Lessons for the health sector

Context: It has been only nine months since COVID-19 was declared a pandemic on March 11, but the world has changed in previously unimaginable ways.

Discuss the challenges put forth by the pandemic.

• Health systems: The health systems in many of the wealthy countries struggled; some were overwhelmed due to inadequate beds, supplies and healthcare workers who struggled with infection, fatigue and stress, recognising their inability to care for everyone who needed it.
• Damage by virus: Outside the healthcare system, the information epidemic (termed an “infodemic”) in society led to fear, stigma and discrimination that added to the damage caused by the virus.
• Learning: The closure of schools affected the learning of children, with those from disadvantaged backgrounds struggling to cope and frequently giving up.
• Accessibility: Access to non-COVID-19 essential health services was affected, the impact of which will be fully understood in the time ahead.
• Business activities: Reduction in business activities caused massive losses of both formal and informal employment and a fall in economic growth.

How did the countries tried to cope up with the challenges?

• Health services: COVID-19 related health services including hospital beds, intensive care unit (ICU) and ventilator beds were increased even as research on drugs and vaccines kicked off at an exceptional rate.
• Vaccines: Vaccines have moved even faster than drugs with over 300 vaccine candidates being developed, nearly 40 of them undergoing clinical trials.
• The accredited social health activists: ASHA who visited hundreds of households repeatedly during the pandemic to ensure that every possible case is identified as early as possible.

What did the other countries which handled the pandemic successfully do?

• The countries which handled the pandemic best: Thailand and Vietnam have well-functioning health systems designed to deliver primary healthcare services.
  • These countries also have strong preventive and promotive health services as well as a dedicated public health workforce.
• The role of community health workers: In recognising, referring and motivating individuals for therapy was remarkable.
  • Community trust and participation is essential for implementation of non-pharmacological interventions.
  • Dharavi in Mumbai is an example of the difference community participation can make.
• The response to the pandemic was multi-sectoral: Health staff, policy makers and technical experts in multiple domains worked together to identify and implement solutions.
• Quality data: The need for timely and quality data in a health information system was recognised again during the pandemic.

Way forward

• Investments in scientific research:  The solutions that have brought us hope have come from long-term private or public investments in scientific research and developments. It is self-evident that we need to emphasise what is feasible when resources are available.
• National health policy: All we need is commitment and that is outlined in the recent National Health Policy 2017 and reiterated in the report of the Fifteenth Finance Commission, which for the first time has a dedicated chapter on health.

This is an opportunity and should use the challenge posed by the pandemic to accelerate long pending initiatives for health system reforms, accelerating towards universal health coverage, the central goal of the National Health Policy 2017.