Covid-19: Is India prepared enough?
By Javaid Bashir Mir
Covid-19 popularly known as coronavirus has almost hit every nook and corner of the world. The effects of Covid-19 turned out to be far more severe and contiguous than the epidemiologist would have expected. The pandemic has put the whole world on a standstill and the life of billions on threat. Pandemics aren’t new to humans. In different historical periods, humans have encountered dreadful epidemics consuming thousands and millions of lives. Nevertheless, so far as the Covid-19 is concerned, it has put not only medical professionals on toes, but also has exposed the failure of world’s acclaimed medical service providing countries. In this dreadful situation, countries are left with only one option to control the mass spread of virus, which is a complete “Lockdown”. Consequently, all local and multinational businesses have come to a halt. The economic pundits are predicting a deep-down unmanaged economic decline, leaving closure of companies and about 25 million job cuts worldwide. Many millions of low-income and marginalized families and communities will face the horrendous sufferings in coming times. The “hopeless” world is hoping for a “solution”, whatever and from wherever.
The fast spread of the virus pushed the WHO to declare it as pandemic. India was well aware about the depredations in China, Iran and Italy since news were surfacing in print and electronic media about the fatalities in those countries. India played it down the situation until it reported its first case in Kerala on 30 January, 2020. Since then India has officially confirmed close to 1000 positive cases. The continuous rise has become a real worry for local and international experts. The concern is, if spread of the disease enters into its third phase in India, it will create irreparable damage to its inhabitants, keeping in view the population density, vulnerability of poverty-ridden communities (nearly 21.9% of India’s population is living below the poverty line), and dearth of advanced health care system. According to reports, India spends only 1.5% of its GDP on health care system, which is substantially low compared with developed countries such as the US, Italy and Germany where the disease has already caused a large-scale human destruction. Unfortunately, India, a growing nuclear power in South Asia, even lags behind its relatively poor neighbors such Bangladesh, Bhutan and Sri Lanka in healthcare advancement. In 2016, India scored 41.2 points on the healthcare access and quality (HAQ) index created by the Global Burden of Disease study that was published in the medical journal The Lancet on May 23, 2018. This 16.5-point improvement in 26 years leaves India’s score well below the global average of 54.4. Despite improvements in healthcare access and quality, India lags way behind its BRICS peers such as Brazil, Russia, China and South Africa on the HAQ index. This index was based on 32 causes of death considered preventable with effective medical care.
Presently, India has 14 million doctors. Yet, India has failed to reach its “Millennium Development Goals” related to health. The healthcare system of India lacks in three areas: provision, utilization, and attainment. Provision, or the supply of healthcare facilities, can lead to utilization, and finally attainment of good health. However, currently there exists a huge gap between these factors, leading to a collapsed system with insufficient access to healthcare. Differential distributions of services, power, and resources have resulted in inequalities in healthcare access. Access to hospitals depends on gender socio-economic status, education, wealth, and location of residence (urban versus rural). Furthermore, inequalities in financing healthcare and distance from healthcare facilities are barriers to access. Additionally, there is a lack of sufficient infrastructure in areas with high concentrations of poor individuals including millions who dwell in slums. Rural areas in India have a shortage of healthcare infrastructure and medical professionals. According to available data, 74% of doctors are based in urban areas that serve the 28% of the population. This is another challenging issue for rural access to healthcare. The lack of human resources causes citizens to resort to fraudulent or ignorant “healing” providers. Doctors prefer not to work in rural areas due to insufficient housing, healthcare, and education for children, drinking water, electricity, roads and transportation.
India is home of 1.3 billion people. So far it has officially reported close to 1000 cases which is remarkably low. However, it is predicted that this confirmed number may be the tip of the iceberg. India has to be ultra-careful given the dense population, poor hygiene and low level of health care system. India which is only screening people who have either traveled from countries that have been badly affected or those who have come in contact with a patient or are presenting symptoms themselves. Experts like Balaram Bharghava, who heads the Indian Council of Medical Research (ICMR), said the WHO guidance was “premature” for India because the coronavirus’ rate of spread is not as rapid as it has been in other countries and community transmission hasn’t been detected yet. However, the reality may be different from how Mr. Balaram Bharghava has apprehended the situation. It is worth mentioning here that India is not facing the lone problem of corona virus. There are other contagious diseases across India such as tuberculosis that have already made less-equipped government hospitals congested. The burden of cost of Covid-19 tests, which is around 5000 Indian rupees, for the government is manageable to some extent. However, if the numbers increase as happened in US, the government would collapse under the cost of tests.
Another concern for India is to deal with its bloated population, which seems to be least concerned in listening to authorities while practicing “social distancing”. The negligence of the people has increased the threat of Covid-19’s fast spread in India. Although, having estimated the magnitude of the problem, the Indian state has declared a complete “Lockdown” for 21 days and imposed strict guidelines in this regard. Nevertheless, the question is how long it will go on. Since millions of families living under below poverty line, they will face food crisis.
To conclude, I would suggest that India should maximize its expenditure on health sector. All those people who have a travel history should be identified and “isolated” until proven negative. There should be a high-scale testing, which according to Gagandeep Kang, a clinical scientist who heads the Translational Health Science and Technology Institute, is crucial to control the spread of the disease.
Javaid Bashir Mir is a 5th year Student, School of Law, University of Kashmir. Email: email@example.com
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