Covid-19 And Restructuring Of Healthcare Infrastructure

• As per a recent study based on data from the National Health Profile-2019, the total number of hospital beds in the country was 7,13,986 — which translates to 0.55
• beds per 1,000 population. Furthermore, twelve states that account for 70 per cent of India’s 1.3 billion population were found to have hospital beds per 1,000 population below the national average of 0.55 beds. In terms of access and quality of health services, India was ranked 145 out of 195 countries in a Lancet study published in 2018, below countries like China (48), Sri Lanka (71) Bhutan (134) and Bangladesh (132).
• India’s general government expenditure on healthcare as a percentage of GDP was just 1.0 per cent in 2017 according to WHO data, placing it at number 165 out of 186 countries in terms of government expenditure on healthcare.
• Another glaring issue is India’s dependence on medical devices imports. According to the Association of Indian Medical Device Industry (AiMeD), India’s medical devices imports were around Rs 39,000 crore in FY2019, having seen a growth of 24 per cent from the previous year. These imports were said to account for around 80 per cent of India’s medical devices requirements, with the bulk of the devices coming from the US, China, Germany and Singapore.
• India’s expenditure on R&D as a per cent of GDP has continued to remain stagnant at 0.7 per cent of GDP for three decades, with the public sector accounting for 51.8 per cent of the national R&D expenditure. Furthermore, while India’s public R&D expenditure on healthcare as a share of central government spending on R&D has increased to 5.5 per cent, a figure that is now comparable to that in Germany, it remains low compared to over 25 per cent in the US and around 9 per cent in Korea.

• India now should build on its competitive position in the pharmaceutical and biotechnology sector, where it has resilience in delivering low-cost drugs and vaccines.
• Given the massive industrial base and demand for healthcare in India, ramping up the spending on health infrastructure and healthcare R&D — with a focus on healthcare equipment and services — would surely aid in India’s economic recovery, by not only protecting the well- being of its citizens but also providing access to high quality and affordable healthcare equipment globally.
• To build a robust health system for the future, focusing on India’s infrastructure and technology needs would require emphasising the triple helix model of innovation, that is, bringing together the government, academia and industry, now more than ever. To this end, the government of India has established a “COVID-19 Taskforce” with the objective of mapping together various technological advancements related to COVID-19 in public R&D labs, academia, start- ups, and industries. Better coordination of the various technological developments through greater synergy between the government, academia and industry concerning research and manufacturing, could help minimise the duplication of efforts.

Although government is providing grants and financial support via various channels like department of science and technology’s CAWACH- Centre for Augmenting WAR with COVID-19 Health Crisis – to provide support to 50 innovations and startups addressing various challenges posed by the pandemic; it is also imperative to support open innovation models. The open innovation model allows for the integration of an external knowledge talent pool with the in-built capabilities of a firm, thereby bringing together a network of collaborators involved in biomedical research and drug discovery.

COVID-19 is a health crisis that is expected to stay with us for some time to come. The response to the pandemic offers an opportunity to bring about structural changes in India’s health policy, see greater technology deepening in the healthcare sector with a focus on healthcare equipment, reduce India’s dependence on imports of medical devices, and aid in India’s economic recovery.