An oportunity to Rebuild Healthcare amid Covid Crisis

Context

COVID-19 pandemic and the rising demand of best possible solutions providing the opportunity for creative innovations.

Background

Despite the third position on global ranking on COVID-19 cases, the efforts performed by the local healthcare workers, the recovery rate is still high and perhaps the best one in the world. Incresaing participation to the government machineries is one of the best creative step towards the new innovation. The distribution of cases also presents itself as the world’s biggest opportunity to intervene and blunt the global toll of the pandemic. The case of Dharavi is an example. On July 10, the Director-General, World Health Organization (WHO), Dr. Tedros Adhanom Ghebreyesus, acknowledged the success of Mumbai’s densely populated Dharavi slum in containing the COVID-19 pandemic.

Chance amid Crisis

The post-COVID world will be shaped by decisions being made in the crucible of the fight against the virus. The profound uncertainty about the virus and its trajectory, and about how other people will respond, only magnifies the importance of collective participation.

In addressing an epidemic, innovative acts can fuel the better household nutrition and income outcomes obtained, then these would be a huge victory.

In the current uncertainty, one thing is certain health care will be a reliable career opportunity (from the laboratory to the bedside, and all points in between and beyond). Not using emerging talents in educational institutions in Tier 2 and Tier 3 towns in many districts in India would be a wasted opportunity, both in terms of training and nurturing ambitions. So it is necessary to gain benefits from these talants.

This will require administrative imagination and collaboration from the Indian Council of Medical Research, the Department of Biotechnology as well as the University Grants Commission. Such a step can create the equivalent of the rush, as seen in the late 1990s, for Information Technology and computer training among students for better job prospects.

Increased Learning of Experiences and Practices

Regional cooperation offers critical opportunities of learning from others and to achieve collectively what would not be possible at the individual level. As the COVID crisis is unique, there are opportunities for a quantum leap in systemic crisis management to be better prepared next time around. Moreover, people will benefit from exchanges with regional partners as they confront new and more challenges during reconstruction.

Ground Level Administrative Exercises

The first step towards this would be to disaggregate the COVID-19 tracking mechanisms and the national level tables and graphs that are updated daily. Instead, there should be 733 district-level versions, where each one is updated and reported on a daily basis, at the district level. State and national summaries are important but are not as critical as ensuring the accuracy and timeliness of district-level tracking.

The first output of such disaggregation will be to see, with great relief, the number of districts with extremely small or no incidence numbers. In order that they retain their low incidence status, such districts should be supported with all comprehensive testing kits and contact tracing know-how. The earlier scheme of designating districts as green, yellow and red will be strengthened with this disaggregated reporting.

A significant step in this direction would be to encourage District Magistrates (as they are already empowered), to use the full range of social support schemes available in support of the District Health Officer and team, to be able to prevent anyone from facing situations of hunger or economic distress.

The testing capacity in the district can be scaled up dramatically by coopting the science departments of every college and university. Thus, chemistry and zoology-allied departments such as microbiology and biochemistry can lend their laboratory services to carry out basic polymerase chain reaction (PCR)-based tests.

On Testing

It would be good to look at rapid innovations that have been surfacing within the past 12 weeks globally. It will not be very long before testing could become a self-administered process. One has to look at recent insights into using saliva as the start point for testing rather than using a nasopharyngeal swab for sampling.

Increased testing is not only necessary, indeed, it will be the single biggest contributor to stemming the tide of morbidity and mortality in India and the rest of the world. Wherever testing has been constrained, incidence rates have risen.

Imaginatively expanding testing by coopting all colleges and technical institutions (till individual level test kits become available) represents the best opportunity to prevent the epidemic from becoming a surge in over 80% of the Indian population.

Opportunity for Biotechnology

Besides providing opportunities in the healthcare and biotechnological spheres for young minds, the emphasis should also be to encourage innovators and entrepreneurs to bring out and scale up their products without making compromises on the standards or rigor of evidence needed for regulatory and manufacturing approval. At the moment, the world is increasingly looking at personalised diagnostics and therapeutics and biotechnology is the key to success. India is the pharmacy and vaccine manufacturer to the world, and with a coordinated effort, the COVID-19 crisis can provide great opportunity for India’s biotech and pharmaceutical enterprises.

Way Forward

Epidemics are not to be treated as law and order situations with policing. Lockdowns, without on-demand testing, are administratively easy-to-administer exercises. But they are harsh, with possibilities of multiple collateral damage at the community and economy levels.

Freely available, quality assured testing, even without lockdowns, can achieve far more they inspire confidence among the population, encourage early treatment seeking behaviour, and at a public health level, enable the understanding of disease dynamics within the community.

India’s general health-care spending has been far below optimal. But if innovations to help manage the current crisis are suitably capitalised on, they can enable India to move far ahead in health-care delivery and related outcomes. COVID-19 is both a crisis and an opportunity for health-care reform as well as understanding the interplay of health outcomes with social and economic support interventions, and limitations of law enforcement in managing epidemics.

Connecting the Dots:

Question for Prelims

With reference to the World Health Organisation, consider the following statements:

1. It is the specilized body of United Nations.
2. All members of the United Nations are its members.

Which of the statements given above is/are correct ?

(a) 1 only
(b) 2 only
(c) Both 1 and 2
(d) Neither 1 nor 2

Question for Mains

‘India is the pharmacy to the world, and with a coordinated effort, the COVID-19 crisis can provide the opportunity for innovations in India’s biotech and bio-pharmaceutical enterprises.’ Comment.