The COVID-19 pandemic brings to India the imminent danger of community spread, a challenge of internal labour migration and an economic recession that we have not even accounted for during this chaos. To manage our short and the long-term priorities, we need to galvanise efforts in public health, police, public order, sanitation and hygiene, all of which are constitutionally state subjects. Along with this, we absolutely need clear guidance, forethought and communication from the Union government, exceptional contribution and engagement by the private sector and an enormous amount of courage and patience by citizens.
The past
India’s public health outlay has remained below two per cent of GDP for more than a decade now, which is almost one-quarter of what comparable nations, South Africa and Brazil, have been spending. The outcome of this is the perennial shortages of doctors, trained midwives, registered nurses, inadequate R&D and weak healthcare infrastructure. The reality is that India ranks 145th among 195 countries in terms of quality and accessibility of healthcare.
The ongoing COVID-19 crisis serves as a reminder of the opportunities we have missed in our journey in the last few decades, and an opportunity we now have to change course. An effective implementation of this crisis management plan can kick off a positive and bi-directional feedback loop between health of citizens and economic revival, which will be on top priority soon.
The present
The exact number of confirmed and emerging COVID hotspots in India are almost impossible to determine due to paucity of data in India, in general, novelty of the virus strain and the low rate of testing in the country. Given that it is a communicable disease and the density of population in most districts is enormous, confirmation of even one COVID-19 case demands an immediate containment and isolation plan of action.
The World Health Organization (WHO) has championed India’s lockdown but we know there is a major crisis in implementation bubbling underneath if a significant number of people become less worried about a virus that has hit more than a million people globally, and more worried about joblessness and wellbeing of their families in months to come. Plans to expand testing, boosting supplies of essential medical equipment and enhanced tracing measures are robust short-term measures. The larger point is that as India shifts its public health strategy to a war-footing, it will not just help survive the ongoing crisis, but it could alter it forever.
The science of social distancing suggests that if this technique fails in COVID-19 scenario, one infected person can potentially infect more than 400 within a few days. India's preparedness and COVID-19 response measures now include identification of hotspots, implementation of regional containment plans and undertaking contact tracing on a war-footing. Sadly, all of these are logistical nightmare in a country like India. Contact tracing can perhaps be the most promising identification and mitigation measure if it brings the digital capability and reach of our public sector combined with the technological might and reliability of the private sector together. However, any restrictions on use of the internet by citizens and regular interruptions in data transmission due to whatever reason, can render this technology-led tracing solution purposeless. This will also most certainly come in the way of narrowing down COVID-19 hotspots in the country.
The future
Not so long ago, economists found that the returns on a dollar investment in health are between 9 and 20 times for developing countries like India. The novel strain of coronavirus which has caused havoc around the world should act as a wake-up call for the pharmaceutical industry and the governments. It is important to bolster R&D effort to investigate new antiviral agents and to develop prospective vaccines and fresh approaches to vaccines. This is the time for governments to take a leadership position and provide legal, regulatory, scientific and financial support to promote pharmaceutical innovation. This is also the time to reach out to all stakeholders in the private sector, other state agencies, international organisations, public health authorities in other countries and civil society groups. The approach to deal with a global emergency like this one ought to be multi-pronged, collaborative and resource intensive. India must identify best practices in not just developing tests kits, treatments and new models of preventive care but also macro containment frameworks in pandemics and supply chain management in times of large-scale lockdowns.
In the scenario where, post expedited human trials, effective treatment and vaccine for COVID-19 have been discovered, industry must be ready to put their weight behind ramping manufacturing capacities on national and international scale. Governments play an enormous role in ensuring that the support systems are in place such that distribution and delivery lines are not interrupted by bureaucratic hurdles.
Public health strategies need to be brought to the discussion table of political parties, and the existing frameworks must be reformed. India needs to focus on affordable, quality and innovative healthcare infrastructure that is accessible to every citizen. Right to health must be a fundamental right in India.
Bharadwaj is the dean of Jindal School of Banking & Finance and Kaushik is public policy consultant at Chase India.
The opinions expressed in this article are those of the authors and do not purport to reflect the opinions or views of THE WEEK.
