We Need To Urgently Invest In Public Health

Context: Only a robust public health system, and not healthcare alone, can lead to disease prevention and control.

Significance of Healthcare during the pandemic:

• Saved countless lives: The e?orts of healthcare personnel, from ASHA workers with only basic training to highly specialised intensive care physicians, have saved countless lives and made India proud.
• A mix of Science and Ethics: Along with the focus on the labs and research, healthcare personnel worked tirelessly, with single­-minded devotion to duty, providing care.

Difference between Healthcare and Public Health:

• Healthcare refers to the transaction between one care­giver and one sick person at a time – hence the client is the sick person, and therapy is the mainstay.
• For public health, the client is the community at large, and the goal is disease prevention and control. (which is data-driven and total population is the denominator).
  • For, E.g. Data collection for HIV control is sample-­based, under the unique Indian design of sentinel surveillance, established in 1986 and still continuing.
  • Counting of Acute ?accid paralysis (AFP) and laboratory tests for polio­ viruses were crucial for polio elimination in India.

Issues with India’s Public Health Management

• No way of a prospective collection of data: we do not have a comprehensive and quanti?ed pro?le of any disease in the entire population, including tuberculosis, malaria, leprosy, AIDS.
  • Failure of serosurveys: an attempt to derive the to­tality of infections, reported widely disparate ?gures and failed to give us a reasonably reliable picture.
• Ignores social vaccination: Public health management lacks effective communication to the public for self-­motivated beha­viour modi?cation.
  • Leading to considerable vaccine hesitancy among even healthcare staff
• Lack of Post-­vaccination surveillance, vital for assessing vaccine efficacy and safety,
  • This presents a challenge since public health in cases of infectious diseases like COVID-19 has a strong social determinant like overcrowding, lack of cough/sneeze etiquette, and urban-­rural divide in health awareness and education.

Conclusion: Investment in public health will result in health, wealth and prosperity.