Coronavirus threat reveals the flaws in India’s health system
By Yves-Marie Rault Chodankar
While the number of reported cases of the new coronavirus in India remains , concerns are already growing about the capacity of its healthcare system to deal with the potential threat.
This is a major political test for the Hindu nationalist government of Narendra Modi. It is already having to deal with a disappointing economic performance – growth is at its – and is now facing a social and political crisis as a result of discriminatory . The legislation has led to riots and anti-Muslim pogroms across the country, especially where at least 53 people have been killed and many injured.
In this particularly tense context, is Modi’s government capable of managing the pandemic?
Cow urine and homeopathy
On social networks, have already circulated about Modi’s inability to manage this crisis. promoted what they thought were anti-coronavirus virtues of cow products, and the Ministry of Alternative Medicines (AYUSH) advocated .
Some Ayurvedic practitioners in South India even used the opportunity to offer .
Pseudo-science does have followers among some hindu supremacists, including many in the educated and English-speaking population. Hashtags such as were tweeted in India during the early stages of the contagion in China. This “fake news” encouraged cases of racism against as well as as the virus started spreading in Europe.
Conventional preventive measures
While it has initially called for people to , Modi’s government says it has taken the threat seriously. Officially on March 19, the prime minister asked people to observe on March 22 from 7am to 5pm. It could be a test for a potential longer lockdown.
As in many countries, the Indian authorities also issued prevention messages about wearing masks and stressed the need to wash hands regularly, sneeze into one’s inner elbow, and avoid public events such as the , held on March 10. The also set up a crisis unit, an information hotline, and planned two quarantine centres around Delhi.
Despite , the government has also chosen to establish temperature tests at airports as well as at some seaports and land borders, some of which (Bangladesh and Myanmar) have been completely closed. The country has also to all visitors until at least April 15.
Indian states have also taken radical decisions. Several closed primary schools in some cities, including Delhi and Bangalore. In Maharashtra, the authorities have started to in order to dissuade them from breaking restrictions on movement. The state of Kerala, at the heart of an outbreak, declared itself on high alert and took of containment and closure to the public.
A largely private healthcare system
However, Kerala, with its in government hospitals, has the . The comparatively high number of positive cases identified in this traditionally socialist state therefore probably further highlights the failure of other states to screen for the virus.
Only are equipped to identify the presence of COVID-19, although 54 private laboratories could also eventually be mobilised. Even though the government has ordered a million test kits from Germany, concerns have emerged concerning the relatively effectively done.
One explanation for India’s poor testing ratio is the . In contrast with China, where hospitalisation capacity is higher than in high-income countries with 4.2 beds per 1,000 inhabitants, the rate is only on average.
These deficiencies are all the more worrying since the suggest that patients should contact their doctor directly, rather than an emergency number, if symptoms occur.
After 20 years of , infrastructure development has largely been taken over by the private sector, to the extent that of cases of disease are now treated by public services.
Pharmaceutical industry affected
In fact, it is to successful private pharmaceutical companies such as Cipla, Sun Pharma and Dr. Reddy’s that the Indian authorities immediately turned to ensure the availability of certain products needed in the event of a major outbreak. The government of about 20 products including protective equipment and some medical ingredients, such as Lopinavir and Ritonavir. These antiretrovirals are currently being used together against HIV and are being touted by Indian doctors, like their Chinese counterparts, as .
Despite about the strength of their stockpiles, however, fears which prompted the government to restrict exports are not unfounded.
Between 80-85% of the active ingredients used in drugs assembled in India , 25% of which are from the Hubei region, the epicentre of the epidemic.
To cope with the disruption of their supplies, pharmaceutical companies have recently had to import some of the active ingredients with the support of Indian military planes. While this dependence on Chinese imports has had the immediate effect of increasing the cost of the active ingredients, of Indian medicines.
In mid-March, the of protective masks was already depriving access to a large part of the Indian population, of which .
With its 1.3 billion inhabitants and high population density, India will have difficulty in taking care of contaminated patients in the event of a major spread of the coronavirus. Only the presence of a very young population – – could minimise its public health impact.
