Speaking at the 47th Foundation Day celebrations at IIM Bangalore, medical scientist Dr Gagandeep Kang, said, “There is no reason why India cannot chart a new path for the emerging world of healthcare. Despite the challenges and complexity, we must use our learning to re-imagine the healthcare system to lay out a path, that works with State and non-State actors, to provide a resilient system that gives a comprehensive, accountable, accessible, inclusive, and affordable healthcare to everyone.”
Healthcare is not a luxury
Explaining the evolution of modern or Allopathic medicine in India, Dr Kang, the first Indian woman scientist to be elected Fellow of the Royal Society (FRS), London, said today we can broadly classify Indian healthcare as ranging from the best-in-class services that are available to the relatively wealthy and insured population that never need to access a government hospital to everyone else without that luxury of choice.
She went on to say that despite economic growth over the last two decades, we often hear that India’s healthcare system is broken. “However, we have been improving our statistics related to infant mortality, maternal mortality, and immunisation,” she observed.
Role of trust during a public health crisis
Discussing the lack of emphasis on healthcare in our country, she said, India spends a very low proportion of its national income on public healthcare. “In the structuring of medical education, in the building, staffing and running of health and wellness centres, in the regulation of healthcare providers at all levels from the village to the five-star hospital, and of the industry that provides drugs and devices, there are failures of form or function that need attention.” Hailing the National Health Policy, 2017, which is committed to increasing government health spending and laying out the role of the Government in shaping health systems in all dimensions, she said, “any policy is only as good as its implementation.”
Dr Kang said that the SARS-CoV2 experience has taught us not just the importance of planning and preparedness, but has also highlighted the crying need for communication and trust where public health concerns necessitate any form of action. “A lot has changed in the last six months; we have recognised that diagnostics is important and needs to be scaled to provide information on infectious diseases. We have begun to manufacture equipment, tools, consumables, kits, that we have never done at scale never imagined before. We have realised that global supply chains are easily disrupted and strategic planning for disasters requires an understanding of critical control points. And I hope that we have also realised the tremendous economic impact that the pandemic has had which must force us to rethink and re-imagine India’s healthcare system.”
Dire need to reform
“The long-standing need for universal health coverage in India has been brought into sharp focus, but healthcare in India was in dire need of reform long before the Covid-19 pandemic. The pandemic could worsen health disparities since most of the public health systems have been redeployed in response to the pandemic, disrupting routine health services.”
Recommending a few measures to address the challenges, she said, “An affordable, accessible healthcare system which delivers a good patient experience is not within the reach of most Indians. Most of us recognise that investing in health is an investment in our future. We must leverage new technologies and tools and the time is now.”
Building complementary systems
“We must also delve into building relationships and complementaries between the private, public, and informal healthcare sectors; we need to see how complementary systems of medicine could be incorporated and regulated to benefit from traditional knowledge. We ought to find out how to replicate positive exemplars in public healthcare systems. We must research the distinctive roles of Central, state and local governments in delivering and regulating healthcare, identify regulatory measures to ensure accountability, financial protection, etc.,and implement systems of feedback and transparency.”
She concluded her talk on an optimistic note. “At the moment, the world is in crisis, pinning hopes on a vaccine will not restore 2019 no matter how fervently we desire. But in nine months, public health and science have shown us that we can move with speed, implement measures of control, collaborate, and come up with new technologies for potential solutions. Although there have been examples of isolationism and denial of science, in the main, we have demonstrated solidarity, and a recognition that we are in this together and that complex, interlinked problems can be understood and worked upon leading to solutions through careful design and experiment.” Covid catalysed tele-medicine
Dr Devi Prasad Shetty, Chairman, Board of Governors, IIMB, and Professor Rishikesha T. Krishnan, Director, IIMB, also addressed the audience about resetting ourselves in view of the current situation — in business and in health.
Talking about the growing popularity of tele-medicine, Shetty said: “Tele-medicine was considered illegal before Covid-19 came, now it has been legalised. People have embraced it too. In the field of academics as well, there was a lot of debate about online education before, now it is a reality. All these are the need of the hour and beneficial to society.”