Covid-19: Why is India faring worse than its neighbours?

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 Covid-19: Why is India faring worse than its neighbours?

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• India surpasses Brazil, set to overtake US in incidence: Covid-19 cases continue to rise in India. World’s second most populous nation has a teeming informal sector and poor health infrastructure, all factors that explain the disproportionate spread of the disease.
• Comparison with South Asian countries mirrors the global trend: The country has overtaken Pakistan and will leave Bangladesh behind in the next few days in incidence while acing the leader-board for number of deaths. Sri Lanka has recorded no increase in positive cases or deaths after the end of July. 
• What did India get wrong: India’s per capita income is second only to Sri Lanka in the region. Bangladesh and Pakistan are among the least developed countries in the world, and Pakistan is struggling economically. India’s dismal fight against Covid then has to do with its government’s response and a history of insufficient attention to public health.
• India’s response: The government imposed a complete lockdown but failed to apply the same rigour to testing, tracing, isolating and treating the affected. The lockdown bought it some time, but the country did not use it to ready its health infrastructure. With little financial help from the government, distressed migrant workers journeyed home in poor conditions and this accelerated the spread of the disease.
• History of poor public health: The failure can’t be attributed to the government’s incompetent response alone. Health statistics before Covid point towards years of neglect.
• Health expenditure: India’s health expenditure as a percentage of government spending is the lowest among the five countries. And although its per capita health spending is higher than that of Bangladesh, Pakistan, and Nepal, it’s critical to note that its per capita income is also higher. 66% of health spending is out-of-pocket expenditure. 
• Other indicators: The country’s life-expectancy-at-birth is higher than Bangladesh and Nepal. Its child mortality rate is among the highest in the region, nearly four times worse than Sri Lanka’s. 
• Ayushman Bharat: BJP’s flagship healthcare insurance scheme that promises to provide health cover to the underprivileged is a step towards improvement of healthcare in the country. But it has proved ineffective in Covid times. National Health Authority (NHA) reported a drop of 51% in average weekly claims during the lockdown. 
• The most disappointing part: The monumental loss of lives and inability to arrest the spread of the virus still has not impelled the government to increase investment significantly or take a hard look at its strategy.

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