Subject: Health

Context

The deaths of nearly 200 children in Kota, from largely preventable diseases, lays bare the condition of the healthcare system in India.

Where does India stand?

• According to UNICEF’s ‘State of World’s Children 2019’ report, India reported the maximum number of deaths of children under five in the world in 2018.
• 8,82,000 children under five died that year.
• That means around 2,416 deaths per day.
• The death of children due to largely-preventable illnesses is a matter of serious concern and calls for urgent introspection.

Factors that govern child health

• Most of the children who died in Gorakhpur, Muzaffarpur and Kota belong to the lowest strata of the society.
• It won’t be wrong to conclude that they were victims of structural violence.
• This structural violence is unleashed through a multitude of social, political and economic factors apathy of healthcare professionals, poor health services/infrastructure
• And low rates of female literacy, economic inequality, the rigid caste system, social apartheid, lack of political will and patriarchy play role.
• As a society, we have stopped looking at the deaths of our citizens through the prism of compassion and concern.
• Structural violence influences the nature and distribution of extreme suffering.

What is being done in the wrong way?

• The government is considering the takeover of 750 district hospitals by private medical colleges through a public-private partnership (PPP) model.
• This, despite ample evidence about the failure of the model in the country’s healthcare system.
• Nobel laureate Kenneth Arrow demonstrated that profit and private involvement in healthcare lead to an erosion of trust.
• An Individual’s demand for medical services is irregular and unpredictable, the involvement of a private market model for such services can be disastrous.
• The U.S.’s experiences in the PPP model in healthcare have shone a light on the deficits in transparency and highlighted the lack of care of vulnerable groups.

Conclusion

• What urgently a sincere engagement by the state in matters concerning peoples’ health.
• We need to question the government’s priorities in a country where nearly a million children die every year

At the End TB summit, 2018 the prime minister of India made a bold commitment to end tuberculosis by 2025-five years ahead of the global target. Which is possible to achieve if the efforts are put at the level it was done in case of polio.

The toll taken by TB

• Despite the disease being fully curable, people still die from it.
• TB usually affects people in their most productive years and drives families into debt.
• It has a direct link to human suffering, discrimination and also poverty.
• Due to its infectious spread, it directly affects our economic growth as well.
• With resilience, sufficient investment, innovative approaches and strategies and the participation of all stakeholders, TB can be defeated.

First Step- Awareness

• The first step is the creation of awareness and empowering of communities.
• TB affects millions, yet very few know enough about it.
• Multilingual, multi-stakeholder awareness effort to ensure that all Indians knows about the challenges of TB and where to seek treatment is required.
• With the expansion of the media and evolving technology, it is possible to reach everyone with the right information.

Second Step- Access to diagnosis and treatment

• Ensuring that every Indian get access to correct diagnosis and treatment for TB, regardless of their ability to pay for it is the second step.
• To do so, working with the private sector is necessary as was done in the case of polio.
• There are numerous innovative private-sector programmes and partnership schemes for TB.

Role of  Private sector

• Recently launched programmes for doctors and labs offer the private sector various incentives.
• Even today, about half a million TB cases go unnotified, especially those seeking care in the private sector.
• Those cases need to be tracked and ensured that everyone in the need of treatment and care gets it.
• Organisations like Indian Medical Association and Indian Academy of Paediatrics are working with the private sector to ensure patient-centric care as per “Standards of TB Care in India” (STCI).

Drug-resistant TB

• A key challenge is building a forward-looking plan to address and control drug resistance.
• Drug-resistant TB is a man-made menace that is a major roadblock in a fight against TB.
• Every TB patient must be tested for drug resistance at the first point of care, whether in the public or private sector, to rule out any drug resistance.

Efforts by the government

• Nikshay Poshan Yojana -in which TB patients receive Rs 500 every month while on treatment was launched.
• Nikshay Poshan Yojana ensure that the patients have economic support and nutrition during the required period.
• ‘TB Harega Desh Jeetega Campaign’ was launched to accelerate the efforts to end TB by 2025.
• The campaign aims to initiate preventive and promotive health approaches.
• By applying “multi-sectoral and community-led” approach, the government is building a national movement to end TB by 2025.
• Resource allocation towards the TB Elimination Programme has been increased by four-fold.
• Sincere efforts need to be made to make our health systems more accessible and reliable.
• It also required to ensure that those seeking care trust the healthcare system and get the appropriate care for completing treatment.
• There is a need to create more labs, point of care tests, an assured drug pipeline, access to new drugs.
• The government should also ensure counselling and support for those affected.
• Every patient who is diagnosed late and does not receive timely treatment continues to infect others.
• To break this cycle, government machinery at the field level should work with communities and provide free diagnosis and treatment to every affected individual.

Conclusion

With all the efforts, planning and resource put in place to eradicate the menace of TB from India, it is possible to achieve the goal by 2025.