The past 21 months of collectively battling the biggest public health emergency in over a century has reinforced the fact that all crises are also opportunities for transformative reform, re-aligning priorities, and changing policies to pursue the greater common good. As we come to the end of 2021, the promise of a more resilient future brings us hope. While threats of new variants continue, we stand at a pivotal moment to secure our future against any other viral onslaughts in future.
The pandemic highlighted the critical need to democratise access to healthcare services such as diagnostics and ensure equitable vaccination for the urban poor and rural populations to comprehensively contain infectious diseases. With recent announcements such as the PMASBY Scheme, which focuses on strengthening primary healthcare facilities, India will also see increased spending on primary healthcare centres. This will help in rapid responses during emergencies.
In particular, ensuring continued healthcare services to vulnerable sections, including pregnant women and children, on whom the pandemic has had a disproportionate impact, is important. This will help combat not just the ongoing pandemic from the ground up but build more resilient systems at the sub-district level, which tends to have fragmented infrastructure and limited resources.
Strengthen Screening, Ensure Data Access
Moreover, India has already made significant progress in genomic sequencing and surveillance over the past few months. However, strengthening surveillance systems for emerging diseases further, with a combination of both active and passive surveillance, is important. Further, as reinforced during the pandemic, access to localised data and local capacities is important for timely public health responses. Therefore, expanding district-level rapid response teams and surveillance units with adequate infrastructure, healthcare staff, and epidemiologists is imperative.
While the National Centre for Disease Control (NCDC) has been instrumental in monitoring and containing outbreaks, there is a strong case for the revitalisation of the NCDC along the lines of similar organisations such as the CDC in the US. This will help improve epidemiological intelligence, enhance capacities to handle emerging and re-emerging infections, and strengthen surveillance.
In light of the above, enforcing responsible and better data sharing needs greater attention. Efforts have been made to strengthen ICMR laboratories and this should be complemented by seamless data sharing and networking of institutions across ministries and global organisations dealing with emerging viral diseases.
Encourage Research, Improve Facilities
There is also a need to encourage research and improve infrastructure to facilitate epidemiological studies on virus outbreaks and other pathogens related to public health. This will ensure that India’s health ecosystem is at all times prepared to deal with the next disease. For instance, the government focus on antimicrobial resistance (AMR) is promising as it has been deemed the next big public health emergency and silent pandemic in the making. Therefore, there is great merit in setting up national institutions for pandemic research and a multi-sectoral platform for One Health. [One Health has been defined as “the collaborative efforts of multiple disciplines working locally, nationally, and globally, to attain optimal health for people, animals and our environment.”]
India has a very high burden of non-communicable diseases (NCD) such as cardiovascular disease, diabetes, cancer, renal disorders, as well as emergency and elective surgery. Care and treatment of NCDs were hit during the pandemic, resulting in an increase in the death rate. To avoid this, India should focus on having more infectious disease hospitals in every district as well as inflatable systems, which could be quickly turned into isolation and ICU beds so that the healthcare system is not overburdened and can continue to cater to all patients.
Indian Medical Services Corps
In addition to these interventions, an Indian Medical Services could be established along the lines of other civil services for better management, both at the hospital level and coordination within the government.
Investing in health will be essential to build resilience against future health crises and to foster social and economic equity by improving health outcomes. These critical investments are required to sustain the fight against Covid-19 and other neglected and overlooked elements of an overburdened healthcare system. It is important to continue large-scale vaccinations and additionally focus on adult vaccinations and boosters for other vaccine preventable diseases.
India needs to also build on the momentum of innovation and cooperation sparked by the Covid-19 crisis to address larger public health challenges. Our learnings from the pandemic have paved a unique path for us to build a more promising healthcare sector in the coming years. We must act now and bring in collected commitments and resources to steer the country towards a stronger, healthier and a more resilient 2022.
NK Ganguly is Former Director General, Indian Council of Medical Research (ICMR). Views are personal and do not represent the stand of this publication.
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