India Envisions a Healthier World Order- By Dr Mansukh Mandaviya (Union Minister of Health and Family Welfare, and Chemicals and Fertilisers )- India’s vision of a healthier globe emanates from the philosophy of Vasudhaiv Kutumbhkam (the world is one family) that translates into One Earth, One Family, One Future. In health terms, this principle encourages G20 members to consider local health crisis and collaborate to create universal solutions. As part of India’s G20 presidency, policymakers from member countries and experts from the medical fraternity shall unfold the foundation and framework of a Global Health Architecture at a series of Health Working Group meetings, starting this month. The Global Health Architecture is envisaged to equip countries to face the next health emergency and institute robust healthcare systems.
World over, COVID-19 resulted in the collapse of fragile health systems and further sharpened disparities and inequalities in Low-and-Middle Income Countries (LMICs).It made world leaders realise that health emergencies in a single country can impact health systems across the world; the interdependence over life-saving drugs, vaccines, medical equipment and devices became apparent during the pandemic.
A single country, however well-equipped and endowed with medical infrastructure, may not be able to turn the tide against a crisis like the pandemic. For LMICs, the situation in such times worsens as access to basic health is restricted and uneven.
Prime Minister Narendra Modi has defined the central objective of India’s G20 Presidency as “healing, harmony and hope”. He envisages a more human-centric globalisation that envisions universal healthcare as a key priority.
Considering the lessons learnt during the difficult phases of COVID-19, the Indonesian presidency (2022) called for strengthening the Global Health Architecture, encouraging health sector institutions across countries to build a system that endures under extreme pressure. COVID-19 also enhanced the climate change challenges: increased zoonotic events, extreme weather conditions and water and vector borne diseases continue to increase threats for epidemics.
For India, the Global Health Architecture rests on three key priorities. The first is strengthening national capacities to prevent, prepare and respond to major outbreaks. The agenda will include a ‘One Health’ approach and Antimicrobial Resistance (AMR). Partnering with multiple organisations like the WHO, World Bank, G 7, Access to COVID 19 Tools Accelerator, this effort will attempt to synergise existing strengths and identify the bottlenecks in the system.
One Health approach is critical in addressing the linkages between human, animal and environment sectors to resist the impact of AMR on communities. Coupled with pandemic counter measures that are affordable, equitable and universal in access, G20 India Health Track aims to facilitate seamless interweaving towards global health emergency architecture. It plans to work towards creating a bank of best practices that address health emergencies from different countries. Already, considering the future risks, the Saudi Arabian, Italian and Indonesian Presidency established the Financial Intermediary Fund for pandemic prevention, preparedness and response.
The second priority of G20 is strengthening cooperation in the pharmaceutical sector in order to improve the mechanism of equitable access to quality vaccines, therapeutics and diagnostics. Indian generics are valued across the world. In FY 2022, pharma products worth $24.47 billion were supplied to 200 countries. India continues to provide affordable HIV drugs and anti-TB generics to several LMICs. Out endeavour shall be to create a more conducive framework for clinical trials, R&D support and affordability of medicalcounter measures, especially to the LMICs.
India’s role in addressing life-saving vaccine inequity has been acknowledged and appreciated worldwide. While high income countries during COVID-19 speeded towards buying billions of doses of the vaccine, several poor countries struggled to protect their citizens from the catastrophic challenges of the virus. People from LMICs stayed unprotected and vulnerable for close to a year with no access to vaccines. Under the leadership of Prime Minister Shri Narendra Modi, India provided critical doses to more than 100 countries during the most difficult phase of COVID-19 through the ‘Vaccine Maitri’ initiative. This was accomplished without loss in quality or hiking the prices of vaccines and drugs.
With the aim to strengthen the pharma sector, the government has introduced production-linked incentive schemes. It has planned Bulk Drug Parks to create world class infrastructure facilities and initiated Medical Device Parks to provide easy access to standard testing and laboratory facilities. Building common facilities will reduce cost of production and enhance better availability and affordability of medical devices.
While Italy (2021 Presidency) and Indonesia (2022 Presidency) concentrated on setting up regional manufacturing and research hubs, India’s G20 Presidency proposes to address the gaps in the availability, accessibility and affordability of medical countermeasures. It shall continue to prioritise global networks for R& D and manufacturing for medical countermeasures and end-to-end medical countermeasure platforms during its presidency.
The third priority is digital health innovations and solutions to aid universal health coverage. The global COVID-19 experience has amply demonstrated how digital technologies can help in remote data capture, medical diagnosis and virtual care. The experience was transformative in India. Millions of citizens used the COWIN app to access the vaccine programme; thousands moved to online medical consultations; in remote areas, tele-consultation proved to be life-saving. We have witnessed in the last two years, an impressive increase in HealthTech start-ups in India. Government of India’s free telemedicine service, eSanjeevani, has recently crossed a remarkable milestone of 90 million crore tele-consultations. India’s platforms of tele-cmedicine have bridged the last mile delivery gaps of achieving targets of Universal Health Coverage (UHC). It is pertinent to note here that India is marching ahead to attain goals of UHC through the health assurance initiatives such as Ayushman Bharat- PMJAY where more than 500 million people are eligible for free of cost tertiary healthcare, backed by technology to make it portable, scalable and paperless across states.
Under this priority, we plan to promote the Global Digital Public Health Goods – Telemedicine, Teleradiology, Teleopthalmy and even an e-ICU. CoWIN has been shared with several countries as a digital public health good. The collective efforts of G20 members will result in creation of an ecosystem that provides open access to several LMICs for more equitable healthcare. India plans to draw a framework for the Global Initiative on Digital Health and harness the potential of artificial intelligence in building more resilient infrastructure.
During difficult phases of COVID-19, India carved a position for itself as one of the leaders in universal vaccination programmes. At a time when several countries endowed with better healthcare infrastructure have been challenged on several fronts, India has demonstrated how timely planning, efficient management of vaccination cold chains, R&D in vaccine development, focussed policy decisions and integrated implementation through strong Centre-State collaboration can achieve COVID vaccination of more than 2.2 billion doses.
Enriched with the experience, the G20 Presidency provides us the mandate to assume a leadership position for the Global South and propose a fresh vision of a healthier world order.