April 15, 2020 | Aman Gupta in The Pioneer
The pandemic has reinforced the need for inclusive policy-making where countries think internationally and act locally during a crisis
On February 23, Italy recorded around 150 positive cases of COVID-19. Within a week, that number touched 3,000 and four days later it had surpassed 7,000. What happened in Italy after that was surreal as the numbers and deaths mounted exponentially. It was the same with the US which has turned into a hotspot after President Donald Trump ignored repeated warnings by scientists, doctors and experts to act in time and impose a lockdown. The businessman in Trump prevented the President from paying heed and he chose the economy over lives and at one point even considered letting the Coronavirus “wash over” the US in keeping with the “herd immunity” theory that many experts were propounding.
Worldwide, too, the numbers are going up each day with the cases touching 19,31,261 and 1,20,134 casualties. What is even more worrying is that China and South Korea have seen cases resurfacing, giving this nightmare another dimension altogether. The World Health Organisation (WHO), which had declared COVID-19 a pandemic on March 11, and has come under fire for allegedly covering it up initially on China’s behest has now announced that the Coronavirus is 10 times more dangerous than the Swine flu . But, despite the world health watchdog’s warning in early March, it had taken over two weeks for world leaders to take comprehensive action to curb the spread of the Coronavirus. By that time it was too late and too little. Now, as the number of cases is spiralling, countries across the world have receded into a lockdown. India, which began its shutdown from March 25 for 21-days, has now extended its lockdown till May 3.
It is now more than ever that the world is looking up to its policy makers for tackling the spread of COVID-19. However, as more countries across the world impose heavy restrictions on their citizens and stress upon the urgent need for social distancing amidst this growing pandemic, there are still many countries that haven’t completely acknowledged the impact of this virus. Such inward and self-centered policies of nations have severely limited the global consistency of action in such a trying time as this.
A global health crisis like COVID-19 goes beyond borders and the need of the hour is unanimity across the world. In a short span of time, the virus has spread rapidly through the world and with each passing day, the pandemic lays bare the inadequacies of healthcare systems and crisis unpreparedness across the globe.
From infrastructure and medical technology to resources and administration, there are glaring insufficiencies in the healthcare industry. European countries with developed healthcare systems have failed to battle the enormity of this pandemic. The UK took a different approach towards dealing with the problem by experimenting with the “herd immunity.” However, this approach backfired on the UK as the number of cases in the country soared while their National Health Service struggled to keep up. Even though now the UK has imposed a full-fledged lockdown, a crucial period when the spread of the virus escalated was spent without active administrative action. This existing introversion of ideologies to tackle global health emergencies has led to an unsynchronised response of countries in tackling the crisis. There has not only been a delay in action response but also a failure in delivery of productive action making it extremely difficult for countries to — at this stage — flatten the curve. In an era of such populist inward-looking ideologies, there is a need to revamp our crisis management strategies and look outward to avoid a situation where the internal machinery reaches the edge of a collapse.
In India, the COVID-19 pandemic has gradually been exposing the neglected state of healthcare. WHO executive director J Ryan recently referred to India as a country with immense capacity when it comes to eradicating epidemics. His reference was in line with India’s contribution in eradicating polio and smallpox. In addition to that, Dr Roderico Ofrin, WHO’s Regional Emergencies Director, commended India on its comprehensive and robust action-plan to tackle COVID-19. However, healthcare in India has for most part remained an ignored industry. Less than three per cent of the Gross Domestic Product (GDP) is allocated to healthcare and the country is perpetually dealing with a shortage in medical resources and infrastructure.
According to the Government, India has about one doctor per 1,500 citizens while the WHO recommends one doctor per 1,000 residents. In rural areas, where two-thirds of Indians live and rely almost solely on Government hospitals, the ratio is one doctor to more than 10,000 people.
These statistics are haunting when evaluating the action response required to tackle a pandemic such as COVID-19 which is growing by the minute. Moreover, India faces a problem of plenty within an informal sector of residence and profession where crowd control is difficult.
For instance, 49 people from the famous Dharavi slum in Mumbai were tested positive for COVID-19 and there have been five deaths till now. This slum could turn out to be India’s biggest hotspot. The nationwide lockdown that India is currently experiencing is one step in ensuring social distancing and breaking the chain of transmission of the Coronavirus. However, in a slum like Dharavi, social distancing cannot be practised and contact-tracing is very difficult. The challenge is manifold without adequate resources to know the extent of spread of the virus.
Until a couple of weeks ago, India had only 52 official testing centres for COVID-19 but now that number has gone up slightly. In Tuesday’s address to the nation, Prime Minister Narendra Modi assured people about the arrangements to fight the Coronavirus pandemic in India. “It is said that around 1,500 beds are required for 10,000 COVID-19 patients. In India, we already have made arrangement for one lakh beds. More than 600 dedicated COVID hospitals too are there. These facilities are being expanded speedily,” he said. For a population of 1.3 billion, that number still falls way off the mark. We are at a point where the nation is entirely dependent on internal policies to drive the health market. On the other hand, a coordinated global lockdown could have avoided panic and given countries time to strengthen healthcare systems.
Another point of worry that has emerged amid this crisis is the supply-chain disruption especially in the health sector. Countries which have been severely affected by the pandemic have resorted to sealing borders and enforcing complete lockdowns, which is an entirely unprecedented situation. Most nations don’t have a support system or infrastructure to manage such large-scale disruptions in the supply-chain of essential goods, especially pharmaceutical and medical device companies. International collaboration on delivery of essential services like medical equipment and pharmaceuticals could go a long way in ensuring availability of these services during a crisis.
India is popularly known as the pharmacy of the world. In this regard, India could particularly look at expanding its pharmaceutical industry into a more robust operation that caters not only to domestic but also international needs in the time of crisis. The recent decision to allow export of anti-malarial drugs chloroquine to other nations in need is a step in the right direction. The Government needs to rope in experts in the industry from the world-over to develop policies that expand the market significantly and also make it self-sufficient during a time of crisis. This could create a mutually beneficial global platform wherein all agencies can be timely brought in to effectively tackle a public health emergency. For long, India’s protectionist economic tendencies have prevented this from happening which emphasises upon the need for a policy revamp even more.
If COVID-19 has taught us anything, it is that we need to initiate an active united response where world bodies come together to develop long-lasting policies which can be played out during public health emergencies. It has become imperative to incorporate globalisation in policy narratives and work actively towards providing comprehensive solutions to world problems.
A simple case study of the turn of events in Italy would clarify the importance of preparing a comprehensive strategy of testing, tracking and self-isolation to fight COVID-19. While Italy wasn’t prepared, it gave other countries the time to do so. Unfortunately, the lack of coordination in dealing with this crisis on a global level has slowed down the fight against COVID-19 today. Even though ultimately countries have resorted to a lockdown to curb the spread of the Coronavirus, the action response in the interim has been lackadaisical.
Significantly, Modi roped in SAARC leaders to develop a strategy to deal with the growing COVID-19 pandemic. The discussion revolved around creating a global fund to tackle COVID-19 in the region and also to be better prepared for the future. Taking a cue from that, steps need to be taken at the stakeholder level to develop more inclusive strategies for when disasters hit. East-West collaboration lies at the core of this strategy. One way to move forward in this regard is for policymakers to think globally and act locally. There is a need to break out of existing traditional practices and align with the global viewpoint while thinking of implementation on the grassroot level. We live in a world with extensive cross-country interaction and movement. It is essential now to be aware of possible health threats that might require a coordinated policy narrative to deal with. Countries should focus on policymaking at a local level while integrating and defining these policies at a globalised macro level.