Why India needs transparency about the health of Amit Shah and other leaders

The union home minister, Amit Shah, has been hospitalised thrice in the last six weeks. On 2 August, Shah, the most powerful political leader in the country after Prime Minister Narendra Modi, tweeted that he had contracted the novel coronavirus. He checked into a private hospital in the national capital region. There were no updates about his health till he was discharged on 14 August after reportedly testing negative for the disease. Three days later, at 2 am on the intervening night between 17 and 18 August, he was rushed to the All India Institute of Medical Sciences for “post-COVID care,” according to a press statement issued by the hospital. Shah was discharged on 30 August, and within two weeks, late night on 12 September, he was admitted to AIIMS once again.

With the hospitalisation through most of August, India was left without an active home minister for almost the entire month. The latest hospital admission came two days ahead of a two-week Parliament session, which will begin from Monday, 14 September. It is uncertain if the home minister will recover in time for the session, but according to an AIIMS press release issued on 13 September, Shah “has now been admitted for complete medical checkup before parliament session for 1-2 days.” Apart from these snippets of vague details released by AIIMS, the hospital and the home ministry have provided little information about the health of the minister and his ability to attend to matters of significant national importance.

Shah has a crucial session ahead, and hospitalisation would mean that the home minister would be unavailable to appraise Parliament about major policy matters. His portfolio covers a spectrum of critical internal-security issues, including those relating to the raging COVID-19 pandemic that has seen India cross Brazil to become the second-worst affected nation in the world, with the highest daily surges in infections seen so far globally. Shah oversees the two crucial union territories of Ladakh, where there is a Chinese incursion, and Jammu and Kashmir, with its unstable internal security. Immediate issues before the minister include the deployment of the Indio-Tibetan Border Police on the Ladakh border with China, signing off on all senior bureaucratic appointments before the Appointments Committee of the Cabinet and salvaging the Naga-peace process, which has hit a deadlock after 23 years of negotiations. Shah is also a member of the Cabinet Committee on Security, which decides on matters of military action. 

It may not be possible to engage with these critical issues from a hospital bed or when one is fatigued due to an illness. The ability of an elected representative holding public office to function efficiently ought to be a matter of public concern. However, in India, the health of elected public officials is considered a “personal” issue—an aspect of individual privacy not to be discussed publicly.

This was witnessed in the cases of Arun Jaitley and Sushma Swaraj, who continued to hold office despite acute illness and possible physical and mental vulnerabilities resulting from their ailments. The most striking case was that of Manohar Parrikar, who continued as the chief minister of Goa despite a pancreatic cancer diagnosis, and even appeared at public events with enhanced oxygenation tubes attached and intravenous fluid bottles in tow. 

The public disclosure of the health of top leaders is less secretive in several other countries. On 28 August, Japan’s prime minister, Shinzo Abe, announced his resignation because of ill-health. He informed the nation that the recurrence of a chronic bowel ailment did not allow him to carry on as prime minister. Abe had also resigned as premier in 2007 because of the same condition. Such transparency is in marked contrast to practices elsewhere including in India, where the health of its political leaders is treated almost as a state secret. 

In the United States, there is a convention—though not a legal requirement—that the president undergoes an annual medical check-up and makes his health report public. The president can, however, choose his doctor and control what information is released. Many American presidents including John F Kennedy, Ronald Reagan and Franklin Roosevelt are known to have hidden their illnesses while in office, although none of them died of it during their presidency. Yet, it is clear that the convention existed because of a recognition that the health of a national political leader is an issue of public importance. 

As with Shah and these US presidents of past, other world leaders have also historically shown a tendency to keep their medical ailments a secret. In 1996, Claude Gubler, the physician to a former French president, Francois Mitterrand, revealed that the president had hid information about his prostate cancer while in office. Excerpts from Gubler’s book, The Great Secret, were published weeks after Mitterrand’s death and revealed that the former president had learnt that he suffered from prostate cancer just months after he assumed office, in 1981, but did not disclose this information to the French public. His secret assumed scandalous importance in light of the fact that during his election campaign that year, Mitterrand assured the electorate that he would publish regular bulletins about his health. The assurance came after Georges Pompidou, a previous French president, died in office in 1974 from a rare cancer.

According to Gubler, upon receiving his cancer diagnosis in November 1981, Mitterrand swore his doctors to silence, instructing them, “We must reveal nothing. This is a state secret to which you are bound.” The cancer finally killed Mitterrand in 1996, but according to Gubler, by 1994, he considered the president “no longer capable of carrying out his duties.” The doctor wrote, “He was no longer fulfilling the mandate for which the French people had elected him. He was no longer working, because nothing except his illness interested him.”

The phenomenon of keeping the leader’s health secret is even more pronounced in the developing world. In several African countries, public discussion of a leader’s health is a punishable offence. One knows nothing about the health of the Chinese leadership, and speculations about North Korean leader Kim Jong-un’s health are legendary. In countries where leaders do not adhere to a fixed term in office or are not democracies, such secrecy complicates leadership transition. However, even in democracies, there is no mandated disclosure of the health of the elected leaders. 

In India, the general practice appears to be that as long as a person “claims” to be healthy, he or she is allowed to continue in public office. However, there is no transparent process to determine whether the quality of governance and policy making is suffering because of the health of a leader, or even any clear information on who makes this decision. No independent verification is seen to be necessary. 

Revealing the health condition of a leader requires a tough balancing act between transparency and individual privacy. While transparency contributes to public accountability, its absence can endanger the nation, the government and impact public interest. Transparency also allows voters to choose a healthy leader over someone who may not be up to the rigours of public office. However, public figures also require individual privacy like other citizens. Revealing their health details may give an unfair advantage to their rivals. Such details are also known to roil the financial markets and impact relations with other countries. 

Determining which is more important—the need for transparency or privacy—is not an easy task. But it cannot be left to the wisdom of the affected leader. Disclosing the health status of ministers should be incorporated in constitutional and legal processes, and not left either to them or their patrons. Mandatory disclosures would make Indian democracy more secure and stable.

Correction: An earlier version of this article incorrectly stated that the former US president John F Kennedy did not die during his presidency, instead of stating that he did not die during his term due to a hidden illness. The Caravan regrets the error.