Lessons from COVID-19 for governance

Barring the wars that India was involved in, the battle against COVID-19 is proving to be the most serious struggle that the country has had to deal with since Independence. But there seems to be opportunities for learning as well.

The pandemic that has the whole world in its grip has shone a light on the crippling concerns surrounding the system and policy of public health in India. These are matters that should be taken note of at this time. And they need to be acted upon when the present crisis is brought under control.

As this is primarily a matter of public health, the first point that should be addressed is policy, starting with the allocation for the sector in the State and Union budgets. Consider this: at a meagre 1.6 per cent of the GDP, the allocation for health in India is the lowest in the world – a concern that has been raised time and again by experts and members of the healthcare fraternity.

For a country that still finds a large percentage of its population mired in poverty – lakhs of them well below the poverty line – it is paramount that public health should be given more attention in terms of time, effort, and equally importantly, funding. So obvious is this fact that even the Centre’s own National Health Policy had called for increasing this spend to as much as 2.5 per cent in the immediate future.

However, over the years, the attention seems to have shifted towards promoting private sector investments and the setting up of high investment multi-speciality hospitals across the country. Specialty facilities are undoubtedly an important healthcare infrastructure requirement, but from a policy perspective, primary healthcare at the village level is of critical importance.

Although communicable diseases are responsible for the maximum number of illnesses among Indians – and thus result in loss of productivity, man-hours, additional expenditure – the allocation for the same in the Union Budget is an abysmal Rs 2,178 crore.

When the illnesses comprise acute diarrhoeal diseases, tuberculosis, malaria and hookworm infection filariasis – most of which are diseases that afflict the poor – they rarely become the topic of public or political discourse. But now, we are fully aware that a mutation of a strain in microbes is all it takes to transform a common communicable disease into a deadly pandemic.

The nation doesn’t have to wait for the next iteration of coronavirus before committing itself to a comprehensive health policy. India must reconsider and rework its public health strategies, and it must do it now.