Pandemic and public policy

Tariq Ahmad Dar

What is ‘pandemic’ and how is ‘public policy’ defined? Pandemic generally refers to an epidemic that has spread on a more global scale, affecting large number of people across the globe. While the public policy is a principle guide to action taken by administrative, executive, and political branches of state with regard to the class of issues in the manner consistent with law and institutional customs. The function of public policy is composed of natural constitutional laws and regulations. Before going into the deep discussion of pandemics and the policies the government need to put in place, we must be familiar with the definition of health and of course the public health as well. Health, as per the World Health Organization (WHO) definition, is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. An easy-to-understand definition by WHO is that public health refers to all organized measures (whether public or private) to prevent disease, promote health, and prolong life among the population as a whole. Its activities aim to provide conditions in which people can be healthy and focus on entire populations, not on individual patients or diseases. In short, public health focuses on community health needs and not individual health needs. Public health issues range from global concerns to local community specific needs. Since the middle ages, there have been about a dozen of notable pandemics, including Covid-19. The first among these pandemics was the Bubonic plague. It killed 30% to 50% of Europeans in 1300s, according to the data of World Bank. Then the introduction of Small pox in Americas came in the 1500s. Since 1900s, there have been eight pandemics. The 1918 Spanish flu, a global pandemic, killed between 20 million and 100 million worldwide. The HIV/AIDS pandemic, which was declared in 1981, is still considered an active pandemic. It’s resulted in 36.7 million deaths, according to data from the National Institutes of Health. There have also been two epidemics that were not declared official pandemics — MERS in 2012, which impacted 22 countries but had fewer than 2,000 cases, and West Africa Ebola in 2013, which had nearly 30,000 cases but only impacted 10 countries. At the time of WHO’s pandemic designation, COVID-19 had infected more than 118,000 cases in 114 countries, and killed 4,291 people, according to W.H.O. This millennium has already faced three pandemics and of course the Covid-19 is not going to be the last. The frequent outbreak of these pandemics are reminding us of the need to formulate and put in place the effective and appropriate public policies in order to combat, arrest and minimize the ill effects of the pandemic. Take a look on the India’s health infrastructure, where does India stand? India’s rank in the Human Development Index Report 2018 (130 out of 189 countries) issued by the UNDP depicts the level of ignorance of the health sector in a country like India. India is one of the fastest growing economies of the world. The very essential components of primary health care– promotion of food supply, proper nutrition, safe water and basic sanitation and provision for quality health information concerning the prevailing health problems – is largely ignored. Access to healthcare services, provision of essential medicines and scarcity of doctors are other bottlenecks in the primary health care scenario. As per the Global Health Security index, that ranks assessment in health security and related capabilities across 195 Countries, suggest that not a single country in the world is fully prepared to handle an epidemic or pandemic and further stated that every country has health security gapes. Countries are not prepared for globally catastrophic biological events. Talking about the Indian health care system, although, India has improved its ranking on global health care access and quality (HAQ) Index from 153 in 1990 to 120 in 2019 but, India continues to lag behind most of the countries in terms of health care facilities. 70 percent of the overall household expenditure on health in the country is on medicines. Source: WHO. An estimated 469 million people in India do not have regular access to essential medicines. Source: WHO. While 63% of primary health centers did not have an operation theatre and 29% lacked a labor room, community health centers were short of 81.5% specialists–surgeon, gynecologists and pediatricians. Source: India Spend, January 2018. In 2014, 58% Indians in rural areas and 68% in urban areas said they use private facilities for inpatient care, according to the 71st round of the National Sample Survey Source: India Spend, January 2018. Various studies have shown the rising out-of-pocket expenditures on healthcare is pushing around 32-39 million Indians below the poverty line annually. Heart disease (1/4 people) and stroke is the biggest killer of men and women in India. 7% of Indians fall below the poverty line just because of indebtedness due to this expenditure, as well as that this figure hasn’t changed much in a decade. About 23% of the sick can’t afford healthcare because of these payments. 55 million Indians were pushed into poverty in a single year due to unaffordable healthcare. (PHFI, 2018). 33 out of 55 million fell under the poverty line due to expenditure on medicines alone. (PHFI, 2018). Well, India in 1979 surprised the whole world by eradicating the Small pox, the virus that killed more people on earth then all the wars put together. India also eradicated the Polio virus, another silent killer and gave the world the great gift.
Encourage self help groups who in combination with district administration can aide in distribution of essential commodities with proper care and not violate the norms of social distancing particularly in red zone areas and such an initiative can have a multiplier impact with positive end results. Farmers, who form the back bone of Indian economy, need to be assisted financially.
The outbreak of Covid-19 pandemic has on large scale exposed the government’s fishy, doubtful, and suspicious preparedness to fight the pandemic and has in turn made the policy makers to put in place the appropriate and adequate public policies in order to bring down the rate of infection. So, there is a desperate need to formulate the public policies as well as to bring them into practice amid this unprecedented crisis. The Corona virus pandemic has brought out in sharp focus many challenges policymakers have to face both in getting the right inputs from the experts as well as converting them into actionable programmes in the real-world context. Covid-19 has taught us a lesson that the time has come to be self reliant in the times of crisis, the nations will have to live by themselves, in fact a country like India, if it aspires to become a regional power, India will have to support other nations and not be dependent on other countries for support, well, this is possible if India formulates and puts in place the strong and valuable policies that will work in true sense and will in turn help the country to tackle any unforeseen challenge in the times to come. When we think of formulation of public policies particularly in the times of pandemic, of course the public health care system comes to our mind immediately. The country spends just 3.7% of gross domestic product on health care in 2016, putting it in the bottom 25 of nations globally, according to the most recent World Bank data. Despite the health sector employing 5 million workers in India, India continues to have a low density of health professionals with figures for the country being lower than those of Srilanka, China, Thailand, US, and Brazil, according to WHO data base and had in turn put the country into the “critical stage of health care providers”. One major challenge that India faces is, low public investment in health care system that has given the private entities an edge to spend more on health care. This sort of private investment has made the cure and treatment so expensive that most of the people based in rural areas find it difficult to avail these facilities, therefore, the government should ramp up the investment in public health care across the country so that people lying at the bottom of pyramid are benefited the most. One of the biggest challenges that every country faces during the times of pandemic is the loss of livelihood. There is a massive job loss and in fact we have no estimation of how many people have lost the jobs during this period of pandemic, these people will definitely need assistance from the government in the form of monetary support for their survival during these crucial times of pandemic. The more liberalized economic approach in India has provided an edge to the private sector, who mostly are concerned of their profits, to take over the public industries. These employees working in unorganized sector are now facing the live burns of this liberalized economic approach and also of this unprecedented lockdown in the form of loss of jobs and consequently wage losses, making their living hard, tough, and difficult. The economic revival will entirely depend on the level of demand in the market which has been quite low during this entire period of lockdown. Economists suggest that putting more money/cash directly into the hands of people will automatically ramp up the demand in market and will in turn help in the revival of already hurt economy. One possible way is, making MGNREGA fully functional with enough funds to pay large number of employees. The wings of the scheme need to be extended by increasing the number of working days as well as increasing wages would assist these workers and will provide extra benefit to them. This is the time; India needs to focus on ‘make in India’ initiative that allows reliance on ‘in house manufacturing, rather than depending on foreign countries for support. Food security need to be ensued when it comes to the bottom most section of population, providing adequate food supply to the needy and poor should be primary focus of policy makers. According to recent reports, there are about 9 crore people living without ration cards in India, these people face enormous challenges amid these massive restrictions and have been ignored on large scale. In fact every citizen is provided food security under article-39A of constitution and also ensures to raise the level of nutrition and to live a standard life. The government needs to mobilize the national disaster reserve funds and also 9.6 lakh crore reserve funds of RBI meant for financial emergencies. Announcement of 1.70 lakh crore relief under PM garib kalian youjana is a positive move and will help the poor and vulnerable section to fight the battle against Corona virus. Encourage self help groups who in combination with district administration can aide in distribution of essential commodities with proper care and not violate the norms of social distancing particularly in red zone areas and such an initiative can have a multiplier impact with positive end results. Farmers, who form the back bone of Indian economy, need to be assisted financially. Implementation of PM kisan scheme which provides for cash transfer of Rs 6000 to all land owning farmers in India. Moreover, there must be a support for senior citizens (above 60 yrs), and widows as there are around 3 crore aged widows who face vulnerability due to economic disruptions caused by Covid-19. This is the challenge that we all are facing right now so, let’s remain united and get this enemy defeated. Self reliance is the rudder that must steer our ship as we sail through these rough seas. Everybody should work shoulder to shoulder to contain the spread of transnational contingent.
( The author is pursuing B.SC. HONS, CHEMISTRY at AMU, Aligarh. Views are his own, ahmadtariq@gmail.com)

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COVID-19

India
Confirmed: 625,544Deaths: 18,213