Combating COVID-19 in India

While COVID-19 poses extraordinary challenges for every nation on Earth, India faces a uniquely complex test because of its enormous size and incredible diversity. India must reckon with the spread of the virus both in dense urban centers like Delhi and Mumbai and in thousands of remote rural villages across the subcontinent. And in a country with tens of millions of migrant workers, COVID-19 can travel easily, and transmission patterns may be hard to detect.

Given these circumstances, it is very heartening that, thus far, India has the lowest number of COVID-19 cases and deaths per capita of any large country. The epidemic in India is still evolving, and the next few months will be critical, but the early results are a testament to the decisive action taken to implement screening, social distancing procedures, and ramp up testing from the first days of the pandemic. The rapid response by India’s public health sector, particularly the millions of primary health care workers who lead the last mile of health care delivery, has been remarkable, and has bought the country valuable time to try and prepare the health system for unprecedented pressures. Across the country, an army of volunteers has contributed in multiple ways, from running feeding programs to managing shelters to developing technology to support the response. While the battle is clearly not over, there is reason for hope.

In just two months, for example, India has gone from being entirely dependent on imports for personal protective equipment (PPE) for health care workers to domestically manufacturing two million pieces a week. Soon, India expects to have enough to export to other countries facing critical PPE shortages. Thousands of women in self-help groups across the country have bolstered these efforts, making more than 100 million masks, 200,000 PPE kits, and 300,000 liters of hand sanitizer to combat the virus. Similarly, working with private sector partners, India created a large-scale manufacturing industry for swabs in just ten days, providing crucial diagnostic supplies at one-tenth the cost of imported ones.

India has also ramped up its digital information-sharing networks to help contain and treat the virus. In 2017, the Ministry of Human Resources Development launched the Digital Infrastructure Knowledge Sharing (DIKSHA) platform to provide online training to teachers. In April 2020, the Department of Personnel and Training leveraged DIKSHA’s underlying infrastructure to roll out the Integrated Government Online Training platform (iGOT) to train frontline health workers as well as other government functionaries and officials in COVID-related best practices. Within six weeks, nearly one million users across India were taking courses on iGOT, local philanthropic partners were adding content to the site, and it and DIKSHA were processing more than 2,000 transactions a minute.

These accomplishments demonstrate that India can respond quickly, creatively, and comprehensively to COVID-19. At the Gates Foundation, we are continually working to support the response where we can. We have been working closely with India’s central and state governments, local charities and organizations, and domestic biopharma companies to help increase the availability of necessary supplies and facilities, to train and protect frontline health workers, and to support the roll out of cutting-edge tools (like iGOT) to limit COVID-19’s impact. As we move into the next phases of this pandemic, both on the subcontinent and worldwide, I see three particular areas where we hope to provide further support.

First, India’s innovation capacity will be critical to defeating the virus worldwide. The country’s dynamic biopharma sector, which supplies much of the rest of the word with life-saving and cost-effective drugs, is already hard at work on as many as thirty potential COVID-19 vaccines. We have longstanding partnerships with many top Indian vaccine manufacturers to help increase volume, encourage information sharing and technology transfer, and accelerate research and manufacturing safely. We are also supporting the Indian Council for Medical Research (ICMR), Department of Biotechnology (DBT) and others to share global best practices on treatment protocols, gather more data about the disease that is specific to India, and contribute to the evaluation of potential treatments.

Second, we will continue to invest in strengthening health systems. For example, we are supporting our partners in the states of Bihar and Uttar Pradesh on planning, health care training, digital data-gathering, and procuring essential supplies. These COVID-specific interventions are important, but they alone will not end the health crisis. We must also ensure that primary health care and essential health services get to the people who need them across India, including in urban areas where primary health care networks need a lot of strengthening. A robust system of primary health care across India is necessary both to fight COVID-19 and improve quality of life in the long-term.

Third, we want to develop stronger partnerships with government, multi-lateral partners, domestic philanthropies, and civil society organizations to help cushion COVID-19’s economic impact for the most vulnerable. The half a billion Indians working (or, increasingly, not working) in the informal economy and the quarter of a billion living below the poverty line are extremely exposed to the economic shocks following on the heels of the virus, and Indian women are disproportionately impacted. Through our investments with the World Bank, National Rural Livelihoods Mission (NRLM), and the NITI Aayog-led Aspirational Districts Program, among others, we have been actively working to empower women economically across India. We plan to further our collaborations with local organizations to encourage vibrant local economies and create more opportunities in both agriculture and other sectors.

We have our work cut out for us. But we are inspired by the tremendous response we have already seen from governments, the private sector, and the people of India. India has the ability not just to save the lives and livelihoods of its citizens from COVID-19, but to help lead the world out of this pandemic.