COVID-19 Response in India, Pakistan, and Bangladesh: Shared History, Different Processes

Abstract

One of the core questions emerging from the COVID-19 pandemic is what it means for governments to be prepared for a major health crisis. Does the preparedness include only access to resources, or does it also include having appropriate formal political mechanisms and political traditions?

India, Pakistan, and Bangladesh—three South Asian countries and once parts of British India—face similar healthcare and socioeconomic challenges, share histories of health crises, and rely on somewhat similar frameworks for responding to them. Anecdotally, all these countries rely—or until very recently have relied—on versions of the Epidemic Diseases Act of 1897 as a major public health response document. These similarities in the structural conditions present us with the opportunity to study the role of politics in crisis response.

In this chapter, we set out to explore the differences in the policies adopted in response to the COVID-19 crisis and the politics that produced them. We trace the nonmedical interventions at the national and subnational levels in these three countries from the early signs of the pandemic to late 2020 and examine differences and similarities in the trajectories of policymaking and subsequent policy implementation. We scrutinize the role of institutional frameworks in the formulation of this response, identify the key actors in the pandemic response, and the differences in how they interacted.

As we show in this chapter, despite the similarities in the structural characteristics and toolkits of the favored policy response instruments, the politics of response to the COVID-19 pandemic significantly diverged across the countries, with different, sometimes unexpected, actors and channels involved in the public health decision-making and with varying political outcomes. We believe that this was partly because they did not inherit a common democratic political tradition of epidemic response from the British Raj and partly due to the differences in the ways their quite similar epidemic response rules fit with their different political systems. In search for a confirmation of this belief, we examine the history of current public health frameworks in these countries and situate them in the context of their political development.