Being Prepared, Proactive, and Political





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Jul 29, 2020
by Oscar Tollast
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Being Prepared, Proactive, and Political

Salzburg Global Fellow Mahesh Devnani discusses health care in India, responding to COVID-19, and tech solutions Mahesh Devnani is a Salzburg Global Fellow taking part in the Japan-India Transformative Technology Network

Mahesh Devnani is an associate professor and joint medical superintendent at the Department of Hospital Administration at the Post Graduate Institute of Medical Education and Research in Chandigarh, India. He is a Salzburg Global Fellow taking part in the Japan-India Transformative Technology Network. We caught up with Mahesh at the beginning of June, 2020, to learn about his work and India's response to COVID-19.

Salzburg Global (SG): To begin with, how has COVID-19 affected your life - personally and professionally?

Mahesh Devnani (MD): Professionally it has been very busy keeping in view that it required an entirely different and new approach at the workplace. I haven't taken any leave since the beginning of this year… our summer vacations have also been canceled. [The] initial phase was more chaotic. However, managing fear and stigma related to COVID-19 among health workers is still a challenge even after so many months. On [a] personal front, I am just hanging in there. Concern about the safety of [the] family is always there.  

SG: What issues has COVID-19 exposed within India, and how can health care and technology respond?

MD: There are several issues that we need to take care [of] with respect to public health emergency preparedness and response, and one of them is strengthening public health care infrastructure and human resources. Health is a state subject in India, and there is a wide variation in availability and quality of health services in different states as health services in some states are better than others. And yet, there is no formal mechanism to share best practices to learn from each other.

One factor could be that the health sector planning and response in India is dominated by bureaucrats, as is also evident during this pandemic. Improvements in public health infrastructure require sustained technical inputs with long term vision. Technology can help in data and experience sharing between and within states, which will help in better preparedness and response. Another issue is the timely detection of disease outbreaks or flare-ups, and I believe artificial intelligence (AI) can play a crucial role in it.

SG: In January, you outlined several ways India should respond to the COVID-19 pandemic and provided ways in which readers could take action. To what extent has your advice been followed, and what could be done better?

MD: In view of the large size and population of the country, I had suggested to have a national stockpile of medical countermeasures [that] can be immediately mobilized during public health emergencies if required. It can take care of the lag time in response at crucial stages. There are reports that the Government of India is contemplating a "Drug Security Authority" to stock up on drugs. This is a good start. However, we need a comprehensive "Health Security Authority," which can take a fuller view on such issues instead of just the drugs. Another key issue that requires the government's attention and, in fact, technology can play a big role in it is the insufficient data integration between the human, animal, and environmental health sectors for faster detection of zoonotic diseases.

SG: What's a question no one is asking at the moment India when it comes to providing health care?

MD: I guess one question we all should ponder upon more often is how to make health care in India a political issue. And please don't get me wrong, I am saying it in a positive context. We need more vocal voices for advocacy on health care-related issues from ground level workers, physicians, NGOs, and others and not just from armchair advisors and social media trumpeters. Concerted advocacy for health care issues is something that we don't talk much about.

SG: What do you wish more policymakers and citizens understood about the challenges you face in your profession?

MD: It's important for policymakers to be more proactive than reactive. The fundamental issues and challenges of Indian health care to be addressed [have been the] same [for a] long [time], and yet, except for few honest attempts, most approaches have been cosmetic and/or in piecemeal. Till now, health care in India was not considered to be an election issue and hence was largely neglected. I hope that with this pandemic and its wider implications, citizens will demand better health care services from policymakers.

SG: What would you like to learn more about while being part of the Japan-India Transformative Technology Network?

MD: Despite being one of the first few countries affected by SARS-COV-2, Japan has been able to contain the virus like no other country. It's a remarkable feat considering in view its higher number of old age citizens and the fact that majority of its population lives in urban areas. I would be interested in understanding the technological and social innovations used in Japan to contain the pandemic.

Mahesh Devnani is a Salzburg Global Fellow taking part in the Japan-India Transformative Technology Network, a program held in partnership with the Nippon Foundation. Sign up for our newsletter here to receive updates about this program.