Strengthen 3-tier healthcare system by pouring more resources into PHCs: Sanjay Aggarwal, President, PHDCCI

'The virus has shown the world that there is an urgent need for a paradigm shift in the provision of healthcare.'

PHD Chamber of Commerce and Industry (PHDCCI), a proactive national apex chamber that acts as a catalyst in the promotion of industry, trade and entrepreneurship, has been involved in the fight against Covid-19 pandemic. The New Delhi-based body had put forward a five-pronged strategy to stop the spread of the novel coronavirus in the likelihood of a third wave in the country. These included, initiating vaccination drive aggressively, ensure strict adherence to Covid-19-related protocols of social distancing, adoption of strict norms and compliances for the micro-containment zones, imposing immediate lockdown in a district where the number of active cases are more than 500 and enhancing the capacity and quality of health infrastructure in the country. PHDCCI is providing policy advocacy to facilitate right decision-making and introduce industry best practices. In an exclusive conversation with the Financial Express Online Sanjay Aggarwal, President, PHDCCI talked about how the organization is working towards making a difference in its fight against the possible third wave of Covid-19. Excerpts:

In your opinion, how can India remain better prepared in terms of healthcare infrastructure to prevent the third wave of Covid-19?

First and foremost, there is a need to increase the testing capacity. Only rapid identification of cases and strict isolation can help to flatten the curve till the vaccine rollout is adequate. It is imperative to use our AYUSH systems far more effectively than what we have done in the first wave. India should be able to strengthen our three-tier healthcare system by pouring more resources into the primary healthcare centres. It is estimated that almost 90 per cent of the medical treatment demand can be satisfied at the primary health level and very few patients need to be referred to higher rungs of the healthcare ladder.

Encouraging work-from-home and opening up of the open spaces will better serve on prevention and delay of the possible third wave. This will also balance the lives with livelihood. This pandemic has shown us the deficiencies in our healthcare system and laid bare the systemic under-investment in public health over the last half a century. Building a fair and equitable healthcare system, which works for all the people, may be the only solution to prevent (or rather limit the impact of) future pandemics.

In a densely populated country like India, the national vaccination drive poses considerable challenges in terms of supply, distribution and pricing. How can things be worked out to overcome such hurdles?

The combined production capacity of Covishield and Covaxin is only around 60-70 million doses/month and at this rate it may take more than two years to vaccinate India’s population. So, we have to look at other options, like scaling up capacity and ready-made vaccines from abroad.

Short-term strategy is to convert production plants with flexible machines and lines to vaccine producing plants. We have already seen such instances during the first wave where sanitizers were produced in distilled bottled water plants. The long-term capacity development strategy would be to identify and set up new vaccine production sites across states, so that we are prepared to produce adequate quantities of booster doses. Just like the annual influenza vaccine program in the US, we should plan for vaccinating 40-50% of the population not just one time, but every year, as the novel coronavirus mutates.

Sanjay Aggarwal, President, PHD Chamber of Commerce and Industry

How is PHDCCI, as an apex national chamber, trying to make a difference in addressing some of the concerns related to the Covid-19?

The PHDCCI members have contributed more than Rs 500 crore to the PM CARES Fund. In addition, we are importing 10 oxygen plants which will be donated to government and charitable hospitals funded by our members

PHD Family Welfare Foundation (PHDFWF) and Rural Development Foundation have been working at the grassroot level with the needy and the poor by giving away food packets which can serve a family of four people for two weeks and this exercise is being repeated multiple times. PHDFWF has also distributed more than 28,000 KN95 masks and about 8,000 cotton masks to Delhi and Haryana Police, government hospitals in different parts of India, frontline workers, beneficiaries from skill centre units and beneficiaries of mobile medical vans. PHDFWF has also distributed food packets, energy drinks, sanitary napkins, cotton masks and face shields to the abovementioned beneficiaries and police and government hospitals.

We are not only vaccinating our own employees and their families but we are one of the first Chambers to conduct vaccination camps for the members, their employees and their families under the Corporate Vaccination Program of the government of India.

Telemedicine projects for government/ charitable hospitals are underway with BAPIO (British Association of Physicians of Indian Origin) to provide remote consultation services for Covid and non-Covid patients which can reduce the workload on Indian healthcare workers.

The chamber has been closely working with the industry and the government to resolve the issues related to supply chain of key Covid-19 products related to health and other essential services and contributing to the strategy of the vaccination drive.

PHDCCI has come up with a five-pronged strategy to beat the third wave of Covid-19. Could you shed some light on the same?

As the third wave of Coronavirus is expected in September-October 2021 by various experts, firstly, let’s target to vaccinate at least half of the population in the next 3-4 months, that is by September 2021.

Secondly, ensure adoption of strict rules such as wearing masks, maintaining social distancing, not spitting in the open, frequent hand-washing/sanitizing, among others, along with an impactful penalty on breaking such rules. In the last one and a half year, more than 39.9 crore cumulative samples have been tested for Covid-19 in India. At this juncture, Covid testing should be further increased in the country at a rapid rate.

Thirdly, strict norms and compliances should be adopted for the micro-containment zones. This will help in curbing infection spread in and outside a defined geographic area.

Fourthly, immediate lockdown should be imposed in a district, where the number of active coronavirus cases is more than 500.

And lastly, the next three months should be devoted to enhance capacity and quality of country’s health infrastructure, at a war-footing. The government should ensure adequate availability of oxygen, hospital beds- especially ICU beds, doctors and others medical personnel, among others, to save maximum lives.

The second wave has been quite devastating, especially for rural India, what steps can be initiated to ensure that health infrastructure in small towns and villages can be ramped up while ensuring last mile connectivity?

With a population of about 140 crores, AYUSH System shall be a big saviour in terms of yoga for mental and physical health, Ayurveda for Preventive Health Care with Immunity Boosters like AYUSH Kadha, Giloy tablets, Ashwagadha Tablets, Chywanprash. These all have been recommended by Ministry of AYUSH, Govt. of India as well as Ministry of Health & Family Welfare, the government of India as a Protocol to prevent Covid-19.

There is an urgency to promote the usage of AYUSH systems with modern healthcare facilities needs to be promoted in rural and semi-urban areas.

Essentially, healthcare infra has to see a merging of the two systems (AYUSH and modern medicine) at the ground level to ensure affordability and effectiveness as also promoting prevention by building the immunity of the public at large

The Covid-19 pandemic has been a harsh reality-check and has exposed the gaps of overall healthcare system across the world. The virus has shown the world that there is an urgent need for a paradigm shift in the provision of healthcare. Instead of a patient visiting a doctor, the need of the hour is to reach out to vulnerable sections of society through Telemedicine in the short-term and long-term.

It is essential to strengthen the PHCs and making the doctors available. There is also a need for connecting PHCs to CHCs through telemedicine system to tackle the healthcare infrastructure and speciality consultation issues of rural areas is the best solution.

How can corporate India make a difference amidst the coronavirus pandemic?

The India Inc. can make a difference by contributing for social causes specially for the needy and the underprivileged in terms of giving food and other essentials as also sponsoring the vaccination for the less privileged one.

They can look forward to adopting the families who have lost their breadwinners due to Covid for their basic needs and the education of their children.

Companies can look forward to encouraging and promoting work from home to ensure minimum transmission of the disease.

Corporates can come forward to donate oxygen plants to expand on the existing healthcare infrastructure.

Industry can come forward for skilling and up-skilling the healthcare workers/ providers.

What is the Covid appropriate behavior, which needs to be maintained for the time being to bend the third wave curve of Covid-19?

Adoption of Covid-19 appropriate behaviour is the best way to stop transmission of the virus and its variants- efforts to test, trace, isolate, and treat need to be scaled up and done lot more scientifically.

Communities practising cough etiquette, hand hygiene, wearing mask, ensuring adequate ventilation and social-distancing are the prime important things.

What lessons from developed countries like the US, UK and Israel can be adopted while making them India-centric in the fight against Covid-19?

While the Covid-19 crisis challenges are undoubtedly unique, they are not exceptional insofar as such challenges all have unique characteristics. Nevertheless, the challenges have probably been far greater than for other recent epidemics, raising questions about earlier tested modes of response.

Full social mobilization is undoubtedly needed, but such exceptional ‘emergency’ or even ‘wartime-like’ measures must not be abused, for example, by the temptation to skew implementation for despotic, political or pecuniary advantage. Hence, success can be greatly enabled by legitimate, credible and exemplary leadership, government and otherwise.

Countries can have less disruptive and less costly, but yet very effective containment strategies, especially if they act early, quickly and adequately. The ability to trace and test as many suspected cases as possible, for example, those who have recently come into close physical proximity with an infected person, is also crucial.

Effective containment depends heavily on voluntary compliance, and hence, community acceptance and trust, helped by transparency and shared understanding of what needs to be done. All these require state capabilities working together (‘all of government’) as well as credible and inclusive leadership to mobilize and co-ordinate the ‘whole of society’ for effective containment of contagion, as in the southwest Indian state of Kerala and countries like Vietnam.