FM announces measures to make health infrastructure pandemic ready

In the fifth and final tranche of stimulus announcements, Finance Minister Nirmala Sitharaman on Sunday made two significant announcements that may have far reaching implications on creating a pandemic-ready health infrastructure in the country in the coming years - one is to have infectious disease hospital blocks in all districts and having integrated public health labs in all districts and block levels to manage pandemics.

While the finance minister did not elaborate on the government expenditure planned for these initiatives, the private sector players say that it would be difficult to implement the plan and also scale it up without private sector participation, especially in the diagnostic laboratory space.

Sithraman also spoke about encouraging research in healthcare and having a National Institutional Platform for One Health by the country's apex health research body Indian Council of Medical Research (ICMR). She also spoke about the implementation of the National Digital Health Blueprint under the National Digital Health Mission. This is also an important step in the present pandemic situation when the grass root level needs to be adddressed through telemedicine, and digital tools.

The CEO of a leading private diagnostic lab told Business Standard that the plan to have integrated public health labs at district and block level is a step in the right direction. "How much time this will take would depend on how fast the states choose to act on Centre's advisory. The lacunae in India is that health is a state subject and the Central decisions relegate to mere advisories with each state taking up a distinctive approach, " he said. The diagnostic industry veteran also added that having pathology labs in all blocks is not a project that the government alone can pull off - it has to be a public-private-partnership model. However, the problem with PPPs in the diagnostic space typically has been that they have not been very viable. "The payments are almost always released late by the government and this has discouraged many leading corporate chains to participate in government tenders," he said, requesting anonymity.

Meanwhile, PPPs in the area of telemedicine are already there. For example, Apollo Hospitals Enterprises Ltd (AHEL) has been working on some projects. Vikram Thaploo. Chief Executive Officer- TeleHealth, AHEL said that they run 115 tele-opthalmology centers and  183 urban public health centers (UPHCs) in Andhra Pradesh and specialist doctors are available from the hub hospitals. This apart, it also has 100 digital dispensaries (telemedicine centers) in Jharkhand. Apollo has also worked with the state government during the Covid-19 pandemic and e-emergency centers in Himachal. These PPP projects are being run in many states. While some of the doctors in the emergency centers are from the government, some are on Apollo payrolls.

Thaploo feels that such models could be easily scaled up on a national scale and there can be a national digital health platform.

However, another health industry insider said that India already had the infrastructure of 250,000 common service centers at the panchayat level under the Digital India mission. These could be now leveraged to disseminate information around Covid-19 to the grass root level.

Sitharaman also listed the measures taken by the government in relation to the Covid-19 pandemic - Rs 15,000 crore worth measures (of which Rs 4113 crore has been released to states) related to essential items, testing labs and  kits, protective equipment for health workers etc. This apart the government launched the Aarogya Setu application for self assessment and contact tracing.
 

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