What Next?: The second wave and the healthcare sector in India

Exhausted families, doctors and nurses scarred forever by a healthcare system that failed them completely in their darkest hour.

By Tamojit Dutta & Prateep Sen

Like other waves in other countries this latest Covid-19 wave too shall pass. However, in its wake will remain untold personal losses of people we once knew and loved.Why does a country with such incredible expertise in pharmaceuticals, vaccine manufacture, AI platforms, and human capital find itself now stumbling through a crisis of this enormous magnitude?

Lives snuffed out too early or unnecessarily. Exhausted families, doctors and nurses scarred forever by a healthcare system that failed them completely in their darkest hour. Incredible armies of citizen volunteers who are moving heaven and earth to transport the sick, arrange for oxygen, organise hospital beds and bury the dead. “What next?” asks each one of them.

As a nation -whether we are critical care doctors at top hospitals or septuagenarians suffering from stifling loneliness – we are all asking, “What next”?

Covid-19 is not just a healthcare crisis

At its core, this pandemic is primarily a medical challenge being fought by heroic doctors and nurses in ICUs with ventilators and masks. Even an average citizen is now a “Covid warrior” – as aware of Pulse Oximeters and Oxygen Concentrators as she is about KKR & CSK!

Human inventiveness, when pushed by a Covid-like wrecking ball, will always triumph. Scientific breakthroughs and medical ingenuity will find solutions that will save lives. Yet, for the first time in our living memory, we have a healthcare challenge that needs much more than just a vaccine being discovered in record time or produced with record speed.

India’s struggle with Covid, highlights many endemic problems. Problems we have kicked down the road for future generations to grapple with– lack of well-functioning public hospitals,higher social care spend needs for the aged,a non-existent public ambulance infrastructure. Why do a million children still die before their first birthday?Why do mental issues among the elderly get so little support in government budgets? We have kicked these problems down the road precisely because they are hard to fix and need patience to implement.

Public Health is a Public Good

The Covid crisis is as much a societal tragedy as a medical catastrophe.If you are poor the chance of hospital admissions is lower for you than for your middle-class employer. Successive governments – of whatever symbol or colour – have neither invested resources nor imagination in strengthening our public health infrastructure at any level – central, state, or local.

Not every Covid case needs to go to an AIIMS or a top private hospital for treatment. Yet, let it also be known that promoting untested Ayurvedic, Homeopathic or other Alternative Medicine “solutions” is not an effective public health strategy. As a country we must finally stop accepting politicians’ platitudes and demand better public health for all – through policies, investments, and surveillance.

The poor quality of public health in India is not entirely due to under-investment. While lack of universal health or availability of few trained doctors in rural India is certainly due to historically low healthcare budgets, it is also a function of how badly we utilise resources.

From employing social health workers who promote mass vaccinations to investing in simple digital technologies that track medicines at municipal clinics, there is no reason why India’s healthcare budget cannot be better utilised to scale public health.

Why, in today’s uber-brash, uber-confident India should the poor still not get good, basic health treatment for free?

Invest in primary care, not just tertiary hospitals

For far too long governments have promoted“trophy” projects as proof of their healthcare commitment. Our primary healthcare delivery systems have been neglected for decades. It is certainly not a surprise that primary care clinics, which were already stretched, have struggled to manage the complexities of Covid-19.

When basic or preventative health is abandoned, the cost to society is ultimately far greater, as we have seen during the pandemic. Many more cases needlessly end up in critical care units needing far more resources than if they were managed more effectively at or near home. Local healthcare delivery mechanisms need to be strengthened. The pandemic has shown that identifying and intervening early at the local level reduces the case load for tertiary care. How can that be a bad thing?

“What next?” is a question that affects much more than our management of Covid cases in the months ahead. It is a question about how we manage public health for the benefit of all – and how we hold our governments to account for delivering on promises and policies.

(The author is Co-CEO, Tribeca Elder Care. Views expressed are personal and do not reflect the official position or policy of the Financial Express Online.)

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