by Dr Shah Alam Khan*

A plea has been filed before the Supreme Court, seeking to remove the words “socialist” and “secular” from the Preamble of the Constitution. But despite a persistent erosion over the last couple of decades, both principles were central to the type of republic our political forefathers had imagined. With the embrace of neoliberal policies in the Nineties, socialism was pushed aside. With the ongoing pandemic, however, socialism has become relevant not only for India but also the world. As the world grapples to find a vaccine for COVID-19, a closer inspection of the backwash of the pandemic reveals that socialist ideals have turned out to be a life-saver. This needs further corroboration and evaluation.

Dr Shah Alam Khan, Professor of Orthopaedics, AIIMS, New Delhi

In the neoliberal world, hardly any country can be bracketed as a purely socialist nation. Countries which provide socialised medicine are the ones which have evolved the model of what is called a welfare state — the closest cousin of yesteryear’s socialist state.

The COVID-19 pandemic has exposed the vulnerability of governments, healthcare models and political ideologies. It is thus important to see which countries have done better in this pandemic both in terms of COVID-related morbidity and mortality and the political ideology which governs them.

It is no rocket science to imagine that those nations with good health infrastructure would do better during a pandemic. Having said this, the response and outcome parameters of the pandemic have not shown such simple trends. Besides healthcare management, it also involves political response and will.

The conceptualisation and application of a good public health system, which is an important component of any form of socialism, appears to have had a better outcome during the current pandemic. Capitalist systems with privatised healthcare have fared the worst, despite a good health infrastructure in terms of the availability of state-of-art healthcare technology. The US is a classic example of the latter.

In terms of good response to the ongoing pandemic, one country which stands out in the Australasia region is New Zealand. With around 1,757 cases and a low death rate of 4.56 per million cases, New Zealand has one of the best COVID-19 figures in the world. The country is at present governed by the Labour party, which has left-of-centre leanings. The total expenditure on health as a percentage of the GDP for New Zealand is around 11 per cent. For India, despite having “socialism” in its Preamble, the figure is a dismal one per cent.

Most European nations that have performed well in the current pandemic are thorough welfare states with socialist tilts or left coalitions in power. Germany had a rapid outburst of the pandemic but was able to contain deaths very quickly. Till date, Germany reported a total of 2,47,000 cases with a death rate of 108 per million cases. Germany’s total expenditure on health is about 11 per cent of its GDP and this is about one per cent more than the average spent by other countries of the European Union on health. Portugal, which has had a coalition left-wing government for the last few years, has contained the pandemic well. Its democratically-planned lockdown was eased off earlier than many other European countries. It had a total of around 58,000 cases with 1,827 deaths. This was in stark contrast to next-door neighbour Spain, which was devastated by the virus causing 4,80,000 cases and 29,194 deaths. Portugal’s total expenditure on health is 9.5 per cent of its GDP. Yet another European nation which has done well in tackling the pandemic is Iceland, with a total of 2,121 cases and 10 deaths. Interestingly, Icelanders voted for a majority left-wing government in the general elections in 2017.

Even among the Latin American countries, those who spend more on health have performed better than those who are prudent in spending on people-centric programmes. Argentina is a classic example. With 40,000 COVID-19 cases and 8,00 deaths, it has fared far better than most of its neighbours. The country is ruled by the Peronists, who subscribe to more leftist economic policies. Argentina’s population is comparable in many respects to its neighbouring Brazil, which has a right-wing government and has been devastated by the virus, with 3.96 million cases and around 1.23 lakh deaths. Venezuela, which has been under socialist regimes for the last two decades, on the other hand, showed promising outcomes during the current pandemic. It reported 47,756 cases with only 400 deaths.

An argument against this hypothesis would be that it is difficult to compare the Indian situation with either New Zealand, Germany, Iceland or even Argentina because our population surpasses the combined population of these countries. The problem with the supporters of the market economy is that they lay all problems at the doorstep of population growth. Kerala, the best performing Indian state in the current pandemic, is also the most densely populated. Concerns of population growth have always been part of a populist agenda in which the population of the poor is the main concern. We fail to understand that the path to population stabilisation passes through the overall socio-economic development of the people, and this the COVID-19 pandemic has handsomely revealed.

To conclude, a quick glance shows that socialism is not an odd contraption ready to fall apart. Even in its most deactivated, metamorphosed, desultory form, it has been a handy weapon in successfully fighting the COVID-19 pandemic. India’s quest for a socialist system may have been waylaid but socialist principles provide a semblance of hope concerning issues pertaining to peoples’ health even in a country like ours.

*The writer is professor, department of orthopaedics, All India Institute of Medical Sciences