About the Session: Join Dinsha Mistree, Research Fellow at the Hoover Institution and in the Rule of Law Program at Stanford Law School, to discuss "The Troubling State of India's Democracy," a volume he is co-editing with Sumit Ganguly and Larry Diamond.
Online, via Zoom
Innovation and entrepreneurship rank highly on the strategic agenda of most countries today. As global economic competition intensifies, many national policymakers now recognize the central importance of entrepreneurship education and the building of financial institutions to promote long-term innovation, entrepreneurship, and economic growth. Drivers of Innovation brings together scholars from the United States and Asia to explore those education and finance policies that might be conducive to accelerating innovation and developing a more entrepreneurial workforce in East Asia.
Some of the questions covered include: How do universities in China and Singapore experiment with new types of learning in their quest to promote innovation and entrepreneurship? Is there a need to transform the traditional university into an “entrepreneurial university”? What are the recent developments in and outstanding challenges to financing innovation in China and Japan? What is the government’s role in promoting innovative entrepreneurship under the shadow of big business in South Korea? What can we learn about the capacity of services to drive innovation-led growth in India?
Drivers of Innovation will serve as a valuable reference for scholars and policymakers working to develop human capital for innovation in Asia.
Entrepreneurship, Education, and Finance in Asia
Arzan Tarapore analyzes key factors in the India–Pakistan military dynamic to explore how internal and external factors account to balance the military dynamic between the volatile conflict and prevent any major escalations in disputes. Tarapore argues that geography, economic fragility, strategic implications, and a variety of other qualitative factors serve to deter the two nations from any major conflict escalation.
This chapter is part of the volume Routledge Handbook on South Asian Foreign Policy, edited by Aparna Pande.
U.S. strategy, directed toward an escalating competition with China, now sees the Indian Ocean as inseparable from the Pacific—combined in an organic Indo-Pacific whole—and India as a linchpin partner in it. As the United States plans to redouble its military power in the western Pacific, it is relying on India to grow more powerful and help safeguard their shared interests in the Indian Ocean, easing demands on U.S. resources in that region.
But that will not be the end of the story. India remains the most consequential strategic actor in the Indian Ocean by virtue of its geographic centrality, economic and military power, and abiding networks of influence across the region. But its capabilities and intentions—and therefore the strategic trajectory of the Indian Ocean—will continue to evolve as they have since the uncertain days of 1989 and long before. What if in the coming years India fails to expand its military power as its champions expect and instead is outmatched by China in the Indian Ocean? Or what if, in the throes of competition with China, India exercises its power more nakedly than its regional partners would wish? Relatedly, what if the United States, which has for decades underwritten regional security, chooses to retrench its strategic presence to focus efforts in the western Pacific? Policymakers in Washington, Canberra, and regional capitals would be well-advised to accept that many trajectories—some sharply divergent—are possible.
This essay offers a preliminary attempt at illustrating some of those sharply divergent scenarios. It uses a novel alternative futures methodology known as major/minor trends to derive scenarios of Indian and U.S. strategic behavior and their resulting effects on the Indian Ocean region. The essay briefly introduces the methodology and then sketches three alternative futures designed around a relatively weaker India, an aggressive India, and a retrenching United States, respectively. Each scenario is designed to convey a key lesson for policymakers on the fragility of the assumptions that underpin current policy.
Governments around the world suspended immunization outreach to control COVID-19 spread. Many have since resumed services with an emphasis on catch-up vaccinations. This paper evaluated immunization disruptions during India’s March-May 2020 lockdown and the extent to which subsequent catch-up efforts reversed them in Rajasthan, India.
In this retrospective observational study, we conducted phone surveys to collect immunization details for 2,144 children that turned one-year-old between January and October 2020. We used logistic regressions to compare differences in immunization timeliness and completed first-year immunization status among children that were due immunizations just before (unexposed), during (heavily exposed), and after (post-exposure) the lockdown.
Relative to unexposed children, heavily exposed children were significantly less likely to be immunized at or before 9 months (OR 0.550; 95% CI 0.367–0.824; p = 0.004), but more likely to be immunized at 10–12 months (OR 1.761; 95% CI 1.196–2.591; p = 0.004). They were also less likely to have completed their key first-year immunizations (OR 0.624; 95% CI 0.478–0.816; p = 0.001) by the time of the survey. In contrast, post-exposure children showed no difference in timeliness or completed first-year immunizations relative to unexposed children, despite their younger age. First-year immunization coverage among heavily exposed children decreased by 6.9 pp to 10.4 pp (9.7% to 14.0%). Declines in immunization coverage were larger among children in households that were poorer, less educated, lower caste, and residing in COVID red zones, although subgroup comparisons were not statistically significant.
Disruptions to immunization services resulted in children missing immunization during the lockdown, but catch-up efforts after it was eased ensured many children were reached at later ages. Nevertheless, catch-up was incomplete and children due for their immunizations during the lockdown remained less likely to be fully immunized 4–5 months after it lifted, even as younger cohorts due for immunizations in June or later returned to pre-lockdown schedules.
This article was first published by the social and political economy portal IndiaSpend.
Women from poor households made about 235,000 fewer hospital visits compared to men for seven gender-neutral disease categories between January 2017 and October 2019, a new study analyzing a Rajasthan state health insurance scheme has estimated. The Bhamashah Swasthya Bima Yojana aims to provide health insurance to about 46 million persons living below the poverty line, as a step towards universal and equitable access to healthcare in the state, per the study.
Pascaline Dupas and Radhika Jain of Stanford University studied data of insurance claims from 4.2 million hospital visits under the Bhamashah scheme from its launch in December 2015 till October 2019, and the study was published as a National Bureau of Economic Research working paper. The study was conducted in partnership with the Rajasthan state government.
Women made up 45% of hospital visits under the Bhamashah scheme between January 2017 and October 2019, though their share in the population is 48%, per the study. The gender gap is starker for girls and older women. The share of girls in children aged under 10 years who visited the hospital under this insurance program was 33%, though their share of this age group's population is 47%; among those aged above 50 years, women are 51%, yet their share of hospital visits under this insurance program was 43%.
"We were struck by this discrepancy in the data. We were not expecting such a large [gender] difference," Dupas, an economist and professor at Stanford University, told IndiaSpend. In most other developed countries for which such data have been analyzed, subsidized healthcare usually caters to those who otherwise don't have access to it, added Jain, a postdoctoral fellow in Asia Health Policy at Stanford University, US.
A new study of the Rajasthan government's Bhamashah health insurance program for poor households has found that just providing health insurance cover doesn't reduce gender inequality in access to even subsidized health care.
This opinion piece was first published in the economics and policy portal Ideas for India.
Equity in healthcare is a key goal of health policy in India. Analyzing administrative data from Rajasthan, this article highlights substantial gender gaps in the utilization of subsidized hospital care under the state health insurance program. These disparities persist despite substantial program expansion and seem to be driven by households being less willing to allocate resources to female vis-à-vis male health.
Over the past 15 years, India’s central government and numerous state governments have put in place health insurance programmes that entitle low-income households to free healthcare at public and empanelled private hospitals. Health equity and universal health coverage are explicit goals of these programs. In new research, we study gender equity in the Bhamashah Swasthya Bima Yojana (BSBY)1 health insurance program, which was launched in the state of Rajasthan in 2015, and is similar in design to the national Pradhan Mantri Jan Arogya Yojana (PMJAY).
Our starting point is a dataset of insurance claims filed for all 4.2 million hospital visits between 2015 and 2019, including patient age, gender, residence address, hospital visited, dates of admission and discharge, and service(s) received. We geo-coded hospital locations and patient addresses, which allowed us to calculate proximity to hospitals and the distance traveled for every hospital visit. Finally, we linked the insurance data to the 2011 Census and data on three rounds of village-level (gram panchayat) elections. To our knowledge, the dataset we compiled from these various sources is the first dataset of its type in India and allows us to study care-seeking under insurance with unusual granularity.
Stanford University researchers' study of Bhamashah Swasthya Bima Yojana reveals that just expanding geographical access and reducing the cost of healthcare won't reduce gender disparity.
Using administrative data on over 4 million hospital visits, we document striking gender disparities within a government health insurance program that entitles 46 million poor individuals to free hospital care in Rajasthan, India. Females account for only 33% of hospital visits among children and 43% among the elderly. These shares are lower for more expensive types of care, and far lower than sex differences in illness prevalence can explain. Almost two-thirds of non-childbirth spending is on males. We combine these data with patient survey, census, and electoral data to show that 1) the program is unable to fully offset the costs of care-seeking, which results in disparities in hospital utilization because some households are willing to allocate more resources to male than female health; 2) lowering costs does not reduce disparities, because males benefit as much as females do; and 3) long-term exposure to village-level female leaders reduces the gender gap in utilization, but effects are modest and limited to girls and young women. In the presence of gender bias, increasing access to and subsidizing social services may increase levels of female utilization but fail to address gender inequalities without actions that specifically target females.
This blog post was first published by the Australian Strategic Policy Institute's The Strategist analysis and commentary site.
The Quad is stronger than ever. The informal ‘minilateral’ grouping of Australia, India, Japan and the United States has in the past year held its first stand-alone ministerial meeting and its first leaders’ summit, and launched an ambitious project to deliver Covid-19 vaccines. This ‘golden age’ of the Quad is a product of newfound Indian enthusiasm for the grouping, in turn, spurred by the military crisis in Ladakh, where India faces ongoing Chinese troop incursions across the two countries’ disputed border.
But the Quad is not bulletproof. Some experts have suggested that the economic and diplomatic effects of the devastating second wave of the pandemic in India will preoccupy the Indian government, sapping the Quad of capacity for any new initiatives. Others counter that India remains committed to competition with China—which is what really matters for the Quad—although its partners always expected ‘two steps forward, one step back’ from India.
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Related: On the Conversation Six podcast, Tarapore discusses the policy paper on which this blog post is based with Jawaharlal Nehru University Professor of International Politics Rajesh Rajagopalan. Listen:
The pandemic may well prove to be a hiccup in the Quad’s evolution, but a potentially much larger disruption may come from the ongoing Ladakh crisis itself. As I argue in a new ASPI Strategic Insights paper, the crisis has greatly increased the risk of a border war between India and China, which would present a defining test of the Quad. A possible war could either strengthen or enervate the Quad—depending on how India and its partners, including Australia, act now to shape the strategic environment.
Risk is a function of likelihood and consequence. The likelihood of war on the India–China border is still low—both countries would prefer to avoid it—but has risen since the crisis began. Both countries have greatly expanded their military deployments on the border and backed them with new permanent infrastructure to resupply and reinforce them. China has proved its revisionist intent with large and costly military incursions, although its specific objectives and plans remain unknown. And the interaction of both countries’ military strategies and doctrines would, on the threshold of conflict, promote escalation.
The consequences of a possible conflict would be dire for both belligerents and for the region. China — assuming it is the provocateur of conflict—would likely face some political rebuke from states that consider themselves its competitors, but it will work strenuously to reduce those costs, and would likely have priced them in to its calculations of whether to fight. India will suffer high tactical costs on the border, and may also suffer wider harm if China uses coercive cyberattacks against strategic or dual-use targets.
In a costly war, the repercussions may spill over to damage India’s recently developing strategic partnerships, especially with the United States and Australia. Despite generally favorable views of the US, the Indian strategic elite still harbors some latent suspicions. This was highlighted in two episodes in April 2021, when the US Navy conducted a freedom of navigation patrol through the Indian exclusive economic zone, and when the US was slow in delivering Covid-19 vaccine raw materials and other relief. Both instances quickly receded from the Indian public imagination—thanks to quick correctives from Washington—but they did reveal that, under some conditions, Indian perceptions of its new partnerships can be quickly colored by distrust.
A China–India border war may create exactly those conditions. There is a chance that conflict may result in a redoubled Indian commitment to the Quad, if New Delhi judges that it has no option but to seek more external assistance. Conversely, unless a conflict is managed well by India and its partners, it is more likely to result in Indian disaffection with the Quad. India deepened Quad cooperation during the Ladakh crisis partly as a deterrent signal to China, and partly because the Quad is still full of promise. However, after a conflict—when China hasn’t been deterred and has probably imposed significant costs on India—the Quad’s utility would have been tested, and probably not ameliorated India’s wartime disadvantage.
The task before Quad governments is to be sensitized to this risk and implement mitigation strategies before a possible conflict, to buttress the coalition in advance. As I outline in the ASPI paper, they could do this at three levels. First, they could offer operational support—such as intelligence or resupply of key equipment, as the US already has done in the Ladakh crisis—although Quad partners’ role here would be limited. Second, they could provide support in other theatres or domains—with a naval show of force, for example, although cyber operations would probably be more meaningful in deterring conflict or dampening its costs. Third, they could provide political and diplomatic support — signaling to Beijing that a conflict would harm its regional political standing.
For Quad members, the main goal would be to deter conflict in the first place, and, failing that, to preserve the long-term strategic partnership with India for the sake of maintaining as powerful and energetic a coalition as possible to counterbalance China in the long term.
The Ladakh crisis between China and India seems to have settled into a stalemate, but its trajectory could again turn suddenly. If it flares into a limited conventional war, one of its incidental victims could be the Quad.
The Ladakh crisis between China and India seems to have settled into a stalemate, marked by somewhat reduced tactical tensions and continuing fruitless talks on disengagement—but its trajectory could again turn suddenly, even flaring into a limited conventional war. Despite a limited disengagement, both sides continue to make military preparations near the Line of Actual Control (LAC) to increase their readiness for potential conflict. While China proved its revisionist intent with its 2020 incursions, its specific goals and plans remain opaque. The broader political context is marked by distrust and hostility, and bilateral relations are at their lowest ebb in decades. War remains unlikely—both sides can ill-afford the distraction from higher national priorities and have demonstrated a recent keenness to step back from the brink. But, with growing capabilities and unclear intent, and with military operations no longer impaired by winter, the Ladakh crisis may still escalate to conflict.
The crisis has been full of surprises. Despite observing major military maneuvers in China, India didn’t anticipate the multiple incursions across the LAC in May 2020. For weeks thereafter, the Indian Army leadership insisted the incursions were nothing out of the ordinary. After both sides agreed to an early disengagement plan, the crisis took a shocking turn with a deadly skirmish in June — the first loss of life on the LAC in 45 years. India also mustered its own surprises, deploying troops to occupy tactically valuable heights in late August, to gain some bargaining leverage. And the crisis also abated with a surprise, with the sudden announcement of disengagement from heavily militarised stand-off sites around Pangong Tso Lake in February 2021.
Future surprises may yet occur. This paper argues that the risk of China–India conflict is significant because, even if its likelihood is low, its consequences may be considerable. A limited conventional war would be likely to impose significant costs on India, but, depending on the reactions of its partners, it may also reinforce latent Indian suspicions over the utility and reliability of its strategic partnerships. In that way, even a localized limited war on the LAC may have far-reaching implications, if it incidentally drives a wedge between India and its partners in the Quad. Mitigating that risk will require sound policy settings and astute diplomatic and public messaging from Canberra, Washington, Tokyo, and other like-minded capitals.
The remainder of this paper is in three parts: first, why a border war is plausible; second, what costs it would impose on India and how it might stir distrust of India’s Quad partners; and, finally, a framework to mitigate those risks.
