Stronger universal public health services, not privatization, will deliver #HealthForAll

When the world has come to a grinding halt due to the coronavirus disease (COVID-19) pandemic, and it is majorly the public health services that are on the frontline of the efforts to contain it (with most of the private health industry 'safe distancing' by being shut or busy profit-minting), the writing is crystal clear on the wall: only stronger universal public health could be our saviour.

COVID-19 has also proven how any public health emergency can cause havoc to the economy. If we want sustainable and resilient economies, we need stronger public health systems where no-one-is-left-behind. And there is no health security without social security for everyone. But the government’s plan to reboot the economy includes spending INR 8100 crores (INR 81 billion) “to provide 30% viability gap funding (VGF) instead of the current 20% to boost private sector investment in social sector infrastructure creation” like schools and hospitals.

It is high time we demand that profiteering from ill-health cannot be tolerated. Healthcare must never be dependent on one's capacity to pay. ‘Trade must enhance the capacity of nations to provide quality public healthcare and not restrict it’, demanded a #NoGoingBack manifesto endorsed by millions of nurses and workers of the unions around the world.

COVID-19 pandemic has forced us to learn the harder way, why what ails one - ails us all. An individual's health security is interdependent on everyone else and on the planet's health too. The spread of the coronavirus from the first confirmed case 4.5 months back in China to over 4.7 million cases globally, has brought home the wisdom of the old oft-quoted public health mantra: an infectious disease anywhere is an infectious disease everywhere.

But in the brutally unequal and unjust world we live in, we are forcing people to live in conditions that make them more vulnerable to ill-health, abuse, violence, exploitation, and a range of injustices. Ironically, these are the same people who are compelled to live on the blindspot of a privileged few, who toil hard for some of us to be able to enjoy the fruits of modernization.

As per an important news published in The Indian Express, private hospitals employ four out of every five doctors and have two-thirds of hospital beds in the country, with almost 80% of the ventilators, but are handling less than 10% of the COVID-19 critical load. While private health ‘industry’ is playing ‘safe’ it is essentially the government-run public health services that are on the real frontline of dealing with the pandemic. Many private sector hospitals or clinics have shut doors. Some private hospitals have had to be shut down for quarantine. In Gujarat state of India, ambu-bags were passed as ventilators (made by a private company). It is only the government healthcare services that are still running despite the looming threat of COVID-19. It is high time to realize the futility of private sector in times of crisis.

Indian government’s public health spending is among the bottom 24 countries globally but the nation has the third largest military spending after the US and China. On 16 May 2020, the government opened the gates even more for the private sector in defence, power, space and coal and mining sectors. If our intention is to contain the pandemic and provide relief to worst affected people (those dealing with the virus and those dealing with the humanitarian crises), then how will such measures help the most marginalized? Several state governments' efforts to suspend labour rights is another indication of whose interests are becoming paramount in the garb of 'relief' packages and efforts.

Government is grappling with shortage of capacity for COVID-19 and other non-COVID-19 healthcare services across the country, but it is not nationalizing the health services despite the constitutional authority as per The Epidemics Act 1897. In efforts to develop a vaccine for COVID-19, the virus strain was isolated by the National Institute of Virology of Indian Council of Medical Research (ICMR), Ministry of Health and Family Welfare, Government of India. But instead of nationalizing the biotech infrastructure, the government-run ICMR brought a private sector entity, Bharat Biotech, to further develop the vaccine. Likewise, though an antibody test was developed in a government institute, yet a private company was contracted to take it further, instead of nationalizing it and putting it to public use.

Walking the talk on universal education is an essential component of social justice, and all efforts to increase privatization in education sector are forcing us to go back on all gains made in education and other human indices.

Nationalizing of health services is the only way to ensure same quality of health services are available for everyone. In a just world we aspire for, how can we allow those with money to get way better standards of healthcare than majority of others? India's constitution has equality enshrined in it, but are some more equal than others?

18 May 2020

The Sangai Express, India (editorial page) 20 May 2020
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