Source:
https://scmp.com/week-asia/health-environment/article/3079198/coronavirus-indias-north-south-divide-deepens-it
This Week in Asia/ Health & Environment

Coronavirus: India’s north-south divide deepens as it battles rising infections

  • While the north is home to most of India’s 1.3 billion population, there are more testing centres in the south with indications that more tests are being done there
  • The most populous state of Uttar Pradesh, where infant mortality is 10 times worse than Kerala, has 11 virus testing facilities for 235 million people
A child cries as a doctor wearing protective gear takes a swab to test for coronavirus in the northern Indian city of Ahmedabad on Wednesday. Photo: Reuters

As India’s number of confirmed coronavirus cases crossed the 5,300 mark amid an unprecedented 21-day nationwide lockdown, the country’s historical north-south divide is only deepening.

Fault lines of political power versus development have long existed, with the north’s larger population and use of the dominant language Hindi making it a natural power base, while the states and union territories in the south – home to about 300 million people – have traditionally enjoyed stronger health care and education systems.

This divide has been further exposed by coronavirus testing to determine the extent of the outbreak, with close to half – 97 of 202 – of government-run and private testing centres for Covid-19 located in the southern states of Tamil Nadu, Kerala, Karnataka, Andhra Pradesh and Telangana, the union territory of Puducherry and the south-western state of Maharashtra, though these combined only contain about one-third of the country’s 1.3 billion people.

And while the government agency tasked with overseeing testing, the Indian Council of Medical Research, has stopped issuing state-by-state breakdowns, numbers collected from various state administrations suggest an overwhelming majority of testing samples have come from southern states.

A medical team takes a saliva sample for testing from a man in Mumbai, capital of Maharashtra state. Photo: EPA
A medical team takes a saliva sample for testing from a man in Mumbai, capital of Maharashtra state. Photo: EPA

Of the 127,000 samples tested between late January and Wednesday this week, more than half were from the states of Tamil Nadu, Kerala, Karnataka, Andhra Pradesh, and Maharashtra.

Public health experts say the country’s south has also moved faster to prepare for the next phase of the pandemic, expanding intensive care units and ordering ventilators and protective gear for doctors before other regions. With the exception of New Delhi, the national capital, the north has been sluggish in its response.

India’s most populous state of Uttar Pradesh has just 11 virus testing facilities for 235 million people and is still scrambling to scale up health efforts, while at the same time putting child immunisation programmes on hold because of limited resources. Already, the state’s infant mortality rate is 10 times that of Kerala, on the southwestern coast, and life expectancy is 10 years lower, according to official figures.

Incidentally, Uttar Pradesh is also India’s most politically important state and has witnessed a massive influx of migrant labourers from neighbouring areas in recent weeks, particularly from Delhi.

People wearing makeshift face covering panic buy vegetables on Wednesday following a decision to seal virus ‘hotspots’ in Uttar Pradesh. Photo: AFP
People wearing makeshift face covering panic buy vegetables on Wednesday following a decision to seal virus ‘hotspots’ in Uttar Pradesh. Photo: AFP

In the coming days, forecasters are predicting India’s northern states will witness a surge of Covid-19 cases, at a time when the central government is still struggling to inject money where it is needed. Southern states have already sought more funds from federal authorities to wage the coronavirus battle, and future allocations are only likely to further exacerbate existing social and political disparities between the regions.

This is concerning as the southern states have a track record of exploiting linguistic and regional differences to campaign against the power centres in the north.

A health worker checks the body temperature of a man with mobility impairment in Ahmedabad on Wednesday. Photo: AFP
A health worker checks the body temperature of a man with mobility impairment in Ahmedabad on Wednesday. Photo: AFP

In last July’s health index from Niti Aayog, the Indian government’s policy think tank, the northern states of Uttarakhand, Rajasthan, Madhya Pradesh and Uttar Pradesh were identified as the worst-performing states in the country, while those in the south fared reasonably well.

If state and central governments do not quickly scale up antivirus measures, India’s heavily populated Hindi-speaking heartland – which lags behind the south in almost every development parameter – is likely to be the worst affected part of the country.

To make matters worse, individual states’ powers to raise revenues were greatly curtailed by the introduction of a goods and services tax in 2017 that did away with a multitude of state and central taxes and excise duties – making the states even more dependent on the federal government, where most political power was already centralised, for funds as well.

Medical staff in Amritsar, Punjab state, shout slogans at a protest last week as they demand more personal protective equipment and coronavirus testing kits. Photo: AFP
Medical staff in Amritsar, Punjab state, shout slogans at a protest last week as they demand more personal protective equipment and coronavirus testing kits. Photo: AFP

“If you come to the classic Hindi-speaking belt states such as Punjab, [Uttar Pradesh], Haryana or Himachal Pradesh, their testing is almost not started, and their set-ups and preparations have really lapsed,” said public health expert T Sundararaman, a former director of the national health systems resource centre.

Huge differences in population between states is another issue, said Sundararaman, who is also the co-convenor of the India chapter of global grass-roots health activism network People’s Health Movement, because if a southern state like Tamil Nadu, home to about 70 million people, “orders 100,000 testing kits, how many should Uttar Pradesh [where more than 200 million people live] order?”

He said many states were keeping their tally of Covid-19 infections down by not doing enough testing, although this problem is more exaggerated in the north than the south.