World over there has been debates on the current emergency of COVID-19 and where we failed? Comparing the Spanish Flu 1918 (
India looked at the options of strengthening of the health system but tilted towards lop-sided crowding of tertiary care in urban areas and all-round neglect of health system in rural areas, where more than 70% of its population resides. Some of the thinkers suggested segregating healthcare services, health research, and public health as independent but inter-related pillars of people’s health (
Most of the developed countries like Australia, United Kingdom and group of countries like European Union, deal with public health issues through specific legal frameworks. National Health Security Act 2007 enacted by Australia is used for prevention of health emergencies (
In the wake of current pandemic in Spain, all private hospitals have been nationalized. Potential patients are tested using robust mechanism by South Korea. They have also adopted an IT-based strategy to fight coronavirus. Large numbers of isolation centers were created by Malaysia. The public health laws brings in regulatory framework using innovative mechanisms and good clinical practices to the health sector. Public health does not limit itself to prevention, promotion or prediction; but it also uses principles of primary, secondary, and tertiary prevention.
India invoked colonial era Epidemic Diseases Act, 1897 to fight coronavirus (
Although National Disaster Management Guidelines, 2008 were used at the national level by Ministry of Health and Family Welfare, but there are some basic differences in disasters and pandemic, which require different management approach (
To combat the coronavirus pandemic, Maharashtra government brought out the Maharashtra COVID-19 Regulations, 2020 (
Delhi government also took steps similar to Maharashtra government and passed Delhi Epidemic Diseases, COVID-19 Regulations, 2020 (
The bills like National Health Bill, 2009 (
India also proposed and drafted a National Health Policy, 2017. The principles of prevention and promotion were main target areas under this policy. It was thought that policy will be helpful in identification of existing gaps. The policy was an effort to shift the focus from current curative services through tertiary care centres to community based prevention and promotion activities. The gaps as visible make a strong case for comprehensive public health law through a dedicated agency. Such agency is lacking in India. We may need to relook at National Health Policy, 2017 from the perspective of COVID-19 and epidemic diseases. Proper policy directions through enactment and revision of the existing legal instruments should be the target of National Health Policy. Century old Epidemic Act, 1897 should be revised or upgraded in light of advancements in research, healthcare services and technology development. Different laws related to public health should be integrated for strengthening community response, disaster management, food & nutrition security, and environmental interventions. Public Health angles and impacts of water pollution, noise pollution, and environment should be addressed by a comprehensive law. Special section on sanitation and hygiene should be mentioned, which may include physical distancing, hand hygiene etc. This becomes important under present situation like coronavirus outbreak. Detailed guidelines on physical distancing should be widely disseminated through print and electronic media.
Government of India formed the Ministry of AYUSH on 9th November 2014. The aim was to ensure appropriate placement of AYUSH systems within overall health care system of Inida (
Similar views were raised earlier where an integrated healthcare system was proposed. There is need for change in the structures of medical colleges like allopathic, ayurvedic, homeopathic, dental, and naturopathy. This should be ‘transformational change’, not just an incremental change. A basic medical degree may be considered combining physical health, social, spiritual, mental and therapeutic components of healthcare system (integration at ministry level and college level). These basic doctors shall be closer to communities. Being holistic in approach, their main focus will be preventive and promotive aspects of health. They would be instrumental in delivering integrated solutions by combining modern medicine, alternative medicine, diet, behaviour, naturopathy, and yoga. Simpler solutions are possible with public health measures like Swach Bharat Abhiyan (the clean India campaign). These are proven strategies which may result in eradication or minimization of communicable diseases like coronavirus infection (
A dedicated public health law is the need of the hour in view of the pandemic like coronavirus. A laws which is all-inclusive and comprehensive. India may revise the Public Health Bill 2009 and reintroduce it as a robust public health strategy for creation of separate Ministry for Public Health. This should lay down the foundation of new era for launching Ministry of Public Health. The finer details can be shared once the concept is agreed by top echelons of the power. Ministry of Public Health will have community settings as field areas of work rather than lop-sided tertiary care centres. The focus of such a Ministry will be promoting healthy lifestyles in the communities so that in future any epidemic like COVID-19 can be managed easily. Similar recommendations have been given earlier to have an integrated healthcare systems by segregating best working treatment and prevention modalities from all the systems covered under AYUSH.