The COVID-19 pandemic has caused a lot of pain and suffering to every citizen. The poor, marginalised, the migrants, LGBTQ+ community, and women and children have been amongst the worst impacted. Some of these sufferings could have been avoided.
Yet, ten months into the pandemic (declared on 11 March 2020), we can draw a few silver linings.
First, during the pandemic, health became the central discourse in the initial months. The need to strengthen our healthcare systems was discussed by the top political leaders, both at the union and state levels.
This was significant as in India, health has typically not been a political priority and rarely gets the attention of the governments in power. While health has now made its way into election manifestos, its importance may be forgotten once elections are over.
Second, in the 10 months of the pandemic, vaccine research & development (R&D), arguably, leapfrogged by 10 years. The importance of scientific research got fresh recognition.
What Does ‘Nationalism’ Have To Do With Global COVID Response?
There was another ‘unrelated’ development. Nationalism is not an idea which should figure in a global pandemic response. After all, a pandemic requires global collaboration and coordination to respond. Yet, nationalism — in various forms and varying degrees — has emerged as a key notion in discussions on the COVID-19 pandemic.
An extremity of this idea was that rich countries started making advance purchase agreements to secure any vaccine which would be developed — termed as ‘vaccine nationalism’ — ignoring the fact that no one is safe from the virus till everyone and every country is safe.
The other side of this ‘nationalism’ was that many countries invested to develop their own SARS CoV2 vaccines. This resulted in more than 300 candidate vaccines in various phases of R&D, globally.
Many countries, which are not vaccine developers, for the first time invested in vaccine R&D. Countries wanted to develop their own vaccines, and faster than others. If it was not for such a race, the world may not have been where it is today — with a few approved vaccines and many more in last stages of clinical trials.
Politics & Health Are Interlinked — Here’s How
When health became a central (and for some time, the only) point of discussion during the pandemic, politicking over health was inevitable and natural. However, in true Indian style, much of the political discussion around, even in those states which went to elections, remained narrow and insufficient.
The foundational issues of ‘transforming the health system’, making primary healthcare services functional, increasing community participation in health and ensuring provision of mental health services right up till remote areas (all identified during the pandemic, one more time) were completely missing and remain missing. All that was promised was ‘free’ vaccination against COVID-19, as if the vaccine is the solution to all health problems. As if there would not be any epidemic or pandemic in the future, as if there are no other health challenges currently. Even the other parties got fixated with the idea of free vaccines.
Health being at the centre of politics is not a bad idea.
In the world’s most privatised and most expensive healthcare system, that is, in the United States of America, it was the presidential election which ensured that every single citizen got the free vaccine, something unusual for that nation.
German Physician Rudolf Virchow (1821-1902) famously said that “Medicine is a social science and politics is nothing else but medicine on a large scale.”
Therefore, when politicians talk about health, and if it results in increased access, no one complains. In a similar vein, politicians promise free SARS CoV-2 vaccines in one state and if more states follow suit, it is politics over vaccine which is making it accessible.
It also gives us hope that one day, politicians will truly understand the plight of the people and challenges they face in accessing healthcare services and will have the will to ensure greater healthcare access to all, and affordability.
This is not an impossibly idealistic situation. Ensuring accessible and affordable health services for every citizen is described as the target of universal health coverage or UHC under the sustainable development goals (SDG) agenda and target 3.8. In fact, India has committed to this lofty aim in our current National Health Policy (NHP) released in 2017. The only goal in India’s NHP is fully aligned with the concept of UHC.
Global Solidarity Is Key To Effective Pandemic Response
Even during the pandemic, India has not witnessed a serious political discussion on health issues. Simply talking about linking and associating the vaccine with political parties does not help and even discredits the work of medical professionals, scientists and the research community. While it is a good idea to have indigenous vaccines, haste to be the first may not be in the best interest of people.
Science and any product of science (vaccines) are also global public goods; developments in one country would help others. The world would benefit from these developments no matter where these are created. Rather, opportunities created should be used to boost research capacity, strengthen regulatory mechanism and promote scientific thinking.
In areas where global collaboration and solidarity is needed, ‘nationalism’ and ‘the flavour of patriotism’ may weaken the role that a country may wish to play at the global forum, where it can counter ‘vaccine nationalism’ and ensure that low-and middle-income countries have timely and sufficient access to SARS CoV2 vaccines.
Patriotism in vaccine research may be counter-productive.
Why Not ‘Politicise’ Health?
Historically, nearly all political parties in India have given very little priority to health. The promises made in the election manifestos are not always followed and the attention on health during elections is transient.
The investment made and initiatives taken are largely notional, mostly restricted to changing the names and minor tweaking of ongoing health programs. It has always been a case of ‘too little and too late’.
The SARS CoV2 vaccines and delivery is already becoming mainstream discourse. In 2021, India is likely to focus on the delivery of vaccines (and rightly so). In the process, hopefully political leaders and we the people will not forget about all the challenges in our healthcare systems and continue the discourse on the need for strengthening India’s healthcare system. Ignoring this issue would be a historical failure.
It is not the time for politicking over SARS CoV2 vaccines, but rather, time to ‘politicise’ the need for a better healthcare system in each and every state of India.
(Dr Lahariya is a medical doctor and public policy and health systems expert. He is the co-author of ‘Till We Win: India’s Fight Against The COVID-19 Pandemic’. He tweets @DrLahariya. This is an opinion piece and the views expressed above are the author’s own. The Quint neither endorses nor is responsible for them.)
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