As the COVID-19 pandemic spread across India in March, the Narendra Modi government imposed the harshest lockdown in the world, exposing and exacerbating the country’s socio-economic inequalities. The pre-existing societal divisions based on caste and class resulted in the marginalised communities suffering the most under the lockdown. Migrant workers were left unemployed, struggling to pay rent, afford medical expenses or buy food. Many were unable to return home. Besides migrants, the lockdown proved to be a period of struggle for farmers, Scheduled Caste and Schedule Tribe communities, as well as women and religious minorities. The Indian government systematically failed to ensure food security, labour security and protection for marginalised communities, besides failing to slow the spread of the pandemic and ensure the equipment or manpower required to treat it efficiently. At such a time, Bhimrao Ambedkar’s ideas on social security and public health are instructive on how the country could have been better prepared to deal with a disease of this scale.
Ambedkar—commonly called Babasaheb within Dalit communities—was perhaps one of South Asia’s most prolific authors when it came to understanding and advocating public policy measures. In his oeuvre of over 20 books, countless speeches and newspaper articles, Babasaheb extensively discussed India’s serious lack of food security, labour security, feeble healthcare system and government apathy towards ensuring the welfare of its poor and marginalised communities. Much of his trenchant critique is as true today as when he wrote it. Babasaheb also enacted a range of welfare policies in his various tenures in government. Collating both Babasaheb’s writing as well as the policies he legislated allows us to see how he might have dealt with the public health crisis and humanitarian crisis that India presently finds itself in. While the full breadth of Babasaheb’s policy studies is not easily explored in a short essay, here I shall look at his food policy, his labour policy and his broader approach to the government’s role in health interventions.
Babasaheb’s ideas on social security and public health sought to address these social realities through state efforts that could help bridge the inequalities that are deeply embedded in Indian society. His idea of a democracy emphasised a state that would intervene to break down structural divisions. His conception of public goods—such as health and education—were inclusive and equitable, seeking an equal distribution of and access to public health and social security, in order to ensure the overall well-being of the masses.
Babasaheb’s idea of the government’s role in public health went beyond building medical infrastructure or advocating particular medical interventions against certain diseases. Babasaheb argued that the state’s role was to improve the social determinants of health such as nutritious food, stable income and access to clean drinking water, the lack of which caused ill health. In addition, Babasaheb argued that the removal of caste and class inequalities in access, not only to medical institutions, but to the determinants of health was an essential responsibility of the state. Health required not just medicines and hospitals, but a grappling with India’s grossly unequal social reality.
In Babasaheb’s writing, state-backed food security was an essential requirement for public health. Even in his earliest writing of comparative economy—such as the tenth volume of the 17-part series, Dr Babasaheb Ambedkar Writings and Speeches—the relationship between food security and public health is fundamental. Babasaheb writes, “Although, through various reasons, including a low birth-rate, the economic condition of the inhabitants of countries like England and America is superior to that obtaining in this country—poverty prevents many of our countrymen from obtaining a nourishing food—still it is far from satisfactory. Even there, many find it difficult to maintain a standard of life necessary for perfect health.”