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View: How to battle a pandemic? Valuable lessons from India


In late March 2020, there was a notable prediction by Ramanan Laxminarayan, director of Centre for Disease Dynamics, Economics and Policy, on India’s ongoing Covid-19 pandemic. He forecast that India faced a best-case scenario of about 200 million citizens being infected, if precautionary measures were adopted, with a high case of about 300 million cases, with most infections being mild. About 10 million of such cases were predicted to happen within a 2-3 weeks window, resulting in hospitalisations overwhelming our hospitals. India was asked to beware the Ides of March and beyond.

And, yet, India is still standing, despite the latest resurgence in many parts of the country, having built up its healthcare infrastructure. Consider the metrics. On Covid-19 diagnostic kits, as of January 2021, GoI was able to distribute 408 lakh N95 masks, 169 lakh PPE (personal protective equipment) kits, and had delivered 36,651 ventilators to all states and Union territories (UTs).

By the same date, 15,619,336 RT-PCR (reverse transcription polymerase chain reaction) kits had been distributed by the Indian Council of Medical Research (ICMR) distribution team to all states and UTs.

India’s healthcare infrastructure has received a significant boost. In early March 2020, India had only 48,000 ventilators against a requirement of about 150,000. This situation has rapidly changed over the past year. About 36,651 ventilators were delivered by GoI to all states and UTs between then and January 2021.

The private sector was mobilised rapidly, with firms as varied as Bharat Electronics, Mahindra & Mahindra, Hyundai Motor and MedTech Zone manufacturing and delivering ventilators. Similarly, 55,200 B-Type oxygen cylinders and 47,200 D-Type oxygen cylinders were distributed as on January 24, 2021, by GoI. Until 2020, for any Tier 2 and Tier 3 city hospital, having relatively advanced ventilators was unheard of.

As a consequence, India’s healthcare system has been transformed, with many states expanding their critical care capacity by two or three times. Such investment will pay off even after the pandemic, helping to treat patients with tuberculosis and pneumonia.

Consider another set of metrics. India had about 27,360 intensive care unit (ICU) beds in April 2020. By January 2021, this had risen to 36,008, with oxygenated beds rising by 152% in the same period.

In a world where common non-prescription and prescription drugs ran out, India was able to keep its production and distribution going. Over the past year, India was able to distribute 111.6 million pills of hydroxychloroquine (HCQ), a medicine often used for the treatment of autoimmune diseases. This drug was notably claimed to be effective against Covid-19. The US ended up importing about 50 million HCQ tablets from India in May 2020.

Even on the vaccine front, India was able to develop an indigenous vaccine from scratch (Bharat Biotech’s Covaxin) and mass produce another (Oxford-AstraZeneca’s Covishield by Serum Institute). At the same time, as of January 2021, there were a further 18-20 vaccine candidates in the pipeline. ZyCoV-D, a DNA plasmid platform vaccine, crafted by Zydus Cadila, is likely to be actively used (as an intradermal injection) for India’s upcoming vaccination campaigns in May 2021, with a Phase-3 trial currently underway. Meanwhile, an mRNA-based vaccine by Gennova Biopharmaceuticals is also in development. India is leading the way in R&D for vaccine development and in mass production for the developing world.

On the vaccine diplomacy front, simple statistics are not sufficient to highlight the impact of India’s vaccine exports (as gifts or commercial deals). Bhutan has received 550,000 vaccines from India, sufficient to vaccinate 72% of its population on the first dose. Barbados, off the coast of the US, has received 40,000 doses from India, covering about 13% of its population. Maldives has received 200,000 doses for a population of about 531,000.

Given the West’s vaccine-hoarding, such countries would normally not have been in the frontline of receiving vaccines. At the same time, on the domestic front, India is now running the second-largest vaccination drive in the world, administering about 47 million doses in total, and about 1.9 million doses daily over the past few days.

Such facts highlight that India, unlike many countries in the West, has the innate capacity to manage pandemics, learning from past experiences. Indeed, across the developing world, India’s experience is a hallmark of how to battle with a pandemic in the future, without conducting policymaking in a panic. In a world where most developed countries have battened down their hatches and offer little to no public goods, India has stood tall in offering support — in PPEs, vaccines, drugs, knowhow — to small and large countries alike.

(The writer is a BJP MP)

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