24, Jun 2021 | CJP Team
The Covid-19 crisis has given fresh momentum to conversations surrounding our Right to Health. From the right to basic medication to a demand for vaccine camps for all, organisations like CJP have been at the forefront of defending this right. However, when it comes to the obligations of the State to serve its people, what are the government’s duties?
The Jan Swasthya Abhiyan (JSA), a national network of civil society groups and people’s movement for health rights, in its latest communication to the Government of India reminded it of the various obligations of central and state governments when it comes to ensuring their citizens’ health rights.
These obligations are as follows:
1. Obligation to provide free treatment, ensure transport and prevent denial of care for all patients
2. Obligation to urgently expand and make available beds for critical Covid care, with oxygen and other facilities
3. Obligation to universally ensure increased, required level of continuous medical oxygen supply
4. Obligation to provide ready access to quality testing
5. Obligation to ensure effective contact tracing, quarantine and isolation facilities
6. Obligation to actively promote Covid-19 appropriate behaviours
7. Obligation to ensure universal vaccination with priority to those more vulnerable
8. Obligation to provide all necessary non- Covid-19 health services
9. Obligation to protect from exploitation and irrational care by private sector
10. Obligation to prevent violation of civil rights and liberties
11. Need for Governments to coordinate efforts with civil society organisations and community groups
12. Obligations to ensuring rights of health workers
13. Obligation to ensure dignity in death and ensure health of crematorium workers
14. Obligation to provide reliable data on mortality, morbidity and testing data
The JSA listed these obligations after observing the catastrophic collapse of the healthcare system, where instead of engaging in urgent measures to mitigate the crisis, government officials blamed the non-observance of Covid-19 guidelines and the emergence of mutant strains, for the horrifying second wave of Coronavirus. Decrying such responses that shifted responsibility to the people, while pushing privatisation policies, the JSA also listed policy measures required to meet aforementioned obligations.
These policy measures are as follows:
1. Quantum jump in public expenditure in healthcare, expansion of public health infrastructure and human resources in health. Placing higher levels of direct taxation on the super-rich corporate class could be an option for raising additional revenues.
2. Reverse all decisions on privatisation of district hospitals and other government facilities. Review current health insurance schemes given the coronavirus epidemic.
3. Implement comprehensive regulation of the private healthcare sector covering rates of services, quality of care, treatment practices and patients’ rights.
4. Step up domestic manufacture production of all essential medicines, diagnostics, PPE required for treatment of Covid-19 and adopt a policy of compulsory licensing as per need. GST to be removed on all medicines related to Covid-19 and medical devices and their prices also to be regulated. Basic medicines used to treat Covid-19 can also be produced by reviving the public sector pharmaceutical companies.
5. The crisis in oxygen supply requires not only improved manufacture and logistics, but also increased in-hospital oxygen plants and the widespread introduction of oxygen concentrators.
6. Increase vaccine supply and equitable distribution by expanding manufacture of vaccines beyond the current two manufacturers through licensing/revocation of patent if any, and transfer of technology.
7. The agreements between the Government and the manufacturers/ private players should be in the public domain. The Covaxin patent should be partly or fully owned by the government, and the Covishield patent should come under compulsory licensing if patent becomes a barrier to expansion.
8. Allowing import and domestic manufacture of other vaccines, especially Sputnik V, and others that are emerging.
9. The Central government should provide necessary resources as well as coordination, and vaccination should be available free of cost to all. However in case the private sector is allowed to provide vaccination to some sections, then price of vaccines should be strictly regulated.
10. Scaling up manufacturing capacity by augmenting development and production of Covid-vaccines by reopening PSUs in the vaccine-making process, to increase the capacity of vaccine production.
11. Ensure cost-based pricing of all vaccines manufactured, with public allocation to states and within states based on requirements and equity considerations so that it can be provided freely.
12. Significant expansion of gene-sequencing studies across India, with provision of feedback and samples to diagnostics and vaccine manufacturers and regulators, so that accuracy and effectiveness can be monitored and maintained. Special emphasis on early detection of escape mutants and other mutants of concern or interest. The genome sequencing data should be published in a public domain site.
13. Step up public health research on the operationalization of each element of pandemic response and use this evidence to inform policy decision on lockdown, public health measures and hospital care.
14. Universalize social protection measures and introduce economic relief packages for workers, rural people and others who have lost livelihoods in the pandemic.
15. Over-centralised approach of governance needs to be replaced by a more participatory, decentralised and accountable system of governance involving various layers of government, judiciary and civil society, including public health professionals.
More details on government obligations and policy measures may be read in the following statement by JSA:
*Feature image courtesy Trinity Care Foundation via Flickr