Is India really ready for the next big outbreak?

The country which wants to be a dispensary for the world, its own health system is very bad. Public hospitals are overcrowded and inaccessible, with some of the lowest government spending of any country. A multitude of private facilities are beyond the reach of most citizens. India’s courts were forced to intervene earlier this year to address alarming disparities in hospital oxygen supplies, while state and federal officials battled over the purchase and citizens gasped for breath. He died behind the autorickshaw.

The pandemic pushed many people into severe debt to access health care, forcing families to sell property, jewelry and even livestock to pay hospital bills. Even before Covid, India’s out-of-pocket medical expenses were among the highest in the world, accounting for nearly 60% of total health expenditure. According to World Bank data, public health spending accounts for less than 2% of GDP, compared to 5.4% in China and the global average of about 10%. Researchers from Azim Premji University found that the virus pushed an additional 230 million people – more than the entire population of Brazil – below the poverty line, with a worrying increase in malnutrition and hunger.

The first warning signs that it would be a bad dengue season came in late August, when a hospital in Firozabad in the northern state of Uttar Pradesh reported a rise in deaths from “mysterious fever”. Dengue and scrub typhus. The independent news outlet, News Laundry, reported chaotic scenes at a government-run facility in September, with patients sharing beds, delays in lab reports and a severe shortage of doctors. An open drain and stagnant water ponds make it an ideal breeding ground for mosquitoes that spread dengue, while monkeys, pigs, cows and dogs scour the garbage heaps near the hospital for food.

The number of dengue cases in Delhi crossed 1,500 last week, with severe outbreaks and death rates spiking across the country, federal health minister Mansukh Mandaviya intervened. The ministry deployed teams of experts to nine states and territories and suggested that COVID beds for dengue patients should be rebuilt. Mandaviya inadvertently highlighted one of the main shortfalls of India’s pandemic response – the significant lack of cases and deaths. “Since testing is the most important step in identifying dengue, these deaths will go unreported and the disease will continue to be under-reported,” he said.

Epidemiologists say India’s actual COVID death toll could be between 1.3 million and 5 million, with even the most conservative estimate more than double that of the US, the world’s highest ever recorded. Gone is the most. That’s three to 10 times the official count – a claim denied by Prime Minister Narendra Modi’s government, which has used a consistently low reported death toll of 459,000 to defend its pandemic response.

But unless India learns from its wrong steps, it is doomed to repeat them when the third wave hits. As a priority, it should increase investment in public health, strengthen surveillance systems and significantly increase vaccination. Its 1 billion-shot milestone last month was a significant one, but when you consider that only 24% of India’s 1.4 billion population has been fully vaccinated, while 54% got a shot, it Clearly there is still a long way to go. And it leaves us all vulnerable.

Daniel K. Experts at the Inouye Asia-Pacific Center for Security Studies say the government needs to do more. Public health officials should procure and stock additional essential medical supplies in anticipation of future outbreaks of COVID-19 and learn to manage health emergencies much faster. This is not a good sign that Modi’s administration has taken months to recognize the seriousness of the dengue outbreak, instead taking action when the initial symptoms were so severe.

India must also strengthen its health security borders to avoid another mass movement of migrant workers, who left millions of their cities during the pandemic, when their jobs and housing disappeared, across the country. were roaming in the villages and took the virus with them. It should also take seriously the urgent need to increase the number of health care workers to meet World Health Organization guidelines, and ensure they are properly paid and equipped.

The consequences of moving slowly on these reforms are too big to ignore. India has already slipped to 101st out of 116 countries on the Global Hunger Index, below countries like Myanmar and Pakistan, while unemployment, especially in the vast hinterland, is on the rise. Even as the economy is showing signs of recovery with the consumption-driven festive season, it will take a lot to ease the pain felt by the most vulnerable, who are in urgent need of food, jobs and housing. Here’s hoping this dengue outbreak rings alarm bells for the government.

Ruth Pollard is a columnist and editor with Bloomberg Opinion. Previously she was the team leader for the Government of South and Southeast Asia at Bloomberg News. She has reported from India and throughout the Middle East and focuses on foreign policy, defense and security.

This story has been published without modification in text from a wire agency feed. Only the title has been changed.