General Studies Paper 2

Context: The World Health Organization (WHO) has launched a new initiative to be better prepared for future outbreaks of a similar scale and devastation as the COVID-19 pandemic.

More about the PRET Initiative

  • Global Meeting for Future Respiratory Pathogen Pandemics:
    • The initiative was announced at the Global Meeting for Future Respiratory Pathogen Pandemics held in Geneva, Switzerland.
  • Aim:
    • The Preparedness and Resilience for Emerging Threats (PRET) Initiative is aimed at providing “guidance on integrated planning for responding to any respiratory pathogen such as influenza or coronaviruses”.
  • Immediate focus of the mission:
    • While the current focus of PRET will be on respiratory viruses — in the backdrop of the SARS-CoV-2 outbreak.
      • Possible threat of an avian influenza outbreak work is already underway to assess what should be the next group of pathogens to be mitigated under this initiative.
    • Approach:
      • The three-pronged approach includes: 
        • Updating preparedness plans that affirm priority actions,
        • Increase connectivity among stakeholders in pandemic preparedness planning through systematic coordination and cooperation and dedicate sustained investments,
        • Financing and monitoring of pandemic preparedness with a special focus on bridging the lacunes highlighted during the COVID-19 pandemic.
      • The PRET monitoring framework:
        • The framework is expected to be outlined soon, lists a host of actions which countries will be expected to work on with progress being achieved by December 2025.

Challenges faced globally, during COVID pandemic

  • All countries had insufficient health capacities. This left the world acutely vulnerable to future health emergencies.
    • All countries remain dangerously unprepared for future epidemic and pandemic threats, including threats potentially more devastating than COVID-19.
  • 65% of assessed countries had not published and implemented an overarching national public health emergency response plan for diseases with epidemic or pandemic potential.
  • 73% of countries did not have the ability to provide expedited approval for medical countermeasures, such as vaccines and antiviral drugs, during a public health emergency.
  • Most countries, including high-income ones, have not made dedicated financial investments in strengthening epidemic or pandemic preparedness.

India’s Health Sector

  • About:
    • India’s health care system consists of both public and private components:
      • The government healthcare system concentrates on establishing primary healthcare centers (PHCs) in rural areas while maintaining a small number of secondary and tertiary care facilities in major cities.
      • Majority of secondary, tertiary, and quaternary care facilities are run by the private sector, with a focus on metropolises and tier-I and tier-II cities.
    • In the Economic Survey of 2022, India’s public expenditure on healthcare stood at 2.1% of GDP in 2021-22 against 1.8% in 2020-21 and 1.3% in 2019-20.
  • Challenges:
    • Unequal distribution: 
      • India’s health care system is concentrated in urban areas with very little presence in the rural areas where majority of the population lives.
    • Low Budget Spending: 
      • India’s public expenditure on healthcare is only 2.1% of GDP in 2021-22 while Japan, Canada and France spend about 10% of their GDP on public healthcare.
    • Lack of Medical Research: 
      • In India, R&D and cutting-edge technology-led new projects receive little attention.
    • Low doctor-patient ratio: 
      • The doctor patient ratio in India is about 1:1500 much higher than the WHO norm of one doctor for every 1,000 people.
    • Initiatives: 
      • Pradhan Mantri-Ayushman Bharat Health Infrastructure Mission (PM-ABHIM): 
        • It aims to strengthen India’s health infrastructure and improve the country’s primary, secondary and tertiary care services.
      • Ayushman Bharat: 
        • Ayushman Bharat follows a two- pronged approach:
          • Creation of health and wellness centres to bring health care closer to homes.
          • Formulation of a Pradhan Mantri Jan Arogya Yojana (PMJAY) to protect poor and vulnerable families against financial risk arising out of health episodes.
        • Ayushman Bharat Digital Mission:
          • It aims to connect the digital health solutions of hospitals across the country. Under this, every citizen will now get a digital health ID and their health record will be digitally protected.
        • National Ayush Mission:
          • It is a centrally sponsored scheme for the development of traditional medicines
        • Pradhan Mantri Swasthya Suraksha Yojana (PMSSY):
        • It aims to correct regional imbalances in the availability of affordable/reliable tertiary healthcare services and also to augment facilities for quality medical education in the country

Suggestions for effective pandemic preparedness:

  • Prioritizing health security:
    • Prioritize the building and maintaining of health security capacities in national budgets as they are important for responding to routine health threats and can provide important benefits to countries’ overall health and development.
  • Transparency in capacities and risk factors:
    • National decision-makers need readily available information about their country’s plans and other capacities, and increased transparency is essential for a global prevention, detection, and response to epidemics and pandemics.
  • Conducting post COVID pandemic surveys:
    • Conduct comprehensive after-action COVID-19 pandemic reports so that they can learn from this crisis and ensure that capacities developed during the pandemic are expanded and sustained for future public health emergencies.
  • Global support:
    • Support countries in addressing the urgent global need to strengthen health systems as part of countries’ public health capacity-building efforts.
  • Community engagement and equity:
    • Just as health emergencies have impacts across many sectors, so must our preparedness and response efforts span sectors, disciplines and pathogens.
    • It is critical, too, that community engagement and equity are the centre of our efforts, especially for those populations that are marginalised and most at risk.

Way ahead

  • The PRET Initiative ushers in anew era for pandemic preparedness and represents an evolution of WHO’s core activities to support all member states in strengthening health emergency preparedness, prevention, and response capacities and capabilities.
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