BUILD ON EXPERIENCE

Testing, treatment and vaccination for COVID-19 and other diseases need to be strengthened

AS COVID-19 nears endemicity, especially in urban settings, public health needs to be prioritised. Testing and treatment must be made available to the most vulnerable— those with diabetes and other noncommunicable diseases and with existing conditions of the lung, kidney and liver, whose immune response is not strong despite vaccination.

Advancements made during the pandemic need to be augmented. Diagnostic technologies like the polymerase chain reaction (PCR) have now been scaled up across settings with low resources. For decades, PCR testing has been rationed in the public sector, made available for health programmes for tuberculosis and HIV only after an advocacy push from civil society. In the private sector, it was only available to those willing to pay up to US $100 and more per test. Now, with competition and government support, we see a dip in costs per test. With the Union government’s Department of Biotechnology providing funds, the Indian Council of Medical Research lending technical support and the Union Ministry of Health procuring machines and kits, there is potential to develop PCR testing for a range of infectious diseases.

The pandemic has also highlighted the importance of taking a proactive regulatory approach to repurpose drugs, develop antivirals and facilitate generic production of therapeutics. India’s capacity for generic manufacturing and use of international trade rules for registration of generics of patented medicines were crucial during the pandemic, allowing access to affordable drugs like baracitinib to treat patients with severe COVID-19. But the lack of transparency in data submitted to the drug regulator will be a concern.

Vaccines must be more affordable. In a normal market scenario, high volumes, competition and government procurement can bring down prices to a few cents per vaccine under the Centre’s Universal Immunisation Programme. But COVID-19 vaccines are more expensive. Prices can be reduced by allowing competition.

In addition, the experience of conducting adult and adolescent vaccination drives must be used in initiatives for diseases like hepatitis B, cervical cancer and pneumococcal pneumonia.