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.