Recent protests by IMA and other doctors’ groups against lacklustre performance by the government may kindle a ray of a new hope to find medical justice for hapless patients in India
THE REPORT that the Indian Medical Association (IMA) and other medical groups in India have started to step forward to openly criticize the shocking failure of the government to curb the devastating second wave of COVID-19 pandemic and setting up emergency clinics to help vulnerable COVID-19 victims, must be viewed as a welcome sign by ordinary people across India. But why has the COVID-19 situation suddenly turned into a massive medical catastrophe in India?
India spends only about 1 percent of its gross domestic product (GDP) on healthcare which is one of the lowest in the world. Little wonder that public healthcare infrastructure in India is a shambles even though large private hospitals in India are making hefty profits from hapless patients largely due to almost non-existent regulation of medical expenses.
Although the BJP-led Indian government has recently proposed a major increase in the healthcare expenditure for the next budget year (2021-2022), the crumbling health infrastructure for almost 1.4 billion people needs a lot more funding to fix the present dilapidated healthcare status in India so that the gruesome pictures of COVID-19 patients perishing from lack of oxygen and dead bodies of COVID-19 victims floating in the river are never seen again.
But apart from the severely inadequate funds in the health budget, a complete lack of proper checks and balances in medical education and healthcare regulatory systems also played perhaps an even bigger role for the present abysmal condition of public health in India. Widespread corruption has plagued Indian medical system for a very long time.
Apart from severely inadequate health budget, a complete lack of proper checks and balances in medical education and healthcare regulatory systems also played perhaps an even bigger role for present abysmal condition of public health in India
In 2014, the Indian health minister publicly called the Central Drug Standard Control Organization (CDSCO) a “snake pit of vested interests” and dubbed Indian Medical Council (MCI), highest governmental authority for regulation of medical education and practice of medicine, a “corrupt” organisation.
Despite horrific stories of death of patients from medical negligence appearing on TV and newspapers on a regular basis across India, hardly any doctor is found guilty by the doctor-only members in the MCI and state medical councils (SMCs) as public frequently erupts in protest demanding medical justice.
The actions taken by the Indian Council of Medical Research (ICMR), the top medical authority responsible for control of COVID-19, have also raised serious questions on many occasions. During the initial phases of the COVID-19 pandemic, the ICMR widely recommended “off-label” use of an unproven anti-malarial drug, Hydroxychloroquine (HCQ), in COVID-19 patients based on anecdotal evidence and ignoring warnings from the American Heart Association (AHA), American College of Cardiology (ACC) and Heart Rhythm Society (HRS) for potential heart failure of patients with pre-existing cardiac conditions.
Despite horrific stories of death of patients from medical negligence appearing on TV and newspapers on a regular basis across India, hardly any doctor is found guilty by the doctor-only members in the MCI and state medical councils (SMCs) as public frequently erupts in protest demanding medical justice
More than one year later when the world medical community has almost totally rejected any use of HCQ in COVID-19 and even after systemic reviews of major multi-national clinical trials reported that not only HCQ has no beneficial role against COVID-19, it can also increase the mortality rate when used with Azithromycin in COVID-19 patients, the ICMR has continued recommending HCQ to combat COVID-19.
It is also unfortunate that in order to keep an unblemished image before international communities, Indian authorities have continued to report a grossly reduced number of infection and death as a result of COVID-19. A high court in India recently chastised the government and dubbed the large number of deaths of COVID-19 patients as a result of short supply of oxygen as a “criminal act, no less than genocide”.
But despite such shocking and frequent evidence of transgression, there is no report of anyone ever held accountable or punished for these colossal failures in the management of the COVID-19 pandemic in India.
Actions taken by Indian Council of Medical Research (ICMR), the top medical authority responsible for control of COVID-19, have also raised serious questions on many occasions
There can be no argument that the recent fervor shown by the IMA and other doctors’ groups to protest for the first time against the lacklustre performance by the government may kindle a ray of a new hope to find medical justice for hapless patients in India. But serious introspection and changes in the “self-policing” policy by Indian doctors are essential before public trust for our healers can be restored in India.
Along with a resolute boost in the health budget by the government, medical education and healthcare delivery system in India must also be freed from all extraneous influences by unscrupulous leaders from different political parties.
And most important, conscientious citizens and compassionate doctors must speak up jointly against the visible medical atrocities and corruption to build a robust public awareness to bring an end to the ongoing rampage by the COVID-19 pandemic in India. As the great Elbert Einstein once said, “The world will not be destroyed by those who do evil, but by those who watch them without doing anything”.
This write up was first published in the British Medical Journal as a letter to editor. Author is the founding-president of "People for Better Treatment" (PBT), a national charitable organization (NGO) in India dedicated to promotion of better healthcare and medical education system in India. PBT is also involved in fight against Indian Council of Medical Research (ICMR) and Indian health ministry on the use of unapproved drugs against COVID-19 and other failures in COVID-19 pandemic.