The poor ranking of India (145 out of 195) on Health Access and Quality (HAQ) Index reported by Institute of Health Metrics and Evaluation (IHME) in 2016 had raised the red flag towards the meagre quality and inadequacy of Indian healthcare system.
By Sumit Kaushik and Dr Isha Sharma
Coronavirus pandemic: Numerous metaphors have been used to represent the true gravity of COVID-19 but “The war rhetoric” has topped the charts across the world. In India as well, the metaphor of war has been used extensively, ranging from branding the healthcare workers as “Corona warriors” or by establishing a science and technology innovation hub named as CAWACH (Centre for Augmenting WAR with COVID-19 Health Crisis) or addressing the current situation as “people driven war” or by having a dedicated website keeping a tab of human resource dedicated to fighting COVID-19. Beneath the plethora of rhetoric, it is thought-provoking to comprehend why the whole world is keen to frame the healthcare emergency as “War”. Usually, in the mind of masses, war invokes the picture of bravery and sacrifice, but it is the bravery and sacrifice of the soldiers that makes you win a war. Does it mean the same be applied to the current war against COVID-19 or can the warriors be leveraged with human rights if they wish not to be on the war front?
Corona is not the first war
How can we forget that this is not the first war that the world is witnessing? The war framing has been used for almost every disease condition that demands courage and hope along with medicine and treatment. The phrases such as “Beat Cancer” or “Fight against Tuberculosis” or “War on malaria” have been widely used across the medical literature. The bigger concern is why we are still not prepared for the impending and more intense battles. The fight against Tuberculosis in India is the nearest to the Corona war but with a caveat that the drug and vaccines against TB already exist. The claim that the COVID-19 has brought new threats to the healthcare system are unjustified. It has just exposed the gaps along with the much infamous ignorant attitude of bureaucracy to act towards an impending situation. Had these matters been dealt with due diligence on time, India might have been better prepared with a greater capacity of the health system and less stringent economic measures.
COVID-19: Analysing the corona war preparedness
It is imperious to have a war strategy and preparedness. Implying this to the current situation and analysing the war preparedness of India exposes even deeper inadequacies. The healthcare staff such as doctors, nurses, paramedics, and the support staff are indeed fighting on the war front. Still, the fact remains that India never managed to meet the required doctor and nurse-patient ratio. With the conjoint efforts of central and state government along with the technical guidance from the Ministry of Health and Family Welfare, and Indian Council of Medical Research; the strategy, intelligence and evidence for the timely decision making are to be applauded for. Another effective collaboration with the department of science & technology to support the innovations and start-ups producing new products has augmented the efforts. But even after having these alliances for decades, the intelligence could not perceive the consequences of being among the lowest spenders on healthcare in contrast to being among the top three spenders on military budget. The shortage of adequate ventilators and ICU beds in a public hospital is a long-known fact but in the current crisis, it just adds to the turmoil.
The poor ranking of India (145 out of 195) on Health Access and Quality (HAQ) Index reported by Institute of Health Metrics and Evaluation (IHME) in 2016 had raised the red flag towards the meagre quality and inadequacy of Indian healthcare system. The numerous directives about India’s insufficient healthcare financing at the various high-level technical meetings and numerous healthcare documents have also narrated the same story from time to time. This war against corona provides an opportunity for India to emerge as a healthcare leader, having the best soldiers, intelligence and arms but before that India needs to have a deep deliberation on the missed opportunities or ignored warning that could have saved some more lives or economy. At last, a crucial deliberation that COVID-19 offers is that it is time to change the overtly used “war metaphor” for disease/ healthcare conditions to a “Mission rhetoric” which implies the conjoint efforts by each component and intuitively generates a feeling of solidarity and equal contribution to achieving the success.
Sumit Kaushik is a public policy consultant, Chase India, and Dr Isha Sharma, pursuing MSc Global Health Policy at the London School of Economics and Political Science. Views expressed are their own.