One of the most populated countries in the world, India has been facing problems with regard to well-being of its citizens while sustaining their developmental needs. The need for better health facilities, and developing antidotes for new kinds of pathogens and viruses have made the task more challenging. The respective governments, pharma companies, and testing labs are trying to develop safe trial mechanisms and developing safeguards for protecting the lives of vulnerable sections of society. Within India, the community health programme involves the non-governmental sector, healthcare professionals, economics aspects and social interaction through people and voluntary workers. While the health ecosystem exists, the problem has been finance, support and critical knowledge repository. India did well to address issues such as polio vaccination and creating community awareness for regular medication against tuberculosis. There is a mounting impact of chronic diseases in economic and social sectors, need for quality health services in the wake of changing demographics, and increasing life expectancy have made matters more complex.
In terms of understanding the requirements for building better resilient and health-conscious societies, it is important that the vaccines, lifesaving drugs, and medicines should be developed with certain generalised regulations which can improve the health of the society and address problems faced by people living across regions. While India is a subcontinent comprising of all geographical features, it is also a cauldron of different ethnic communities, and physical features which provides exceptional opportunities for testing and developing medicines which can cater to different physical and pathological profiles of people. Within India, one can find people with different levels of immunity. As the eating and food habits have been different, there is higher incidence of diabetes, hyper tension and cardio diseases in a cross-section of people. It has also been seen that people who are above 40-70 years of age have been more vulnerable to pandemics, and other communicable diseases. A sizeable mortality profile of people suggests that.
In this context it becomes very important that medicines which should be developed should have a better shelf life and give results which can be corroborated with testing facility, with a cross-section of people. The results have usually varied with regard to people with different eating habits and also nutrition factor. Pandemics such as COVID-19 have brought to the fore that India has better resistance mechanisms which has helped in relatively less mortality rate when these people have been infected with COVID-19. The duration of sickness because of COVID -19 has varied from five days to more than three weeks. In such certain times, it has been found that because of lack of any effective medicine or any sure shot diagnostic mechanisms the treatment has prolonged and the recovery has been slow. In terms of legal and other regulatory mechanisms, it has been found that most of the clinical trials which are done in India enroll the vulnerable and poor people and human trials are conducted. There is a grey area of medical compensation and addressing post-tests complications from legal point of view.
For India it has become imperative to develop projects and conduct feasibility studies through government mechanisms rather than through medical companies. While projects have been undertaken to study different kind of diseases that school children and adults will be facing in the next two decades, it has been found that most of the complications will be related to teeth, eyesight, anxiety and mental well-being. However, in the case of pandemics and community health programmes it has been encouraging signs that initiatives such as creating awareness with regard to AIDS, mental well-being, depression and anxiety disorders have been fruitful and rewarding with institutionalising counselling and telephone helplines. Most of the programs have been done and supported by NGOs as well as a few voluntary organisations.
The projects and programmes which can be initiated in India should address core issues. Firstly, the incidence of non-curable diseases, depression, immunity disorders, other issues related to community transmission, and the development of proper safeguards and awareness with regard to pandemics and life-threatening diseases. Secondly, the COVID-19 has opened a Pandora’s box with regard to the incidence of diseases which impact community, and thereby also affect government health budget. Lastly, it is necessary that India will have to create medical soldiers and inform voluntary workers so that the community transmission and community health well-being should be addressed on a priority level.
As the COVID vaccine is in different trial stages, many countries are looking for testing facility in India and also conduct human trials, as legal structure in medicinal trials is still in infancy. India needs to address the issue of IPR on developing vaccines and medical history should be addressed jointly as it has been found that many western countries have been purchasing medical history of the patients living in developing Asia, providing vaccines through great testing mechanisms and subsequently using copyright laws to deny cheap medicines to the larger community.
In this regard it is important that India should conduct research on immunity vectors of its population and develop generic drugs which can help in protecting communities from most transmissions. It is also pertinent to note that in terms of the temperature variance across India it provides unique testing opportunities in different conditions. However, there is a need for a holistic approach and therefore it is important that training and sensitisation of the personnel working in this field is of paramount importance. Initiatives related to preventive and therapeutic services is critical. Also, looking for quick alternatives would save the lives of personnel.
Just like any emergency, there is a need for rapid action medical force which can provide immediate assistance and better cognitive abilities track critical illnesses and the reasons thereof. It has been seen in the case of midwifery and associated postnatal diseases that it has worked wonders with a better equipped and knowledgeable person existing in each society for better assistance and awareness.
The critical importance of voluntary workers is that with sufficient technical assistance (which might come from government and state units) gives them confidence and also strengthens their application of knowledge for better informed public health practices and policies. Technical assistance and quick action through centralised control centre has to create the first line of defence in case of a pandemic.
The institutes which have been working in this field are Public Health Foundation of India, Indian Institutes of Public Health and All India Institute of Hygiene & Public Health, which have been disseminating information through online workshops, seminars, and social media. They have created affiliates and sister agencies working in the field all across India. Networking of public health institutions in medical education need to address issues such as environmental health and countering new kind of diseases which are dominating.
This clearly highlights the fact there is a need for understanding pandemics, developing awareness among communities about public health, and stress on hygienic environment, conducting long term research on emerging diseases and promoting research in tropical medicine.
India need to allocate separate fund for public health initiatives and promote exchange of medical workers with third world countries for better understanding the nuances of medical and health research. In fact, in most of the think tank meetings, public health and awareness is not listed as topics whenever Track II dialogues are held. There is also a need for better practices in public health, education, and developing health demonstration projects, barefoot nurses and doctors, strengthening an eco-system of education, training, and scholarship. Developing traditional medicine and making it easily accessible should be the bulwark against diseases. Restructuring Community Medicine/ Preventive and Social Medicine colleges which impart this kind of education in developing countries is required as the number is relatively less. Across developing world scholarship in community medicine and hospital administration is low and needs structural financial support. The data collection and diagnostics apparatus need micro management to create better response chain. COVID-19 has provided the reason for public health to be taken as a national initiative.
