Introduction. Syndemic South Asia: Health Politics and Inequalities

Abstract

is not a pandemic" as Richard Horton, the editor of The Lancet, one of the most prestigious international medical journals, put it in September, 2020 (Horton 2020). Rather, it is a "syndemic," a disease caused by social inequalities and by the ecological crisis understood in the broadest sense. First conceived by Merrill Singer, an American medical anthropologist, in the 1990s, this notion emphasizes the socioeconomical, politico-institutional, and ecological origins of pandemics (Singer Bulled, Ostrach, and Mendenhall 2017). The most important consequence of seeing COVID-19 as a syndemic is the underlining of its social origins. For Horton, it is not only the disrupted climate, or the continuous increase in chronic diseases that are weakening the population's state of health in the face of new health risks; COVID-19 also appears to be the umpteenth episode in a long series of economic and political choices that have amplified the dismantling of health systems. The lesson drawn by The Lancet is clear: if we do not change our economic, social and political model, if we continue to treat the virus as a biological event whose circulation needs only to be "blocked," health disasters will continue to multiply. 1 2 At the end of 2019, while Wuhan province was dealing with the onset of the COVID-19 pandemic, South Asia had other preoccupations. India was facing massive and violent uprisings against the Citizenship Act passed by parliament, which was deemed anti-Muslim. The authorities seemed unconcerned about the virus and denied any possibility of local transmission, despite the first cases identified in January 2020 in Kerala. Until March, the Indian authorities produced communiqués stating that there was no community transmission of the virus and that it was cases coming from abroad that were to blame. Finally, after this phase of denial, the Prime Minister announced on 24 March 2020, four hours before it came into effect, the complete lockdown of the country for 21 days, which was immediately followed by another two-week period. This lockdown, which was the "most wide-reaching that the world had ever seen," had disastrous economic effects. Many other South Asian states quickly ensured that they