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India’s Covid crisis exposes deep-rooted problems in public health after years of neglect

A family waits inside an ambulance with a patient who tested positive for COVID-19 ,for admission at a hospital in Kolkata, India, on 10 May 2021.

Debarchan Chatterjee | NurPhoto | Getty Images

The world’s attention is now on India, the epicenter of the global pandemic as the country battles a deadly second wave of Covid-19.

The unfolding human tragedy has laid bare the deep-rooted problems plaguing India’s public health system after decades of neglect and underinvestment. 

The crisis has brought India’s public health system to its knees. Scenes of hospitals running out of beds, and people searching desperately for life-saving oxygen or critical medical supplies for their loved ones have hogged international headlines.

Low allocations to health care

The South Asian nation has reported more than 300,000 new daily infections in the past few weeks. Cumulatively, Covid infections reached nearly 24.7 million with more than 270,284 deaths on Sunday, according to health ministry data.

However, health experts warn that the numbers are likely grossly underreported, and the true scale of Covid infections and the human toll may never be officially known.

In a recent report by Fitch Solutions, the research firm said that despite several health care reforms, India remains badly placed to tackle the rapid spread of the pandemic.

“With 8.5 hospital beds per 10,000 population and 8 physicians per 10,000, the country’s health-care sector is not equipped for such a crisis. Moreover, the significant inefficiency, dysfunctioning and acute shortage of the health-care delivery systems in public sector do not match up with the growing needs of the population,” the report added.

The numbers make grim reading for a country like India with a population of 1.4 billion people, making up 18% of the world’s population. 

Lack of political will

Few Indians have health insurance

A wake-up call for India?

India’s prime minister Narendra Modi has been widely criticized for not acting sooner to suppress the resurgence of the virus.

In a rare rebuke, U.K. medical journal The Lancet, recently slammed the Modi government for squandering the early successes of controlling Covid and “presiding over a self-inflicted national catastrophe.”

“I believe that the political will is stronger now, after the prolonged and agonizing pandemic experience,” pointed out Reddy from the Public Health Foundation of India. He added that the recent central budget and recommendations from the finance commission are positive indicators.

The devastating situation created by the ongoing wave is likely to be forgotten. But should not be allowed to be forgotten.

At the budget announcement in February, India’s Finance Minister Nirmala Sitharaman proposed more than doubling India’s health-care and wellbeing spending to $30.1 billion (2.2 trillion rupees).

That includes strengthening national institutions and creating new ones to detect and cure new diseases. There is also a new federal scheme to develop the country’s capacity for primary, secondary and tertiary care.

Still, whether the crippling crisis will be a wake-up for India to take its public health seriously remains to be seen, experts say. 

“With this prolonged pandemic, there will be a stronger and longer lasting imprint on public and policymaker memories. There has to be a constant reminder, even after the pandemic ends, that the economy will keep slipping on the banana peels of public health failure if we do not invest in public health and strong health systems,” said Reddy.

Lahariya added there have been many public health disasters and health emergencies in India before. But most have resulted in very minor changes in health systems, if at all.

“It is time a robust citizen accountability is enforced in India on the elected leaders. They should be asked questions by people who elect them. Then only we can expect some change,” he said.

“The devastating situation created by the ongoing wave is likely to be forgotten. But should not be allowed to be forgotten.”

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