Is health slipping off the policy table?

by Shrutee K

The COVID-19 pandemic brought health to the top of the global, national, and subnational policy agenda. The confluence of crises (climate, pandemic, geopolitical, and financial) being faced by the world today is drawing the attention of policy actors in several directions. Food and fuel shortages are being faced in many countries on account of the ongoing Ukraine-Russia war. Some countries are faced with rapidly rising inflation. Sri Lanka exemplifies the debt and foreign exchange crisis faced by low and middle-income countries. As countries started breathing easy from the perceived waning of the COVID-19  pandemic, there is an imminent risk of health being gradually pushed off the policy table again. The focus themes outlined for this year’s G20 are indicative of this risk says Says Dr. Krishna Reddy Nallamalla, DM (Card) Regional Director - South Asia, ACCESS Health International

Key health policies have been set in motion at the global level during the last two years in response to the unprecedented pandemic. The ‘Pandemic Fund’ has been agreed upon by the powerful G-7 and G-20 countries; there is a consensus on strengthening the World Health Organization and revamping the International Health Regulations (IHR), and there are plans for pooling global public health goods and building the resilience of supply chains. There is a need for continued focus to drive these policies into action.

At the national level, India has launched two more missions – the Ayushman Bharat Digital Mission (ABDM) and the Ayushman Bharat Health Infrastructure Mission (ABHIM) under the Ayushman Bharat umbrella–in addition to the AB-PMJAY and AB Health and Wellness Clinics that were launched before the pandemic. There are plans to strengthen the health workforce, especially in the areas of public health and health management. Policies towards self-reliance in health technologies have been announced. Dialogue is ongoing to find solutions for the inclusion of the ‘missing middle’ in financial protection schemes. Focused attention is needed for the successful implementation of these ambitious policies.

The greatest challenge is going to be the provision of the needed financial, human, and technological resources, given the precarious fiscal space and inadequate human resources for health. India has been able to weather the challenges of food and energy security, climate change, inflation, debt servicing, and foreign exchange reserves. However, India will face the challenge of the diversion of the political leadership’s attention towards the ongoing state and upcoming general elections. Populism will drive how meager budgets are allocated.

In this context, the onus of pursuing the health policy agenda rests not only with the governments, but also equally with non-governments, civil society, academia, the private sector, and the media among others. Otherwise, the great and hard lessons the world learned during COVID-19 will soon be forgotten and the health systems will continue to remain fragile and ill-prepared for future shocks. We even risk being left with further weakened health systems in this post-pandemic era. Unless lessons are translated into policies and policies into actions, we cannot hope to build stronger and more resilient health systems concludes Dr. Krishna Reddy Nallamalla