📰 No quick fix: On the state of medical education in India
India must not allow mushrooming of medical colleges without trained faculty and infrastructure
•The war in Ukraine has brought to the fore the plight of Indian students, many of them pursuing medicine. Amidst the turmoil, Prime Minister Narendra Modi, at a webinar on the Union Budget announcements on the health sector, stated that many young Indians were going to “small countries of the world for medical education” and, therefore, the private sector should be encouraged, along with cooperation from States, to set up more medical colleges and hospitals locally so that such aspirants remain in India. His remarks are well-meaning, but the dynamics of India’s medical education system are complex. The most sought-after international destinations — traditionally, for medical education the U.S., the U.K. and a few west European countries — are, however, too expensive for most Indians. In the last few decades, Russia, China (countries larger than India) and Ukraine (one of Europe’s largest countries), with their historical commitment to public health care have been able to offer more affordable, yet quality, education. India’s huge population still continues to be predominantly rural, but most of the trained medical doctors, paramedics and nurses gravitate towards cities for well-known reasons. The very nature of medical education, an empirical field, requires significant infrastructure — land, equipment, and trained faculty at the post graduate level — all of which are in short supply and uneven in their spread. Without correcting these deficiencies, India cannot expect to dramatically increase the availability of medical personnel. The Government needs to make health care the centrepiece of its economic rebuilding.
•The anaemic spending on health is not unique to this government; for several years, India’s spend on health care has consistently trailed several countries comparable to its size which is why there is barely one doctor for every 1,000 Indians and specialists often a tenth of what is required. These shortcomings have lubricated the phenomenon of young Indians seeking affordable, quality, health-care education in other countries. But merely having private establishments start medical schools, without a long-term commitment to offer necessary training and post-graduate education, could lead to a repeat of the engineering fiasco after the dotcom boom: a surfeit of engineering colleges without adequately trained faculty or infrastructure that churn out students who need a further skills upgrade to be employable. The Government must instead ease procedures for establishing medical colleges, spend more on infrastructure, and provide incentives for a health-care ecosystem to develop in rural areas. While not a quick-fix, over time this could facilitate the growth of private and public medical colleges that could stem the outflow of students aspiring to be doctors. Private investment in medical education by itself will nowhere be enough.
India needs an intellectual ambience that is unfettered, which National Science Day, being observed today, must foster
•The Government is organising a Science Week, ‘Vigyan Sarvatra Pujyate’, as a prelude to National Science Day on February 28 that commemorates Sir C.V. Raman’s discovery on light scattering. The programme appears to have been designed to make youth be proud about India’s scientific achievements. Using this opportunity as nationalistic mission is rather unfortunate. On the contrary, this event should be used to celebrate the true spirit of science that defies all types of intellectual curtailments, thus promoting critical thinking in our academic centres.
The essence
•A prominent physicist of our times, Freeman Dyson in his book, The Scientist as Rebel, makes a clear argument about why dissent is the soul of science: “There is no such thing as a unique scientific vision, any more than there is a unique poetic vision. Science is a mosaic of partial and conflicting visions. But there is one common element in these visions. The common element is rebellion against the restrictions imposed by the locally prevailing culture, Western or Eastern as the case may be. The vision of science is not specifically Western. It is no more Western than it is Arab or Indian or Japanese or Chinese. Arabs and Indians and Japanese and Chinese had a big share in the development of modern science. And what is true of science is also true of poetry. Poetry was not invented by Westerners. India has poetry older than Homer... Poetry and science are gifts given to all of humanity. For the Arab mathematician and astronomer Omar Khayyam, science was a rebellion against the intellectual constraints of Islam, a rebellion which he expressed more directly in his incomparable verses....”
•The main takeaways from Dyson are: one, science is universal, like music, dance or poetry... There is nothing like Indian, American or Chinese science. Science was initially nurtured through exchanges of ideas that moved like merchandise between distant places over the ancient trade routes. Two, Dyson considered evidence-based modern science as an intellectual rebellion or as a form of dissent against social constraints, as exemplified by the Islamic and the European renaissance of science of the Middle Ages, or the reawakening in India around the 19th century that formed the background for the independence struggle.
Then and now
•For Indian scientists of those days, science was a double rebellion, against English domination as well as the fatalistic ethos of Hinduism. This rebellious spirit led to a resurgence of science in India in the pre-Independence days and Sir C.V. Raman’s discovery cannot be seen independent of the social reformism of those days. With the ideological shift toward the right in recent times, the spectre of conformism that was lying low in our collective consciousness has now returned with a vengeance. And, academic freedom is now under greater pressure to tow the official line than ever before.
•If science must excel it needs to promote free spirit, and, as Dyson argues, science is an inherently subversive act — a threat to establishment of all kinds, whether it upends a long-standing scientific idea, or it questions the received political wisdom or irrationality. He writes: “Science is an alliance of free spirits in all cultures rebelling against the local tyranny that each culture imposes on its children.”
•Such ideas must have played in the minds of great physicists like Einstein and others when they turned the scientific theories of the day upside down. Much earlier, Galileo Galilei and Nicolaus Copernicus also took a firm stand against the prevalent wisdom despite their religiosity. As Dyson quotes the British scientist, J.B.S. Haldane: “Let him beware of him in whom reason has become the greatest and most terrible of the passions”. Haldane migrated to India in 1957 and was eternally dissatisfied with the Indian scientific enterprise and its organisational values, centred on hierarchy. He soon began to refer to the Council of Scientific and Industrial Research (CSIR) as the ‘Council for the Suppression of Independent Research’.
•The ecology of dominant conformist traits is intertwined with group identity that determines the attitude towards our superiors and subordinates. Sudhir Kakar and Katharina Kakar in their book, The Indians: Portrait of A People, trace this culture of conformism to our childhood — as a reflection of our obsession with hierarchy that spills over to institutional setups. The word they use for Indians is Homo hierarchicus — a term originally employed by Louis Dumont in his treatise on the Indian caste system.
A setting for pseudoscience
•The Indian family landscape is authoritarian and patriarchal, though benevolent to the obedient, in its dealings. Early on, children are sensitised to a collective self. We grow with a loss of self and learn to subsume our worth as an individual. An Indian is thus culturally tuned to uphold the family’s integrity, religion, caste and/or regional identity rather than her individual strengths. So, when the party in power in India criticises the Opposition parties for being led by dynasts, what is being sidelined is the irony of the dynastic blood relation as a prop for personal advancement is a fundamental part of Indian cultural ethos. Such societies with patriarchal moorings automatically generate conditions for authoritarian rule, generating an ambience of fear that may not be conducive for path-breaking enquiries. Rather, it tends to feed the conceit of the rulers by inventing make-belief science or pseudoscience.
Need for a shift
•In a guest editorial in Science in 2010, R.A. Mashelkar, the former Director-General of the CSIR, discusses why India is unable to break the mediocrity barrier. He concludes that tradition-bound countries such as India need to free themselves from the cultural chains of the past to foster original thinking. In an editorial in the 2010 Current Science, P. Balaram, the former Director of the Indian Institute of Science, explains why a “good humoured disdain for perceived wisdom and disregard for authority”, which is called ‘irreverence’ is important in science.
•The cultural shifts are not easy to accomplish, particularly in a tradition bound society. And, scientists have a special duty to foster a free and unfettered intellectual ambience by actively engaging in the transformation of values both within and outside workplaces. A fundamental challenge, of course, is how to strengthen the social democratic norms within the institutes, representative of Indian diversity and plurality. Only then will academic centres become a marketplace of ideas. National Science Day should offer forums where freewheeling discussion of such themes are organised, epitomising the true spirit of science, thus unleashing its tremendous transformative power.
📰 The anatomy of India’s Ukraine dilemma
New Delhi has taken a subtle pro-Moscow position on the question of Russian attacks against Ukraine
•New Delhi’s response to the Russian aggression against Ukraine appears to have been shaped by harsh geopolitical circumstances, that it is in the middle of, than its normative beliefs or preferences. Late last week, India abstained from a United Nations Security Council (UNSC) resolution which called for condemning the Russian military action against Ukraine, but it went on to note its uneasiness of the Russian action in writing (a first).
•Prime Minister Narendra Modi, who spoke to Russian President Vladimir Putin as the war broke out, called for an “immediate cessation of violence” and has so far refused to pay heed to Ukrainian Ambassador to India Igor Polikha’s impassioned pleas urging Mr. Modi to mediate with Mr. Putin to halt Russian military advances. With the UNSC deadlocked, friends with both the United States/West and Russia, and passionately urged by Ukraine, New Delhi is uniquely placed to undertake some much-needed mediation between the rival sides. But it has chosen to stay on the margins and do no more than the unavoidable minimum. New Delhi just wants this to be over with.
•Let us call it what it really is: New Delhi has taken a subtle pro-Moscow position on the question of Russian attacks against Ukraine. This pro-Russia tilt is not just the position of the Indian government, but is something, somewhat surprisingly, shared by much of the Indian strategic community as well. More notably, one is increasingly hearing subtle, though indirect, justifications of the Russian military actions from the doyens of the Indian strategic community. India’s Russia tilt should be seen not just as a product of its time-tested friendship with Moscow but also as a geopolitical necessity.
The Russia tilt
•There are four potential options India can/could choose from: Condemn Russian aggression, support Russian aggression, stay silent on Russian aggression, or express displeasure (short of condemning) and call for diplomacy. The first option will pit India against Russia, the second will pit it against the U.S. and its allies, the third option will be read as pro-Russia, and the fourth option — which it has taken — is the least harmful. And yet, a position that does not condemn Russian aggression and one that abstains from voting on a UNSC resolution calling for “condemning Russian aggression and withdrawal of Russian forces from Ukraine” is indeed a pro-Russia position.
•There are understandable reasons for India’s (subtle) pro-Russia position. Let me put it this way: an aggressive Russia is a problem for the U.S. and the West, not for India. North Atlantic Treaty Organization (NATO) expansion is Russia’s problem, not India’s. India’s problem is China, and it needs both the U.S./the West and Russia to deal with the “China problem”. I would view India’s response to the crisis in Ukraine in the light of this rather simple logic.
•Let us look at the big picture first. There is today a sobering recognition in New Delhi about the weakening of the U.S.-led global order and the rise of China as a counter-pole, geographically located right next to India. U.S. withdrawal from the region and its decline as the principal system shaper has complicated India’s place in regional geopolitics. Neighbouring China as the rising superpower and Russia as its strategic ally challenging the U.S.-led global order at a time when China has time and again acted on its aggressive intentions vis-à-vis India, and when India is closest to the U.S. than ever before in its history, throws up a unique and unprecedented challenge for India. Therefore, having Russia on its side is crucial for India, more than ever. Moscow may or may not be able to moderate Chinese antagonism towards New Delhi, but an India-Russia strategic partnership may be able to temper New Delhi’s growing isolation in a rather friendless region.
•Second, there is an emerging dualism in contemporary Indian strategic Weltanschauung: the predicament of a continental space that is reeling under immense pressure from China, Pakistan and Taliban-led Afghanistan adding to its strategic claustrophobia; and, the emergence of a maritime sphere which presents an opportunity to break out of the same.
•Herein lies the dilemma for India. New Delhi needs Moscow’s assistance to manage its continental difficulties be it through defence supplies, helping it ‘return’ to central Asia, working together at the Shanghai Cooperation Organization (SCO) or exploring opportunities for collaboration in Afghanistan. Russia, to put it rather bluntly, is perhaps India’s only partner of consequence in the entire Asian continental stretch.
•On the other hand, when it comes to the vast maritime sphere, the Indo-Pacific to be precise, Russia is not of great consequence to India. That is where its American and western partners come into play. India is simply not in a position to address the China challenge in the maritime space without the active support of American and western navies and, of course, the Quad. This unavoidable dualism in the contemporary Indian strategic landscape necessitates that India balances the two sides, but doing so without a subtle Russia tilt may not be feasible at this point of time.
•That said, the war on Ukraine could have major implications for India’s strategic calculus. For one, Russian action in Ukraine dismissing the concerns of the rest of the international community including the U.S. will no doubt embolden China and its territorial ambitions. Second, the new sanctions regime may have implications for India’s defence cooperation with Moscow. Third, the longer the standoff lasts, the closer China and Russia could become, which certainly does not help India. Finally, the more severe the U.S.-Russia rivalry becomes, the less focus there would be on the Indo-Pacific and China, which is where India’s interests lie.
Impact on foreign policy
•India’s responses to the Russian aggression on Ukraine underline the fact that India is operating from a position of geopolitical vulnerability. While the Indian stand does reek of realpolitik, it reeks more of strategic weakness. Here is a country located in a hostile neighbourhood trying to make the best of a terrible situation it finds itself in. This then means that, going forward, India’s ability to be a “swing state”, “major power” or a “leading power” stands diminished. So we must expect more middle-of-the-road behaviour from New Delhi rather than resolute positions on global strategic developments.
•India’s position also shows the unmistakable indication that when it comes to geopolitics, New Delhi will choose interests over principles. This is nothing new: New Delhi has chosen interests over principles even in the past — for instance, India has violated the principle of non-intervention in the domestic affairs of neighbours. The difference this time may be that India is choosing interests over principles even though the issue at hand is not directly pertaining to India. And yet, a careful reading of India’s statements and positions taken over the past few days also demonstrates a certain amount of discomfort in having to choose interests over principles. There is perhaps a realisation in New Delhi that a dog-eat-dog world, where rules and good behaviour do not matter, does not help India in the long run either.
•Going forward, if tensions between Russia and the West persist, balancing extremes will be a key feature of Indian diplomacy. India is perhaps already mastering the art. Consider India’s “explanation of vote” during the recent vote on Russia’s aggression against Ukraine: even though New Delhi abstained from voting on it (thereby siding with Moscow), it made its unhappiness about the Russian action clear in the written note.
On strategic autonomy
•Finally, what does this mean for India’s ‘strategic autonomy’? For sure, India’s strategic autonomy has been under a lot of stress for some time now. However, New Delhi’s response to the recent crisis, especially its “explanation of vote” at the UNSC indicates a careful recourse to the principle of strategic autonomy: India will make caveated statements and will not be pressured by either party. In that sense, India’s indirect support to the Russian position is not a product of Russian pressure but the result of a desire to safeguard its own interests. Therefore, while we may witness a steady erosion of India’s strategic autonomy in the longer term — primarily as a function of the need to balance against China — we will continue to witness instances where Indian diplomacy will take recourse to the principle of strategic autonomy.
📰 Tackling the plastic problem
The UN Environment Assembly meet could finalise a way forward for global cooperation in reducing plastic consumption
•A report released by the United Nations Environment Programme (UNEP) last year estimated that emissions of plastic waste into the aquatic ecosystems may triple by 2040 if no meaningful action is taken. Thus, the UN Environment Assembly meeting in February-March 2022 may finalise a way forward for global cooperation in this regard.
A negative externality
•Plastic products in the form of bags, bottles, etc. are convenient, but take a very long time to decompose. Increasing global consumption and low participation in recycling programmes have led to more plastic waste. This pushes us to consider plastics as a negative externality. We need to analyse the social costs of plastic consumption, which is mainly the loss of marine life. This affects the livelihoods of a major chunk of population dependent on marine life. Marine fisheries and wildlife are mainly harmed due to plastics. Thus, the size of harm is alarming.
•Plastics represent an example of a consumption externality, which involves many people, rather than a production externality, which involves one or multiple firms. Consumption externality is more challenging to address, as it is difficult to differentiate the behaviour of consumers. Imposing the cost of the harm on all consumers may not yield efficient solutions. As the number of consumers is high, the cost of controlling them is also high.
•A number of regions across the world have banned plastic bags. This approach promotes a sustainable environment, intergenerational equity, saves marine and wildlife ecosystems, and restores soil quality. But it also causes inconvenience for consumers, increases substitution cost, and creates unemployment shocks as it affects the production of plastics, leading to less economic activity, less income generation and finally less employment. The replacement of plastics, which are low cost, with substitutes results in deadweight loss for the economy.
•Other key aspects that may be considered for global cooperation are the options if plastics are banned, the effectiveness of imposing tax and the potential problems with both these approaches. It is difficult to identify the exact tax to be imposed, which may depend on country-specific circumstances.
•The environment regulation for plastics may include a ‘command and control’ approach, and fiscal reforms like eco-taxes or subsidies. The efficiency of such a regulation depends on its architecture — how well it is planned, designed and executed. It should be credible, transparent and predictable. A tax rate, in particular, needs to be carefully determined and should work as a deterrent. In general, the rate of tax on plastics should be higher than the cost of compliance.
•Eco-taxes may be imposed in the various stages of production, consumption or disposal of plastics. Pollution due to plastics may happen during the production stage. That is the logic for imposing tax on polluting inputs, as it forces the producer to look for cleaner substitutes. Pollution also occurs during the consumption stage, and thus an eco-tax is recommended to discourage consumption. This may require the polluters or the pollution-controlling authority to install meters for recording the emission or the effluent discharged in the process of production or consumption of plastics.
Estimating the social cost
•Social cost should be evaluated differently in the local/regional and global contexts. While health and hygiene are predominant considerations in the former case, climate change is the predominant consideration in the latter. Ideally, eco-tax rates on plastics ought to be equal to the marginal social cost arising from the negative externality associated with production, consumption or disposal of goods and services. This requires evaluation of damage to the environment based on scientific assessment of the adverse impacts on health, environment, etc. The eco-tax rate on plastics may thus be fixed commensurate to the marginal social cost so evaluated.
•Thus, comprehensive policy measures against plastics may generally involve three complementary activities: the removal of existing taxes and subsidies that have a negative environmental impact, taking into account the different types or grades of plastics, and restructuring existing taxes in an environmentally friendly manner. There are some other suggestions too, which may be creative as also effective policy solutions to reduce the amount of plastic consumption. Those include promoting multiple use of plastics through better waste management, educating the public on the harmful use of plastics, providing subsidy for research and development activity for substitute development, appropriate disposal mechanisms and waste management and use of waste for constructive usage like roads.
