Learn Fast From the Pandemic

Context: The entire healthcare stack — drug R&D, hospitals, personnel and GDP spend — needs an overhaul.

Lessons from the pandemic: Suggestions -

• Universal Healthcare as the national goal: Increasing the public expenditure on health from abysmal 2% to 5%,
• Giving private sector highest priority: Including incentivising on research.
  • Private sector needs to be unchained, as price controls and raids will not attract investment.
  • Clearly commit preference for the private sector in medical education, health infrastructure and medical device manufacturing.
• Reform the ailing hospitals:
  • A national scheme should aim to double the number of hospital beds.
  • Attract investments without any restriction on FDI
  • Introduce predictability of regulation around Intellectual Property rights (IPR).
• Developing a National Health Scheme: Backed with free insurance coverage to all citizens with an annual income up to Rs20 lakh.
• Role of the States: States should be free to adopt GoI’s minimalistic agenda and would qualify for financial assistance on the basis of minimal national programme fulfilment.
  • They can freely go above and beyond this minimum by topping up through their own schemes.
• Urgent review of healthcare framework: While a national programme to set up medical care hospitals is already running, the implementation of infrastructure and staff placement is tardy.
  • The Allahabad High Court recently observed healthcare is seen to be left to ‘Ram bharosey’.
• Include mobile healthcare: Connecting each revenue village to district and primary health centre.
  • Each revenue village should be visited at least three times a month with a pre-fixed schedule.
  • ASHA (accredited social health activist) workers must be part of this scheme, which can be supplemented by private telemedicine initiatives.
• Ensure adequate and quality human capital: There is an acute shortage of trained doctors, nurses and technicians.
  • The admission, syllabus and prerequisites for degree and training should be reviewed to attract more candidates at doctor, nursing and technician levels.
  • Double the seats for medical students and finance medical education at all 500- bed capacity hospitals
  • Nursing colleges should also be compulsory for 300-bed-plus hospitals.
  • Periodic training should be mandatory up to technician level, can be supplemented by digital delivery of training.
  • Skill sets — experience and understanding health tech — are mandatory in modern public health.
• Motivate specialists to work in rural: ‘Good’ doctors must be encouraged to commit their professional time in rural areas and district hospitals.
• Identify alternative sources of medicines and raw materials: Reverse engineering is not enough;
  • Between 2000 and 2019, the Chinese share in active pharmaceutical ingredient (API)-making facilities more than doubled.
• Overhauling regulatory framework to support R&D: The Indian Pharmaceutical Association (IPA) listed a plethora of approvals and delays in the Central Drugs Standard Control Organisation (CDSCO) and Indian Council of Medical Research (ICMR).
  • Higher R&D spending is an insurance premium. It will mitigate future health crises.