Commentary
Find our newspaper columns, blogs, and other commentary pieces in this section. Our research focuses on Advanced Biology, High-Tech Geopolitics, Strategic Studies, Indo-Pacific Studies & Economic Policy
Long Covid Among Kids: Numbers May Not Be Too High, But It’s a Big Risk to Ignore Its Threats
By Priyal Lyncia D’Almeida
Since the Covid-19 pandemic began, it has been clear that children are less severely affected by Sars-CoV-2 than adults. Coronavirus infections in children usually do not cause symptoms, or the symptoms are mild. Nevertheless, many children infected with the omicron variant of Sars-CoV-2, whether symptomatic or asymptomatic, show health effects, even months after the virus was first detected. Recent studies have shown that long Covid is prevalent in children infected with Sars-CoV-2. India started its vaccination campaign for kids above 12 in January 2022, but we need to drastically increase this coverage to protect children from long Covid.
Why Most Indians Not Using Public Health Facilities is a Matter of Concern
By Harshit Kukreja and Mahek Nankani
To facilitate and enhance the ongoing mass vaccination campaign for Covid-19, the government has made booster doses free for citizens above 18 years of age for 75 days, starting July 15. This announcement has come amidst the rise of Covid-19 cases across India. The decision is not only bold, but also smart. This is because a staggering 92% Indians, who are currently eligible for a third dose, have not yet taken their shots and are now late receivers. The move is targeting many objectives together: increasing affordability, improving accessibility to more groups and strengthening the trust of the people in government authorities. However, poor awareness and implementation can hinder the ultimate objective of the decision.
What can we do to Ensure Monkeypox Doesn't become the Next Covid?
By Harshit Kukreja and Mahek Nankani
In addition to the recent surge in the number of Covid cases across several regions, India reported its first case of monkeypox virus last week in Kerala. The infected person is said to have reached the state capital recently from UAE and started feeling symptoms soon after landing. In the wake of the first confirmed case in the country, GoI on Friday released fresh guidelines for international travellers to control the spread of the virus. Health agencies across the globe are still figuring out how severe and lethal the virus can be. Several countries have been failing to control the spread, despite being aware of the origin and integrities of the monkeypox virus in humans since the 1970s. While the Covid pandemic is not over, only timely and strategised measures can prevent another major outbreak.
Why India’s 75-Day Free Booster Drive is a Smart Move and How Can it be Made Smarter
By Harshit Kukreja and Mahek Nankani
To facilitate and enhance the ongoing mass vaccination campaign for Covid-19, the government has made booster doses free for citizens above 18 years of age for 75 days, starting July 15. This announcement has come amidst the rise of Covid-19 cases across India. The decision is not only bold, but also smart. This is because a staggering 92% Indians, who are currently eligible for a third dose, have not yet taken their shots and are now late receivers. The move is targeting many objectives together: increasing affordability, improving accessibility to more groups and strengthening the trust of the people in government authorities. However, poor awareness and implementation can hinder the ultimate objective of the decision.
NFHS-5 Data Shows India Forgot Its Obesity Burden while Fighting Undernutrition
By Mahek Nankani and Harshit Kukreja
A few decades ago, obesity was not considered a public health issue. Even as late as the 1990s, obesity was only seen as a western concern, whereas undernutrition was more of a problem for developing nations like India. However, obesity is now afflicting more than 44 per cent of the world’s population. According to the data from the fifth round of the National Family Health Survey (NFHS), India is not far behind. Most government regimes have focused their efforts in recent years on combating malnutrition, with many schemes launched across the country. While the focus was important for that time, new data on obesity suggests that we may have forgotten the obesity burden.
Vaccine Nationalism of Rich Countries: A Self-Defeating Approach With No Winners
By Mahek Nankani
Just a week ago, Danish officials confirmed that they will be doing away with more than 1.1 million doses of COVID-19 vaccines as their efforts to give them to other countries have failed. While on one hand, several rich countries like Denmark have vaccines in surplus, on the other hand, The Duke Global Health Innovation Centre has estimated that the majority in low-income countries will have to wait until 2023 to be vaccinated.
Health Star Rating for Packaged Food is a Welcome Move. But is It Enough?
By Mahek Nankani and Harshit Kukreja
In India, consumers have always had a difficult time separating unhealthy food items from their healthy counterparts. The country’s plan to implement a Health Star Rating (HSR) system for packaged food items is a long-pending move. The decision to approve HSR was made with an eye on rise in obesity, diabetes and hypertension in India. This rating will help in bringing about a behavioural change in the population. The Food Safety and Standards Authority of India (FSSAI) has been tasked with overseeing its implementation. The decision was made after a report was released by IIM Ahmedabad on ‘Consumer preferences for different nutrition front-of-pack labels in India’. The rating’s aim is to make customers aware and capable of making informed food choices.
From Libya to Afghanistan and Syria, Vaccination Rates in War-Torn Nations Are Alarmingly Low
By Mahek Nankani
Fear grips the lives of people in various disputed regions around the world. Fear of several years of war and destruction and now the fear of a fatal global pandemic. The already hobbled healthcare systems have further been overwhelmed with high infection rates of Covid-19. As newer variants continue to keep coming up, the best possible way out of the situation is to get the maximum possible number of people vaccinated. However, vaccinating people in crisis zones has been fraught with difficulties thus far. Many of these areas have not even partially vaccinated one-fourth of their population. Rapid and concerted efforts in the coming months are critical to closing the vaccine distribution gap.
Ayurveda to Unani—traditional medicine systems can’t run on anecdotal evidence. Need research
By Mahek Nankani and Harshit Kukreja
In the last few years, there has been a push towards traditional medicine. And interest in indigenous medicinal systems has witnessed a boom in the ongoing Covid-19 pandemic. A big reason for this shift in public opinion can be credited to the massive promotion done by the Ministry of AYUSH. AYUSH was once a mere department under the Union health ministry and got promoted to a full ministry in 2014. Although there has been some anecdotal evidence that suggests that ancient forms of medicine such as Ayurveda, Unani, and Siddha are effective in treatment of a variety of diseases, there is dearth of reliable research to support such claims.
There have also been countless incidents that prove that harms caused by the traditional treatment are sometimes more than their supposed benefits. As we move towards achieving healthcare for all, it becomes extremely important that only evidence-based medicine is promoted and allowed.
Missing Females: Underreporting of COVID-19 Cases Among Women Shows A Persistent And Global Problem
By Mahek Nankani
In the healthcare sector, relevant and accurate data has become everything. Public health across the globe can be tremendously improved with the help of accurate and timely data. But data on women’s health has always remained in the dark. Several surveys and reports have repeatedly shown that “Missing Women,” a term coined by Indian economist Amartya Sen, is a global problem. This underreporting of females has come to light yet again. A recent research study has demonstrated that many countries have failed to report female infections throughout the pandemic equally.
In a fast-paced, digital world, data becomes essential at each step. Developing a blind spot for continued underreporting adds to the “normalisation” of men representing the entire population’s health. The missing data is a significant impediment to a country’s holistic development and improvement in overall health. It is now that the world should turn towards addressing and filling in the data gap; otherwise, we would fail to produce better outcomes for women’s health.
Omicron: Is India testing enough?
By Mahek Nankani and Harshit Kukreja
With the onslaught of the third wave, low testing rates have become a point of concern. With positivity rates touching 30 per cent in some cities as against the World Health Organisation (WHO)’s recommended five per cent, we do not see a proportional rise in the number of cases. This low number contributes to the narrative about the meekness of the Omicron variant hindering our implementation of the 3T strategy of testing, tracking and treatment.
Omicron: Clinically milder but potentially deadlier
By Mahek Nankani and Harshit Kukreja
There has been a sudden surge in Covid cases across the country in the past few days. This increase can be attributed to the newest Covid-19 variant: Omicron. Ignorance, misconception, and a delay in response could result in India's even more fatal third wave. With India still reeling from the effects of earlier waves and the economic crisis, a new variant, while less fatal, could turn out to be deadlier.
Omicron Scare - Why International Travel Ban Will Do India More Harm than Good
The possibility of another disastrous wave in the country has increased with the discovery of a new SARS-CoV-2 variant, Omicron, and two such cases being detected in Karnataka. This has come along with the Union government issuing new travel guidelines on November 30. A likelihood of the country putting a partial or complete international travel ban is doing the rounds. Recently, Delhi Chief Minister Arvind Kejriwal issued a statement urging the government to not further delay the curbs on international flights. But contrary to popular belief, an immediate air travel ban can do more harm than good. Moreover, the question arises: is it economically feasible, logically valid and morally correct?
Effective communication about COVID-19 could save lives – but India’s strategy has been flawed
Over the past few decades, public health emergencies across the globe have shown us that a timely and efficient risk communication plan could help in minimising fatalities and managing situations on the ground. In unprecedented circumstances such as the Covid-19 pandemic, implementing effective communication methods becomes even more necessary. At the start of the pandemic, it was critical for the Union government to use all means to convey the gravity of the situation to the public. To do so, several communication plans were devised in order to maximise efficiency while minimising casualties.
Why India shouldn't allow COVID-19 booster dose
The Delta variant caused a fresh wave of Covid-19 infections worldwide, aggravating the global public health catastrophe. The currently available Covid-19 vaccines are effective against the Delta variant, which prompted researchers to evaluate whether booster doses for vaccinated people are necessary and when they should be given. The objective of the booster dose is to extend vaccine efficacy in people already administered with primary vaccination. However, this decision should be taken after careful analysis of the necessity of boosters and their timing. India, however, should refrain from administering booster doses to its population until further studies are done to show its utility.Read the full article in the Deccan Herald
COVID-19 outbreak underlines need for India to develop its own epidemic intelligence service
India's Vaccine Diplomacy should take a Backseat Now
By Arjun Gargeyas
As a major vaccine manufacturer, India is expected to lend its hand to protect global health by exporting vaccines to other nations which are yet to administer vaccination doses to the majority of its population. Sources in the Indian government have mentioned India's plans to restart the export of vaccines to African nations in the coming weeks. There have also been reports that the Prime Minister's visit with the United States President later this month will discuss the possibility of India's role in vaccine exports. Biden is expected to convince Modi to make India release a number of doses as humanitarian aid to other countries to combat the spread of the virus and its deadly variants.But is it time to go back to vaccine diplomacy or should India take time to assess the situation better and make a rational decision? There are reasons to suggest that India, despite being a benevolent state, should adopt a wait and watch approach when dealing with vaccine exports from the country.
How should India's Vaccine Mandate Policy look like?
By Arjun Gargeyas and Shambhavi Naik
The recent wave of Covid-19 infections across the United States has been a setback for employers, schools, and universities who were readying to open their offices and campuses. From a "no mask needed for the fully vaccinated" policy 50 days back to vaccines being made compulsory by both state administrations and private companies alike, the Covid-19 vaccine has become imperative for the recovery process from the pandemic.Given the population size of India and the current pace of vaccinations in the country, the threat of future waves of Covid-19 infections still looms large. Recently, employer institutions (both government as well as private) along with public service provider businesses in the country have mandated the Covid-19 vaccine for their employees and customers, respectively.But if there is a vaccine mandate issued in India, what would be the ideal strategy for implementing it?
Digital health cooperation with Israel is in India’s health interest
By Shambhavi Naik and Gedaliah AftermanIndia’s dramatic surge in COVID-19 cases has refocused the local debate on the mismatch between demand and supply of medical services across the country. This discrepancy is aggravated by local lockdowns impeding access to doctors and fear of infection, as people are encouraged to seek medical attention at home. Pleas on social media have demonstrated the need to use digital tools to address issues of information asymmetry and access of health services in non-urban areas.Noticeably, countries have been able to direct their existing digital health solutions to augment their health infrastructure to respond quickly to COVID-19. Israel, which this week removed most COVID-19 related restrictions, is an excellent example of deploying digital health solutions. India can collaborate strategically with Israel to develop capacity in digital health, in preparation for future pandemics.India’s experiments in recent years with adopting digital health have led to mixed responses. Challenges include lack of digital infrastructure in non-urban areas, language barriers, and the absence of basic health services in remote areas. Thus, a blanket one-size-fits-all approach to digital health adoption is unlikely to work in India.Instead, a tiered approach or ground up building of infrastructure is required. Nonetheless, it is important to build to this goal, as digital health tools can help close several current gaps in healthcare. Electronic health records (EHR) maintained in an inter-operable manner, as envisioned under India’s Data Empowerment and Protection Architecture (DEPA), can reduce diagnostic costs and ease access to a patient’s health history for medical professionals. Such records can also form the basis for health information exchange, where EHR from remote areas can be sent to specialist doctors for their opinion.Telemedicine can be used by doctors to patients or consult amongst his peers. COVID-19 has highlighted the importance of developing telemedicine services even in urban centers, so that patients can continue receiving health services without endangering their lives. In addition, diagnostic tools such as wearables can enable real-time monitoring of patient’s health data, leading to more effective decision-making by medical professionals.While these tools cannot replace core medical functions, they can supplement operations and increase medical outreach. The implementation process is however accompanied by concerns about consent mechanisms for data acquisition, storage, and possible cybersecurity threats. Successful implementation of digital health therefore depends on an ecosystem that fosters not only innovation, but also trust and an adequate formulation of appropriate policies to govern digital health.Extending the India-Israel partnershipTo effectively plan and implement digital health policies, governments can learn from each other and work together. Furthermore, only by creating long-lasting cooperative structures and partnerships can they effectively prepare for future crises. Israel and India offer a particular case in point.Israel has actively engaged digital health tools in its public health service and is well placed to share its experience and knowhow with international partners. Under the aegis of Healthcare Israel, it has already provided professional assessments on health care programs in Africa, Asia, and Europe.Israel has successfully deployed digital health tools, but its population and infrastructural challenges are relatively small. On the other hand, India’s adoption of digital tools is still in its infancy, and choosing the right partner can help it expedite this growth. Both stand to benefit from increased cooperation in this field: India can provide an opportunity for Israel to trial technologies at scale in preparation for their international deployment. An effective way to achieve this, while safeguarding rights and health of Indian citizens, would be to create “regulatory sandboxes,” where innovators can trial promising solutions in a controlled environment under a regulator’s supervision. In exchange, Israel’s innovative capabilities make it a highly suitable partner for India.A good starting point for such a collaboration would be to map technologies for preventive healthcare. Point-of-care diagnostics and screening, as just one example, can help in the early detection of cancer and early intervention, which would not only save lives but also reduce the demand for tertiary healthcare and the costs of surgical treatments. Collectively gathered population-level data could inform on developing infectious disease outbreaks, underpinning a health response to prevent further spread. Such preventive strategies would provide relief to strained health resources and allow their effective use, even as India builds up more capacity.Increased investment in health infrastructure, legislation safeguarding the privacy of citizens, and the strengthening of the health regulator are three key actions that are critical for the successful adoption of digital health in both Israel and India. Creating this ecosystem can not only enable government-to-government collaboration, but also facilitate the growth of the domestic and international private sectors providing digital health services. Private sector participation will underline greater outreach of health services, contributing to improved health outcomes.The ongoing COVID-19 outbreak has demonstrated the urgency of increased international cooperation to protect global health interests. No country can be safe from a pandemic unless all countries have adequate, accessible, and affordable healthcare. Therefore, it is a national and global interest for India, Israel, and others to use this opportunity to collaborate and lead the way in creating world-class products and services that can benefit all.Download this article as a pdf.Authors: Shambhavi Naik (PhD) is the Head of Research at the Takshashila Institution Gedaliah Afterman (PhD) is Head of the Asia Policy Program at the Abba Eban Institute for International Diplomacy.