India must combat healthcare threats through research, education

The world is struck with a health catastrophe since the onset of this year. The novel coronavirus respiratory disease or Covid-19 has been spreading like wildfire across the globe. Within one month since its first reported case in last December, the beta coronavirus has engulfed over 150 countries including all major world economies. Till date, the disease has claimed over 90,000 lives and over 15 lakh people have been infected, worldwide. Besides the threat to mankind, the pandemic has caused unprecedented loss to economic and financial sectors, globally. In India, the disease has claimed over 240  lives with over 7,500 people tested positive, so far. As we are writing this piece, the numbers of affected people are surging. The country is putting up a tough fight to contain the spread of this deadly virus.

Yet, the battle against this deadly virus is still on. While various measures are being taken to contain its spread, India needs to strengthen its inherent capabilities to withstand such healthcare threats. The need of the hour is the formulation of a comprehensive healthcare policy; one which is directed towards ensuring India’s preparedness to deal with unforeseen crises through advanced research, improved education and equitable access to cure and nutrition.

MISSING THE WOOD FOR THE TREES: EMERGENT ACTIONS UNPREDICTABLE CATASTROPHES: India is still among some of the vulnerable countries to combat deadly diseases and natural disasters. For instance, the impact of Covid-19 on the livelihood of the country is profound. The coronavirus-generated lockdowns have led to slowing down of the domestic economic activity, sharp fall in the GDP level of the country, plummeting financial market, and rising unemployment level. India’s large informal sector and small and medium enterprises (SMEs)—the engines of growth and employment—are the worst hit. Similarly, the country is subject to unpredictable changes in the climate witnessing drought-like situations in some states and devastating floods in some other. Projections reveal that global warming might not only raise the average temperature in the country by almost 2°C, but also make the coastal areas more prone to cyclones, with rising sea levels and salt water intrusions. This would, in turn, have an adverse impact on domestic productivity and would also lead to extensive job losses (ILO estimates $34 million job losses by 2030, as a result).

MISSING COMPONENT IN RESEARCH & EDUCATION: Healthcare or medical education has not been a much focused on subject in school and college studies. The general perception of healthcare being an irrelevant and insignificant topic is quite common in India. Therefore, areas such as the challenges in this industry, healthcare security, science policy in healthcare, prediction models on unforeseen/natural threats, combating mechanisms, etc., are generally kept outside the purview of the regular curriculum taught at primary, secondary and tertiary levels of education. Students and teachers are not properly equipped and trained to overcome or at the very least mitigate the adverse impact of unforeseen healthcare threats. Moreover, advanced research in this field is also constrained with the lack of adequate funding and necessary budgetary support. India’s total research and development expenditure as a percentage of its GDP has always remained below 1% (over the years, it has reduced from 0.8% in 2008 to 0.59% in 2018).

SUPPLY-CHAIN CHALLENGES: India is proudly known as the global pharmacy for generic drugs besides being famous for offering quality healthcare services at economical costs. However, in recent times, the country has become an importer of active pharmaceutical ingredients (API) or bulk drugs, with China accounting for nearly 70% of this import share. Where India was once self-sufficient in API (during1991), by 2012 China’s share of India’s imports had gone up to almost 48%. Over the last three years, the share has widened, rising to almost 68% in 2018-19. This could be largely on account of the complex supply chain network in India, domestic APIs running at below optimal capacity and China’s comparative advantage in low cost of production. The former is largely owing to the exorbitant number of domestic market players at each stage, weaknesses in their sourcing strategies by relying on single or limited sources of supply, absence of mapping and monitoring to assess requirements, varying degrees of quality standards and the lack of proximity with the local manufacturers. As a result, fields like manufacturing, automobiles, consumer durables and agriculture, which are highly dependent on intermediate supply-chains, are witnessing production constraints during these tough times, leading to insufficient supply of food and facilities in the remote areas of the country.

POLICY IMPERATIVE
Therefore, India’s policy imperative on healthcare in the context of research and education must be examined carefully. We are amidst of times where not only has Covid-19 created a global health emergency but has also caused a crisis of unprecedented magnitude.

Beyond this ongoing pandemic, the frequent natural disasters attributed to climate change, are also unavoidable, causing extreme loss to life, livelihoods and environment.

Therefore, it is all the more logical to strengthen India’s preparedness in overcoming such adversaries given the country’s unique socio-cultural-economic demography.

Educating young minds could be the starting point. Not only specialised courses on health must be carried out beginning from the primary level of education itself, but the students must also be trained in field food production and supply chain management at the school itself, so that they are sufficiently skilled to handle any form of healthcare challenges and food shortages.

The teachers need to be trained sufficiently to teach the students disaster management mechanisms and predictive modelling tools for such hazards through artificial intelligence or via different audio-visual techniques. The learnings at school and colleges must be blended with physiological support and good parenting practices to ensure healthy upbringing of the students.

The education initiatives must eventually be backed up with adequate policy support.

The apparatuses of Indian science policy must be called into action to address various health challenges through advanced research, knowledge exchange of global best practices on safeguarding mechanisms and sufficient budgetary allocation or funding to promote research and development in this field. Advanced research could take different forms ranging from computational modelling of natural disasters, generating micro-level data on climate projections or trends, predicting the trajectory of such diseases, to the testing of vaccinations for cure of such deadly diseases. Concurrently, a robust supply chain-mapping -monitoring management system could ensure the generation of a seamless supply chain network, especially in the production and supply of essential goods and services.

As the saying goes, “precaution is better than cure”. The ongoing global health pandemic is no less than a “wake-up call” for India to be prepared sufficiently to combat such unforeseen health disasters, going forward.

Dr Anjali Taneja is Associate Director (Science Policy Initiative), Office of Research at Ashoka University. Dr Aarti Srivastava is Associate Professor, Department of Higher and Professional Education, National Institute of Educational Planning and Administration.