Pandemic or no pandemic, healthcare infrastructure in India is highly skewed in favour of urban areas and our overall spend on healthcare is significantly lower.
By Sanjaya Mariwala,
Learn, improve, and implement! That is one of the biggest lessons learned from this pandemic, but not yet implemented enough.
As I am writing this article, ~180 million of India’s population is vaccinated, which is roughly 13% of our total population. Tweets and messages are circulating showcasing the magnitude of this drive as this number is equivalent to the population of Russia and 34 times that of New Zealand. Not just the positive perspective, we too have many success stories narrating our ability to handle the crisis well. However, despite all these, we are still seeing cases of the shortages of beds, people desperate for oxygen supply, and queue in the crematoriums.
Why are we in such a frantic situation?
Let us step back a little. Reports say that the Centre had sanctioned ~Rs 200 Crores for the installation of 162 PSA medical oxygen generation plants in the different parts of the country. This was the action taken by the government learning from the second wave situation in the USA and Europe back in October 2020. Had the states cooperated with the center and installed these plants, we wouldn’t have solely depended on the supply chain management to make the oxygen available in different parts of the country. The situation became grave not because of the lack of resources, but due to lack of planning and execution.
Pandemic or no pandemic, healthcare infrastructure in India is highly skewed in favour of urban areas and our overall spend on healthcare is significantly lower. India’s public health expenditure (sum of central and state spending) has remained between 1.2% to 1.6% of GDP between 2008-09 and 2019-20. The National Health Policy – 2017 stated that health spending by the government should be 2.5% of GDP by 2025. But we still do not have a structured blueprint to deploy these funds. One of the biggest lacunas is the governing body attempting to execute which is neither their job nor are they trained for.
BMC in Maharashtra under the leadership of IAS officer Mr. Iqbal Singh Chahal set an example for the rest of the country in handling the Covid -19 situation with the right approach and judicious use of resources. Mr. Chahal leveraged man power, technology, private sector and set an example for rest of India. Decentralizing the war rooms ward-wise for better reach and continuing to govern and manage everything centrally to ensure uniform execution – these learnings are yet to be implemented by other states that are reporting significantly high active cases and still just knocking the doors of the authorities and courts.
We talk about building immunity and thus a lower probability of catching the infection. But when it comes to adopting a healthy lifestyle and getting vaccinated, we are far from the basic discipline and are highly reluctant to take the vaccine. India’s pulse polio drive is an excellent success model to address these issues. To spread awareness and expand the vaccination reach, we have to implement the lessons from these immunization drives in the past. UNICEF had deployed social mobilizers in Uttar Pradesh back in 2002 just to induce and educate people about the benefits of taking the polio vaccine. It mitigated fears and helped India steadily move towards becoming a polio-free country. The second wave has reached the interiors and villages of India. Any further delay in implementing the learnings will cause substantial damage.
So, how do we brace for this storm?
Private participation is a must. “We are in it together” is what we kept saying the whole of the last year. It is time we now act together and execute what is on the paper. This execution needs a strong PPP model along with end-to-end project management. The government should define the priorities, and then allow the private players to accomplish it. The recent RBI announcement to qualify loans towards healthcare infrastructure and vaccine manufacturing as priority sector lending (PSL) was one of the important steps encouraging private participation. Similarly, the government can encourage corporates to adopt villages and allow this spend towards strengthening healthcare facilities to get qualified as CSR spend for vaccination. For instance, at OmniActive, we implemented preventive care program for all the farmer families associated with us. We focused on handling anemia. 27% of the women tested were anaemic when we began our program in 2018, after our targeted interventions, only 15% were recorded Anaemic in 2019. If as a corporate we are encouraged, such programs can be easily extended for other ailments and build more facilities for the whole village. Involving India Inc will ascertain the speed in building the necessary infrastructure, an integrated and comprehensive approach, and assured outcomes.
We also need to focus on all the various streams of medical science and not just pharmaceuticals. An expansionary and inclusive approach is a must. We need to strengthen both preventive and curative medicine fields to be able to reduce the number of people resorting to tertiary healthcare facilities and are well prepared for self-care. Adopt technology and use AI and ML extensively for research, innovation, and clinical studies to respond to the situation more swiftly. While the focus has completely shifted to the Covid-19, do not lose sight of other chronic ailments and lifestyle disorders. Continue to build infrastructure to support these diseases as well.
Black fungus is here and speculations around 3rd wave have already started, we must scale up the war rooms quickly, invite more private player participation, and engage more professionals to not just chart out the plan but effectively implement too.
Let us now aim to Implement, prevent and enhance!
(The author is Executive Chairman and Managing Director at OmniActive Health Technologies, and President of the Association of Herbal and Nutraceuticals Manufacturers of India (AHNMI) Views expressed are personal and do not reflect the official position or policy of the Financial Express Online.)