As a coping mechanism, humans tend to limit memories of fears they have faced in the past. As the world and India learn to live with Covid-19, those of us in a hurry to get back to normal must not forget the lessons this crisis has taught us. Most importantly, there is an urgent need to invest in and build infrastructure for our health systems.
The pandemic has shown India’s healthcare system to be in tatters.despite having Doctor population ratio If this exceeds the World Health Organization’s recommendations, India’s healthcare system will be overloaded and overworked. This is likely due to uneven access to doctors across the country, disparities in access to private and public health care, and unaffordable health care costs for the majority of Indians. The availability of doctors to serve everyone always seems to outweigh the need.
Access is critical and often not affordable for millions of Indians who struggle on a daily basis. This struggle was magnified during the Covid-19 pandemic. Public hospitals have 0.5 available beds per 1,000 inhabitants, below the national average in the 12 states that make up his 70% of the country’s population. There are even fewer ventilators and critical care beds.
Is this lack of universal access surprising? India’s healthcare budget is just over 1% of Gross Domestic Product (GDP) and ranks 107th out of 188 countries. Now is the time for nations to prioritize their people’s most precious asset: their health. The public health system is overloaded and private health care is not affordable. Here, funding implementation through robust systems and accountability is a pillar of change in policymaking and an overhaul of the overall health system. This is the first lesson.
Many died from Covid-19 because of underlying conditions. The second lesson is simple. Without investment in health, the vicious cycle of poor health, mortality and disease cannot be broken. This should be a political priority.
Even today, testing services remain limited and inadequate at best. In the private sector, diagnosis and treatment are inaccessible and often overused. Where do people go when public systems are overloaded and private systems out of reach?
A third lesson is that we need to stop viewing investments in health as well-being. Health is a human right and we pay for it with our taxes. As citizens, we must demand healthcare as a priority in our election manifesto. Long-term investment strategies for health determinants and health systems are needed.
But where do you start? We need to secure political commitment to investing in health and transforming our current health infrastructure. States should provide free or affordable testing and treatment accessible to the grassroots level. If we can’t test and treat everyone, we’re already losing half the battle. Even today, thousands of people with Covid-19 are underreported because they are not tested. Investments in diagnosis and treatment are urgently needed.
Initiatives like Jan Aushadi Kendra, which offers generic drugs at affordable prices, have not achieved the reach they need. Self-payment of medical expenses is over 60% nationally, reiterating the need for accountability as well as affordability.
Through its dedicated distributors known as Pradhan Mantri Bhartiya Janaushadhi Kendras, PMBJP aims to provide the masses with low-cost generic medicines of the same quality as other branded medicines.#PMBJP #health care #jan aushadi pic.twitter.com/ANoqnARi3Q
— Pradhan Mantri Bhartiya Janaushadhi Pariyojana (@pmbjppmbi) December 14, 2022
Being the world leader in affordable medicines and vaccines is not enough. Transparent decision-making, public trust and access are critical. Despite being a major vaccine leader, India’s delivery of immunizations and building public trust has been slow. These efforts have been hit by slow decision-making and low public trust. . Delays and low public confidence have resulted in heavy losses, as the deadly second wave in the summer of 2021 showed.
Perhaps the most important lesson is to invest in grassroots. Well-equipped public health centers are needed to ensure last-mile reach. Innovation is needed within the system, and a public-private partnership model needs to be explored to free states to focus on ensuring delivery everywhere.
Grassroots workers must recognize the significant impact they have on health service delivery and overall public health. Perhaps the most important are the unrecognized ASHA workers, certified social health activists who are not just volunteers, but agents of change. They must be compensated for their work with wages at least equal to the minimum wage.
Another important lesson is that health cannot be achieved without a social security net. Lockdowns have highlighted the need for social and economic security by governments. The collapse of the informal economy has left millions without a safety net, fueling desperation.
Small businesses, migrant workers and day laborers were unable to work and had no alternative source of income. This demonstrates the importance of investing in food security as a preventive measure. The lack of proper implementation of welfare measures, and the unclear nature of social, economic and health-related decisions, help us understand the bigger picture of what could go wrong during the crisis.
Finally, innovation matters. In India, technology has been used in various sectors to enable telecommuting and to access essential services such as medicine delivery and doctor visits. While this applies primarily to urban areas, it could also be a game changer for rural areas where telemedicine has made health care more accessible. Such innovations need to be continuously introduced and the ideas of the Healthcare Innovation Council can help promote, track and introduce such innovations in the healthcare sector.
The pandemic has taught us that health is central to our growth as people and as nations. This requires long-term political will and investment in health, but it also requires accountability. To do that, we need to build public trust in the health care system and create processes where people have a say in health policy. The most important lesson is to learn from the crisis and transform policies and systems. Because otherwise, you are doomed to repeat your mistakes.
Chapal Mehra is director of the Rahaat Project and public health expert.
Dr. Lancelot Pinto is a pulmonologist and epidemiologist.
