The world’s attention is now on India, the epicenter of the global pandemic as the country battles a deadly second wave of Covid-19.
The unfolding human tragedy has laid bare the deep-rooted problems plaguing India’s public health system after decades of neglect and underinvestment.
The crisis has brought India’s public health system to its knees. Scenes of hospitals running out of beds, and people searching desperately for life-saving oxygen or critical medical supplies for their loved ones have hogged international headlines.
Low allocations to health care
For a long time since its independence in 1947, health was not viewed as an economically productive expenditure in the country — unlike investments in industry, agriculture and service sectors, K Srinath Reddy, president of the Public Health Foundation of India, told CNBC.
“For several decades, health systems in India have not received the respect and resources they deserve. Public financing of health stagnated around 1% of GDP and out-of-pocket expenditure on health was over 60% even in recent years,” he said in an email. “The central government as well as most state governments had low allocations for health in their budgets.”
India’s spending on health care is comparatively much lower than many other countries.
The U.S. spent nearly 17% of its gross domestic product on public health care in 2018, while France and Germany spent more than 11% of GDP that year, according to data from the World Bank.
Comparing India to the rest of the BRICS nations — Brazil, Russia, India, China and South Africa — India spent the least on health care in 2018. Brazil spent 9.5% of its GDP on health care that year, South Africa 8.1%, Russia 5.3% and China spent 5.35%.
India is now the second-worst infected country in the world, behind only the United States.
Made with Flourish
The South Asian nation has reported more than 300,000 new daily infections in the past few weeks. Cumulatively, Covid infections reached nearly 24.7 million with more than 270,284 deaths on Sunday, according to health ministry data.
However, health experts warn that the numbers are likely grossly underreported, and the true scale of Covid infections and the human toll may never be officially known.
In a recent report by Fitch Solutions, the research firm said that despite several health care reforms, India remains badly placed to tackle the rapid spread of the pandemic.
“With 8.5 hospital beds per 10,000 population and 8 physicians per 10,000, the country’s health-care sector is not equipped for such a crisis. Moreover, the significant inefficiency, dysfunctioning and acute shortage of the health-care delivery systems in public sector do not match up with the growing needs of the population,” the report added.
The numbers make grim reading for a country like India with a population of 1.4 billion people, making up 18% of the world’s population.
Lack of political will
India’s second wave began around February and accelerated through March and April. The virus spread rapidly due to complacency on mask wearing at religious festivals and political rallies that attracted large crowds in various parts of the country.
While the pandemic has highlighted the structural weaknesses in India’s public health system, those issues have always existed, said Chandrakant Lahariya, a medical public policy and health systems expert, based in New Delhi.
