COVER STORY/PANDEMIC
estimated need of $2 billion, says Pai.
In case of HIV/AIDS, global targets set by the Joint UN Programme on HIV and AIDS (UNAIDS)—to diagnose 95 per cent of all HIVpositive individuals, provide antiretroviral therapy (ART) treatments for 95 per cent of those diagnosed and achieve viral suppression for 95 per cent of those treated by 2030—are being derailed due to shortage of funds. Antiretrovirals used to tame the disease are expensive and there is a shortage of funds to make them available. There has been a decrease in funding which fell by 7 per cent between 2017 and 2019.
This might soon change, as there is already a move to increase funds to strengthen health systems, vaccinate people and provide treatment. On February 14 this year, the US launched a global action plan to vaccinate the world and preparing it against future pandemics. Efforts would be made to strengthen the supply chains for vaccines and other critical supplies, like syringes, test kits, treatments. Access to treatments and therapeutics would be improved. Additionally, the action plan will strengthen global health security for the next emergency. A few days earlier, the newly established European Health Emergency Preparedness and Response Authority budgeted €1.3 billion ($1.47 billion) to prevent, prepare for and respond to cross-border health emergencies in 2022. It has allotted a total of €6 billion ($6.78 billion) for 2022-27. This fund would be used for research and development of medical countermeasures and innovative technologies against emerging
COVID-19 has exposed the weaknesses of the public healthcare system. Governments must take note of them and provide more resources to help prepare for future health emergencies
since 2019. There was a 15 per cent reduction in the number of people treated for drugresistant TB. Funding too went down from $5.8 billion to $5.3 billion between 2019 and 2020. Given these setbacks, progress toward the 2022 targets established by the UN highlevel meeting on TB is off track.
Similarly, in 2020, over 22 million infants missed their first dose of measles vaccine—3 million more than in 2019. Measles surveillance also deteriorated with the lowest number of specimens sent for laboratory testing in over a decade. As a result, major measles outbreaks occurred in 26 countries and accounted for 84 per cent of all reported cases in 2020. During this time, 24 vaccination campaigns in 23 countries, originally planned for 2020, were postponed.
‘The COVID-19 pandemic has brutally exposed the weaknesses of our public health services,” says Abhay Shukla, co-convenor of Jan Swasthya Abhiyaan, a national network on health rights. There was gross overcharging and there were instances when treatment was denied to COVID-19 patients, he says. “This clearly shows that market cannot drive health care. We need to ensure major strengthening of the public health system and regulation of private healthcare,” he recommends. For instance, he says, the Clinical Establishments (Registration and Regulation) Act, 2010, which would regulate all clinical establishments in India and provide a set of standard treatment guidelines for common diseases and conditions, is yet to be implemented. He feels with COVID-19, health now comes much higher on the political agenda.
“The middle class, who had largely ignored the poor conditions and availability of diagnostics, essential commodities such as oxygen and drugs, till now, started to recognise, mobilise and advocate for these services within the public health system,” says Menghaney. The Union and state governments need to provide more resources for the public health system to prepare for health emergencies. This is the big learning from COVID-19.