From UPSC perspective, the following things are important :
Prelims level : Not much.
Mains level : Paper 2- Poor health infrastructure of SAARC countries and other common problems.
The article discusses the various common features shared by the South Asians countries. One of them is the poor public healthcare infrastructure. So, the pandemic offers an opportunity to make the required policy changes. It also offers the opportunity for cooperation among the regional countries in dealing with Covid-19. These issues are discussed in the article.
South Asian countries: Common features, common problems
- South Asia, one of the world’s most populous regions, is also affected by the COVID-19 pandemic.
- Both Karachi and Mumbai, among the world’s most densely populated cities, where we live and work, are being overwhelmed by cases.
- While the death rate in these places may not be as alarming as in Europe and the U.S., the collateral damage of the lockdown is taking its own toll.
- Common features of South Asia: While there are many differences amongst the countries of the region, there are also common features which impact the health of its people, some of them a result of our shared cultural and geopolitical history.
- The collective experience of dealing with COVID-19 may provide important lessons, which transcend national boundaries.
Poor healthcare system: a common problem
- South Asian countries have invested very little in health.
- This is reflected in our abysmally low health parameters.
- It is interesting that Britain, which formulated our health policies before independence, went on to form one of the world’s strongest public health systems, the National Health Service.
- Whereas its South Asian colonies chose to stray from that path.
- This resulted in a dysfunctional public healthcare
- Governments have also relinquished what ought to have been their primary duty, of health care provision, to the private sector.
- Having become an industry, the focus of healthcare in the private sector is on profit rather than on people’s needs.
- High treatment costs in private sector: Whilst privatisation has brought in advanced technology and expertise, the high costs of treatment in the private sector have resulted in impoverishment as most of the population has no insurance or third-party coverage, and pays out of pocket.
- The sector has also been poorly regulated.
- The result is that it is responsible for several excesses in its quest for profit.
Other common features of the region
- Hunger, malnutrition, poor sanitation and large-scale migration are features of this region.
- Existing infectious diseases like TB, HIV and malaria have been worsened by emerging ones like dengue, chikungunya, healthcare-associated infections and antimicrobial resistance.
- The region is also an epicentre of an epidemic of lifestyle diseases.
- Conflicts and expenditure on defence: Constant internal and external conflicts in South Asia not only consume a large portion of national budgets but also divert the attention of the public and policymakers from healthcare needs.
- Defence budgets take the largest share of national budgets, and obviously adversely impact social sector spending.
- Underfunded public health is going to hinder region’s capacity to fight COVID-19.
- The central role of religion: Religion continues to occupy a central space in the society and politics of the region.
- Though it offers succour to many, religious dogma can impact health policy and health-seeking behaviour.
- The refusal of devotees across Pakistan to avoid religious congregations during Ramadan despite the government’s orders has significantly fed the community spread of the virus.
Opportunity for policy changes to address healthcare problems
- COVID-19 has forced us to seriously reflect on our healthcare system.
- This is welcome if it results in policy change.
- Healthcare professionals and bodies must seize this opportunity to push our respective governments to address it seriously and not just as a pre-election strategy.
- A long-term commitment to universal health care, with not only a national but also a regional and global focus, is needed.
A question on this theme could be asked by the UPSC, for instance, “South Asian countries share the common problem of poor public healthcare infrastructure, which increases their vulnerability to the pandemic. But corona pandemic also offers an opportunity to improve the shortcoming in the health infrastructure and cooperation among the SAARC countries. Comment.”
Regional strategy and cooperation needed
- The SAARC heads of state have already offered help to one another.
- A regional strategy has a better chance of controlling the pandemic than isolated national-level efforts.
- The pooling of resources and sharing data may not only help flatten the curve but perhaps even develop into longer-term efforts towards effective treatment.
- It is being speculated that our populations are behaving differently; that the BCG vaccine may be a protective influence.
- Joint research into such areas can be a unifying point for SAARC.
It is in our collective interest to look at health security and not just national security. By the accident of their birth, South Asians have endured a lot. They merit better.