By Dr Sumeet Kad
Today, India steps up its battle against Covid-19 by implementing a 12 hours self-imposed curfew across the nation, Many states have already declared the extended lockdown till March 31 and this could continue for even a longer period of time as the new cases keep rising. India’s approach has ranged from screening people at airport arrivals, evacuating citizen from foreign affected areas, shutdown of mass gathering and public places, requesting people with mild symptoms for undergoing self-quarantine and widening the criteria for testing to avoid spreading of community transmission.
But are these steps enough? The more important question being why India didn’t take any proactive steps to boost its healthcare system? India’s dismal health infrastructure can come under severe stress if the cases continue to rise. Clearly, with a bed: population ratio of nearly 1:1000 and less than 100,000 ICU beds, India is hardly prepared to confront this pandemic which can lead to severe consequences. Italy, the US, and China have 3.2, 2.8 and 4.3 hospital beds per 1000 people respectively and they are struggling to handle the coronavirus cases.
With inadequate insurance penetration, India population is largely dependent on public sector hospitals which are severely inadequate. Nearly, 75% of private corporate hospitals are located in less than 40 districts and over 80% of hospitals have less than 30 beds. Infection control, patient management and isolation standards are under severe doubts. There is also a huge deficiency of skilled healthcare professionals adding to the existing woes (doctor-populations ratio of 1:10000 which is way below the WHO norm of 1:1000).
India’s healthcare system is devoid of integrated and inter operable data systems and platforms. This along with non-standardisation and inadequate mobility of health records and data is a vital hurdle in deploying targeted, continuous and connected care. Digital infrastructure needs to be strengthened and monitored regularly. Such technologies can be very effective in isolating and diagnosing positive cases, as shown by state of Kerala.
From pharma side, India is overly dependent on China for bulk drugs or APIs (active pharmaceutical ingredients), around 70% of APIs need of India is catered by China. Now, with China being under indefinite lockdown, India will struggle to produce basic medicines for cancer, malaria, HIV and even antibiotics for its own usage. There is an imminent need to make India a manufacturing hub for APIs. India needs to invest in setting up R&D facilities and provide tax incentives to encourage API manufacturing within the borders.
For these steps to be implemented India needs to increase the budgetary spend on health from current 2% of GDP to 5% in next 5 years. This crisis does provides an opportunity to reflect on the failures and issues within India’s weak healthcare policies. A huge chunk of the government healthcare spending goes into urban-based infrastructure whereas the primary healthcare centers are being neglected since decades.
In this article, I have listed these challenges and measures that need to be taken by India to establish a robust healthcare ecosystem in the coming years. Time is right to evaluate and assess in these trying times and look into the future.
About the author
Dr Sumeet Kad is a Healthcare and Artificial Intelligence Leader, focusing on leveraging technology to create a model for affordable care.