Two Ways to Take Action for India Now

Gabrielle Fitzgerald, Co-founder, Pandemic Action Network

This weekend’s sunshine and blue skies had what seemed like the entire population of Seattle outside enjoying the early summer weather.  Everywhere you went, people were enjoying the sunshine—it almost felt like COVID-19 was a bad dream that we’d finally woken up from.

But, we know that isn’t true… The past weeks have marked the highest number of COVID-19 cases the world has recorded to date. Since the beginning of this pandemic, COVID-19 has exposed and amplified our inequities. Now, as the U.S. has accelerated vaccination (even for youth) and has preemptively given Americans the chance to take off their masks and enjoy summer, the pandemic rages around the world.

Most notably, India is in the grips of a terrible and all-too-real nightmare. India currently has the highest daily number of COVID-19 cases and deaths of any country in the world. Official totals from India’s health ministry report 24.6 million total COVID-19 cases and 274,000 deaths. Daily case counts range between 350,000 to 400,000, with most experts believing these numbers are significantly underplaying the extent of the disease.

Dr. Ashish Jha of Brown University, believes deaths caused by COVID-19 in India could be closer to 25,000 to 50,000 per day, and new infections happening each day in India could be between two million and five million.

So, while we should celebrate our progress here in the U.S. and hug our loved ones, we must understand that we are not out of the woods. With variants and the nature of COVID-19 waves, we must understand that only together can we truly end this pandemic for everyone. Now is the time to support the needs of India and other countries who are facing dire consequences from the disease, while also advocating for equitable distribution of COVID-19 vaccines and access to life-saving supplies.

On Friday, WHO Director General Tedros spoke of his bittersweet feeling as he received his COVID-19 vaccine.  While he celebrated the “triumph of science,” he lamented the fact that only 0.03% of the vaccine supply is going to low- and middle-income countries (LMICs). A New York Times vaccine tracker shows that many countries are yet to administer a single dose of the vaccine.

Meanwhile, access to basic medical supplies like oxygen remains challenging in many countries, as documented by the COVID Oxygen Needs Tracker. According to Dr. Marc Biot, MSF Director of Operations, “Oxygen is the single most important medicine for severe and critical COVID-19 patients. Yet oxygen supply is often insufficient because infrastructure has been neglected in lower- and middle-income countries for decades.” The crisis in India, now spreading to Nepal and other nearby countries, highlights that oxygen is the most critical medicine for people with severe COVID-19 and 18 months into the pandemic, oxygen supply is under-resourced and LMICs are often the last in line.

Stories in the media and from colleagues in India provide devastating details on the crushing burden faced by hospitals and health care providers, as well as stories of entire families being lost to COVID-19 in a matter of days.

While we have seen donations from governments, businesses, and philanthropies to respond to the humanitarian crises in India, they don’t seem to meet the scale of the problem.  And the breadth of these challenges can make it seem as if there is little an individual can do to help, but individuals and organizations can make a difference in this unprecedented situation.

Here are two ways to take action for India now:

Dasra was established more than 20 years ago to channel funds from philanthropists to small non-governmental organizations across the country. Over this time, they have built the capacity of more than 1,000 organizations to provide services to their communities. With the COVID-19 crisis, they set up the #BacktheFrontLine COVID Emergency Fund to provide immediate resources to 50 of their trusted, high-impact partners who work in local communities providing a range of services to respond to the emergency.

Oxygen for India is a new initiative created by Dr. Ramanan Laxminarayan of the Center for Disease Dynamics, Economics & Policy. A long-time health researcher currently based in Delhi, Ramanan quickly mobilized a large network of partners to provide reusable oxygen cylinders and 3,000 oxygen concentrators for hospitals in Delhi and Kolkata. This volunteer-led program has utilized local knowledge and relationships with global connections to procure 40,000 oxygen cylinders.  When an emergency hits, a catalytic coalition made up of individuals and organizations who jump in to help can sometimes move quicker than large, established organizations with complex procurement processes and bureaucracies.

These are two of the many organizations who desperately need funding, and both organizations can receive tax deductible donations from U.S. citizens.

While we in the U.S. are reconnecting with family and friends we haven’t seen in a year, please take a moment to think of the desperate need of so many families in India and other countries around the world.

And for those who are celebrating the end of COVID-19 in the U.S., India should be a cautionary tale.  Less than six weeks before the surge of new coronavirus infections, government officials said India was at “the endgame” of the pandemic.  At that time, India had 11,000 cases per day, and an average of about 100 deaths.  Here in the U.S., we still have almost 800 deaths per day.

We are still fighting this pandemic. In today’s interconnected world, COVID-19 anywhere is COVID-19 everywhere.

 

India Post-COVID-19: An Opportunity to Strengthen Health Security Through Cross-Sector Collaboration

Patrik Silborn, Pandemic Action Network Regional Advisor, Asia-Pacific and Madhav Joshi, CEO, India Health Fund and Pandemic Action Network Advisory Committee Member

Around the world, COVID-19 has laid bare critical gaps in the world’s health infrastructure, and India is no different. In the past two decades the country has significantly improved health outcomes with sharp reductions in child and maternal mortality and the successful elimination of several infectious diseases. Yet, the pandemic threatens to reverse this progress.

Since the start of the COVID-19, over 13 million cases have been registered, resulting in 171 thousand deaths. However, it is believed that these numbers severely underestimate the true spread of the disease. Estimates vary, but some researchers believe that as many as 90 cases are missed for every confirmed infection. The economic impact has been significant, with GDP expected to contract by 8% in 2020 and the hardest effects felt by the most vulnerable. India also has the highest rate of tuberculosis (TB) in the world, claiming around 436 thousand lives every year. In the first half of 2020, TB case notifications dropped by 25 percent compared to the year prior, which is expected to increase mortality rates further. Adding to the challenge, people with TB are at greater risk of COVID-19, and the potential for co-morbidities points to the need for integrated multi-disease approaches instead of the diagnosis and control of one disease at a time.

COVID-19 has been an extraordinary challenge, but the crisis is also an opportunity for India to rebuild better. The pandemic has created new opportunities for improving collaboration across sectors in India. To do this effectively, however, public and private stakeholders must come together to establish joint priorities, improve the pooling of resources, and leverage the unique capabilities of every actor. 

In short, India needs a new compact between the public and private sectors. A number of factors make this both a relevant and opportune time to seize this opportunity.

First, India has a thriving private healthcare sector. The country is home to some of the largest pharmaceutical and vaccines producers in the world, and it has become the largest supplier of generic drugs and vaccines globally. India’s private hospitals attract patients from around the world for specialised treatment. And in India, over 70 percent of people — including low-income earners — seek healthcare services from private providers. 

Second, the government is demonstrating a commitment to improve healthcare outcomes.  In 2017, the Government of India embarked on its most ambitious health program ever.  Ayushman Bharat is a social health insurance scheme that will cover healthcare costs of over 500 million people when fully deployed. Further, the Government of India increased the health budget by over 100 percent this year with ambitious plans to upgrade health infrastructure at all levels.

Third, there is a growing philanthropy movement that brings both ambition and capital to address challenges at scale. India is home to some of the largest and most innovative companies in the world, and private wealth has exploded in recent years. Spurred on by a desire to give back to communities, and the 2 percent CSR tax, new philanthropic initiatives have sprung up in recent years. This is a trend that has been accelerated by the recent pandemic. The multiple interlinked COVID-19 induced crises — from migrant workers and vulnerable populations losing their livelihoods and homes, children missing education opportunities, to overburdened health workers — has spurred unprecedented individual and corporate philanthropy in India.

Finally, there is recognition by all stakeholders for the need to reimagine primary healthcare delivery in the country. With a population of 1.3 billion people, providing access to care for everyone and putting in place effective pandemic preparedness and response systems will require a reimagination of the entire healthcare system. To detect and respond to existing diseases or new pathogens, India must strengthen both public and private service delivery. This requires innovation — not only of tools and systems — but also in how services are being delivered through primary health care systems. 

There are several stakeholders across the public and private sectors that must come together to make this happen. 

  • Universities and research institutions in India have the knowledge and basic research needed to develop innovative solutions that can meet the unique needs of a large and underserved population, especially in screening, diagnostics and technology-enabled solutions. 
  • Indian companies and start-ups have the ability to apply these technologies to develop solutions designed for low-resource settings in India and other parts of the world. 
  • The Government can create a favourable policy environment for innovations as well as avenues for introducing new solutions in the public health system.

COVID-19 has highlighted the need for pandemic-proofing the world. Leaders have an historic opportunity to take actions now that will not only hasten the end of this pandemic, but will also begin to pandemic-proof the planet so that future generations never again experience the health, economic, and social devastation wrought by COVID-19. To do so, all countries must invest more money in health security, in the capacity to develop and produce vaccines, in the detection and response to new pathogens, and in reinforcing collaboration across borders. 

But India can engage globally while taking action at home. Now is the time to develop the partnerships that can drive innovation, the surveillance systems needed to quickly detect and respond to new pathogens, and the approaches that put the needs of patients at the centre. This will make India better equipped to respond to COVID-19 and make India healthier in the future. The fight against this pandemic is still not over. But this is a unique moment to build a bridge to a better future.