New Delhi: The Lancet Citizens’ Commission on Reimagining India’s Health System has suggested eight urgent measures for the Centre and state governments as a response to the COVID-19 surge in the country.
What is this commission?
It was launched in December 2020 to establish universal health coverage in India over a span of the next decade. It undertakes work through a participatory and consultative process with citizens and stakeholders in India’s healthcare system.
Who were the writers?
The writers of the suggestions were 21 experts, including virologist Gagandeep Kang, Chairman of Narayana Hrudayalaya Limited in Bengaluru Devi Shetty, and Professor at Harvard’s TH Chan School of Public Health Vikram Patel.
The eight measures
- Decentralisation of the organisation of essential healthcare services.
- A one-size-fits-all approach is untenable since the numbers of COVID-19 cases and health services differ substantially from district to district. District-level working groups that have the autonomy to respond to rapidly changing local situations must be empowered to receive funds and resources to coordinate efforts across all sectors of the health system, from front-line workers to tertiary care.
- A transparent national pricing policy for all essential services involved in healthcare, including ambulances and medical oxygen. Hospital care should not require any out-of-pocket expenditure and costs should be covered by existing health insurance schemes for all people, as has been done in some states.
- Evidence-based and clear information on the management of Covid-19 must be “more widely disseminated and implemented”. This should include information on home care and treatment, primary care and district hospital care “in local languages that incorporate local circumstances and clinical practice”. The information should also include what should not be done.
- All available human resources across all sectors of the health system, including the private sector, must be marshalled for the COVID-19 response and adequately resourced, particularly with sufficient personal protective equipment, guidance on the use of clinical interventions, insurance, and mental health support.
- Central systems should procure and distribute Covid-19 vaccines for free.
- Community engagement and participation of the public, transparency in government data collection and community-based tracking of the effectiveness of COVID-19 treatment protocols and long-term outcomes.
- The profound suffering and risk to health caused by loss of livelihoods should be minimised by making provisions for cash transfers by the state to workers in India’s vast informal economy who have lost their jobs, as is being done by some state governments.
