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COVID-19 and the Transformation of Healthcare System: The economics, delivery and relevance in new era

The growing COVID-19 crisis threatens to disproportionately hit developing countries, not only as a health crisis in the short term but also as a devastating social, economic and political crisis. At present the bigger challenge for the world and for the developing countries is to keep economic wheel moving to ensure food security and wellbeing of the society during the various barriers of physical distancing and lock downs. COVID-19 threatens to have devastating consequences in developing countries. Health systems are unable to cope with the precipitous increase in infections and these countries limited resources to cope up with the socioeconomic consequences of lockdowns around the world is paramount challenge and comprehensive policy actions are required in this regard. Even before the current crisis, developing nations were pursuing the SDGs, which emphasizes as a core principle “leaving no one behind”, including the most marginalized countries. Any further obstacles mean the 2030 Agenda for Sustainable Development will be compromised.

Once the coronavirus spreads within developing countries (DSCs), prospects are dire. COVID-19 has certainly wreak havoc in the countries with fragile health systems. There are on average only 113 hospital beds per 100,000 inhabitants in LDCs, less than half the number in other developing countries and around 80 per cent below developed countries. Even the most basic public health interventions like frequent hand washing are impossible for many people in DCs. At this juncture, USA, UK and Europe, who claimed to have a modern health system, are in a strange conundrum, so imagine the impact of this monster on third world countries that are already deprived of basic healthcare facilities and less than average available budget. The massive population is another challenge. Initially, the world knew little about this menace and hence experienced serious implications. But third world countries like Pakistan, Bangladesh, India and Sri Lanka had enough time to learn from the mistakes of the US and Europe and proactive measures of the Republic of China where recovery rate is more than 90 per cent and out of 84,000 reported cases, more than 78,000 have been fully recovered. Other European countries such as Spain, France and Germany are witnessing hundreds of causalities daily along with Iran when its government brought back all their citizens, unlike Pakistan who took the sagacious decision at that interval to not repatriate Pakistani students despite huge pressure from public and bashing from media house, people thinks that the abrupt decision of concerned authorities to release the pilgrims from Taftan border aggravated the situation. But simultaneously the public is also not blame-free. We can only defeat this through unity. Although its spread is inevitable, safety measures can surely be helpful to contain this menace. Thus, it’s a responsibility of citizens to cooperate with concerned authorities because the example of the western world is hovering around. Despite having all resources and state-of-the-art technologies, the US is struggling hard to contain this atrocious COVID-19.

In a similar vein, medical experts across the globe are in full swing to come up with a better and effective drug or vaccine along with the challenges of availability to contain this deadly virus. It’s also a sigh of relief for Asian countries because research is being carried out at regular intervals and new strategies and measures are being proposed to boost up the immunity of the affected ones. There is no denying the fact that sooner or later, we will learn to contain it because relentless efforts are on the way to find out the way. At this juncture, despite limited resources in Pakistan, it’s the right time to give a tribute to our healthcare workers pursuing a war against brutal invaders of the human body. These workers are fighting against an invisible enemy and sacrificing their lives. Traditionally, we have thrown ourselves at the mercy of others. Most in surroundings come up with an argument that it’s fine if some foreign help comes to us otherwise we can survive because of the power of faith. This is a wrong approach because along with the trust in Almighty, one should also tie the camel. However, on the other side of the spectrum, the incumbent crisis is a blessing in disguise and offers an opportunity to strengthen the dilapidated health system by imposing a health emergency and work on healthcare transformation. It’s the right time to invest more in the health sector and bring it to a level of state-of-the-art hospitals concerning quality services.

Today the greatest risk of worldwide catastrophe is pandemic, an enormously infectious virus that’s more devastating and may kill many people. The transparency that we have gained through this current COVID-19 situation, we now understand that we were not geared up for this pandemic situation. The next pandemic is not a matter of “if it happens”, but “when it happens”, would we be prepared in advance against the pandemic at an individual and collective level. What we actually need is preparedness. Upscaling of virtual care capacity and mainstreaming of telehealth and transformation of health care system must be needed to reduce the impact of disaster. A comprehensive action plan with implementation mechanism is very much required with respect to; Quarantines SOPs, Clinical case management guidelines, Suspected & Confirmed Cases, WHO standard, Logistics & Stockpiling, Infection prevention and control, Waste Management, disinfection and environmental decontamination, disinfection and environmental decontamination, Risk Communication & Community Engagement.

We all are already aware that special financing arrangements are required to support surveillance and preparedness before, between, and during outbreaks while underscoring the importance of incentivizing the right types of capacity, including the right research and evidence generation capacity, to mount effective prevention, containment, and mitigation strategies. With billions of dollars in emergency funds now being directed toward the COVID-19 response, particularly in countries with weak health systems, it will be critical to use these resources wisely. This means:

  • Health system must be given priority and allocation must be at least 4% of GDP from the present of 1% in Pakistan.
  • Investing in country-led capacities and systems functions that provide value long after the threat of COVID-19 has waned, with inputs supporting routine health services as well as future response ability as threats emerge.
  • Drawing upon, sharing, and adapting global and local evidence of what works (and what doesn’t) to minimize the spread of disease and avoid inefficient spending of constrained resources.
  • Engaging the decision-makers in national and local government, service delivery, and the universities to advance evidence-informed approaches to resource use and determine the appropriate role of domestic versus external financing.
  • Regional public health institutions are facilitated to exchange information and lessons among countries, link fragmented efforts by multiple stakeholders, develop region- wide policies and interventions, and provide guidance on resource allocation decisions.
  • Avoiding or mitigating the harmful diversion of resources during outbreaks that jeopardize key health gains and priorities in areas of maternal and child health, endemic infectious diseases, and non-communicable diseases and other health system strengthening efforts. Every one before induction in health sector should undergo a training before placement on job.
  • Investment in health sector should be increased with a major portion going into preventive health and health promotion and specific protection.
  • Communities should be trained in various aspects related to collective action.
  • Health system inputs should be rationalized.
  • Health system should not be overburdened and for this proper referral system should be created.
  • Curative healthcare should not be neglected.
  • Health care workers should be trained at the time of induction to handle the situation.
  • Proper data management system are managed to analyze any worst situation.
  • Rationalize the health budget.
  • Mobile Health are used by utilizing mobile technology such as short messaging service (SMS), wireless data transmission, voice calling, and smartphone applications to transmit health-related information or direct care.

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