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.
