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Healthcare for all not Hysteria!

Sunday, Apr 26, 2020 13:15 [IST]

Last Update: Sunday, Apr 26, 2020 07:35 [IST]

Healthcare for all not Hysteria!

KAMAL BARUAH
Send “hi” to +41 79 893 18 92 on WhatsApp, you can join Health Alert. My phone is throbbing with messages of information and guidance from WHO. These are strange, scary times of quarantine at home. World Health Organisation has launched a dedicated easy-to-use messaging service to keep people safe from coronavirus and enables WHO to get information directly into the people. India also launched “Arogya Setu” App to connect essential health services with the people of India. Such is the platform in 21st century where we are scrolling phone for the live updates of Coronavirus. Throughout the course of contemporary period, we witnessed Asian flu (1956-68) following AIDS (1981 to present day), Swine flu (2009-10), Ebola (2014-16) and Zika virus (2015-present day) that affected millions of people worldwide with casualties. Disease outbreaks have ravaged humanity and Covid-19 is no different from others. There has been a wave of panic buying and created sudden overwhelming fear over lockdown. The electronic media have gone further spreading panicky. The world community haven’t realised after huge technology advancement until a microscopic pathogen attacked. 
Following the end of World War II, the WHO formed in 1948 for relief of victims of war unfortunately we’re yet to achieve health for all globally. United Nation pushed to begin initiatives worldwide health programs with UNICEF, WHO and UNRRA. It was indeed a historical declaration at Alma-Ata 1978, when most of the countries and international organisations agreed upon a common definition on PHC (Primary Health Care). Amid gross inequality in the health status, it talks about physical, mental and social wellbeing to an acceptable level of health. The focus is given on the big three - HIV/AIDS, Tuberculosis and Malaria. Also global organisations are doing research on specified disease like Cancer. WHO’s Publications for essential medicines helped countries to develop medicines. The Child survival revolution by UNICER aided to reduce child mortality in developing world. DOTS for stop TB partnership have done most effectively. Yet people from poor / developing countries deprived off basic healthcare.
While following Alma-Ata Declaration, socialist republic Cuba fought for the challenges of PHC most effectively and uniquely. Cuba has one of the highest doctor-to-patient ratios (8.2 in 1000) in the world. It has a history of sending medical teams to nations in crisis and Cuban doctors and nurses have arrived in Italy and other countries to help fight the battle against the spread of coronavirus.  Cuba invested heavily in the biotech industry to develop medicine, vaccines and support for prevention since it faced with several outbreaks of infectious disease. While public healthcare of developed/developing countries interfere with private interest for profit-making, Cuba’s total healthcare financed with public resources. It has produced enviable results with the community-based polyclinic now transformed into multi speciality for clinical services too.
Despite India’s high economic growth, it spends just 1.2% of GDP on health which is one among the lowest in the world. Ours health for all remains a dream in terms of drugs, nurses, doctors, vaccines and X-ray equipment. Low level of public investment in PHC causes India’s poor health index. There is one doctor for 1,457 people, which is lower than the WHO norm of 1:1000. In compare to the World Bank data India has 0.8 (1.5) doctors, 1.3 (3.4) nurses and midwives, 0.7 (2.7) hospital beds. We have just 7 in 1 lakh population for specialist surgical against Cuba’s 101. But Indian pharmaceuticals are a formula for success as India ranks 3rd position worldwide for production by volume (10%). She recently exports hydroxychloroquine to US and other developed countries after global shortage of drugs.
The huge investment for the health sectors is the need of the hour for 1.3 billion people. Our infrastructures are exposed hollow inside for in case of ICUs, ventilators and emergency services. Medical career is in high demand as Healthcare market is driven by rising incomes, greater health awareness, lifestyle diseases and increasing access to insurance. Our scientists and researchers take challenge to crack the vaccine so with US, China and other countries are sparkling hectic research globally. The world had to wait 5 years for the development of Ebola vaccine. It requires $billions of investment and takes a long process from exploratory to clinical, regulatory, manufacturing and quality control.
The health for all agenda fizzled over decades and the causes of ill health to lie beyond the four walls of hospitals are still unanswered. Although India is doing health and medical research leading by ICMR - Indian Council of Medical Research and other institutions on specific to communicable diseases and preventive medicine etc. it’s not mere absence of disease but relook of physical, mental and social well-being of common people. The WHO recognised health as a human right. Thereby social and economic sector need to be actively involved with health sector. Rural India lags clean water, sanitation, nutrition, immunisation and access to treatment and availability of essential medicines in PHC.
With increasing adoption of universal health coverage, it found healthcare for all was unrealistic and it slowly catered for selective healthcare. UNICEF adapted “GOBI-FFF” (an acronym for Growth monitoring, ORS, Breastfeeding, Immunisation, Family planning, Food supplements and Female education). Developing countries started initiating privatisation and liberalisation processes under the duress of World Bank and IMF. Over a period of time, PHC has seen the entry of private sector in the form of PPP - Private Public Partnerships. Although they’re largely unregulated and known to fleece patients, governments steadily promote private health care sectors as it has huge area of investment in several hundreds of $ billions. Thus it all goes against to the vision of the Alma-Ata Declaration. Whilst ‘Health for all by 2000’ was not achieved, world health activists sat down at Savar, in Dhaka for the cause of the failure.
Meanwhile another pandemic has arrived now.  Stopping an outbreak is never just an easy task while Healthcare is struggling around the world with rising costs. Despite being developed nation, it sparks a lot of panic in countries like Italy, Spain and US from coronavirus. The world must fight together for global healthcare. There are many countries offering universal health care systems. In these countries, employers/individuals share in the cost of healthcare through contributions and cost-share arrangements. However, the goal is to make healthcare as affordable and accessible as possible for the largest number of people. Is Universal healthcare a possibility for all Indian citizens? The world is busy fighting over the unseen virus. India responded well in advance to flatten its Covid-19 curve. People cowered in fear as the horror of death over life. Amid lockdown we are glad to be home. Aren’t you? Rather hysteria!
The writer can be reached at email kamal.baruah@yahoo.com

Sikkim at a Glance

  • Area: 7096 Sq Kms
  • Capital: Gangtok
  • Altitude: 5,840 ft
  • Population: 6.10 Lakhs
  • Topography: Hilly terrain elevation from 600 to over 28,509 ft above sea level
  • Climate:
  • Summer: Min- 13°C - Max 21°C
  • Winter: Min- 0.48°C - Max 13°C
  • Rainfall: 325 cms per annum
  • Language Spoken: Nepali, Bhutia, Lepcha, Tibetan, English, Hindi