Development, progress and economic growth of a society and country is proportional to the participation of workforce in these activities. Only a disease free healthy person can contribute effectively in this process. Disease scenario in our country is very dismal. India accounts for a relatively large share of the world’s disease burden. The National Sample Survey Office’s (NSSO) 71st round report on ‘Health in India’, has brought out certain facts which need serious consideration.

About 9 per cent of rural population and 12 per cent of urban population reported ailment during a 15 day reference period. Proportion (no. per 1000) of Ailing Persons (PAP) was highest for the age group of 60 & above (276 in rural, 362 in urban) followed by that among children (103 in rural, 114 in urban). About 4.4 per cent of the urban population was hospitalized (excluding childbirth) at any time during a reference period of 365 days. The proportion of persons hospitalized in the rural areas was lower (3.5 per cent). When such a large number is unwell at any time of the year, their participation in nation’s building is bound to be affected.

The COVID-19 crisis has brought to the fore shortcomings of our system to meet the challenge of health crisis. It appears the lockdown has worked only for about 20 per cent population who own their house, have sufficient income to feed themselves for a few months and have education level to understand the importance of steps for prevention. But for a majority population it has been a cause of misery. They do not have sufficient income to feed themselves even for few days if they do not work. The physical distancing is not possible as many live in the shanty areas with 7-8 persons sharing a 8 x 8 feet room. Nor do they have android mobile phones to download the applications to understand the intricacies of the preventive measures from COVID-19. Availability of healthcare for routine illnesses in this crisis situation is a dream for them as OPD care in several state run hospitals is closed and they are unable to afford expenditure in private set up.

India is always in an emergency situation for health. Tuberculosis is cause of death for about 1400 persons per day in our country. Over 900 people in India die due to Respiratory Tract Infection (RTI) every day. Despite decline the current infant mortality rate for India in 2019 stands at 29.848 deaths per 1000 live births (1).

A study by Lancet, one of the most credible medical journals, points out death of hundreds in India due to poor nutrition. The study estimates that one in five deaths globally are due to poor dietary intake. This contributes to a range of chronic diseases in people around the world (2).

The World Bank estimates that 21 percent of communicable diseases in India are linked to unsafe water and the lack of hygiene practices. Further, more than 500 children under the age of five die each day from diarrhea in India alone (3).

The Lancet had formed a 37 member EAT Lancet Commission for the purpose including Dr. K Srinath Reddy, a renowned Cardiologist and President of Public Health Foundation of India and Ms. Sunita Narayan - Director General, Centre for Science and Environment and editor of the Down to Earth. It had recommended for a healthy adult an average daily intake of 232 grams of Whole grain (Rice, Wheat, Corn etc.), 50 grams of starchy vegetables (Potatoes and cassava), 300 grams all vegetables, 200 grams fruits, 250 grams dairy foods (milk or equivalents), about 200 grams Protein Sources from non-vegetarian food, about 50 grams added fats (Unsaturated oils and Saturated oils) and 30 grams of Added Sugar all sugar to meet the requirement of our balanced diet.

The average approximate cost of this diet at the present market price was found to be around Rs.130 per person per day. For a family of 5 members this comes out to be Rs.650 per day or Rs.19500 per month. This is impossible to be met with in present day socio-economic structure of our country particularly in the present day context when the many people have lost the jobs and in the absence of provision of a nutritional diet to such persons by the state, several of them are at the mercy of others to get food / ration. This falls much below the nutritional requirements even for subsistence level.

Under the present circumstances when large number of population is away from their families as result of lockdown, the mental health is at a great risk. Lack of food, distance from kith and kin, uncertainty of future, walking hundreds of kilometers on foot to reach their native place is a grave issue. Unfortunately this does not come under any discussion in our country, while it can have far reaching impact on people’s health in time to come.

Therefore steps need to be taken and strategy evolved to meet the nutritional needs of our population as a whole, provide clean drinking water and sanitation facilities to all the population, ensure healthy housing for all the people including the workers at their work places as well as in their native places, strengthen the state healthcare system to provide adequate healthcare facilities to the low income groups. There is also a need to have hospital care for already prevalent diseases in emergency situations as today. It is however commendable in the present crises the state sector, despite extremely poor infrastructure, is doing yeoman’s job right from giving medical aid in the healthcare facilities and public education through field workers.

Unfortunately our public health spending is very poor hovering around 1.02 per cent of the GDP. This must be increased minimum to 6 per cent. Growth with mere wealth generation producing inequities will not meet the above needs. There is need for urgent policy evaluation to develop growth strategies centered around health. Otherwise times to come will be very hard for the working people with low wages. (IPA Service)