Day 42 – Q 2. In the light of the ongoing COVID-19 pandemic and the preparedness to deal with the upsurge in cases, what lessons can be learnt by India’s healthcare sector? Discuss.

2. In the light of the ongoing COVID-19 pandemic and the preparedness to deal with the upsurge in cases, what lessons can be learnt by India’s healthcare sector? Discuss.  

चल रहे COVID-19 महामारी और मामलों में होने वाली गड़बड़ी से निपटने की तैयारियों के मद्देनजर, भारत के स्वास्थ्य सेवा क्षेत्र द्वारा क्या सबक सीखा जा सकता है? चर्चा करें।

Demand of the question:

It expects students to put forth their views on the kind of lessons be learnt by India’s healthcare sector in the light while dealing with COVID-19 pandemic.

Introduction:

The novel corona virus pandemic is the most devastating public health emergency in this 21st century of human history. It is making countries around the world take a hard look at their health systems. India’s inadequate health infrastructure accompanied by factors like population density, poverty and illiteracy made India highly vulnerable to Covid-19.

Body: 

Since, Covid-19 is a respiratory pathogen, its spread over the world is unprecedented. Hence, World Health Organisation has declared it as a Pandemic. In this context, India needed an adequate  preparedness to deal with this global emergency.

India’s Vulnerable Health infrastructure and Covid-19:

• The total expenditure by the Centre and states for FY20 was ₹2.6 trillion, or 1.29% of GDP, including establishment expenditure comprising salaries, gross budgetary support to various institutions and hospitals and transfers to states under centrally sponsored schemes such as Ayushman Bharat.
• India’s total healthcare spending is  (out-of-pocket and public), at 3.6% of GDP, as per OECD, is way lower than that of other countries. The average for OECD countries in 2018 was 8.8% of GDP. Developed nations—the US (16.9%), Germany (11.2%), France (11.2%) and Japan (10.9%)—spend even more.
• According to WHO, India has only 80 doctors per 1,00,000 people.
• Lack of Primary Healthcare Services: The existing public primary health care model in the country is limited in scope. Even where there is a well-functioning public primary health centre, only services related to pregnancy care, limited childcare and certain services related to national health programmes are provided. 
• It is implicit that the primary healthcare sectors network lags training to deal with the emergency situations like COVID-19 pandemic.
• Supply-Side Deficiencies: Poor health management skills and lack of appropriate training and supportive supervision for health workers prevent delivery of the desired quality of health services. 
• Overlapping Jurisdiction: There is no single authority responsible for public health that is legally empowered to issue guidelines and enforce compliance of the health standards. e.g. Recent eruptionof  controversy between ICMR and AIIMS due to Different guidelines to treat COVID-19.
• Sub-optimal Public Health System: Due to this, it is challenging to tackle Communicable Diseases, which is all about prevention and early detection. It diminishes preparedness and effective management for new and emerging threats such as pandemic like Covid-19.
• Lack of health care infrastructure: Many of the hospitals even in metro cities lacked major health care equipments such as ventilators, pulse oximeters, etc. For instance, Non-availability of beds to treat COVID-19 suspects is observed in many of the hospitals across India.
• While the public health system has gone into overdrive to tackle Covid-19, the response from private healthcare providers – responsible for 70% of healthcare provisioning in India – has been muted. There have been reports of massive overcharging of Covid-19 patients, with rates charged in Mumbai by certain private hospitals being up to Rs one lakh per day.

The Covid-19 pandemic is concentrated in cities and has affected the middle class. Illness can attack anyone. Hence, We need Right to Healthcare to protect everyone.

Following steps needed to be taken to strengthen healthcare system in India.

• India can raise its supply—8.5 hospital beds and 8 physicians per 10,000 people—to the standards of Japan and South Korea: over 100 beds per 10,000 people.
• For this, a specially designed fiscal stimulus can be funnelled into public health and policy bottlenecks removed so that the sector becomes the engine of GDP growth.
• Creating a Nodal Health Agency: There is need to create a designated and autonomous focal agency with the required capacities and linkages to perform the functions of disease surveillance, information gathering on the health impact of policies of key non-health departments, maintenance of national health statistics, enforcement of public health regulations, and dissemination of information to the public. 
• In this pursuit, NITI Aayog’s National Health Stack is a step in the right direction, which needs to be operationalised as soon as possible.
• India must also rapidly increase its operational labs for rapid diagnosis, equip hospitals, and train medical staff for isolation and treatment of those infected.
• Behavioural Change: There is a need to ensure people eat right, sleep right, maintain good hygiene, exercise, and adopt a healthy lifestyle that necessitates concerted interventions at various levels of the system. For example, In order to catalyse people’s participation for healthy India, there is need for Swasth Bharat Jan Andolan on lines of Swach Bharat Abhiyan also promoting Ayurveda as healthy way of life.
• Kerala’s experience in 2018 with the deadly Nipah virus showed the value of investing in education and health over the long term.
• There is a need to establish an emergency loan facility, as the World Bank uses for disasters, natural or health, that can help augment own resources in times of a public health catastrophe. Subsidized loans, earmarked land, single-window approvals, tax holidays, etc. can be used for making medical devices and drugs and setting up hospitals.

Pandemics such as Covid-19 starkly remind us that public health systems are core social institutions in any society. The government has made several efforts to address the shortfall in the public health system through the schemes like the National Medical Commission (NMC) Act, 2019, Pradhan Mantri Bhartiya Janaushadhi Pariyojana, Pradhan Mantri – Jan Arogya Yojana etc.

Conclusion:

Hence, the need of the hour is an adequate investment, for creating a health system that can withstand any kind of public health emergencies, deliver universal health coverage and meet the targets of the Sustainable Development Goals. So, that India can withstand any kind of COVID-19 like pandemic situation in future and win over it.