The health of India's healthcare sector | Context India

Summary

Context India's final episode on the COVID-19 crisis in India examines the healthcare system's collapse during the second wave. It discusses the lack of public health investment, oxygen shortages, and the vaccine policy's challenges. The show features interviews with K. Sujata Rao, ex-Health Secretary, and BJP spokesperson Sudan Shu Mittal, debating India's preparedness and response. The episode concludes with pandemic-inspired music reflecting India's cultural resilience.

Takeaways

• 🏥 The Indian healthcare system faced a severe crisis during the second wave of COVID-19, with hospitals struggling due to a lack of oxygen and medical resources.
• 📉 Prior to the pandemic, India's healthcare system had weaknesses, including insufficient investment in public health and a heavy reliance on the private sector.
• 🌐 The Delta variant of the coronavirus significantly intensified the spread of COVID-19 in India, leading to a higher demand on healthcare resources than anticipated.
• 🛑 India's response to the first wave of COVID-19 included the world's largest lockdown, which helped contain case numbers but also contributed to complacency before the second wave.
• 💉 India has a robust vaccine manufacturing capacity, but domestic vaccination efforts were initially slow, and the second wave necessitated a halt in vaccine exports to meet domestic demand.
• 💼 There were missteps in India's vaccination policy, including the involvement of the private sector in vaccine administration, which led to underutilization due to cost concerns.
• 🚀 India's vaccination drive has since made significant progress, with 925 million doses administered by October 2021, and innovative measures like drone delivery to remote areas.
• 📉 The pandemic exposed the chronic underinvestment in India's healthcare system, with public financing of health remaining around 1% of GDP and high out-of-pocket spending.
• 🤝 There is a call for increased state funding in healthcare, with experts suggesting at least 3% of GDP should be allocated to public healthcare financing.
• 🎤 The script features pandemic-inspired music from Indian artists, showcasing the cultural response to the crisis.
• 🔮 While India's experience during the pandemic was devastating, there is optimism that lessons have been learned and the country is better prepared for future health challenges.

Q & A

What is the main focus of the 'Context India' series?

The 'Context India' series focuses on delivering a considered analysis of India, its politics, and its people, with each episode examining a specific facet of the country's biggest crisis since independence, the COVID-19 pandemic.

What were the main issues in India's healthcare sector highlighted by the second wave of COVID-19?

The main issues highlighted were insufficient investment in public healthcare, a severe shortage of oxygen in many parts of the country, and concerns regarding India's vaccine policy.

What is the significance of the delta variant in the context of India's second wave of COVID-19?

The delta variant turbo-charged the spread of COVID-19 in India during the first half of 2021, contributing to the overwhelming pressure on the healthcare system and the high number of cases and deaths.

How did India's healthcare system fare during the first wave of COVID-19 compared to other countries?

India weathered the first wave relatively well, implementing the largest lockdown in the world, which helped contain case numbers despite the chaos caused by its sudden announcement.

What were some of the factors that contributed to the intensity of India's second wave of COVID-19?

Factors included weaknesses in the health system, dismantled temporary hospitals, fragmented center-state coordination, election fever, large gatherings for festivals and elections, and the emergence of the delta variant.

What role did India's vaccine manufacturing capacity play in the global COVID-19 response?

India's vaccine manufacturing capacity is one of the highest in the world, and its supplies were crucial for many countries' vaccination campaigns, including the COVAX program backed by the WHO and UNICEF.

What was the initial state of India's domestic vaccination drive in early 2021?

India's domestic vaccination drive was slow in the early months of 2021 compared to other countries, but the second wave demanded faster action, leading to changes in the vaccination policy.

How did the Indian government address the issue of vaccine shortages and the slow immunization drive?

On March 25, India halted all exports of vaccines to meet domestic demand. The government made several changes to the vaccination policy, although there were missteps and challenges in bringing the immunization network up to full capacity.

What was the controversy regarding the involvement of the private sector in India's vaccination policy?

The controversy centered around the government's decision to involve private hospitals in vaccination efforts, with concerns about high costs charged by private hospitals for vaccines that were free through the state.

How has India's vaccination drive progressed since the peak of the second wave?

India's immunization drive has made significant progress, with 925 million doses administered by the start of October 2021. Efforts to expand distribution, such as using drones for remote locations, and increased domestic production capacity have allowed India to resume exporting vaccines.

What are the key lessons and recommendations from specialists and policy advisors regarding India's healthcare system post-pandemic?

Specialists and policy advisors advocate for a boost in state funding, suggesting at least 3% of GDP should be allocated to public healthcare to improve infrastructure, equipment, drugs, supplies, and particularly the health workforce.

Outlines

00:00

🏥 The Indian Healthcare System's Struggle with COVID-19

In the first paragraph, the host, Frey de Souza, introduces the series 'Context India' focusing on the impact of the COVID-19 pandemic in India. The episode specifically examines the Indian healthcare sector's collapse during the second wave of the virus. Key issues discussed include underinvestment in public healthcare, oxygen shortages, and India's vaccine policy. The conversation includes interviews with Ke Sujata Rao, former Secretary of Health, and Sudan Shu Mittal, BJP spokesperson. The segment also features pandemic art, specifically music by Punjabi indie singer Vipul Verma, reflecting the cultural response to the crisis. The narrative highlights the tweets from hospitals in New Delhi indicating oxygen shortages and the devastating impact of the Delta variant on India's healthcare system.

05:01

🛑 Dismantling of Preparedness and Vaccine Policy Challenges

The second paragraph delves into the weaknesses of India's health system, the lack of preparedness after the first wave, and the fragmentation of center-state coordination. It discusses the impact of elections and festivals on virus spread, the importance of immunization drives, and India's role as a vaccine manufacturer. The narrative covers the slow start of India's domestic vaccination, the halt of vaccine exports, and the challenges in scaling up the immunization network. It also touches on the controversial involvement of the private sector in vaccinations and the high costs that affected vaccine uptake, leading to a slow immunization drive.

10:03

📈 Public Health Financing and the Pandemic's Impact

In the third paragraph, the discussion centers on the need for increased public financing in healthcare to address the inadequacies exposed by the pandemic. It emphasizes the stagnation of public health funding as a percentage of GDP and the high out-of-pocket expenses leading to poverty. The conversation includes an exchange between K. Sujata Rao and Sudan Shu Mittal, where Rao criticizes the lack of public health leadership and the government's failure to utilize the window of opportunity to prepare for the second wave. Mittal argues that the pandemic was an unknown entity that affected the entire world, and India performed admirably given the circumstances.

15:05

🚑 The Central Government's Role in Healthcare Infrastructure

The fourth paragraph focuses on the responsibility of the central government in the lack of healthcare infrastructure, such as oxygen and hospital beds, during the pandemic's second wave. It includes a debate between Rao and Mittal about the government's preparedness and response to the crisis. Rao argues for better public health leadership and decision-making transparency, while Mittal defends the government's efforts, stating that the scale of the pandemic was unpredictable and that the government made sincere efforts to tackle the situation.

20:06

🛡 Controversies and Preparedness for Future Waves

The fifth paragraph discusses the controversies surrounding the government's handling of the pandemic, including allegations of suppressing information and prioritizing political goals. It also addresses the question of preparedness for potential future waves, with Rao emphasizing the need for better data transparency and modeling, and Mittal expressing optimism about India's vaccination program and the lessons learned from the pandemic.

25:15

🎶 Artistic Reflections on the Pandemic

In the final paragraph, the script shifts focus to the artistic community's response to the pandemic, highlighting the diversity of languages and perspectives in their work. The episode concludes with a song titled 'Mahamari,' which translates to 'pandemic,' written and performed by Vipul Verma, showcasing the cultural and emotional impact of the crisis on India.

Keywords

💡Context India

Context India is the name of the show being discussed in the transcript. It is a program that provides an in-depth analysis of various aspects of India, including politics and the people. In the script, it is mentioned as the platform from which the host, Frey de Souza, is delivering the content, focusing on the Indian healthcare sector during the COVID-19 pandemic.

💡Healthcare System

The healthcare system refers to the organized provision of medical services to individuals or communities through various health professionals and allied health fields. In the video, the Indian healthcare system is discussed in the context of its challenges and shortcomings during the second wave of COVID-19, highlighting issues such as insufficient investment and lack of preparedness.

💡Pandemic

A pandemic is an outbreak of a disease that occurs over a wide geographic area and affects an exceptionally high proportion of the population. The script discusses the impact of the COVID-19 pandemic, also known as 'Kovit' in the transcript, on India, particularly focusing on the second wave that overwhelmed the healthcare system.

💡Oxygen Shortage

Oxygen shortage refers to a situation where there is not enough oxygen available, especially for medical purposes such as treating patients with respiratory issues. The script mentions the severe shortage of oxygen in many parts of India during the second wave of COVID-19, which led to tragic outcomes in hospitals.

💡Vaccine Policy

Vaccine policy pertains to the strategies and decisions made by governments or health organizations regarding the distribution, administration, and promotion of vaccines. The script discusses India's vaccine policy during the pandemic, including the challenges faced in ramping up vaccination efforts and the involvement of the private sector.

💡Delta Variant

The Delta Variant is a specific mutation of the SARS-CoV-2 virus, which causes COVID-19. It is known for its high transmissibility and ability to cause more severe disease. In the script, the Delta Variant is mentioned as a contributing factor to the severity of the second wave of COVID-19 in India.

💡Public Health

Public health is the science and art of preventing disease, prolonging life, and promoting health through the organized efforts of society. The script discusses the state of public health in India, emphasizing the underfunding and neglect of the public healthcare system, which contributed to the challenges faced during the pandemic.

💡Immunization Drive

An immunization drive refers to a campaign aimed at increasing the vaccination rates among a population. The script highlights India's efforts to ramp up its immunization drive during the pandemic, including the use of drones for vaccine delivery and the resumption of vaccine exports.

💡Health Financing

Health financing involves the resources and mechanisms used to pay for healthcare services. The script mentions the need for increased health financing in India, suggesting that at least 3% of GDP should be allocated to public healthcare to improve the infrastructure, equipment, and workforce.

💡Pandemic Art

Pandemic Art refers to creative works produced during a pandemic, often reflecting the experiences, emotions, and responses to the crisis. The script mentions a piece of pandemic art music created in India, showcasing the cultural response to the COVID-19 pandemic.

💡Vaccination Network

A vaccination network is the infrastructure and organizational framework that facilitates the administration of vaccines. The script discusses the challenges of bringing India's vaccination network up to full capacity during the pandemic and the subsequent improvements made to strengthen the distribution chain.

Highlights

Context India explores the Indian healthcare sector's response to the COVID-19 pandemic, focusing on the second wave's impact.

Discusses issues of insufficient investment in public healthcare, oxygen shortages, and India's vaccine policy.

Features an interview with K. Sujata Rao, former Secretary of Health for the Government of India, and Sudan Shu Mittal, BJP spokesperson.

Examines the Indian healthcare system's weaknesses and its inadequate response to the pandemic's demands.

Reports on the oxygen crisis during India's second wave, with hospitals running out of supply and its deadly consequences.

Analyzes the Delta variant's role in intensifying the second wave of COVID-19 in India.

Highlights the paradox of India's healthcare system, with a weak public sector and a profit-driven private sector.

Reviews India's initial success in containing the first wave of COVID-19 and the subsequent challenges of the second wave.

Criticizes the lack of preparedness and the fragmented center-state coordination during the second wave.

Details India's vaccine manufacturing capacity and its role in global vaccination efforts.

Discusses the halt of vaccine exports from India to meet domestic demand during the crisis.

Explores the controversy of involving private hospitals in vaccination efforts and the challenges it posed.

Notes the rapid progress of India's immunization drive and efforts to expand vaccine distribution.

Advocates for increased state funding in healthcare to address the underinvestment in India's healthcare system.

Reflects on the long-term impact of the pandemic on India's healthcare sector and the need for systemic improvements.

Concludes with a discussion on India's preparedness for potential future waves of COVID-19 and the importance of learning from past experiences.

Features pandemic-inspired music and art from India, showcasing cultural responses to the crisis.

Transcripts

hello and welcome to context india i'm

frey de souza coming to you from mumbai

on context india we take the time to

deliver a considered analysis of this

country its politics and its people in

each episode in this series we are

taking a close look at a specific facet

of what has perhaps been the biggest

crisis india has faced since

independence the kovit pandemic

this our fourth and final episode we are

examining the indian health care sector

that crumbled under the pressure of the

second wave of cobit 19.

we will be looking at issues of

insufficient investment in public health

care the severe shortage of oxygen in

many parts of the country and india's

vaccine policy

i'll be speaking with ke sujata rao

former secretary of health for the

government of india and sudan shu mittal

national spokesperson of the bjp

at the close of this week's episode will

be an excerpt from a piece of pandemic

art music created in india through the

kobit months this week we're featuring

punjabi indie singer vipul verma

[Music]

in april and may 2021

indian social media space was flooded

with messages like these

[Music]

the second wave of kovid in india was

wreaking havoc and it seemed as though

the country's healthcare system was

going under

on the 1st of may 2021 these were the

tweets being posted by hospitals in the

capital new delhi

we have just run out of oxygen

we are currently surviving on some

oxygen cylinders

over the next 10 minutes that will also

run out about half an hour after this

video message was issued by the

executive director of a private hospital

in new delhi

12 patients there

died when the oxygen ran out

it wasn't the first time during the

second wave that a lack of oxygen

resulted in deaths

the delta variant of the corona virus

turbo charged the spread of kovari in

india in the first half of 2021.

healthcare systems around the world had

struggled with the virus in 2020 there

were stories of medics in new york

wearing garbage bags as ppe

in the uk in january 2021 soldiers were

deployed to chronically understaffed

intensive care awards in the same month

regions in brazil struggled with oxygen

shortages and critically low hospital

capacity

however the crisis in india's healthcare

sector was of a magnitude the country

hadn't seen before

the delta variant alone doesn't explain

the seemingly collapse of so many

hospitals at the most crucial phase of

the pandemic

the indian healthcare system had several

weaknesses even before the kobet

pandemic struck

it did have

some strengths

in the sense that

a rural primary healthcare system was

established right after

independence

but it was very inadequately resourced

and over a period of time failed to

serve the functions it needed to urban

primary healthcare system was still

neglected

right from the very beginning

under the false premise that there would

be adequate number of doctors in urban

areas to serve the urban population so

the healthcare system in india is really

a paradox between a weak

under funded and neglected public health

system and the private sector that is

growing constantly there is also very

deep dependence on the private sector

which caters to a very large proportion

of healthcare delivery in the country so

what we've really ended up with is on

one hand very sub optimal care that is

provided through a weakened uh

public health system and on the other

hand we have the private sector which

operates obviously on a

profit driven model and is operating in

a regulatory vacuum compared with many

other countries india weathered the

first wave of kovid well the government

implemented the largest lockdown in the

world which despite creating chaos due

to its sudden announcement helped

contain case numbers

what happened after the first wave

however very likely contributed to the

intensity of the second wave

it was

in the second wave

that the biggest challenge was thrown at

india's health system a combination of

several factors

first of all we had several weaknesses

in the health system

the level of preparation that we mounted

in the latter half of 2020s in terms of

temporary hospitals started uh becoming

uh dismantled and

then we also saw the centre-state

coordination becoming fragmented and

frayed

because a

variety of reasons not the least of

which were was that because election

fever was on and the virus super highway

to travel across india with the large

crowds gathering for festivals for

religious gatherings and for elections

and

at this time the variance also came in

a key element of the global covid

response strategy has been immunization

drives india's vaccine manufacturing

capacity is one of the highest in the

world and supplies from india were a

crucial factor in the plans put together

by many countries for their own

vaccination campaigns

19 vaccines global access a covax

program backed by the world health

organization and unicef signed

agreements with india in august and

september 2020 for 200 million doses of

vaccine medication

in february 2021 the director general of

the who tweeted this

by mid april 2021 india had donated and

sold a combined of a total of 66 million

doses to nearly 100 countries india's

domestic vaccination drive in the early

months of 2021 had been slow compared to

other countries

but the second wave demanded action on

the 25th of march india halted all

exports of vaccines those supplies were

needed to meet domestic demand

bringing the immunization network up to

full capacity in a short period of time

was not easy though there were many

changes that were made to the

vaccination policy

and along the way there were many

missteps there was of course lack of

preparation when it came to the

production of the vaccine which led to a

situation of shortages and slowed down

the immunization drive at the early

stages another controversial aspect of

the vaccination policy has been

how the government has chosen to at

various points involve the private

sector so that's private hospitals

specifically

in vaccination

that policy announced in mid-april 2021

meant the private hospitals were allowed

to purchase and administer vaccines by

august however the health minister

mansook mandavia reported in parliament

that only seven to nine percent of the

vaccines reserved for private healthcare

companies were being utilized

a key reason for the lack of uptake was

cost many indians were reluctant to pay

high prices being charged by private

hospitals for vaccines that were being

administered for free by the state

less than six months since the peak of

the second wave of kovid in the country

india's immunization drive had made up a

remarkable amount of ground

according to government data at the

start of october 2021

925 million doses have been administered

in the country

in an effort to expand distribution

drones were being tried out to deliver

vaccines to remote locations

and with domestic production

capabilities having increased india was

able to resume exporting vaccines there

are certain strengths to

india's vaccination drive which is one

of the largest in the world

uh

for one it has created very high levels

of of awareness about covet and phobia

vaccination in the public another

positive outcome is that due to the

sheer scale of the drive a lot of

healthcare workers and other kind of

district administrators and you know

staff even in remote areas have been

enlisted

and have been working closely for the

success of the program

we've also achieved to some degree uh

you know the capability of strengthening

the whole chain uh for distribution of

the vaccines while the scale and

strength of india's vaccination network

has been noteworthy the second wave

exposed the chronic under investment and

inequalities in the country's healthcare

system overall

in the aftermath specialists and policy

advisors have advocated a boost in state

funding over

the past few decades

we have seen

public financing of health

stagnate around one percent

of the gross domestic product

it has risen now in the recent years

there is still a high out of pocket

spending that is incurred by a number of

people resulting in poverty so we do

need

much greater health financing at least

three percent of the gdp

as public financing of health care

without that all the vital elements of

the health system

which need to function effectively

whether it is infrastructure equipment

drugs and supplies and particularly the

health workforce will not fall into

place

kovit devastated numerous countries but

india's experience especially during the

second wave was one of the most shocking

pandemic ordeals the covert impact both

in the short and the long term

will be significant especially so in the

health care sector

and so i'm discussing the challenges

india faces with k sujata rao former

secretary of health for the government

of india and sudan

spokesperson of the bjp

welcome to context india my first

question is to the both of you india has

an admirable record when dealing with

the likes of polio smallpox why is it

then that we weren't able to deal with

the pandemic better miss rao

yeah you are right absolutely that you

know we did a tremendous job in dealing

with those two uh pandemics and also in

hiv aids and we have we've done well in

tb and malaria and other

viral infections but this pandemic

really came in as a surprise because it

was very very infectious and also very

lethal and

we were really part of god

mr vital my opening question to you as

well given india's expertise in dealing

with

health pandemics why didn't india deal

with the pandemic better

if you look at the enormity of the

pandemic

it's not just india this spread that

took the entire world

by surprise

if you look at the developed economies

developed countries look at how many

deaths they had

look at how many cases they had and look

at how many deaths which took place in

india

so to say that india did not handle it

is you know erroneous because this is

something which was completely unknown

to the entire world

and if you look at casualties elsewhere

given the size of the indian population

and the casualty all the number of cases

and the size of the population india did

fairly well i mean settle the uh you

know on a competitive scale india did

brilliantly

look at look at the look at the number

of vaccinations india has been able to

achieve so in the perspective if you

look at how things have happened and how

india has done

i think

we've we've done an admirability your

argument that this was an unknown may

have been true in the first wave of 2020

but in the second wave of 2021 we had a

very clear idea of what this virus was

and how it moved around and let me if i

may please call out some statistics

according to the u.n human development

report 2020 india ranked 155 out of 167

countries on hospital bed availability

according to data by the union health

ministry march 17 2020 we had one doctor

per 11 600 indians these statistics show

that we could have been better prepared

if our health care

was stronger which it was not mr

mitchell fight there are two two

different things you are addressing

one is the infrastructure of the country

now the infrastructure of a country is

never built in six months or one year or

two years so yes india given its

population and given its economy has

inadequacy in the infrastructure there

is no denial on that

the issue is how did we deal with the

second wave i mean these are proportions

which nobody could in the world

anticipate there is an infrastructure

issue which because india being a

developing economy has its limitation

but

looking at the infrastructure which was

available

and looking at the vaccination which has

been done the vaccination program has

been so successful and that has led to

the containment of what could have been

the third way this route do you agree

with mr um mithal's argument here

i'm afraid i'd have to respectfully

disagree yes uh this this was a new

virus that really hit us very

uh sharply and we were a little

unprepared for such an attack and much

more unprepared for the second attack

which is of course unforgivable given

the fact that not only have we gone

through way one but we also saw a new

variant that popped up in between and uk

was suffering hugely again with the

backlash of that in december so we ought

to have expected the second wave and got

ourselves ready there was undeniably a

lot of complacency that drove the second

day of disaster

now where i say why i disagree is that

yes it's true that the health system

is weak in india it's fragile largely

because of the political neglect over

the last 77 years whatever from 1947

because the amount we spent on it is so

miniscule and it continues today but if

you ask me one reason why we

failed to do as well as we could have

and we had the capacity and the

knowledge to do better was because of

the failure of the public health

harder not being there public health

leadership not being there in india it

was literally driven by technical

people who are not public health

specialists advising the pm advising the

policy makers and they made several

missteps which could easily have been

foreseen by any public health expert

so you know there were some mistakes

made and he paid clearly for that and at

least now what i worry about

statements made by political leaders

like mr mitchell is when you feel that

oh it was overwhelming and we did very

well it's a nice feel-good factor that

okay we battled it out but in that we

forget that we need to see that it never

happens again but as of as a point i

would like to say that i think that we

need to be more humbled by the

experience we've gone through

many of the deaths and suffering could

have been avoided we could have we had

the capacity and the knowledge in india

to be to have done better

if only the public health leadership was

allowed

in space and

if that lesson is not

then i would say this experience is not

lost on us mr vital during the second

wave people weren't just dying of covet

they were reportedly dying of a shortage

of oxygen and a shortage of hospital

beds

what responsibility does the central

government bear for that

you know as i said the inadequate

health infrastructure is a legacy issue

really to apportion it to the government

of the day would be most unfair

you don't uh

make hospital beds in a day i mean it's

it's not like putting up a tent

the government did well in uh not only

the census damage i would say all the

state governments did equally well in

trying to augment the

medical availability of beds see when

you are planning you you look at the

first wave 8 000 cases a day is maximum

you would say probably what can it go to

it can go to 12 000 it can go to 14 000.

it can go to 62 000. you don't

anticipate that it will go to 38 000 or

40 000 cases a day in a city like delhi

when you get the statistics of doctors

per million population or beds yes

it is a fact this country has inadequate

infrastructure because it's a developing

country it has limited resources these

resources are spread over all all

sectors

but

how did we respond to the challenge is

the most important issue yes there was

an oxygen shortage because nobody

anticipated that this kind of an oxygen

requirement could be there i'm not

saying bjp government did this the

opposition government did this no no i'm

not getting into that at all because i

think every government realizing the

enormity of the situation

made its the best effort to really

tackle the issue which they did they

could have they were delays yes they

were delays they were as i said there's

no benchmark of perfection yes things

could always have been better for

everything

but

did was there sincerity yes there was

sincerity was there a genuine effort yes

there was a general effort was

ultimately

uh

the effort succeeded yes that is it i

take it to miss rao who has worked with

the health ministry for over two decades

mr if you want to respond to mr um you

know mr mitchell's point that it was no

way to predict the number of cases that

our cities actually saw creep up on a

daily basis you know

it is a fact and i agree with him there

that you can never really i mean a

health system can only be

expel

expanded or readied up to a point uh

even the best health system like italy

had was overflowing with patients onto

the streets is largely because the way

which and this variant really hit us but

far more cases than the system could

open yes it's true that you could never

expect the kind of demand for oxygen

that came up due to foreign it was way

beyond and uh beyond expectations and

our ability to be ready but we ought to

have been ready the problem is that our

modeling was so poorly done because data

was not put out so we didn't have good

modeling and that went to bring in the

complacence saying babe

everything is okay there's nothing to

worry and wave two was not expected and

that's where we fail and that's the

reason why we ought to be transparent

and give the data out because only the

country can only benefit by more data

being

made available in the public domain so

better research comes in the kind of

modeling exercises that were based on

which decisions were taken is truly

appalling and completely indefensible so

yes it was overwhelming i do agree 40

000 cases that dave

is something that that you know every

day so many patients coming in was

difficult but was the effort educate no

it was not and had we been aware that

this kind of calamity could happen we

would have been better prepared like we

are now for third wave this kind of

preparation is what we ought to have

done when we got that window uh thanks

to the uh forward cases coming down

from november december january february

the four months we that went in

was a wasted opportunity mr mithal a

question for you and i'm reading out of

the new york times dated september 14

2021 which said senior officials uh from

the government forced scientists at

elite institutions to downplay the

threat of kovid

to prioritize mr modi's political goals

what is your response to this i think it

is a typical case of venom being stood

new york times has never questioned the

us government

when it came to seven and a half lakh

deaths in u.s

new york times has questioned its

government i believe that's a factual

error you know verbosity comes very easy

i can make any kind of allegations it

must be something which is backed by an

empirical evidence it is backed by

something a mere statement being quoted

by new york times becomes gospel truth

so when we look at ourselves we look at

ourselves with facts and figures i am

thankful to sujati to concede that these

were not things which could have been

anticipated miss rao uh i i come back to

you to respond to uh mr mithal do you

also believe that uh the government did

a fair job in making those decisions you

know i would want to get into this blame

game i'm i do feel that even the best of

us if you were there there would have

been some element of

confusion and delays because of the

nature of the pandemic and the way it

rolled out but having said that there

were some

situations that could have been averted

as i said if they'd had a far more

inclusive and more transparent way of

decision making and discussions and even

in a vaccine policy i agree with mr

mitchell we have done very well i mean

it is amazing that we've been able to

cover 900 million people with a single

shot but only 25 of our population has

two shots which is full protection so

there is a long way to go and we could

have achieved a much better

the previous ambition of the prime

minister to have us all vaccinated

completely by december could have been

realized had we

taken did what we did in april had we

done it

way back last year in november itself

and in january 4th when the two vaccines

were approved people have placed orders

and there were so many other uh steps

that could have been uh

taken up at that time my question to mr

mithal of all of the decisions being

made by government now do you think we

are adequately prepared for a third wave

of anything else that might hit our

public health sector i think the proof

of the pudding is isn't it seating while

the third wave has hit a lot of

countries how it is affecting india is

for everybody to see and the reason why

it has been contained is largely because

of the vaccination program which the

country has undertaken i would also say

that because of the third way being

contained it has given the nation a

confidence that the resolve of uh

fighting up in the menace like a

pandemic can be

successfully

solved if if you have the resolution

determination which the government with

the country is shown

and i i am very optimistic that uh the

lessons which

uh this unexpected uh

hair to unknown

disease

has uh given the nation those lessons

have been well understood well

well learned

and the government and the people of

this country are prepared for it

thank you both for speaking to us and

for giving us your time

and finally there are a multitude of

artists in india who created work

through the long months of the pandemic

we wanted to feature some of the varied

languages they work in and the

perspectives they bring

this week we're closing with an excerpt

of a song in punjabi titled mahamari

which translates to pandemic it was

written and performed by vipul varma

thank you for watching context india

here on al jazeera english

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foreign

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