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India’s health gap can be closed through close collaboration beyond the sector


The COVID-19 pandemic is certainly seen as a ‘black swan’ chain of events. The term was coined by former options trader Nassim Taleb in his seminal book of the same name to describe an outlier event (or events) beyond current expectations, and which creates massive impact. According to theory, this combination of unpredictability and effect causes us to “concoct” explanations after the fact, to try to explain and create understandable logic for the same thing.

I will leave such speculations for others. . . . the debate will certainly survive the duration of this virus! I am focusing on an issue which is sorely exposed by the pandemic, but which has been evident (albeit latent) for many years in India.

Rising incomes have not only precipitated the emergence of a thriving middle class, over the past 20 years, it has also helped lift millions of people out of poverty. For example, according to the United Nations study published at the end of the last decade, nearly 273 million Indians have been lifted out of “multidimensional” poverty (encompassing issues such as access to employment, risk exposure and safety / security, as well as average financial problems) between 2005-06 and 2015-16.
An inevitable (and welcome) consequence of this change is the increase in awareness and expectations for people’s health and well-being. The evidence that more and more people are now prioritizing their personal and family health is compelling. According to a Mintel study (conducted long before the pandemic), almost half (48%) of Indian consumers aim to adopt a healthier lifestyle, while almost three-quarters (72%) say that increased happiness is their motivation for leading a healthy lifestyle.

And India’s focus on health also results in higher expectations and demands on their health services. Indeed, while these expectations grow exponentially, the provision of such services remains on a purely linear trajectory; this discrepancy is at the heart of India’s “health gap”. Over time, this gap will only increase (see right).

One of the absolutes of India’s current healthcare delivery is the availability of infrastructure, which remains – in terms of growth at least – on a markedly “linear” path.
The lack of infrastructure was evident long before the emergence of a pandemic; ventilators (there are currently 48,000 in the country against 150,000 actually needed), hospital beds (there are 1.4 beds per 1,000 citizens against 4 for China and around 7 for Europe) .

None of these problems are the result of COVID-19; these are all longstanding infrastructure shortages; they would have been exposed sooner or later, as Indian demand for professional health services continues to diverge from the available supply.

So now India’s health gap is firmly established on – not just the government – but everyone’s agenda, what can be done to close it?

First, how the country (and the world) mobilized to address the infrastructure gap exposed in the second wave of COVID-19 demonstrates what collective action can achieve. In particular, collaboration between the public and private sectors. Companies ranging from Google to the Tata Group have stepped in to fill the gap in the supply of oxygen and ventilators; the kind of partnerships that will also be essential in order to address such infrastructure shortages in the long term.

It is precisely the kind of partnerships that are essential to close the infrastructure gap. While in many cases the private sector has entered the breach, longer-term collaborations will be needed to anticipate and meet infrastructure needs for the next 10 to 20 years.

Second, address the skills gap. According to the National Medical Commission, India has 554 medical schools with an annual enrollment of 83,075 Bachelor of Medicine and Bachelor of Surgery (MBBS) degrees. Despite these unprecedented figures, skills gaps persist. Today, for example, more than 69,000 Indian-trained physicians were working in the United States, United Kingdom, Canada and Australia in 2017, according to the Organization for Economic Cooperation; the equivalent of 6.6 percent of the total number of physicians registered with the Medical Council of India.

As an industry – and as a society – we must inspire, recognize and encourage trained professionals to practice their profession in India. Again, this is not the sole responsibility of the Department of Health, it will require the health sector (and society at large) to ensure the kind of conditions and compensation that will inspire our professionals to do so. to do.

Third, technology – not only to discover new cures and treatments – but to make existing ones more accessible and affordable for all Indians. Data science and artificial intelligence are already helping specialists make diagnoses remotely – in many cases, via the Internet. A practice that will transform the delivery of health care in India.

It will also reduce dependence on traditional infrastructure; more patients can be seen in clinics (rather than requiring a hospital stay), many will be able to receive pre- and post-operative care at home.

Incorporating the “new age” type of science and technology will certainly reduce the strain on India’s infrastructure. Again, only close collaboration between public and private organizations will ensure that such benefits are actually realized.

What is clear is that India’s health gap is endemic and predates the emergence of the pandemic. While – in terms of probability – the latter could be defined as a “black swan”, the resulting strain on the country’s health infrastructure was all too predictable.

What is equally obvious is that the only close collaboration at the societal level will fill the infrastructure deficits that have been sorely exposed.

—Anand Narasimhan is Managing Director, Merck Specialties. Opinions expressed are personal

(Edited by : Bivekananda Biswas)

First publication: STI

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