ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

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Whither One Health in India?

The COVID-19 pandemic has sharply brought into focus how intrusions into natural landscapes are not just environmental concerns, but are also intricately entangled with public health. Little attention has been paid to systemic causes such as large-scale biodiversity loss that underlie the emergence and re-emergence of these diseases. Institutional networks of public and animal health in India that are involved in the surveillance and control of zoonoses are outlined herein. It is shown that the lack of a systematic framework that explicitly involves institutions that manage biodiversity and wildlife health leads to gaps in operationalising a One Health framework in India. Addressing these lacunae requires a supra-ministerial mechanism that brings together public health, ecology, and veterinary and social sciences to combat the threats posed by existing and emerging zoonoses.

The COVID-19 Crisis

India’s public health system has struggled to cope with the COVID-19 crisis. Even before the pandemic, India’s public health infrastructure was inadequate with only 0.55 beds per 1,000 population, while out-of-pocket expenditure was pushing almost 63 million people back into poverty, as a large number of healthcare positions lie vacant across the country. Faced with a growing disease burden, India’s public health system is in dire need of investment and the COVID-19 crisis is the perfect opportunity to back this policy decision with political will.

Beyond Biomedical and Statistical Approaches in COVID-19

The evolving COVID-19 pandemic requires that data and operational responses be examined from a public health perspective. While there exist deep contestations about the epidemic control strategies to be adopted, past experience seems to be corroborated in the present epidemic that a contextually rooted “shoe-leather public health” approach provides the most effective interventions and operational strategies, more so in a society as diverse as ours. Drawing from this, an analysis of the COVID-19 situation in India is put forth, and debates on mitigation strategies, optimisation of testing, and the essential steps for a comprehensive set of interventions in order to minimise human suffering are addressed.

Public Health Lessons

Odisha, in spite of a poor public health system, did well in managing the pandemic in the initial month. This is on account of three reasons. It drew from its now globally recognised swift disaster preparedness and management aimed at zero casualty. It adopted a proactive, as against reactive, course, which in itself is a difficult proposition in such an uncertain and dynamic scenario. It took lessons from success stories and challenges based on happenings elsewhere.

Disability during COVID-19

COVID-19 and the resultant lockdowns have severely curtailed the mobility of persons with disabilities, restricted their ability to seek basic necessities, healthcare, and assistance. Uncertainty on the disbursement of financial protection schemes meant for persons with disabilities have exacerbated their existing financial precarity. At this juncture, obstacles in accessing healthcare should be identified, facilities should be made affordable, and financial support should be exclusively planned for persons with disabilities to save them from the dreadful risk of the coronavirus and its aftermath.

Covid-19 Progression

Countries across the world are relying on trial-and-error interventions to arrest the COVID-19 pandemic. But, even as health systems are close to breaking down and economies are flailing while underprivileged citizens are battling unprecedented social and financial catastrophes, most governments are failing to provide appropriate social security and relief.

Public Good Perspective of Public Health

India’s response to the COVID-19 pandemic is linked to its abandonment of the welfare state, marginalisation of public good principle and collapse and fragmentation of the public health system. As COVID-19 cases surge, many states could barely treat patients needing medical support due to bed shortages and poor infrastructural facilities. The overwhelmed system disrupted routine and emergency non-COVID services as well. The interstate differences in coping with COVID-19 are rooted in the public sector health infrastructure, investment in rural services and disease control programmes. A comprehensive healthcare system is needed as COVID-19 is not the end of the problem of the globalisation of epidemics.

Indian Public Health Associations on COVID-19

Leading Indian professional associations of public health have released a second joint statement on 25 May 2020, on the COVID-19 pandemic and its management in the country. The central issue they raise is the ignoring of technical advice of the country’s leading experts and institutions in decision-making about strategies for handling the pandemic. The larger politics of knowledge in public health and its interdisciplinary requirements are discussed.

Why Bihar’s Record in Handling COVID-19 Is Dismal

Among the states, Bihar faces the greatest challenge, particularly in terms of the reverse migration occurring from the lockdown following the COVID-19 pandemic. Considering the poor state of its health services infrastructure, the state government should have taken urgent and appropriate measures to screen, test and quarantine the returning migrant workers. This article takes a look at the trajectory of the government’s response to the health crisis.

Underestimation of the COVID-19 Burden

The number infected with SARS-CoV-2 in early May in India is estimated by a method utilising the unequivocal number available, namely deaths due to COVID-19. The estimated numbers are far in excess of reported numbers and indicate the systemic flaws in reporting deaths in India, augmenting the extent of underestimation. Additionally, there is the overestimation of the doubling time of infection. A realistic picture of the epidemic at the community level is presented, which informs us about the level of preparedness required to deal effectively with the epidemic.

A Dilemma for the Government

The response to the pandemic has aggravated both the economic as well as the health crises.

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