by Professor Dr Dasan Swaminathan
Democracy, long regarded as a cornerstone of just and participatory governance, is now experiencing a period of profound disruption.
Despite maintaining electoral processes, many democracies are witnessing rising political instability, institutional weakening and growing public disillusionment.
This article examines the widening gap between democratic ideals and contemporary realities, highlighting the consequences for governance, public health, and long-term societal resilience. A call is made for the renewal of democratic values through robust institutions, ethical leadership, and civic engagement.
Democracy has historically symbolised the empowerment of citizens and the equitable distribution of political power. However, the current global landscape reflects an increasing divergence from these ideals. Numerous studies indicate a troubling trend toward democratic backsliding —where core principles such as transparency, accountability and citizen participation are progressively undermined.
While the formal structures of democracy (e.g., elections, parliaments, constitutions) remain intact, the substance of democratic governance—freedom of expression, independent institutions and civil liberties—is increasingly at risk.
Defining Democracy: Ideals and Principles
The word “democracy” originates from the Greek dēmokratía, meaning “rule by the people”. In modern political theory, democracy is defined as a system in which citizens exercise power by voting in free and fair elections, with elected representatives held accountable to the public.
Core democratic principles include:
• Political participation and pluralism
• Rule of law and constitutional governance
• Equality before the law
• Institutional checks and balances
• Protection of fundamental rights and civil liberties
These elements are essential not only for political legitimacy but also for societal stability and development.
The Reality: A Drift from Democratic Ideals
Despite democratic frameworks, the actual practice of democracy often reveals systemic shortcomings. Elected officials may initially campaign on platforms of public service and reform but can become increasingly detached from the electorate after consolidating power
Political patronage, clientelism and elite capture frequently distort the decision-making processes.
Institutions meant to protect democratic integrity—such as anti-corruption agencies, independent judiciaries and free media—may become co-opted or weakened. Political interference in institutional functioning contributes to a broader erosion of trust in governance
Consequences of Democratic Decline
The degradation of democratic systems has profound and measurable consequences. Empirical data links democratic erosion to slower economic growth, weaker development outcomes and heightened inequality. Moreover, public dissatisfaction leads to political disengagement, voter apathy and social unrest.
Critically, health systems are among the most vulnerable sectors in politically unstable environments. Evidence shows that countries with poor governance and weak accountability mechanisms often experience higher mortality rates, inequitable health access and reduced resilience to public health crises. The COVID-19 pandemic, for instance, exposed stark disparities in health governance and preparedness—often along lines of political integrity and institutional capacity.
Without effective democratic oversight, health funding can be misallocated, essential services neglected and vulnerable populations overlooked—adversely impacting not only current health outcomes but also intergenerational wellbeing.
Reviving the Democratic Spirit
Revitalising democracy requires more than procedural reforms. It necessitates the cultivation of ethical leadership, institutional independence, active civic engagement and a renewed commitment to public service.
Strengthening electoral systems, ensuring judicial autonomy, fostering media freedom and encouraging civic education are foundational steps.
Scholars and policymakers increasingly advocate for a “deliberative democracy” model—where citizen participation extends beyond voting and includes meaningful involvement in policymaking and institutional accountability.
Modern democracy is at a crossroads and faces a critical juncture. If present trends continue unchecked, democratic systems may persist in form but be hollow in function. To safeguard democratic values and ensure societal resilience, especially in essential sectors such as healthcare, urgent reform is needed.
The time is now to revisit democracy’s founding ideals and reinvigorate them through principled governance, institutional integrity, and inclusive civic participation. Only then can democracy truly serve its intended purpose — empowering.
Professor Dr Dasan Swaminathan is an Advocate for Healthcare for All and A Just and Fair World
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