6 April 2020, NIICE Commentary 3948
Dr. Monish Tourangbam & Dr. Elsa Sanatombi Devi
The COVID-19 outbreak, has loudly and emphatically, put public health at the forefront of national, regional and global governance. India’s initiation of the South Asian Association for Regional Cooperation (SAARC) video-conference with heads of the member states (except Pakistan which was represented by the Special Assistant to the Pakistani Prime Minister on Health) and Prime Minister Narendra Modi’s virtual outreach to the Chief Ministers of Indian states makes it imperative to assess the role of public health in India’s national policy and its regional diplomacy. COVID-19 has been a wakeup call for all nation states, to think through the conceptualization and operationalization of the role of health in not only their development, but also their national security policies. While the need of the hour is to join hands with countries within its region and beyond, to combat increasing COVID-19 infections, it will be in India’s as well as the region’s interest to recognize the acute role of health in national as well as regional development and security. It is important to explore and employ India’s medical advances and experiences in times of the raging pandemic, to build regional understanding and mutual appreciation. In the context of India’s diplomatic challenges in South Asia, owing to complex bilateral relations, geopolitical equations and external interventions, avenues like regional health security, could be a force multiplier to other politico-economic initiatives, aimed at regional cooperation and integration.
In the context of the COVID-19 outbreak, it will be an understatement to contend that India’s health diplomacy will play a pivotal role in its Neighbourhood First Policy. However, the relevance of regional health security and India’s potential to lead from the front should be visionary, long-term and inclusive of a range of evidence-based public health issues that are of mutual concern to all South Asian countries. If COVID-19 has provided a pedestal on which India and its neighbours can develop habits of cooperation and synergies in medical responses, it should be cemented and sustained for the pursuit of a healthier South Asia.
Post SAARC video-conference, a number of developments have taken place such as the COVID-19 emergency fund and efforts being made to launch an Information Exchange Platform (IEP) to enable real time exchanges among healthcare professional belonging to SAARC countries. New ways and means are being probed, to make optimum use of available resources and expertise to not only fight the current outbreak, but also to ramp up preparedness for future outbreaks of epidemics and pandemics. According to the Times of India report, the IEP, among other things, “is aimed at comprehensively covering the aspects of disease surveillance, contact tracing, travel restrictions and evacuation, risk assessment, diagnostics, isolation and quarantine methods and facilities, clinical management of patients, treatment options and protocols and safety of healthcare providers.” India’s Ministry of External Affairs as well as the Health Ministry has been using all feasible avenues to reach out to SAARC countries to provide training “on ventilator use, infection management and control, isolation facility and quarantine management.”
South Asia is a densely populated region and its urban as well as rural centres present challenges in terms of affordable quality healthcare. The fear apparent among policymakers and health workers regarding community transmission of COVID-19 and the heartbreaking images from Indian cities, of migrant workers walking miles to their villages, are signals of a public health situation that calls for near and long term interventions. The funding as well as implementation for inclusive public healthcare systems in India, and other South Asian countries as a priority area has been emphasized because of the current outbreak.
Diseases that are common across genders and age groups, or that are gender-specific and applicable to certain age groups and those which are seen as a common concern to all South Asia countries; require the intervention of evidence based research, education and practice. Evidence based practice remains in protocol, which needs to be re-emphasized and made available in easy formats to healthcare personnel through online platforms for immediate reference and adaptation. New communication technologies could be used in normal times as well in healthcare emergencies like the one that is currently being experienced. Updated protocols and procedures could be made available readily on mobile apps for healthcare learners and workers. Moreover, as being witnessed during the current fight against COVID-19, the physical and mental health of the healthcare professionals are equally important.
For outcomes that are mutually beneficial to the health of the people of South Asia, it is imperative for India to link its research and innovation through collaborative ventures with its neighbours in South Asia, focusing on the primary health concerns in the region. Better academia-industry interaction, scholarship schemes, financial and infrastructure support, specialized training forum, collaborative research, professional and scholar exchange programmes, outcome based research funds, joint collaboration with universities across the world and joint regional innovation clusters are imperative for long-term results, catering to public health security in the region.
The geographic, demographic and socio-economic environment of the South Asian region, calls for joint identification of common public health concerns that are evidence-based, and strive together for solutions that are effective and sustainable. India, at this juncture, can play a bigger role in increasing the potential of its neighbouring countries, given its relative advances not only in modern healthcare system but also in traditional healing practices. Indian states that share open and porous borders with others South Asian countries should be equipped and encouraged to play a bigger role. In this context, India’s regional health diplomacy with Nepal is significant due to open border and it should reach out to even Myanmar in Southeast Asia, given its porous borders with India’s Northeastern states, and hence similarities in public health concerns and quest for coordinated solutions.
