When Mansukh Mandaviya was named India's new health minister, many were surprised that Narendra Modi picked him to head the ministry at this crucial juncture. The decision, however, was rather natural. The low-profile man from rural Gujarat is not new to Delhi. He has walked the power corridors for around a decade—first as a Rajya Sabha member, and since 2016, as Modi's man across ministries, taking on the role of junior minister, be it road transport and highways, or chemicals and fertilisers.
Modi relies on a certain brand of men and women for executing his vision. He likes technocrats. And, he likes people he has worked with in the past, especially the younger lot who can go far if they work well. Mandaviya is from the latter group, having been a legislator when Modi was Gujarat chief minister. During their Gujarat years, Modi had said he saw a bright future for Mandaviya. The 49-year-old has so far proved worthy of Modi's trust in almost every assignment, whether it was in managing the BJP’s membership drive in Gujarat or representing India at the United Nations on sustainable development.
Mandaviya's elevation has much to do with his quiet, diligent work. While Rajpath was abuzz with what the cabinet reshuffle would bring, Mandaviya was busy visiting the premises of Zydus Cadila, which is making the ZyCoV-D vaccine for Covid-19. He is vested with two ministries now—health, and chemicals and fertilisers—hoping to bring synergy between them. The need to ramp up vaccination is underscored by doctors and researchers alike, who say the severity of the dreaded third wave is directly dependant on how well India vaccinates its population.
“The medical code of ethics does not allow doctors to promote drugs on brand name, and the same code should be extended to the minister, too. Handling this combination of ministries could cause a conflict of interest,” says J.A. Jayalal, national president, Indian Medical Association. In these extraordinary times, the helmsman’s ability will ensure whether conflict can be turned into confluence of interest. As junior minister in chemicals and fertilisers, Mandaviya helped establish more than 5,100 Jan Aushadhi stores, providing over 850 medicines at affordable rates. So far, he is on the right path.
The task of vaccine management, from manufacture to procurement to ensuring it reaches the neediest, will claim a lot of his time. Its success or failure will be overtly visible. Failure, however, will scream louder than success. “Mandaviya needs to ramp up infrastructure and manpower for that third wave, if and when it happens,” notes Shuchin Bajaj, founder director of Cygnus Ujala Hospitals and member of StepOne, a collective of professionals and volunteers fighting the pandemic. The country cannot afford the helplessness and global humiliation of April, when the world saw India gasping for breath and even countries that had so far been recipients of Indian largesse sent us oxygen cylinders.
The price of freedom: A big crowd in McLeod Ganj, Himachal Pradesh, with lockdown restrictions being lifted. A major challenge for Mandaviya is to be prepared for the known unknowns of the pandemic | Aayush Goel
While infrastructure is slowly building up, its even distribution has to be ensured. The northeast is now dealing with rising cases, and an implosion in those ill-equipped and far-to-reach areas needs requisite infrastructure. Mandaviya, along with Modi, has already had discussions with ministers of these states.
Human resource is tiring and needs fresh inputs fast. With the NEET-PG postponed, hospitals attached to colleges have an acute shortage—there are around 45,000 seats lying vacant. Doctors have been mocking the irony that they are expected to report for Covid duty, but sitting for an entrance test is deemed risky for them. With his daughter, Disha, herself a medical student on Covid work, Mandaviya has a personal understanding of the situation. He is the original Beti Padhao, Beti Bachao man, having done a padyatra in Gujarat to raise awareness for girl child education much before it became a national slogan.
Beyond the pandemic, too, Mandaviya needs to ensure that schemes like Ayushman Bharat stay functional. “Seventy per cent of health care is in the public sector, but planning considers only the private sector. Here, again, he needs to build synergy,” says Jayalal. Bajaj adds that he needs to work at making non-communicable diseases part of primary health care. “While it is good to have dialysis centres, managing hypertension at early stages reduces increase in kidney ailments,” he says.
Most importantly, Mandaviya has to show he is the right man for the job. The health ministry cannot afford the luxury of “giving him a chance”. His predecessor, Dr Harsh Vardhan, was much beloved, with a squeaky clean image, but even well-wishers admitted he failed at his job, despite being a doctor. Mandaviya needs to be the face of pandemic management, a slot currently filled by a joint secretary in the ministry. Many policy decisions, like vaccination or Vaccine Maitri, are taken at the prime minister’s office, but the inputs come from the ministries concerned. He will need to be prepared for the known unknowns of the pandemic, for this virus cuts the smug to size, and how. If he builds a cadre of medico-crats, health management in the country will improve. Another synergy he needs to work on is Centre and state, so that the ugly spats of the past months are not repeated.
Mandaviya's success will lie in how he walks the tightrope between managing his ministries and toeing the political line. For instance, while the government talks about yet another synergy between various branches of medicine, he will need to maintain the purity of systems, and let the Ayush ministry do its task. So far, he has let his work do the talking. He would do well to keep it that way, given how his predecessor's unfortunate utterances spelled his career doom.