India’s Natural Advantages as a Lighthouse for Global Health - The compulsion to manage its paradoxes

This is probably a proposition that generates disbelief at home in India and certainly for the rest of the world.

Look again though!

Necessity being the mother of Invention, is a tired cliché, but rings more true today, than it ever did.

The Pharmaceutical Industry in India and her Vaccination supply chain which proved to be of stellar importance in the recent pandemic, really grew out of an organic and compelling need. That of a giant nation of 1.4 billion people, to address its healthcare challenges in a sustainable fashion. The PPE and Diagnostics industry received its baptism by fire during the pandemic, and rose to the occasion, as did healthcare providers and other ancillary services.

It is easy for doomsday prophets to commandeer attention by pedaling touching stories of failure and loss. Change makers however, do not lack empathy, but have the ability to see beyond the pain. There is lies hope and potential that nations and leaders need to build with.

Beyond the quibbles, the much-maligned governance apparatus delivered above expectations, and the results are there to see.

This is not to say that things could not have been better, but what are we measuring against? The dearth of Primary Healthcare in mature economies with massive resources, and its impact, has been glaringly exposed and they now look to retrofit their healthcare systems. This, even as we rate our own primary healthcare as abysmal.

The fact that India could scramble up and provide triage and appropriate care while the pandemic raged, is easy to overlook but did help public health in India do better than most of the world.

So, let us not throw the baby out with the bathwater and see beyond the gloom and doom.

So, why are lessons learnt in India of value to the world?

Clearly Public Health and its security are now key issues that nations need to address, regardless of their resource levels. Healthy and Productive populations are what lift nations out of poverty and ensure their sovereignty; and address the collective aspiration of societies anywhere, which they entrust their leaderships with.

The Indian experience becomes relevant due to the inherent characteristics of the Indian nation and the paradoxes she must manage.

Diversity and Interoperability

India’s diversity in terms of genetics, culture, lifestyle, food, language climate, environmental issues, economics, education and skills etc. is of a higher order than most societies can fathom. Its culture is ancient and it has legacies of knowledge and practices that evolved organically. These must be folded-in to any change that is required to be made. This is unlike younger, more homogenous societies. Health, unlike more fungible domains is profoundly impacted by all of these variables and therefore involves decision making that is far more subjective. It also requires the working together of a larger number of stakeholders in tandem to deliver care. Achieving meaningful Interoperability, which is an intricately layered concept to begin with, in such an ecosystem can be a daunting challenge.

Scale and Speed

There are only two nations on the planet that have populations of over a Billion. These are then spread over a huge landmass with a large number of microcosms – which represents a mammoth challenge, both in terms of scale and speed, for health systems to respond and serve, in order to ensure access and equity in healthcare.

Mobility and Federated Governance Structures

Of these two nations, one is a democracy, market driven economy and also federated in its governance structure. Greater freedom of choice at all levels, calls for more consensual, inclusive solutions and can be challenging both in terms of technology and transformation.

Mobility is therefore is high, and providing equitable care across the country requires nimble and evolving solutions.

Resource Optimization and Continuity

Countries like India need to be careful about managing their resources both in development, deployment and operational costs while protecting these investments against obsolescence and waste.

The need to evolve is greater as its population continues to grow in numbers and in life expectancy. This creates a unique demography that will need to be cared for longer than ever before.

Asset Light Innovation and Technology Life Cycles

Given the velocity of technology shifts and innovation, the unique paradoxes discussed above require that Transformations be done leveraging asset light innovation using technology that is nimble and resilient and allows for evolution on a continuous basis.

Leveraging Digitalization as Nervous system to balance all these paradoxes, maximizing virtualization to conserve resources, both human and material - that go into building facilities and optimizing their utilization is key for nations to be able to sustain the costs of offering universal healthcare.

Leveraging digitalization has been the key to the Vaccination success, through in-silico development, and will again be key to addressing challenges in therapeutics as the world moves forward and leverage converging disciplines to innovate efficiently.

Mobile First, Elastic Cloud Based Open-Source Innovation that India has put in place strikes a judicious balance of these factors. The Minimum Viable Product based approach allows it to address the bottom of the healthcare pyramid which even mature economies have failed to do adequately.

The Indian journey with Digital Health for Universal Healthcare, is rich with potential for the entire global south to leverage and has lessons that will benefit a majority of humanity as it addresses the complexity and paradoxes with great elan.

Caution!

1.Digital Health is a cross domain discipline and the temptation to adopt or force templates from other domains can result in a quixotic Monkey and Razor experience. Nuance and Depth of understanding are critical. There are Geostrategic implications too, but that is a discussion for another day.

2. A number of experts tend to use Digitization and Digitalization interchangably. This is fallacy that can take everyting awry.

Resources

Please feel free look at www.openhealthcode.blogspot.com or request more information on aspects that you may want to examine deeper for your part of the world. I am reachable at [email protected]

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