The fourth phase of lockdown in India has been unlocked, the daily number of confirmed patients of COVID-19 crosses new benchmarks every day and the problems remain the same: a spiralling economy and inadequate containment making the lockdown completely ineffective and only stalling the inevitable. Saturday, 30th May, a spike in confirmed cases was a whopping 8,380 — the highest for a single day and today we have a record 184,364 positive cases. These numbers make it clear that the lockdown implemented by India has been a complete failure!
A core management team, assisted by similar forms of organised groups at every level from every BLOCK to every DISTRICT to every STATE, needs to be in place and to be in charge of coordinating and mapping all essential health services in the country. While protection against COVID-19 is of importance, the same should not cause disruption in the treatments of other crucial diseases which are just as prevalent everywhere. India deserves a new Health Policy.
The latest National Health Profile 2019, released in October 2019, shows India's public expenditure on health (Centre plus State) has been less than 1.3% of the GDP for many years. The NHP 2019 also shows how India's public investment is one of the lowest in the world, lower than even the 'low-income countries'.
Compounding this problem of poor health infrastructure and low spending, is India’s dependence on medical devices imports. These imports are said to account for around 80% of India’s medical devices requirements, with the bulk of the devices coming from the US, China, Germany and Singapore.
In September 2018, India took a major initiative in healthcare when the Pradhan Mantri Jan Arogya Abhiyan (PM-JAY) or the Ayushman Bharat was launched. It is fully funded by the taxpayers' money (Centre and states share funds at 60:40). The central budget of 2020-21 earmarked Rs 6,400 crore for it, prior to the break of the pandemic. However, there is no study or assessment yet to establish its efficacy, and the PM-JAY has already sparked conflicts between the Centre and states. The governments of Kerala and Madhya Pradesh have strongly opposed the move. The Indian Medical Association (IMA), too, has opposed it. The IMA's secretary-general Dr RV Asokan says the PM-JAY "is yet to take off".
In April, the Indian government launched the Arogya Setu app, a tool that aimed to help people to self-assess their risk of being infected with COVID-19. However, when the app was tested to find out if the alert feature actually worked in the real world, the results weren’t convincing.
India remains among the countries with the lowest rates of testing per million patients. The low testing rate (ratio of total persons tested to the total population) serves as evidence of serious problems in India’s testing process. As of 19th April, 2020, India, in 64 days has gone up from 100 to 100,000 cases and tests/thousand conducted were 1.8 as compared to UK that went from 100 to 100,000 cases in 42 days and tests/thousand were 39.5.
In a predicament such as this, it is the primary responsibility of the Government to formulate schemes which ensure that the citizens are provided with basic facilities like food, income and proper healthcare. However, the citizens are living in a constant state of mayhem. Our health care workers are still not well equipped with the means to carry out proper investigations. Migrant labour have moved from urban to rural with no help from the government, and unfortunately have increased the spread of the virus, highlighting poor governance and complete lack of apathy.
Data from the National Health Profile-2019, shows the total number of hospital beds in India was 7,13,986 — which translates to 0.55 beds per 1,000 persons. Shockingly, twelve states that account for 70% of India’s 1.3 billion population were found to have hospital beds below the national average of 0.55 beds. In terms of access and quality of health services, India has ranked 145 out of 195 countries.
It is imperative to remind ourselves that the lockdown is not the end solution of the disease but merely a means to slowdown the virus. Much of the data presented above highlights the fact that fighting any major health emergency let alone a pandemic was always going to be a tough task for India. There is a hesitation on the part of the people to rely on any aspect of the 20-lakh crore package that has been announced, which brings the situation back to square one.
The writer is former advisor of Externally Aided Projects Department, Govt of UP and Samajwadi Party member of Legislative Council. He is also the Founder Of Metro Rail Projects of UP, India.