Accessibility and affordability of Covid tests

Syllabus- General Studies 2(Governance)

Issues relating to quality of life: livelihood, poverty, hunger, disease and social inclusiveness.

Context

The second wave of Covid-19 is sweeping through the country. Health systems are overwhelmed and the need for critical medical supplies is expanding by the minute.

Amid rising cases, testing — a potent tool to contain the spread — is escalating steadily and inching close to two million tests daily.

Current Situation

• The government’s emphasis on reverse transcription-polymerase chain reaction (RT-PCR), considered the gold standard of tests and essential for sequencing purposes, also continues to remain high.
• The appetite for testing among populations has risen in this wave. Diagnostic labs are reeling under the stress of skyrocketing demand and some private labs have called for government intervention to ensure seamless and expeditious supply of critical material (reagents for RT-PCR).
• However, with parallel tasks of
  • purchasing vaccines under the liberalised Covid-19 vaccination programme,
  • securing medical oxygen supplies, and
  • managing hospital beds, state governments are stretched thin on resources including financial resources.

At this critical juncture, pivoting to cost rationalisation approaches holds the key to sustaining the pandemic response momentum.

Why Testing is crucial?

• It is critical to remember that intensified testing is not a substitute for the vaccination programme, and vice-versa.
• While universal vaccination forges a barricade against the virus, it cannot be the only answer as building that barricade amid a vaccine shortage will take time.
• Testing is essential, as it is testing data that provides real-time information on a virus that continues to reinvent itself. These are distinct tools that complement each other and with strategic calculation and smart execution, they can be deployed to transform the challenging landscape we face and prepare for future infectious disease pandemics.

Challenges in testing

• Governments have banked on the private sector to augment Covid-19 testing due to limited capacity in the public sector. But with the ongoing wave increasingly afflicting rural populations, there is a renewed need to review the costs attached to testing.
• For marginalised and underserved pockets that hail typically from the lowest socioeconomic strata, even state-imposed price caps trigger affordability constraints and lock them out of accessing care in the private sector.
• State government-imposed ceiling prices on the private sector fail to account for the diverse cost elements: Consumables, personnel, transportation, overheads.
• The affordability of testing is a cornerstone of equitable pandemic response.
• Collection and testing consumables (viral transport media kit, reagents, testing kits, plate) constitute around 88 per cent of the total cost of the RT-PCR test.

Way forward

• Reducing the procurement cost of consumables can slash the overall cost of tests, leading to lower test prices for consumers.

What is needed is a model of consolidated and pooled procurement to drive down testing costs, improve the quality of testing, and increase test kit availability.

• Substituting fragmented buyers – governments and private labs – with a consortium can lead to a three-fold cost reduction. With greater bargaining power, the consortium can leverage volume purchase to negotiate with different sellers and ensure a uniform and lower cost for all buyers.
• If this mechanism is facilitated by the central government, in addition to test prices, information exchange across states can also be standardised, to minimise existing disparities.
  • Earlier precedents-
    • The Global Fund to fight Malaria, AIDS and TB uses the pooled procurement mechanism to reduce the cost of insecticide-treated malaria nets and antimalarial treatment to less than $2 and $0.58, respectively.
    • The National AIDS Control Organisation (NACO) and Central TB Division (CTD) have, in the past, piloted similar exercises and their functional expertise can be effectively harnessed for Covid-19 testing cost reduction.
  • Elaborate and accurate test demand forecasting channels have proven to be a key ingredient in pooled procurement strategies.

This refashioned model can propel the country’s Covid-19 testing framework towards greater overall capacity, access, and equity. Extending the benefits of pooled procurement to private players can translate to affordable and increased testing options for the public. It will also serve as an incentive for private labs to join the Indian Council of Medical Research’s (ICMR) laboratory network and scale up testing.

Question- Covid testing can prove to be a cornerstone in winning the fight against covid and also better prepare for such future pandemics. Elucidate.

Article- https://indianexpress.com/article/opinion/how-to-make-covid-tests-more-accessible-affordable-rt-pcr-price-7358756/