11 April 2020, NIICE Commentary 4039
Dr. Rohidas Mundhe
COVID-19, the virus that emerged in Wuhan city of China, spread across the world. It has affected millions of people globally. According to World Health Organization (WHO), as on 11 April, there are around 16 million confirmed COVID-19 cases with more than 99 thousand death across the globe. In India, on the same day, confirmed cases reached 7447 with 239 death. Europe and the US are worst affected. However, as every crisis has opportunities, COVID-19 has forced the world to understand the importance of sanitization and public health. The article is aimed to understand the gravity of epidemic worldwide, access the situation of the public health in India and provide policy options to the government.
The COVID-19 pandemic which emerged from China rapidly spread in Europe and the US causing highest casualties. So far, the US is most affected with 461,275 thousand cases and 16,596 death, as per 11 April data provided by WHO. It is followed by Spain with 157,022 cases and 15,843 death. Similarly, Italy has 147,577 casualties and 18,852 death; France has 89683 confirmed cases and 13,179 death; Germany has 117,658 confirmed cases with 25400 death and China has 83369 confirmed cases and 3349 death.
The world is struggling with this pandemic in a situation where there is shortage of medical supplies, equipment, testing kits, and facilities to fight with it. It is advised to maintain distancing to stop the spread of virus and many of the countries are in total lockdown. In South Asia, India is the worst hit. The government of India has taken strong measures to stop the spread of virus imposing total lockdown across the countries. Similarly, Indian government has announced INR 150 billion financial package to ramp up healthcare infrastructure and fight COVID-19. Apart from that, Asian Development Bank (ADB) has also assured USD 2.2 billion support package to India to fight the COVID-19 pandemic.
India, one of the most populated country in the world, might have to go through worse situation if proper precautions are not taken to stop the virus from spreading. Because of high population density in the major cities and lack of proper healthcare facilities in rural parts of India, it will be herculean task for the government to control it. According to Rural Health Statics 2018, in India, only 7 percent of the Sub-Centers, 12 percent Primary Health Centers and 13 percent Community Health Centers are functioning as per Indian Health Standard. According to the WHO, there must be 1 doctor per 1000 people while in India it is below the standard, which is 0.8 doctors per 1000 people. Therefore, the policymakers in India need to pay high attention on health system. Probably the pandemic like will bring some awareness among the policymakers around the world. Moreover, qualified medical practitioners can be produced only through quality education. Hence, government should give emphasis to quality health and quality education at the same time, as both are interconnected.
Countries around the world, including India, have left healthcare mostly to the private sector and is one of the major profit-making institution. This is one of the major reasons that most of the governments failed to act promptly to control the COVID-19 in several parts of the world. Thus, the government has to take the burden and create public healthcare facilities to deal with the situation like these, else it can bear dangerous outcomes. There is the need of the government to strike a balance between private and public health sector.
Some of the European countries have failed to win over the COVID-19 pandemic in spite of having good healthcare system. Italy, the worst affected country in the Europe spends 9 percent of its GDP on healthcare while India spends only 3.5 percent of it. Most of the healthcare centers of India lack proper infrastructure, sufficient staff, fund and efficient leadership. According to National Health Profile 2019, there are 713,986 total beds available in government hospitals in India. In terms of population bed ratio, it is 0.55 beds per 1000 population.
India should take lessons from the COVID-19 pandemic situation of the US and Europe. It should upgrade the existing health system with adequate equipment, staff and infrastructure. The Government should immediately scale up its expenditure in healthcare from 3.5 percent to 5 percent of its GDP. As there is huge disparity between the urban and the rural healthcare infrastructures, it should be minimized. There is urgent need to improve the quality and quantity of healthcare workers so that it meets the doctor to population ratio standard set by WHO. It is also right time for the countries around the world, including India, to setup special disaster management center related to healthcare to fight against the pandemic like COVID-19. These kinds of infrastructures can also be setup under WHO, by strengthening these international institutions.
