How will India emerge out of the lockdown?
The below excerpts are taken from the discussion posted on The Hindu regarding “How will India emerge out of the lockdown?” A question on preparation of future pandemic involves investing in health sector and insurance.
After a 39-day lockdown, what will be the shape of things to come? How should one strike a balance between ensuring livelihoods, minimising strife, and maintaining social distancing? In a discussion moderated by G. Ananthakrishnan, Reetika Khera, and Giridhar R. Babu examine the options.
How can we prepare for a future pandemic?
Reetika Khera: I feel that we must understand that we have been cheated for more than 70 years by the political class, that used every possible excuse to underspend on health. Today, public spending on health in India is barely 1% of GDP, compared with more than 10% in countries like France and Germany. There needs to be a serious discussion on resetting our priorities — not focusing on overall GDP growth only, but also on where GDP growth is coming from. Expenditure on health (nurses, doctors, hospital beds etc.) adds to GDP as much as roads and fighter jets do.
There also needs to be a serious rethink about the health system. At the very least, we should be regulating the (for-profit) private health sector, in a similar manner as Germany and Japan. These countries do not have socialised healthcare like the National Health Service of the U.K. But Germany has not-for-profit social insurance funds; in Japan, the government regulates what private practitioners can charge patients. In India, the private health providers seem to dictate terms to the government, as happened recently with respect to pricing for the COVID-19 test. This must change right now.
Giridhar R. Babu: It is time that we start investing in strengthening the public health system. There is disproportionate spending on curative services and heavy reliance on insurance. Pandemic preparedness is a small component of health system strengthening. Public health is the art and science of preventing diseases and promoting health through the organised social efforts. Any aspirations for an increase in GDP allocation should, therefore, be prioritised for the public health system, towards preventing diseases and promoting health. Preventing the disease includes addressing behavioural changes, adequate nutrition, improved living conditions, screening, early diagnosis, and treatment. A significant portion of this should be towards prevention, including strengthening disease surveillance. Public health should be managed by a specialist cadre —_epidemiologists, social scientists, economists, bio-statisticians, behavioural scientists. Our response has been mostly reactive — in terms of measures such as scaling up purchase of equipment during a crisis.
Giridhar R. Babu is the head of Lifecourse Epidemiology at the Public Health Foundation of India; Reetika Khera is an associate professor at the Indian Institute of Management-Ahmedabad.
Source: The Hindu