The eruption of the coronavirus (Covid 19) epidemic in China’s Hubei province with Wuhan (pop.11 million) as its epicentre — which threatens to mutate into a global pandemic — and the efforts of the Central and provincial governments of the neighbouring People’s Republic of China (PRC), have important lessons to offer government and civil society in India.
For one, despite the deadly virus which is resistant to all extant antibiotics and medication having claimed 2,746 lives in China and 51 abroad, indications are that the spread of the epidemic has been successfully contained. For this, the PRC government notwithstanding its initial laxity in acknowledging the first signals of the epidemic, has to be congratulated. Given PRC’s massive population (1.40 billion) and even of Hubei province (58 million), restricting the fatalities to 2,746 (at the time of writing) and 78,596 suspected cases, is indicative of rapid reaction and competent disaster management.
For India’s Central and state governments and civil society, the outbreak of this deadly disease in our neighbour nation should serve as a timely wake-up call. It’s dreadful to imagine the chaos and pandemonium that would be precipitated if Covid 19 or a similar life-threatening virus-borne disease was to break out in India, especially in any of the country’s over-crowded metropolitan cities.
For one, it’s well-documented that in all the major metros, 40-60 percent of inhabitants live in fetid slum shacks, severely under-served by way of piped water and modern sanitation. Viral contagions can spread and surge rapidly in these conditions. And from slums to more upscale homes in India’s poorly planned cities, the distance these contagions have to travel is very small.
Ill planned and serviced cities apart — there is a shortage of 23 million homes in contemporary India — the public health infrastructure is pathetically inadequate. The doctor-people ratio in 21st century India is a mere 0.6:1,000 as against 1.49:1,000 in PRC and the ratio of hospital beds 0.7:1,000 (2011) cf. 4.2:1,000 people in PRC (2012).
Moreover, annual expenditure of the government (Centre plus states) on health since independence has averaged less than 2 percent of GDP cf. the global average of 10 percent and 10-17 percent that’s normative in developed OECD countries. In the Union Budget 2020-21, the provision for public health is Rs.69,234 crore, a mere 0.30 percent of GDP. In this connection, it should be borne in mind that the Black Death influenza virus took a toll of 200 million lives in the 14th century in Europe and Spanish flu caused 30 million deaths in Europe between the two world wars.
The point to note is that these virus-borne pandemics haven’t afflicted Europe for almost a century. That’s because governments and civil society learned the lessons of these destructive epidemics and took preventive measures — built well-planned cities, augmented housing stock, improved water and sanitation, and constructed public health infrastructure. Contemporary India is dangerously vulnerable to this or the next health pandemic.
