By Gyan Pathak
India achieves a milestone by administering 100 crore doses, including both the first and second doses, of anti-corona vaccines. The achievement is celebrated across the country, and it was good. However, it still reminds the cost of unpreparedness the country has paid since the first case of COVID-19 surfaced in Kerala on January 30, 2020, and may still pay dearly in future if public health is continued to be ignored, access to health facilities are kept beyond the reach of common people while hoodwinking them with schemes like ‘health insurance’ such as Ayushman Bharat, that has nothing to do with strengthening the health facilities and infrastructure in the country. Increasing public investment in health and making access to health facilities a basic human right might be the only answer to our predicaments that the present vaccination drive itself has proved.
Around 75 per cent of the adults have been administered the first dose, but only around 31 per cent having received both doses, is still a matter of concern considering the time India took to achieve this level since the launch of the vaccination drive on January 16, 2021. It took nine months and one week to fully vaccinate 31 per cent of the population, chiefly on account of unpreparedness, coupled with adhocism in policy implementation and the faults therein. It delayed the process, created vaccine hesitancy, hampered the production and supply of vaccines, and numerous other problems which also included the faulty eligibility criteria. At this rate of vaccination, India may need 12-18 months more to fully vaccinate all its citizens. Then there is also a possibility of booster dose for those who have been fully vaccinated.
All these indicate how much India needs to do, apart from celebrating the achievement of this milestone, the big number of which must not be allowed to influence our sentiment to astray from the task ahead of us. Modi government do have a political interest in the high pitched celebrations to make the people forget about the lapses and callousness of his government when the pandemic struck the country last year at a time when the whole health sector was suffering from very low budgetary support of only about 1.1 per cent of the GDP in 2019-20.
Even the National Health Policy 2017 had envisaged an increase in India’s health expenditure from1 per cent to 2.5-3 per cent of the GDP. It must be noted that the COVID-19 crisis has made the situation worse on the ground and according to international estimates India’s actual requirement could be anything in the rage of 9-14 per cent of GDP depending on different scenarios. The real cause of celebration would be if Modi government could enhance the budgetary support to the healthcare to this level to make the country fully prepared to face the present and future health challenges of the country. It should also not be out of place to remind the Modi government that the Union Budget 2021-22 was cleverly made to show 137 per cent increase for healthcare by an allocation of 2.23 lakh crore, as against 94.45 thousand crores in the fiscal 2020-21. However, in reality, the amount included the budgets for Jal Jeevan Mission (Urban), Swachch Bharat Mission, Clean Air programme and others. Ministry of Health and Family Welfare got only Rs 73,931 crore as against 69,000 crore for a year before. An outlay of Rs 64,160 crore for Aatmanirbhar Health Yojna was to be spent over six year time frame.
Even the Economic Survey 2020-21 has mentioned that 66 per cent of the spending on healthcare is done by the states, which shows that Modi government still needs to increase health expenditure of the centre the enable the state governments to meet the present challenge successfully. However, we have seen during the COVID-19 crisis, how the centre has been pulling the legs of the states on several accounts while shifting blame on them.
What we need is to improve India’s global ranking which was 179th out of 189 countries of the world in the priority accorded to health in its government budgets. Such a low level of prioritization of health in India is “similar to donor dependent countries such as Haiti and Sudan, and well short of its peers in development,” the Economic Survey 2020-21 has said.
As for the healthcare access, the Economic Survey 2020-21 even mentioned India’s 145th rank out of 180 countries, The country managed its rank only above sub-Saharan countries and few others such as Nepal and Pakistan.
India also needs to significantly work towards improving its Maternal Mortality Ratio (MMR) and Infant Mortality Rate (IMR) metrics. The hospitalisation rates in India are among the lowest in the world at 3-4 percent while the average for middle-income countries is 8-9 percent and 13-17 percent among the 17 OECD countries. It is still a matter of concern that the aggregate human resource for health density in India is close to the lowest possible threshold of 23 per 18,000 people, almost half of 44.5 to achieve sustainable development goal as prescribed by the WHO. The series of celebrations planned and celebrated included the announcements made on airplanes, ships, metros, and railway stations etc when India achieved its target of administering 100 crore doses. Modi government even announced to go on mission mode to ensure cent per cent vaccination. It would not be a bad thing but it is only one task out of the many that has not been even attended to though those are immediately required to secure good health for all the people of the country.
Our PM has been patting his back for “India scripts history” in vaccination, but we need more than self-praise. The cost of achieving this milestone was too high due to our unpreparedness and callousness, in which India lost more than 4.5 lakhs lives, crores of livelihoods, a reversed economic development with 7.3 per cent contraction in GDP in 2020-21, and an uncertain economic revival. It should serve as a lesson to the country in general and our PM Narendra Modi in particular. We must build on the basis of the lessons learnt. (IPA Service)