Health Minister Mansukh Mandaviya at Express Adda: No poor person in this country should die due to lack of treatment

Author: Yuvi August 5, 2022

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In the latest edition of Express Adda, Union Health Minister Mansukh Mandaviya talks about India’s massive vaccine campaign, preventive health module and how the Digital Health Mission can make treatment both accessible and affordable.

On the success of India’s COVID-19 vaccination campaign

I don’t see success through the prism of vaccine administration alone. India’s story is built on vaccine research, development, manufacturing, administration and distribution of indigenous resources. In short, it defines Atmanirbhar Bharat. When over 25 million doses were administered by the midnight of 17 September, it became the highest single day vaccination, a personal milestone.

I’m from a village where hearing about a vaccine was a big deal in itself. Getting vaccinated was a big challenge. Vaccines are available in villages today. About 73 percent of the rural population has been vaccinated.

On Center and States working together during Vaccine Drive

This is the USP of PM Narendra Modi. When the covid crisis started, people were apprehensive about the quality of the home vaccine, will we be able to vaccinate the entire population within the given time frame. But Shri Modi asked us to fight the crisis in mission mode, to fight with the spirit of service, and not to be blinded by political squabbles. Our goals were specific and single-minded: rapid vaccination of citizens, increasing vaccine manufacturing, and financially supporting manufacturing companies. I was then the Minister of State for Chemicals and Fertilizers and the Department of Pharmaceuticals was part of my portfolio. I visited each plant and personally documented their strengths, weaknesses, requirements and worked out ways to increase production. Many companies had the scientists and capacity to produce in bulk but no facilities. So we linked them to companies that had these. We imported raw materials and our production volume has tripled. Today, 98 percent of the population (18 and over) have been given the first dose while 91 percent have received both. The dose of precaution continues. We have also exported vaccines and supported other countries. Indian manufacturers did not think of profit. Rather, we supplied quality medicines at affordable prices. Globally, vaccines costing $20-25 were made available for $4-5. The kind of fear and death that occurred during the second wave was seen in many countries in the third wave as well. But we had already been vaccinated, so we survived. There were enough vaccines, syringes at around 150,000 immunization centers per day. Our campaign was an example of best management practices. That’s why the world praised us. Bill Gates congratulates our COVID management efforts at the World Economic Forum. When covid started, the PM assessed that we do not lack brain power and manpower, but we lack faith in our scientists. We trusted them.

Why Moderna and Pfizer were not launched in India?

We did not stop anyone from entering the country. We asked them to register in India just to sell their vaccines, but they objected. There was a clause to remove indemnity and sovereign guarantee but we insisted on compliance with local rules and regulations. Also, by then Indian companies had started mass production, so they won the race.

On dealing with regular Covid surges

We take decisions only after consulting experts. Once, after discussing a survey in New York that studied 200 people to assess the effects of a vaccine, we discussed whether a modern app like CoWIN, which contains data on doses in every Indian city and vaccinators Yes, can be used. The Indian Council of Medical Research (ICMR) has also released a similar report. ICMR came out with its study which was recognized globally. Similarly, for COVID, our experts guide us. Currently, there are different subtypes of infection causing . Our team says that when a variant has a sub-variant, its effects are less severe. So, the virus will persist and become like influenza, which afflicts people once or twice every year. But in India it is under control.

On collaborating with the private sector to investigate non-communicable diseases

Screening is important to make healthcare accessible and affordable, in addition to strengthening public health. Modiji decided to start 1,50,000 health and wellness centres. Of these, 120,000 have already been exposed and can test for 13 diseases. India is the only country where apart from primary, secondary and tertiary health care, we also have ASHA (Accredited Social Health Activists). The role of these workers is important in the management of women’s health. Keeping this data set in mind, we should focus on a national awareness campaign on screening.

on sedentary lifestyle and health care

We are adopting western lifestyle but how do we balance it? There are more bicycles than people in a country like Switzerland. It is the same in Denmark. Every country’s climate, soil and resources are different which affect their food. Our country is extremely diverse. Every state has its own unique cuisine. In addition to eating the food we grew up with, we also need to exercise. Simple changes like using a bicycle for shorter distances and reserving the car for longer journeys are helpful. When I lived on North Avenue, I used to cycle to Parliament. Health should be seen as a key index of development. The idea of ​​making healthcare affordable and accessible led to the expansion of the Ayushman Bharat Scheme, the ECRP-II Package, the Ayushman Bharat Health Infrastructure Mission and the National Health Mission.

A person living in a far flung area should feel that there is public concern about his well being. A poor villager with heart disease often avoids surgical intervention as he cannot arrange Rs 1.5-2 lakh without the help of moneylender. And he does not want to bear the burden of repaying the debt on his family. I have seen many such incidents in my village. Ayushman Bharat has emerged from this gap between accessibility and affordability. In the last few years, 3.5 crore people have undergone surgeries and their lives have been saved.

On measures for those not eligible under Ayushman Bharat

After strengthening Ayushman Bharat, we will look at expanding the health infrastructure by setting up 22 AIIMS centres. Health care in government hospitals is free and the poor are covered under some scheme or the other. But the plans don’t work straight away. Over time, we will need to improve. No poor should die in this country due to lack of treatment.

On going secretly for direct reports

What is the last-mile impact of the decisions I am making inside my office? You won’t understand it until you see it. And it is not only me, the entire cabinet is doing this so that the beneficiaries are not cheated and the implementation of the schemes is fair. When I visit cities, I survey various hospitals and Jan Aushadhi Kendras. It is satisfying to see a person comfortably buying medicines. So when we sit down to make decisions, our morale is high.

On the lack of trust between doctors and patients

Even today the faith and respect that people have for doctors in India is much better than in other countries. Our citizens often consider doctors as semi-gods. Stressed patients may express themselves aggressively. It should not happen. We are also doing orientation courses with doctors. In many countries, doctors, nurses and paramedical staff stopped coming to hospitals during the COVID crisis, but in our country medical personnel risked their lives to report for duty.

On the need for change in medical training

We are working aggressively on two things. There is an affordable and quality healthcare for which a lot of medical tourism is taking place. How do we redeem it? Second is our health workforce which is in demand all over the world. Can India contribute to global healthcare?

If we want to transform medical education, we have to assess the needs of the country, the kind of medical education being followed globally and the need to prove ourselves in the future. We have to talk to our scientists, hospital staff and bureaucrats. Only after taking the suggestions and opinions of all the stakeholders can we make actionable plans and move forward. The government’s vision for the health sector is not short-lived. We are planning ‘Amrit Kaal’, when the country will celebrate 100 years of independence. Governments keep on changing but when you plan like this, there can be overall development of the country.

on digital health ID

Modi ji has focused on Digital India from the very beginning. Jan Dhan accounts have helped people get direct cash transfers during the COVID-stressed times. Similarly, under ABDM, an important element is the Digital Account or Ayushman Bharat Health Account (ABHA). This is important as my attending physician can access all my health information and history on the digital platform and only one OTP can activate it. There is also data privacy. My account cannot be reopened until a new OTP is generated. This is going to be a game changer as more than 20 crore people have opened ABHA account. This is a huge campaign and could be a global first. I request people to join hands with this mission.

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On R&D, innovation and invention of drugs

We are the world’s largest exporter of pharmacy and generic drugs. The cost of one injection for muscular dystrophy is Rs 16 crore. Imagine if we could make it cost-effective. We have connected industry and academia and we are strengthening the National Institute of Pharmaceutical Education and Research (NIPER). We will soon bring a policy for the pharma sector.

on a national mental health plan

During COVID, many institutions started teleconsultation and every day up to 200 distress calls were received. There should be a teleconsultation center in every state. We have also started a program to train doctors to address mental health issues in hospitals. We want people to also use e-Sanjeevani app to get teleconsultation with an expert to avoid stigma. We have started mental health programs in districts and trained doctors.

5 August, 2022, 3:59 am

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