India is currently in the throes of a catastrophic second wave of the Covid-19 pandemic, which has exposed the severe lack of our health infrastructure. Since March 2021, we have seen the situation spiral out of control to the extent that people are now left with no choice but to crowdsource life-saving drugs, oxygen cylinders and hospital beds on the internet.
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Technology is serving us during this crisis and it is natural for it to be viewed as a measure for vaccination. Here, the principal response has been through the CoWin portal that has been launched by the Government of India to digitise the vaccination drive. It is, however, resulting in vaccine exclusion and a lack of privacy.
The most obvious criticism of the portal is its mandatory nature for vaccination in the 18-44 age group. CoWin, which on May 1 opened for registration of individuals ranging from 18-44 years of age, has come under criticism for its propensity to exclude people who are still on the other side of the digital divide as well as for its inherent design issues.
According to the Indian Telecom Services Performance Indicator Report for October-December, 2020, released on April 27, 2021, the percentage of the rural population that subscribes to the internet is 34.60 per cent. It even conflicts with the early-stage learnings from CoWin’s own dashboard. On April 28, the dashboard showed that for the 45-plus age group, out of a total 14,42,10,652 vaccination registrations, only 2,52,96,511 were through CoWin.
In the absence of the internet and without knowledge of how the portal functions, the majority of India’s rural population is being discriminated against and a form of technical rationing is being implemented by CoWin based on broadband connectivity and digital literacy.
This is anecdotally reinforced even in high connectivity areas. A report in this paper (IE, May 12) carries a self-explanatory headline, “In Delhi’s slums, barriers to vaccination: Few smartphones, English-only website”.
The second area of concern is that of data protection and cyber security. At present, vaccination slots on the portal are being released without any notice or schedule, and are being snatched up within seconds of being released by whoever is lucky enough to be checking the portal at the time, turning the vaccination drive into a game of “fastest finger first”.
Even this metaphor is inaccurate as either through its official API or automated scripts, a range of functionality is available for people to automate functions ranging from notification to even slot reservation. These exist in multiple variations and risk exposure of medical healthcare data through third-party providers.
It would be appropriate for the National Health Authority to issue an advisory or change the technical flow of CoWin to prevent such automation, which compounds exclusion and also risks the privacy of Indians.
However, CoWin’s own record speaks poorly on privacy. The CoWin website has no privacy policy even while India lacks a data protection law. While the Union Minister of State for Health, Ashwini Choubey, has provided, in a response to Parliament, an undertaking that the Data Privacy Policy of the National Health Mission would cover CoWin, on a finer reading of the policy, its applicability is not specifically defined.
This is contrary to the Supreme Court’s right to privacy judgment but also to the departmental guidelines of the Government of India for official websites. The departmental guidelines clearly state that government websites when collecting personal data, “must incorporate a prominently displayed privacy statement…”.
In an interview on April 6, 2021, R S Sharma, the current CEO of the National Health Authority, revealed a pilot study stating that “Aadhaar-based facial recognition system could soon replace biometric fingerprint or iris scan machines at Covid-19 vaccination centres across the country in order to avoid infections.”
Following criticism from public health and digital rights organisations, Sharma claimed that, “the process involves face authentication and not facial recognition”. This change in nomenclature means little. Facial recognition bundles within it the process of authentication and can match against a person’s own biometrics (as has been claimed) for identity authentication, or against the general population, which is a wider body of data, for surveillance and security. While the privacy risk in the latter is more significant, the former continues to erode rights.
Use of Aadhaar-based facial authentication for access to vaccines creates further technical barriers for universalisation of vaccination with a worrying prospect of false negative results. The available technical studies consistently demonstrate high error rates in facial authentication.
Environmental factors as opposed to ideal laboratory conditions will further contribute to operational complexity. The technology is not mature enough for deployment and a pandemic is an inappropriate time for experimentation. Again, facial authentication is being piloted in a legal vacuum of a data protection law, where the facial recognition data that will be layered with medical healthcare data can be stored, captured and shared without any legal limits or practical safeguards.
The technocratic approach in using digital systems has prioritised data collection and efficiency over vaccine equity. It disregards the experience of public healthcare and digital rights experts. The present deployment of CoWin, rather than augmenting the right to health, is undermining it.
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Steve Ovett, the famous British middle-distance athlete, won the 800-metres gold medal at the Moscow Olympics of 1980. Just a few days later, he was about to win a 5,000-metres race at London’s Crystal Palace. Known for his burst of acceleration on the home stretch, he had supreme confidence in his ability to out-sprint rivals. With the final 100 metres remaining,
[wptelegram-join-channel link=”https://t.me/s/upsctree” text=”Join @upsctree on Telegram”]Ovett waved to the crowd and raised a hand in triumph. But he had celebrated a bit too early. At the finishing line, Ireland’s John Treacy edged past Ovett. For those few moments, Ovett had lost his sense of reality and ignored the possibility of a negative event.
This analogy works well for the India story and our policy failures , including during the ongoing covid pandemic. While we have never been as well prepared or had significant successes in terms of growth stability as Ovett did in his illustrious running career, we tend to celebrate too early. Indeed, we have done so many times before.
It is as if we’re convinced that India is destined for greater heights, come what may, and so we never run through the finish line. Do we and our policymakers suffer from a collective optimism bias, which, as the Nobel Prize winner Daniel Kahneman once wrote, “may well be the most significant of the cognitive biases”? The optimism bias arises from mistaken beliefs which form expectations that are better than the reality. It makes us underestimate chances of a negative outcome and ignore warnings repeatedly.
The Indian economy had a dream run for five years from 2003-04 to 2007-08, with an average annual growth rate of around 9%. Many believed that India was on its way to clocking consistent double-digit growth and comparisons with China were rife. It was conveniently overlooked that this output expansion had come mainly came from a few sectors: automobiles, telecom and business services.
Indians were made to believe that we could sprint without high-quality education, healthcare, infrastructure or banking sectors, which form the backbone of any stable economy. The plan was to build them as we went along, but then in the euphoria of short-term success, it got lost.
India’s exports of goods grew from $20 billion in 1990-91 to over $310 billion in 2019-20. Looking at these absolute figures it would seem as if India has arrived on the world stage. However, India’s share of global trade has moved up only marginally. Even now, the country accounts for less than 2% of the world’s goods exports.
More importantly, hidden behind this performance was the role played by one sector that should have never made it to India’s list of exports—refined petroleum. The share of refined petroleum exports in India’s goods exports increased from 1.4% in 1996-97 to over 18% in 2011-12.
An import-intensive sector with low labour intensity, exports of refined petroleum zoomed because of the then policy regime of a retail price ceiling on petroleum products in the domestic market. While we have done well in the export of services, our share is still less than 4% of world exports.
India seemed to emerge from the 2008 global financial crisis relatively unscathed. But, a temporary demand push had played a role in the revival—the incomes of many households, both rural and urban, had shot up. Fiscal stimulus to the rural economy and implementation of the Sixth Pay Commission scales had led to the salaries of around 20% of organized-sector employees jumping up. We celebrated, but once again, neither did we resolve the crisis brewing elsewhere in India’s banking sector, nor did we improve our capacity for healthcare or quality education.
Employment saw little economy-wide growth in our boom years. Manufacturing jobs, if anything, shrank. But we continued to celebrate. Youth flocked to low-productivity service-sector jobs, such as those in hotels and restaurants, security and other services. The dependence on such jobs on one hand and high-skilled services on the other was bound to make Indian society more unequal.
And then, there is agriculture, an elephant in the room. If and when farm-sector reforms get implemented, celebrations would once again be premature. The vast majority of India’s farmers have small plots of land, and though these farms are at least as productive as larger ones, net absolute incomes from small plots can only be meagre.
A further rise in farm productivity and consequent increase in supply, if not matched by a demand rise, especially with access to export markets, would result in downward pressure on market prices for farm produce and a further decline in the net incomes of small farmers.
We should learn from what John Treacy did right. He didn’t give up, and pushed for the finish line like it was his only chance at winning. Treacy had years of long-distance practice. The same goes for our economy. A long grind is required to build up its base before we can win and celebrate. And Ovett did not blame anyone for his loss. We play the blame game. Everyone else, right from China and the US to ‘greedy corporates’, seems to be responsible for our failures.
We have lowered absolute poverty levels and had technology-based successes like Aadhaar and digital access to public services. But there are no short cuts to good quality and adequate healthcare and education services. We must remain optimistic but stay firmly away from the optimism bias.
In the end, it is not about how we start, but how we finish. The disastrous second wave of covid and our inability to manage it is a ghastly reminder of this fact.