Two years after the World Health Organization declared the onset of COVID 19 in March 2020 as a pandemic, in 2022, the world continues to reel under the waves of this global pandemic impacting the entire humanity on the planet.
The pandemic has been exposing long-standing weaknesses in our healthcare system, intensifying in the face of an emergency.
Some of the challenges of our healthcare system are lack of awareness, lack of access, workforce shortages, and lack of affordability and accountability.
A recent study by the Centre for Disease Dynamics, Economics and Policy estimated that for India's total population of 130 crores, the country only has "1.9 million hospital beds, 95 thousand I.C.U. beds, and 48,000 ventilators". Doctors, too, are overburdened.
As per the arbitrary estimates, the doctor-to-patient ratio in India is around 0.74 per 1000 people.
Going by WHO standards, it should be 1:1000 – one doctor for every 1000 patients. Such deep-rooted and extensive issues make India vulnerable to any healthcare crisis like the one we are currently experiencing.
But the people and policymakers have been prompt enough to take charge right on time and act towards filling these gaps through all possible means. The health sector has found a prominent place in the government's agenda amid this pandemic.
While the health budget saw a rise of about 16 percent in absolute terms from the last fiscal, it has already paved a solid foundation to make the health sector future-ready and make it more resilient than ever in the post-COVID-19 era, and achieve Universal Health Coverage by 2030 as part of India's commitment to the Sustainable Development Goals (S.D.G.s).
Through the Budget 2022-23, the Union Government has tried to achieve two prime objectives; one is to keep on providing support to existing transformative policies and programs, and another one is to launch innovative initiatives which will be well integrated horizontally and vertically to make the Indian Healthcare Sector genuinely future-ready.
Another spinoff of the pandemic has been the emergence of a much-needed public-private partnership model in healthcare in the past two years.
The deadly second wave of COVID in 2021 caught everyone off guard, revealing the massive gaps in the system.
The P.P.P. model developed during the second wave spotlighted and strengthened the systemic loopholes in the health sector in India.
The World Bank also notes that "India has adopted more comprehensive service delivery P.P.P.s, where not only are the facilities developed and improved by the concessionaire but services are provided." A 'Build-Own-Operate-Transfer' (B.O.O.T.) model would undoubtedly benefit all stakeholders.
However, we can now try to make this system more inclusive to reach the poor and unreached.
The private sector players should commit a certain, flexible percentage (e.g., 25 percent) of their entire treatment to the Ayushman Bharat Schemes and provide services at low fees to the poor.
An enabling structure must be put in improved private sector participation will bode well for an overall improvement in healthcare delivery and deep implementation of the healthcare policies.
Along with all other sectors in India, even healthcare reformed for digital mode. On February 1, while presenting the Union Budget for the financial year 2022-23, Finance Minister Nirmala Sitharaman made critical announcements in the healthcare sector.
This includes the roll-out of an open platform for the National Digital Health Ecosystem and the National Tele-Mental Health Programme launch. Telehealth diagnosis, counseling, and awareness were introduced and implemented seamlessly throughout India.
Another key takeaway from the pandemic has been up-skilling the healthcare ground forces. N.G.O.s, experts, and retired doctors can be looped in for the same.
Government should also be increasingly proactive in setting up hospitals, clinics, and other healthcare facilities. It can do so by reverse auctioning land, reducing red tape, and taking a solid stand against local troublemakers. Further, 'health' should also be moved from the State to the Concurrent List, as rightly suggested by a high-level group (H.L.G.) constituted by the 15th Finance Commission.
A critical aspect of our Primary healthcare, one of the essential elements of healthcare provision in an efficient and equitable system, is now getting strengthened, with even the previously neglected urban healthcare component receiving attention and resources.
Nearly INR 64,180 Crore will be invested over six years to improve primary, secondary and tertiary healthcare as part of the newly announced PM Atma Nirbhar Swasth Bharat Yojana.
This will be in addition to the National Health Mission. A certain amount from the budget will be used for establishing critical care hospital blocks in 602 districts and 12 central institutions. The budget also mentions the introduction of the National Commission for Allied Healthcare Professionals Bill and the soon-to-be-introduced National Nursing and Midwifery Commission Bill.
The regulatory improvements and institutional restructuring that have been proposed will hopefully contribute to improving health outcomes and enhancing economic growth.
Indeed we are right in the direction. While India did prove its health support prowess while supplying around 60 percent of the global COVID vaccine demand, Indian healthcare is sure to maintain its momentum and innovation in 2022 and beyond.
This has put the healthcare industry back on track, and N.I.T.I. Aayog report has predicted that India's healthcare sector would grow to $372 billion in 2022, with a compounded annual growth rate (CAGR) of around 22%, with the pandemic opening up several opportunities.
It will be essential to shift our focus towards the quality of implementation of the new programs and schemes and foster convergence across health programs.
Our efforts should lead to creating a robust, collaborative ecosystem for the public and private healthcare providers to work together in quest of desirable outcomes.
In the face of the current health exigency, all these new initiatives must be implemented with utmost diligence and seriousness to reach the last mile. We need to remember that - Unless all are safe!