The current scenario is ideal for policymakers and practitioners to drive home the importance of health spending and institutional development
With the first batch of anti-COVID vaccines being rolled out, the mood of the nation seems to be upbeat as it bids farewell to the pain and anguish of last year. The emergency-use approval to the vaccine developed by Oxford University and the Swedish-British pharma major AstraZeneca, manufactured in India by Pune-based Serum Institute, and Bharat Biotech’s Covaxin has sent positive signals to the market. The debate between the two manufacturers in the aftermath of the approval speaks of attempts to dominate the market. In a crisis of this magnitude, relief units try to be fast moving while addressing the needs of as many people as they can. Vaccine developers and marketers see themselves as no different from such relief-units; they, however, desire economic gains as well. There is, therefore, both an economic impetus as well as an altruistic impulse for vaccine-developers to push their products – there’s also the promise of “instant returns”. Such a situation demands regulatory intervention. A balance needs to be struck between the urge for return to normalcy and the patience required to see this crisis through.
Public health practitioners know that regulatory approval is merely the beginning of a long journey towards effective health provisioning. A well-defined COVID-19 immunisation policy is, therefore, likely to be the first step in a rebuilding programme that could span decades. The impacts on the mental and physical well-being of the direct and indirect survivors of COVID-19 will have a bearing in the years to come. The role of frontline health workers (FLHWs) and medical practitioners was critical during the crisis, especially in the rural areas. The demands of these workers for fair wages and labour recognition remains to be addressed. Moreover, the real scale of the pandemic’s impact on rural areas and migrant economies is yet to be ascertained. Along with the redressal of the immediate health crisis, it is incumbent upon policymakers and practitioners to take lessons from developments in the past 10 months and overcome the shortcomings in the country’s welfare mechanisms that have been exposed by the pandemic. Strengthening overburdened health systems and guaranteeing health workers due protections is an urgent imperative to ensure that the vaccination programme is a long-term success.
Public health in India has traditionally been ignored as an electoral subject with governments focusing more on issues such as economic growth or employment generation. The current scenario is ideal for policymakers and practitioners to drive home the importance of health spending and institutional development. India still ranks significantly lower than countries such as Sri Lanka and Bangladesh in healthcare spending. The need to create accessible and quality healthcare facilities that comprise both traditional service delivery and a holistic approach to well-being can be pressed forward at a time when health is a salient concern for central and state governments. Policymakers should seize the moment.
Developing countries do not have the luxury of slowing down in the face of rapid progress nor can they fall prey to the “planning fallacy” and be over optimistic about the time it will take to attain the Human Development Goals. The pandemic has increased the vulnerabilities of large sections of the population. Many who were barely managing to make ends meet have been pushed into extreme poverty, resulting in major setbacks to their aspirations – it has also hit the prospects of their future generations. It is imperative that people’s resilience is enhanced by government efforts. Policymakers must now provide society with a blueprint for a better future. We must not forget that even the most dedicated relief unit must eventually depart. In the aftermath of a crisis, it is the citizenry, therefore, which must be resilient.
This article first appeared in the print edition on January 19, 2021, under the title “The vaccine and resilience”. The writer is a researcher at Centre for Social and Behaviour Change, Ashoka University
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