Sharing best practices

Centre should help states share ideas on curbing pandemic

The second wave of the pandemic, which continues to spread across India, has been left largely to state governments to combat. On one level, this is a failure of the Union government when it comes to leadership and capacity expansion. But it is also a failure in another way — one of coordination, and of policy exchange. Different state governments have evolved different policy mechanisms to deal with their second waves. Unfortunately, there is no systematic effort to share insights on this subject in a manner that would enable best practices to spread across the country.

Several such best practices have been identified. For example, the Brihanmumbai Municipal Corporation (BMC) has set up ward-level war rooms that help identify those cases that require hospitalisation, and which then enable the patients in question to be assigned to the appropriate care facility. Indeed, various states and municipalities of differing capacities have set up such triage functions. Other useful state-level innovations include the Maharashtra government’s decision to create an expert body of doctors that would provide guidance to those on the front line, which had the effect of curbing over-prescription and even the overuse of oxygen. Ernakulam in Kerala has a war room that oversees the entire city, and allows for resources to be shifted swiftly between hotspots. The southern states of Tamil Nadu and Karnataka both have telephone-based triaging systems. It is unclear why, for example, Delhi does not.

It is also unclear why the Union government would not collect and collate such systems and make them available to bureaucrats in other state capitals searching for ways to manage the exploding demand for health care, both public and private. In the past, it was possible that this would be the function of the Planning Commission. Indeed, it is possible to make a case that it is still the domain of the NITI Aayog, which has in the past discussed the creation of policy “garages” in which good ideas from states could be parked and then driven out by others. Its Aspirational District Programme is supposed to focus on collaboration among bureaucrats in 112 districts. In other words, there is a clear understanding that policy exchange is a duty of the Union government. On this occasion, however, it has not enabled such exchange.

In a recent interview with The Indian Express, the BMC’s Commissioner, Iqbal Singh Chahal, said when it came to sharing best practices, “it is up to the district collectors, municipal commissioners of states and how they react to it”. He added that till recently he would get calls from “my colleagues in the Government of India”, but that they would “laugh at us”. He added: “If someone is laughing at us, how do I share my model with them?” This is a disappointing reflection of not just overconfidence in the face of growing numbers some months ago, but also the unwillingness to create a collaborative environment between state-level administrators. The second wave now appears to be receding in some of the areas that were worst hit in its initial weeks, but is almost certainly yet to peak in other parts of the country. It is past time that those areas were given access to the ideas that helped manage the pandemic in places like Mumbai that have now apparently turned the corner. The Union government must take the lead in instituting systemic policy exchange.