South Asia’s healthcare burden -Syed Munir Khasru
Despite the debilitating pandemic, state investment in the health sector remains deeply inadequate.
On May 18 this year, India recorded 4,529 deaths from COVID-19, the highest daily death toll recorded in the world after the United States in January saw 4,468 deaths. As India combats the pandemic, its neighbours are experiencing spillover from the menacing second wave. The virus has swept through Nepal, while Sri Lanka added as many as 78,218 cases in May. Pakistan crossed over 200 daily deaths in April, its highest since the pandemic started. The situation in Bangladesh is precarious, given the recent detection of the highly contagious Delta variant. Bhutan is the only exception, with only one death and 1,724 cases so far. The country’s success stems from a well-funded and prepared public health system with stringent measures, responsible citizenship, and an accountable government.
As bodies piled up at overcrowded crematoriums in India in the last few months, several things were to blame — “super spreader” events, a fragile health infrastructure neglected for decades, citizens not following health protocols, and logistical mismanagement. What has exacerbated the situation is a subpar public healthcare system running on a meagre contribution of a little over 1% of India’s Gross Domestic Product (GDP). While the private medical sector is booming, the public healthcare sector has been operating at a pitiful 0.08 doctors per 1,000 people, falling miserably below the World Health Organization’s (WHO) prescribed standard of 1:1000. India has only half a bed available for every 1,000 people, which is a deficient figure even for normal days.
Bangladesh and Pakistan fare no better, with a bed to patient ratio of 0.8 and 0.6, respectively, and a doctor availability of less than one for every 1,000 people. While ideally, out-of-pocket expenditure should not surpass 15% to 20% of the total health expenditure, for India, Bangladesh and Pakistan, this figure stands at an appalling 62.67%, 73.87% and 56.24%, respectively.
The situation in rural India, where people largely rely on threadbare healthcare facilities, is disconcerting. Numerous distressing reports have emerged in the media, from patients being treated on the hospital floor for lack of beds, to some walking hundreds of miles just to get to a hospital, let alone one with oxygen or drug supplies, and many being left to resort to homemade concoctions and local quacks. Further, the fact that hundreds of healthcare workers have succumbed to COVID-19, unable to seek a bed in the very hospitals they serve, is telling.
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The Hindu, 10 June, 2021, https://www.thehindu.com/opinion/op-ed/south-asias-healthcare-burden/article34773947.ece?homepage=true