South Asia’s healthcare burden

INTERNATIONAL/ GOVERNANCE

Topic:

• GS-2: India and its neighbourhood
• GS-2: Issues related to Health and Governance

South Asia’s healthcare burden

Context: On May 18 this year, India recorded 4,529 deaths from COVID-19, the highest daily death toll recorded in the world after the United States in January saw 4,468 deaths.

Several things are to blame for such high deaths

• super spreader events
• Fragile health infrastructure neglected for decades
• Citizens not following health protocols 
• Logistical mismanagement

As India combats the pandemic, its neighbours are experiencing spillover from the menacing second wave.

• Sri Lanka added as many as 78,218 cases in May.
• Pakistan crossed over 200 daily deaths in April, its highest since the pandemic started. 
• Bangladesh’s situation is precarious, given the recent detection of the highly contagious Delta variant. 
• Bhutan is the only exception, with only one death and 1,724 cases so far. The country’s success stems from a well-funded and prepared public health system with stringent measures, responsible citizenship, and an accountable government

Health issues in South Asia

• India’s health expenditure is little over 1% of India’s GDP. Public healthcare sector has been operating at a pitiful 0.08 doctors per 1,000 people (WHO Standard is 1 per 1,000)
• India has only half a bed available for every 1,000 people. Bangladesh and Pakistan fare no better, with a bed to patient ratio of 0.8 and 0.6, respectively.
• While ideally, out-of-pocket expenditure should not surpass 15% to 20% of the total health expenditure, for India, Bangladesh and Pakistan, this figure stands at an appalling 62.67%, 73.87% and 56.24%, respectively.
• While India has the world’s third-largest military expenditure, its health budget is the fourth-lowest. 
• In Pakistan, even amidst the pandemic, the defence budget was increased by 12% in the fiscal year 2020-21, to $7.85 billion, while the spending on health remained around $151 million.
• Major public sector investments by the ‘big three’ of South Asia, i.e., India, Pakistan, and Bangladesh, are towards infrastructure and defence, with health taking a backseat.

Way Ahead

• South Asia can take lessons in pragmatic healthcare policy from Southeast Asia, which has prioritised investments in healthcare systems while broadening equitable access through universal health coverage schemes.
• Given the high chances of another wave or even the impending crisis of climate change, stopgap measures ought to be replaced by a well-thought-out vision and political commitment for long-term healing.

Connecting the dots :

• SAARC
• BIMSTEC
• COVAX Facility