In India, which is the biggest democracy in the world with over 1.3 billion people, the question of public health has never been debated in public.
By Martand Jha
The one lesson that governments across the world should take from the ongoing Covid-19 pandemic is to focus more on healthcare. Most of the countries, especially in the third world, have not been prioritising healthcare enough. Therefore, healthcare budgets constitute a very low percentage of a nation’s overall GDP. It wouldn’t be wrong to say that until now, health is a ‘low key’ affair across nations. Although health security constitutes one of the fundamental aspects of human life, it has still not got a popular appeal on which elections are won or lost, unlike matters like national security and defence on which elections are won and lost.
For instance, India, which is the biggest democracy in the world with over 1.3 billion people, the question of public health has never been debated in public or been used an election pitch in any of the national elections. This shows how much importance is given to healthcare–it constitutes 2% of India’s GDP. Comparatively, the defence budget this year is five times more than the health budget. The reason why healthcare has not got a popular appeal is that till now, the nations didn’t come across a situation where community health was so much dependent on individual health. Now, with over 100,000 deaths and nearly two million infected, the pandemic has pushed healthcare systems to the very limits.
This is because of two things: One, the scale of pandemic and the mortality rate, and, secondly, the non-preparedness of health systems to deal with such a situation. Now, if the healthcare systems were better prepared and intact, there is no doubt that the scale of the pandemic could have been curtailed. If enough tests were done, those who were infected could have been isolated much earlier.
All this is in the past. However, the future can still be saved. For that, governments should start looking at healthcare as a ‘high priority’ area, much like national security and defence. This means increasing the allocation to healthcare and making public healthcare systems stronger. Governments should also start considering healthcare as a ‘security issue’ rather than just a ‘health issue’.
What it means is that governments across the world should understand that health and human security are directly related to each other. An unhealthy individual or society would always make the community insecure about the present and the future. This would in turn impinge upon the national security of all such nations because an insecure society can’t have an intact national security. This is also the reason expenditures on healthcare in developed economies are much higher.
Today, when the US, China, UK, France, etc, which spend much more on healthcare than other nations are facing a crisis, one can very well understand how bad the situation could have been if the outbreak was in the third world, where a majority of global poor live with very little or no access to public health care. The situation would have been much worse.
In a post-Covid world, health care should become a political issue across nations on which elections are fought because only then political accountability can be set for those in power to make the healthcare systems strong. Also, infectious diseases should be seen as a national security threat, and such threats should be discussed in detail.
Because diseases, like Covid-19, pose an immediate threat to the very survival of masses, therefore, health care should be strategised on a war footing with the help of doctors, medical staff, police force, NGOs, media and the larger civil society.
Currently, many governments have pandemic action plans as part of their national security plan to deal with the ongoing crisis, but they are not permanent. The requirement now is to put permanent institutional structures in place to keep a check on such diseases. Top medical staff and officials are needed to be given a seat in the national security councils or institutions alike across nations.
Governments should be looking at ‘securitising’ the health sector permanently. This would require governments to come out with new laws, and enforcing strict measures like wearing masks, using sanitisers, avoiding overcrowding at public places permanently. Post Covid-19, nations can’t afford to go back to the ‘old normal’. Societies need to adapt quickly to function smoothly.
The author is a Senior research fellow, School of International Studies, JNU
Views are personal