at IIM, Ahmedabad, told IndiaSpend in this interview. “Bihar only deregulated the market instead of reforming.” Incentives would include infrastructure and supporting policies to, for instance, enable small farmers to create FPOs (farmers producer organisations) and become attractive to private agencies for contract farming or direct purchase. To enable farmers to participate meaningfully in the market economy, they need widespread availability of pre-production inputs (such as seeds, fertilisers, credit and machinery) and post-production aggregation (such as for marketing and selling through FPOs), he added.

(Mandal is an independent journalist and focuses on development, sustainability, agriculture and green growth.)

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New Delhi: India saw the second highest number of heat-related deaths in the world among those over 65 years of age in 2018. At an estimated 31,000 deaths, India was right behind China which had an estimated 62,000 deaths, as per a new report.

Heat stress, heat strokes and their impact on existing cardiovascular and respiratory diseases claimed 296,000 lives of those over 65 years of age across the world in 2018, said the fifth edition of the Lancet Countdown on Health and Climate Change report published in The Lancet on December 3, 2020. This crisis was observed in both big and small economies indicating that wealth cannot shield countries from the health impacts of climate change.

The Lancet report termed its latest findings as “the most worrying outlook” observed since the inception of its Countdown series in 2016. It noted productivity losses equivalent to billions of working hours; increasing intensity of wildfires and droughts; and rapid transmission of diseases such as dengue and gastrointestinal infections as potential dangers.

The elderly have been increasingly exposed to high levels of heat since the early 2000s, and globally, fatalities caused by heat in those above 65 increased by 53.7% over 18 years to 2018, the report said. The reason is a combination of increasing instances of heatwaves and ageing populations.

The COVID-19 pandemic has shown that a global health crisis can bring entire countries to a standstill and without urgent action, climate change too can cause similar damage to lives and livelihoods, the report said. Just like the ongoing pandemic, climate change can overwhelm healthcare systems across the world.

Whether the world can limit global temperature increase to below 2°C will depend on how countries deal with the post-pandemic recovery, the report said--by aligning both climate and pandemic recovery, the world can deliver near-term and long-term health benefits. A green recovery requires that countries invest in climate-friendly projects that reduce/avoid fossil fuel use and promote clean transport, buildings and so on.

“The threats to human health are multiplying and intensifying due to climate change, and unless we change course, our healthcare systems are at risk of being overwhelmed in the future,” said Ian Hamilton, executive director, Lancet Countdown.

Yet, countries have been slow in factoring climate change fallouts into national health plans. Half of the countries surveyed for the report (51 of 101) have developed national health and climate change strategies. Financing still remains a challenge: Of the 45 countries that have plans to tackle climate change impacts and the funding needed for it, only four (9%) reported availability of adequate national funding to fully implement such strategies, the report found.

India’s approach to heat and related mortality has similar shortcomings, IndiaSpend reported on June 16, 2020. Heat-related deaths are under-reported in India due to its medical practices and its adaptation strategy is underfunded, we found.

The annual average temperature in India has risen by 2°C over 200 years till 2006. It is predicted to rise further by 0.6°-2.4°C by 2030. Within 50 years, 1.2 billion people in India would live in areas as hot as the Sahara, if greenhouse gas emissions keep rising. India’s poorest and most underdeveloped areas are the most vulnerable to heat waves. The country is set to lose millions of working hours in agriculture and construction sectors.

Millions of working days lost

While most deaths were reported from China and India, other countries too dealt with fatalities in the thousands--Germany (around 20,200), the US (neary 19,000), Russia (18,600), and Japan (around 14,200), the report estimated.

The last two decades have seen a 54% increase in heat-related deaths in older people globally, with a record 2.9 billion additional days of heatwave exposure affecting those over 65 years in 2019, it said.

Other than mortality, rising heat also has significant, direct implications for a country’s economic output and livelihoods--heat is increasingly affecting people’s ability to work outdoors in developing regions, the report found. For instance, in 2019, the world lost a total of 302 billion work hours due to heat--that is, about 40 hours for every person on the planet and 100 billion more than in 2000. India and Indonesia were among the worst-affected countries, losing potential labour capacity equivalent to 4-6% of their annual GDP (gross domestic product).

India is projected to lose 5.8% of working hours in 2030, a productivity loss equivalent to 34 million full-time jobs, either because it would be too hot to work or because workers would have to work at a slower pace, particularly in agriculture and construction, IndiaSpend reported on June 16.

For India, the impact of heat stress is not limited to sectors where employees are directly exposed to sunlight. Small industries, such as cloth-weaving units, which cannot afford air-conditioning, are also vulnerable to production losses due to temperature rise, found a 2018 study by the Energy Policy Institute, a think tank at the University of Chicago (EPIC).

For every 1°C rise in temperature beyond 27°C on a hot day in India, productivity of workers drops by as much as 4%, said the EPIC study.

More wildfires, droughts and disease

The changing climate has downstream effects, impacting broader environmental systems, which in turn harm human health, the report said. Heat and droughts are also driving up wildfires, for example. Since the early 2000s, 128 countries have experienced an increase in population exposure to wildfires resulting in burns, heart and lung damage from smoke, and the displacement of communities. The US has seen one of the biggest increases in this disaster.

Based on current populations, between 145-565 million people face potential inundation from rising sea levels. Global food security is threatened by rising temperatures and increases in the frequency of extreme events: global yield potential for major crops declined by 1.8-5.6% between 1981 and 2019, said the report.

Changing climate patterns are also impacting the transmission of various diseases: Since the 1950s, disease transmission capacity has been growing rapidly, with a 15% increase for dengue in 2018, and regional increases for malaria and vibrio bacteria causing foodborne infections.

COVID-19 and climate change

COVID-19, a zoonotic disease whose roots can be traced back to environmental degradation, brought the world to a standstill in 2020, killing millions and exposing the holes (here and here) in the healthcare systems of several countries.

The health harms of climate change are compounding the impacts of the pandemic. Wildfires, cyclones, heatwaves, floods and other extreme weather events have affected communities (here, here and here) at the same time as the pandemic. Without urgent actions to mitigate and adapt to climate change, its health impacts are set to worsen, potentially overwhelming facilities. But the world does not have the luxury of tackling one crisis at a time.

“Addressing climate change is a powerful way to reduce the risk of future zoonotic pandemics,” said a Lancet editorial published alongside the new report.

The recovery from the COVID-19 pandemic offers a key moment to act on climate change. A joint response that addresses all the crises, including the pandemic and the threat to the environment, would help improve public health, create a sustainable economy, and protect the environment.

Green recovery

The anniversary of the Paris Agreement falls on December 12, 2020, and countries are set to update their national climate commitments that come up for review every five years. The next five years can be critical: To reach the 1.5°C target and limit temperature rise to “well below 2°C”, the 56 gigatonnes of CO2 equivalent (GtCO2e) currently emitted annually will need to drop by more than half to 25 GtCO2e within only 10 years to 2030, the report said.

This will require a 7.6% reduction in emissions every year, representing an increase in current levels of national government ambitions by a factor of five. With no interventions in the next five years, the reduction needed to achieve this target increases to 15.4% every year, moving the 1.5°C target out of reach, said the Lancet Countdown report.

But this journey will mostly depend on how countries deal with the post-pandemic recovery, the report said, calling for an alignment of climate and pandemic recovery for near- and long-term health benefits.

For a green recovery, countries must move away from fossil fuels across sectors, increase their forest cover and make their economies energy efficient, as we said earlier.

Getting rid of polluting fuels could help the world avoid some, most or all of the 7 million annual deaths from air pollution associated with the combustion of fossil fuels, the report said. Countries like India, with the highest absolute number of deaths from air pollution, around 1.6 million annually, can have huge health benefits from a green recovery.

In Europe, modest steps to promote cleaner energy and transport sectors saw pollution-related deaths from ambient PM 2.5--tiny particulate matter that can sicken or kill people by entering the bloodstream--fall from 62 per 100,000 in 2015 to 59 per 100,000 in 2018. Globally, deaths from ambient PM 2.5 associated with coal fell by 60,000 in the same year.

The European Union’s marginal air quality improvements from 2015 to 2018 could be worth an estimated $8.8 billion every year if sustained, the report said. Stemming from the annual average reduction in years of life lost, the figure will grow with further improvements in air quality.

Nevertheless, most countries of the world including India seem to be moving towards a fossil-fuel led economic recovery instead of a green one, IndiaSpend reported on June 11.

(Tripathi is an IndiaSpend reporting fellow.)

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Mumbai: Lack of sex-disaggregated data and other gender-related gaps in Indian government’s official data sources is making it difficult to track issues such as girls’ and women’s employment, asset ownership, health, sanitation and education, our analysis shows. This results in limited understanding of gender issues and poorly designed policies and programmes.

In the second story in our Data Gaps series, we examine which women-specific data points are not collated or made public, and how this makes women invisible and hinders progress towards gender-equality goals.

India ranked 112th of 153 countries on the Global Gender Gap Index 2020, a drop of four places since 2018. India was among the five worst-performing countries on the economic participation, opportunity, and health and survival sub-indices of the index. Gaps in data mean increased difficulty in identifying existing gender disparities and formulating policies to close the gap.

In India, the gaps in data exist due to three major reasons, our analysis found: (i) most surveys look at household-level data but do not assess women’s ownership of assets or their access to basic amenities in the household--asset ownership is an indicator of the power an individual holds within a household; (ii) many crucial data points are not sex-disaggregated and are not periodic; (iii) definitions are unclear and underreporting is routine, particularly in cases of crimes against women.

Gender data gaps are prevalent across the world, says a 2018 brief by UN Women. Only a little over a third (37%) of the 126 countries had a coordinating body for gender statistics, found a 2012 review; only 13% countries had a regular dedicated budget for gender statistics. The brief emphasised the need to plug data gaps in order to remove gender biases in concepts and methodologies, and ensure that policies and interventions address the “lived reality of women and girls”.

Disaggregated data are divided into detailed sub-categories such as region, gender and ethnicity, and can reveal inequalities between different sub-categories that aggregated data cannot. Here is a detailed analysis of the key domains that lack sex-disaggregated data: 

Jobs and livelihoods

Nearly half (48%) of India’s population are women, yet their participation in the workforce is low and has been on the decrease. Only 20.3% of women above the age of 15 are in the workforce--a decline of almost 12 percentage points from 31.7% in 2005.

India’s data on employment and access to credit miss crucial data points on women’s work conditions, wage discrimination, the type of credit that women receive and its interest rates, as per a 2019 study by the Initiative for What Works to Advance Women and Girls in the Economy (IWWAGE).

While the National Statistical Office (NSO) releases hundreds of pages of data on employment, labour force and active participation annually in the form of periodic labour force surveys and quarterly reports for urban areas, the reports do not adequately take into account women’s unpaid labour. Time-use surveys that highlight this issue--by collecting data on how each household member spends time--are less frequent.

Since a six-state survey in 1998-99, the NSO conducted a similar survey in 2019, after a gap of 20 years. This survey shows how women spend nearly five hours each day on unpaid domestic services for household members against 98 minutes spent by men.

Presence of relevant data, however, is only one part of the puzzle; periodicity (or collection and availability of data at regular time intervals) is the other. The relevant data, in the same form, has to be available periodically to enable assessment of progress over time. For example, it is difficult to analyse whether women have spent more time in unpaid labour over 20 years between 1999 and 2019 using the two time-use surveys because while the 2019 survey covers all of India, the 1999 survey has data for only six states.

The lack of periodicity of data on gender is a concern across the world. Only 23% of the available data is from 2010 or later and only 16% is available for two or more points in time, said the UN Women brief.

“Gender statistics on unpaid work have an essential role in developing and monitoring policies on expanding women's participation in paid work,” said Ruchika Chaudhary, senior research fellow at IWWAGE and co-author of its study on gender data gaps. “And, lack of such data could lead to the making of ineffective policies on employment and care economy [the economy of unpaid care work].”

Low participation of women in the workforce also demands analysis of how social and economic norms affect hiring practices, working conditions and social security benefits for women.

However, the available data do not allow for analysis of demand-side factors that could provide insights on the discrimination women face in being hired and in pay.

“To meaningfully understand the reasons for the low levels of labour force participation, we need evidence on both demand and supply sides,” Ashwini Deshpande, professor of economics and the founding director of the Centre for Economic Data and Analysis at Ashoka University, told IndiaSpend. Data on supply-side factors answer questions on why women may not be working or why they drop out of the labour force, Deshpande said, adding, “But to answer questions like--do employers discriminate against women, is there a skill mismatch, and are there not enough jobs that can utilise women’s expertise, skill and education, data on demand-side factors are essential.”

Information is also not available on how many women work in “decent” work conditions, on access to working women’s hostels and crèche facilities, and on how many lactating mothers get feeding breaks during work timings, the IWWAGE study found. Pregnancy, child care, elderly care, lack of family support, and unsupportive work environment are the main reasons for Indian women quitting the workforce, we reported in August 2018. Hence, robust data on access to safe working conditions and child care facilities could help create policies that can address these issues.

While the Annual Survey of Industries provides sex-disaggregated data for employed workers, no similar data exist for contract workers. Also, no sex-disaggregated data are available on wages. Similarly, no data exist on the large proportion of self-employed women workers in the informal sector. While the NSO’s annual reports collect data on women workers ineligible for social security benefits, job contracts and paid leave, they do not identify the proportion of women who need social security benefits and those who receive them.

The dashboard of the world’s largest employment programme, the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA), provides sex-disaggregated data only for the total person-days worked. Information on supportive facilities, wages, and duration of work are not available by sex, according to the IWWAGE report.

Female workers are highly disadvantaged in the labour market--they are in large part low-skilled informal workers, engaged in low-productivity, low-paying work, IndiaSpend reported in March 2018. While the government’s flagship Skill India programme provides sex-disaggregated data on the number of beneficiaries trained and training sessions completed, it does not provide the details of the types of training imparted, the IWWAGE report showed. Such data, if made available, could help in understanding if there is a skill mismatch amongst women workers that is shrinking their employment opportunities, and then help design programmes to fix this mismatch.

Collecting information on gender norms and perceptions affecting labour market participation is new to quantitative surveys and official data sources do not include it yet, said the IWWAGE report.

The current ‘static’ methodology in collecting data is inappropriate to capture the different constraints women face at different stages of their lives, the IWWAGE report said. Women in different age groups, at different stages of their lives, and whether married, single, divorced women or single parents, have different problems.

Issues of safety and security, wage gaps and child care policies affect each category of women differently. The current system of data collection fails to capture these multiple issues and results in gender-blind policies, said Chaudhary.

Access to credit and asset ownership

In addition to employment, access to easy credit can open up economic opportunities for women. The National Rural Livelihood Mission (NRLM)--a government programme for easy finance to self-help groups--increased household incomes by 19% and savings by 28%, we reported in October. While the Ministry of Rural Development, under which the programme runs, provides annual state-wise data on the progress of the scheme, it does not provide sex-disaggregated data on member-wise credit access and utilisation, and their participation and performance. This makes it difficult to analyse how many women benefit from the programme.

The Pradhan Mantri Mudra Yojana (PMMY)--the government’s flagship programme providing loans upto Rs 10 lakh to small and micro enterprises--only provides data on the number of women entrepreneurs availing the benefit. It does not give detailed information on how many women have availed the loan under each of its three amount-based categories, the IWWAGE report found. While the scheme guidelines mention that banks may provide loans to women entrepreneurs at lower rates, no data about this are available.

Besides the lack of sex-disaggregated data points, gender biases in definitions and classifications, sample selection for population surveys and the way questions are asked and data are collected also affect the robustness of the data source, said the UN Women brief.

Decline in labour force participation also depends on how women’s work is categorised. While the government’s national sample surveys show a decline of nearly 25% in participation between 2004-05 and 2011-12, the India Human Development Survey (IHDS) records a 5% decline over the same period. The National Council of Applied Economic Research (NCAER) that conducted IHDS says that this is because the sample surveys’ questions tend to miss out on obtaining data on women’s family-based work. The survey respondents and interviewers may wrongly categorise women farmers or women who run small businesses as homemakers, while men in similar occupations are considered employed.

Suicides by women farmers in India are underreported as they may be categorised as suicides by housewives because conventional societies mostly do not acknowledge women as farmers, IndiaSpend reported in August 2015.

Inconsistencies are also found in data on asset ownership. These data are only available at the household level and, hence, there are no data on what assets women in the household own, the IWWAGE report showed. “Most of the available statistics are not granular enough for disaggregation,” said Chaudhary, adding, “Household data cannot always be divided into individuals to reveal gender dimensions.”

For instance, the Agricultural Census consolidates data from state land revenue surveys that consider operational holdings at the household level as the primary unit. Therefore, there are no sex-disaggregated data for title holders within the household. In India, land ownership is integral to the definition of a farmer, but many women do not own the land they work on. This alienates them from access to government benefits, we reported in September 2019.

Health, sanitation and education

Women are responsible for over 70% of water-related chores and its management globally; and access to clean water, adequate sanitation and hygiene facilities are especially essential for health and survival of women and girls.

While both the Census and NSO provide data on water availability and distance travelled to fetch water, information is not available on the quality of water, the number of days for which water is not available or is not safe, and individual access to water. India has 69,258 “water-quality-affected habitations”, affecting nearly 46 million people, we reported in November 2018. However, these data, which could have helped address health and sanitation issues within a household, are not available at the household level.

The NSSO, NFHS and Census collect information on whether a household has access to a latrine (owned/shared), but there is no information in any of these surveys on whether women use the latrine facility or have access to it throughout their lives. There is no information available on what toilet amenities are available at the workplace.

There are also not enough data on caregiving within households. Caregiving at home helps save time and cost to the public health system. Hence, appropriate indicators are needed to capture months of care provisioning, support provided by the state, and distribution of the care burden between men and women, according to the report.

While the NFHS and other official data sources on health indicators such as the Sample Registration System (SRS) provide robust data on infant and maternal health, data on adolescent girls are lacking. If India were to focus on adolescent health for the country’s 236.5 million children between the ages of 10 and 19 years, it would create a healthier and more productive working population to benefit the country’s growth and development, we reported in August 2019.

Education also plays an important role in improving health outcomes and fewer dropouts can mean fewer child brides and, hence, fewer infant deaths. While the Unified District Information System for Education (U-DISE) collects data on enrollment and attendance, it does not look at average daily attendance of girls and boys in schools--data that could help track girls with low attendance.

Also, data on girls who are socially excluded due to race, ethnicity, religion, location or disability are important so as to understand why girls drop out, since these girls are likely to face multiple forms of discrimination and exclusion, the IWWAGE report said.

Crimes against women are underreported

Along with missing data points and lack of sex-disaggregated data, underreporting is a concern when it comes to data on crimes against women.

The National Crime Records Bureau’s (NCRB) Crime In India is the only comprehensive data source of crimes across India. The report is collated based on administrative sources or police records and has extensive data on different categories of crimes against women.

However, crimes against women in India are considerably underreported, which is a fundamental and common obstruction in addressing these crimes, we reported in August 2019. The underreporting of these crimes puts a question mark over how representative NCRB’s data are.

The NCRB’s report does not reveal the correct levels and pervasiveness of crime against women in the country, stated a 2011 report by a committee constituted by the ministry of statistics and programme implementation (MOSPI) to review crime statistics.

The extent of underreporting of crimes against women is important to understand the factors that prevent women from reporting these crimes. Only one in 13 cases of sexual harassment in Delhi and one in nine in Mumbai were reported to the police, found a 2015 survey of close to 5,000 households by the Commonweath Human Rights Initiative (CHRI). A majority of the respondents said they did not report the crime because they did not want to be entangled in a legal case or feared retaliation.

The MOSPI committee expressed the need for a nationwide household level survey to have reliable estimates of the crimes in India. In addition to the survey, data should be collated from various statutory bodies like the National Commission for Women and be made available at regular intervals, said the report.

Besides the NCRB, the NFHS releases data on violence against women and girls between the ages of 15 and 49 across rural and urban areas, religions and castes. However, the NFHS does not include any information on such violence against girls younger than 15 or women older than 49. The survey also does not specify the severity of violence.

Yet, as many as 99.1% of cases of sexual violence against women are not reported, with the perpetrator being the victim’s husband in most cases, a 2018 analysis of the NCRB and NFHS data by Livemint found. Only about 15% of the cases of sexual violence where perpetrators are not the victim’s current husbands are reported.

(Shreya Raman is a data analyst with IndiaSpend.)

We welcome feedback. Please write to respond@indiaspend.org. We reserve the right to edit responses for language and grammar.

Mumbai: The UK has issued emergency-use authorisation to administer the COVID-19 vaccine developed by Pfizer-BioNTech, and over 50 hospitals are expected to begin vaccinations this week. A second vaccine by Moderna is awaiting similar authorisation. The US is expected to follow soon. India is still in the middle of clinical trials, and while Pfizer has applied for emergency-use authorisation in India, it may take longer to roll out.

As the vaccines arrive, how are they going to be distributed? Can individuals or private parties import them freely? What will the cost be? Will the disease progress the way it has, or will it peter out at some point as immunity kicks in?

To discuss this and understand the way forward, we speak with Chandrakant Lahariya, epidemiologist, public policy and health systems expert, and co-author of the upcoming book, Till We Win: India’s Fight Against COVID-19 Pandemic, and Ajay Shah, professor, National Institute of Public Finance and Policy, who has written an article recently asking how the vaccine could be potentially distributed, and the market forces that could play a role in doing so.

Edited excerpts:

Dr Lahariya, how do you see the vaccine roll-out from the Indian standpoint at this time?

CL: We see a vaccine coming soon. It is going to happen in a week in the UK, probably another two weeks [later] in the US. However, both these vaccines--one that has already received emergency-use authorisation [Pfizer] and the other that might receive soon [Moderna]--have not partnered or done clinical trials in India. So, these two vaccines--Moderna and Pfizer BioNTech--are unlikely to be available in India for a few months, at least till February or March.

The one vaccine that is being seen as a hope for India is the Oxford-AstraZeneca vaccine, of which there are bridging studies in India. We can hope that it will receive emergency-use authorisation in the UK in the coming weeks. And since there are bridging studies in India, we can hope that either [by] late January or early February 2021, the Oxford-AstraZeneca vaccine might be available for use in India. Since there is an Indian manufacturer, we can [also] expect that there would be [a] reasonable quantity.

Will every country have to administer clinical trials before it allows the launch of a vaccine?

CL: One is the large-scale clinical trials done on 30,000 to 40,000 people, which are being done for different vaccines. However, if a country is not part of large-scale trials--[take] the Oxford-AstraZeneca vaccine for example. The trials are being done mainly in the UK, Brazil and the US. But within India, “bridging studies” on a smaller number of people are being done. And those bridging studies are required before our national regulatory authority can license those vaccines, even on emergency-use authorisation basis.

So considering those studies are not being done for Pfizer BioNTech and Moderna vaccines in India, the first requirement--even if these vaccines receive EUA in other countries--is that the bridging studies are done within the country to get a license.

[Editor’s note: Pfizer has since filed an application with the Drugs Controller General of India for emergency-use authorisation to import, sell and distribute its COVID-19 vaccine, along with a request to waive the requirement of clinical trials/bridging studies in India.]

Dr Shah, you've tried to look at this subject from a distribution, logistics and cost point of view. What do you feel are the key issues that will come into play in a few months’ time as the vaccine doses start rolling out?

AS: It's important to think that you and I are happy to pay money to get the vaccine. There are paying customers, there is demand, and there are private firms who are willing to sell the vaccine. So we should think about this market where there are private producers, and there are private buyers, and the two will try to find each other.

Now, when a vaccine goes through a large-scale clinical trial elsewhere in the world, there is merit in rapidly removing barriers to import and allowing it to happen in India. I would not see much gain by demanding large-scale trials or a great deal of scrutiny here, once something has worked elsewhere in the world. So I feel that the authorities should not come in the way of private initiatives to import boxes of vaccines and to roll them out.

Think of this market where there are multiple players--Pfizer, Moderna, Oxford-AstraZeneca, and there will be many others. The story is not going to end at three. So, there will be competition. There will be multiple vendors trying to sell vaccines, and there will be private people. You will be running shows where you will be helping customers choose this vaccine or that. Some vaccines will work better for older people, some for women, and so on. And that's a market where there are many products and people should choose. There are price points, like Rs 2,000, Rs 3,000 or Rs 4,000. And all over the country, there is a very large private sector in healthcare that is quite capable of rolling this out on a gigantic scale.

At the same time, while the producers are ramping up their output, the demand for the vaccine will be going away, because many of us will get vaccinated and herd immunity will set in and the threat of the disease will really go away. So it's a very interesting situation in India, unlike many other places in the world. In India, we've actually got large-scale seroprevalence already. So, relatively modest amounts of vaccination will tip the system over into herd immunity, and people will subjectively start understanding that [for example], “I'm in Pune, and nobody's getting sick anymore. So let's stop fighting with this”. And demand for the vaccine in Pune will evaporate. So this is the interesting dynamic that will take place, that there will be and there should be multiple private vendors offering vaccination. And at the same time, in a way pretty rapidly, vaccine demand is going to go away. So the prices are going to collapse.

Are you saying that the government should not at all be involved in distribution, or that it should be involved in distribution only up to a point?

AS: The government should pick a few important categories. In my mind, civil servants, public sector healthcare professionals, police personnel--this is really the job of the government, the employees of the government. I would like it if a lot of employers will take care of their own people. And the government should take care of civil servants. So the employees of hospitals, police personnel, the people who have any kind of frontline roles, that's the job of the government--that may be 10-20 million people all over the country. If the government can organise that, can manage that, that will be quite an achievement. In India, state capacity is low. So if we make large demands on the state, it will really not work out too well. We should ask for small things from the government and hope that competence will actually come about.

Dr Lahariya, how do you see it from a medical standpoint?

CL: We need to understand that we are in a pandemic where individual protection will also benefit the society. For example, if one individual is vaccinated, they will stop spreading the virus or will reduce the risk, and that will benefit the entire society.

So in this kind of situation, [a] vaccine is a public good. That means two things. One, if left to the market forces, or if people were to start buying and using it, the people who are the worst affected--the poorest, the marginalised who cannot afford--will be left behind, while they are at as much risk as anybody else. So I strongly believe that the government should take the responsibility and the front seat, and offer the vaccine on the basis of priority.

Of course, all of us want a number of players and multiple manufacturers. And I'm sure that there will be a number of manufacturers. But still, with the kind of advance market commitments and advance purchases done by multiple countries, the availability of a vaccine is going to be limited. This limited vaccine needs to be prioritised. The prioritisation is most essential, which most governments--including the government in India--are doing. And for the prioritisation and optimal utilisation of the limited vaccine, the government should take charge; otherwise, if left to the private sector or the individual, it will bring inequity and result in those who need vaccines being left behind.

The third issue is the cost. If left to market forces, the cost is going to be very high and unaffordable. But when the government is involved in the purchase, the cost of a vaccine is going to be low.

What should be the cost of the vaccine? It should be looked at from the people or citizen’s perspective and from the government’s perspective. In my opinion, the vaccine should be free of cost for a majority of the population, if not the entire population. Let's say 60-70%, or even up to 80% population should get it free of cost--because if they are protected, it will prevent the spread and then that's how the pandemic will disappear. So, the government should bear the cost for them.

How much should be the cost for the government? We know that some of the vaccines which are getting emergency-use authorisations are really expensive--$20 to $40 per dose, which is unaffordable for a country like India. We also know that there are mechanisms working out, so for the government, the cost would be $3 per dose. It is still very expensive. I foresee, in the future for example, if the collaborative vaccine between the Indian Council of Medical Research and Bharat Biotech is developed, around $1 or 50 cents per dose will be the real cost from the government perspective.

You're saying that the government should be in full control, [and] not even the blended approach that Dr Shah is suggesting. Let's say if I can afford to pay and import the Pfizer vaccine from the UK, I should not be allowed to. Is what you are saying?

CL: That discussion is already happening in India, that the government should be taking charge of this work and vaccinating the majority of the population. At the same time, there is a discourse that the economic activity should be continued [such as people returning to work]. We know that the economic activities are done by the healthier adults who are not in the priority list [for vaccination]. There would be some vaccines which are really expensive--like Moderna, Pfizer BioNTech vaccines. The government is unlikely to use those vaccines, but if those vaccines become available, and if there are private players who are willing to buy and use those vaccines, I guess that's the kind of mechanism that should be used. The government is already allowing or considering that the private sector or industry can purchase some vaccines, and they can use it. But immediately, [it is the] government who should be in charge or [in the] front seat for vaccination in the country.

Dr Shah, how do you see this? Will we be able to manage this balance with the government leading it, and should the government lead it? Have you worked out the numbers on what a $3-dose means, in terms of affordability, for the government as a whole?

AS: I'd like to come to this discussion with many, many elements of the logic. There are so many things that are different about the Indian context. To think about vaccines in India is profoundly different, say, when compared with how you might think in the UK. Problem one: We have seroprevalence in India amongst poor people, which is already very high. There was a recent survey in Mumbai where 75% of the slum dwellers already have antibodies. So in some sense, the story with poor people has already unfolded far more than we may have liked. There is a very large-scale expansion of the disease amongst poor people. So when we start saying that we want to protect poor people, we have to be cautious in understanding that maybe it's too late, that the epidemic has already swept through a lot of poor people in India. This is the first point that needs to be kept in mind, that seroprevalence in India is unprecedented by international standards.

Second, I'm a little uncomfortable with the word “public good”; it is a technical economics term. A vaccine is a private good with an externality. It is a private good because I spend money, I get vaccinated, and I benefit. It has an externality, which is [that] I stop transmitting the disease. So we should be careful about the use of these words. There is a case for government subsidy, to encourage me to get vaccinated, but it's not a public good.

The third point that we should think about is, what state power do you want to use? What state violence do you want to bring into the picture? Does the state ban the import of mobile phones into India? Do you want the Indian state to ban the import of vaccines into India? I doubt it. Will the Indian state really prevent you and me from importing a vaccine into India? That would be kind of extreme and we really should think 10 times before doing that. Will the Indian state ban private people from rolling out vaccines to private customers? That would be kind of extreme. We saw what happened, for example, with testing. The Indian state tried to interfere with private labs doing testing. And that just retarded India's development of the testing system. We just lost two-three months because the Indian state tried to tell private firms, “Thou shalt not test individuals, who are willing to pay money for a COVID-19 test”. [States such as Telangana, Delhi and Gujarat had restricted testing in private labs.] So these kinds of interventions are really suspect. And we should think a lot before using state power.

Let's imagine we're only trying to do good. Can the government go out and vaccinate some more people? I'm all for that--without interfering in the private behavior. That is key. Let the government try to vaccinate more people, but don't harm other people who are trying to do vaccination. I think “don't do any harm”--some kind of Hippocratic oath--should be a part of health policy thinking, above all. Let the government system do what it can, but don't harm other people who are trying to do immunisations. And state capacity in India is very low. If they can immunise their own civil servants, that will be pretty good. Beyond that, let's see what they feel like doing.

Dr Lahariya, seroprevalence studies in Mumbai, Delhi, and in the south show a large number of people are already carrying antibodies, and therefore, have likely contracted the disease and overcome it. In that sense, as an epidemiologist, how do you approach this? Do we really need that many vaccines? And even if we do, how do you distribute it in a way that the right people get it?

CL: It's good that we have brought up the issue of seroprevalence in this discussion. We know that across the country, there are around 30 different cities and states which have conducted seroprevalence studies. And what we know [is] that the seroprevalence in these studies has been found [to be] ranging from 5% to around 56% in Mumbai slums. But we also know that there were two nationwide studies conducted by Indian Council of Medical Research. The first one found a seroprevalence of 0.72% and then second one found seroprevalence of 7% across the country. So, we can definitely not say that all poor people have been infected. Mumbai was an outlier and there are reasons. I have written a paper on that, about why this is slightly higher in Mumbai settings. But we cannot say that poor people have been fully exposed. There is a wider agreement that globally, only 10% of people were affected by the end of October; 90% were still susceptible. If we go by ICMR’s study, the second national seroprevalence survey, only 7% were affected, and 93% were still susceptible. So there is a wider susceptibility.

The second point I want to bring up here is that the concept of herd immunity is not applicable in a setting of a smaller geographical area. It is applicable in a wider setting where there is limited in- or out-migration of people. For example, a person living in a setting--even [one that has] a 70% seroprevalence--the moment he walks out to work in other settings, he is exposed. He's not protected by that seroprevalence or herd immunity. So those are the challenges.

I want to go back to the point of public good and social contract. And I want to really emphasise that health is a social contract. Here, people have given some rights to the government; so, the government needs to act on their behalf. And in the pandemic, which is affecting everybody, people agree that the government has some right to work on their behalf and do some good. Also, any health intervention--this is a moral and scientific principle--should not result in increasing inequities. Anything that is a market-based principle, where people who can afford to buy a particular limited good, will result in inequities and will affect the poor the worst.

Are you saying that the seroprevalence data are not believable or that there are not enough surveys being done? If we look at the overall fatality ratio, we are doing much better than we thought. We were expecting a massive Diwali surge. That does not seem to have happened--at least in many parts of the country.

CL: Each of the data is believable, but those are applicable for smaller settings. We have seen seroprevalence of around 25% to 30% in Delhi, which is believable, and 56% in Mumbai slums, and then 46% in a second survey. But we have seen that Indore had a large number of cases being reported, but seroprevalence in that setting was only 7%. So what we know is that there have been smaller pockets which have a higher transmission, but there are other pockets which have less transmission. But as a whole, for the nation, the number of people who are still susceptible was around 90% in mid September. This number [of those who have antibodies] might have gone up to 15% or 20%, but nearly 80% would still be susceptible and would need to be protected.

The second point is that we don't know how long the protection after natural infection would last. We don't know what is the level of population that should be infected for herd immunity to develop. It has been discussed from the range of 43% to 70%. And if we know that over a period of 10 or 11 months, if the country has reached 15% to 20%, it is unlikely to reach that level [soon].

There are many unknowns. In those unknowns, the best intervention is that we don't simply rely too much on seroprevalence studies. We simply don't focus too much on herd immunity. And we use the interventions that we can. The vaccine is one such intervention coming to our rescue. We have also seen in past pandemics that the pandemics do not disappear without effective interventions, and the vaccines appear to be promising, especially when we are seeing that these vaccines are highly efficacious. So if something is efficacious, it should be prioritised. It should be used, made available to those people who need them most, irrespective of their buying or purchasing capacity. That's something only the government can do.

Dr Shah, we are basing a lot of these interpretations on available data, which is limited at this point. What is your sense on where we can go with our interpretations?

AS: There are many seroprevalence studies. We need to index them by date, because the speed at which the epidemic is going through society is quite remarkable. As an example, recently, there was a Mumbai slums paper which got a number of 75%. There is a good Karnataka paper, high-quality statistical random sample of Karnataka that was conducted from June 15 to August 29, where the overall average answer is 50%. And that's a survey conducted, if you take a weighted-average date, the average date on which the measurement was done was July 21. Every month that goes by after that, actually, the epidemic is spreading in the country. We're already standing in December. There is no reasonable possibility of a significant rollout before January or February. So by that time, the pandemic will have made significant progress. There are different numbers for different locations--that's entirely correct. And that, in fact, is the beauty of a market-based system. If in Mumbai, we are understanding that our neighbors are not getting sick, people around us are not getting sick, the threat perception changes, and then our demand for the vaccine goes down, whereas in a place where lots of people are getting sick, where the threat perception is high, there will be a greater clamor for the vaccine, and then there will be demand and then private persons will take vaccines there.

So I would just reiterate, the Hippocratic Oath of public policy should be that the government should not interfere with, for example, you importing 10,000 doses. The Government of India should not interfere with you giving out doses to your friends and family. If the government wants to run a programme, great, please do so. I have my own skepticism about what the Indian state is capable of.

[Editor’s note: The study conducted in 20 of Karnataka’s 30 districts is yet to be peer-reviewed. The samples were limited to villages within 30 km of the centroid of each town in the sample.]

Assuming the state plays a leading role in giving out vaccines to everyone, or most people, what is the kind of cost that we're looking at--because economically, we are not in the healthiest of shape either?

AS: There's going to be a rapid price collapse, because one by one, these factors will come into motion, and the demand is collapsing. So this is a very interesting market. There will be like an infinite price for the first dose. And there's going to be a rapid price collapse after that, because one by one, more and more vaccines are going to be approved and there will be a ramp up of manufacturing capacity and the demand will go away. So you're going to have a crazy imbalance between supply and demand. Every month, the prices of the vaccine are going to collapse.

We welcome feedback. Please write to respond@indiaspend.org. We reserve the right to edit responses for language and grammar.