The standing committee on Home Affairs recently submitted a report on the management of COVID-19 and related issues. Among other issues, the committee made a specific set of recommendations for safeguarding the interests of migrant workers including the creation of a national database.
The Standing Committee on Home Affairs submitted a report on ‘Management of COVID-19 and related issues’ in December 2020. The report broadly covers preparedness, improvement in health infrastructure, and the social and economic impact of the pandemic. It also makes a mention of the lessons learnt from this experience. This report was submitted about one month after the standing committee on Health released a report on the same issue.
Committee appreciated efforts of government, MoHFW, AIIMS and other institutions
The committee appreciated the government’s efforts in managing the pandemic and also the imposition of lockdown to delay the peak infections, mop up healthcare infrastructure, and the announcement of relief to the vulnerable under PM Garib Kalyan Yojana. It also appreciated the government’s efforts to bring back Indians stranded abroad. Appreciating the efforts of AIIMS, Health Ministry, and other institutions involved, the committee extended its gratitude towards the frontline healthcare workers and the Corona warriors who lost their lives while on duty. The committee also felt that there are some areas that governments should look into to ensure better preparedness in case of future pandemics
Disparity in public and private health facilities revealed by the pandemic
The committee appreciated the efforts put in by the central and state governments by overcoming the infrastructural hurdles and quickly responding to the situation by increasing testing capacity, availability of beds, testing centres, medical equipment, etc. The committee highlighted that the pandemic revealed the disparity in the health infrastructure in public and private facilities. Private facilities are expensive and inaccessible for many.
The committee called on the government to allocate more funds and strengthen the public health infrastructure, which will also be useful to handle future pandemics. It also said that the availability of health infrastructure and development should be ensured in rural and remote areas. It was also observed that private facilities charged exorbitantly high rates for COVID-19 treatment and called for regulatory oversight on hospitals to ensure that insurance claims are not rejected blindly. In the long run, the committee felt that government should aim at making COVID-19 treatment cashless for those covered under insurance.
Data should be made available for research taking care of privacy concerns
Precise studies on test rate, recovery, and fatality rate are vital for discerning the pattern, opined the committee. It further added that the testing facilities were not uniform across states and arrangements should be made to ensure that adequate health infrastructure is available in all districts. This was emphasized in the report of the Committee on Health as well. Furthermore, the committee stated that relevant data should be made available for the research community to provide inputs for managing the pandemic. The data should be such that it adheres to data anonymization and privacy laws. The committee also recommended that an open and transparent data sharing mechanism should be put in place for the public, scientists, and health professionals to access which would help in strengthening pandemic control.
Over-pricing, black marketing and other malpractices should be monitored
Another concern raised by the committee is the sale of beds by private hospitals, black marketing, and overpricing of some medicines used for the treatment of the coronavirus infection. The committee noted that people should be made aware of the inexpensive and effective repurposed medicines so that they do not end up spending a lot of money on expensive drugs. Efforts should be made to ensure that quality medicines are available for all at a subsidized rate, especially during pandemics.
The committee highlighted the need to devise a comprehensive Public Health Act, preferably at the national level such that it helps to monitor and control private hospitals to curb malpractices. The Act should also keep a check on the black marketing of medicines and product standardization.
AYUSH medicines and treatment can also be considered for dealing with the pandemic
Further, it was also recommended to include other cost-effective medicines including AYUSH medicines. Even the health standing committee report emphasized using AYUSH medicine and treatment to fight the pandemic. Both the committees suggested that AYUSH has huge potential to prevent and treat the ongoing pandemic. Patients and common people were recommended to have herbs and spices as part of their diet and practice Yoga to boost immunity.
Emergency Use Authorization of vaccines should be given after due consideration
While the report was being drafted, no application was received for the grant of Emergency Use Authorisation (EUA) of COVID-19 vaccines. The Health Ministry also informed the committee that as per the records, Central Drug Standard Control Organization (CDSCO) had not approved any vaccine in the past for emergency use authorization. The committee recommended that all mandatory requirements should be fulfilled and trials in all phases must be complete on a sufficient sample size. EUA should be given by the government only after due consideration and caution.
DGCI granted restricted use approval for indigenous Bharat BioTech Vaccine
The Drugs Controller General of India (DCGI) gave restricted use approval for the indigenous Bharat Biotech & Serum Institute of India’s vaccine and phase III clinical trial approval for Cadila’s vaccine. The Indian vaccine was first tested successfully on mice, rats, rabbits, Syrian hamster, and non-human primates. Phase I and Phase II trials were carried out involving around 800 people and the results were positive. About 22,500 persons of 25,800 in phase III of trials got the vaccine and data proved that the vaccine was safe, according to the press release. Interim data of Cadila’s vaccine in Phase I/II trials covering about 1000 persons in India suggested that the vaccine was safe and immunogenic.
Epidemic diseases Act should be revisited since it is outdated
COVID-19 was declared a notified disaster in India so as to provide funds under State Disaster Response Fund. The National Disaster Management Act, 2005 was invoked by the centre to lay down uniform guidelines for the entire country. The National Disaster Management Authority is actively involved in fighting the pandemic. While lauding the efforts of the authority, the committee expressed that a separate wing may be formed under NDMA specialised in handling pandemics in the future.
The Epidemic Diseases Act, 1897 is outdated and was framed in a pre-colonial era even before the Spanish Flu which struck more than a century ago. The committee suggested that the Act be revised and updated so as to address challenges out of unprecedented events in the future. The committee noted that Disaster Management Act (NDMA), 2005 is meant for addressing natural disasters that occur every year and not meant for pandemics.
Committee made recommendations to safeguard migrant workers
According to the committee, the sudden imposition of lockdown resulted in an unprecedented disruption. The intra-state and inter-state movement of people and goods came to a standstill because of the lockdown. Further, the shutdown of economic activities resulted in severe social and economic consequences for migrant labourers, factory workers, and daily wage earners who were the most affected. The uncertainty resulting from the untimely dissemination of information about the arrangements made for food, shelter, and other facilities is what led the migrants to leave for their home states, as per the Committee. The halt in economic activities impacted the unorganized sector more than the rest. The committee made the following recommendations on this issue.
- Inter-State Migrant Workmen (Regulation of Employment and Conditions of Services) Act, 1979 provides for payment of minimum wages, journey allowance, residential accommodation, medical facilities, etc. The Government has also enacted the Unorganized Workers’ Social Security Act, 2008 to provide for social security and welfare of unorganized workers including migrant workers. Lack of data is what is said to have hindered the delivery of relief measures for migrant workers. The committee pointed out the ineffective implementation of the migrant workmen act and called for the preparation of a comprehensive National Database on migrant workers at the earliest. The database should include details on source and destination, past employment details, and the nature of skills. Aadhar linked National Database should be maintained for vulnerable sections of society.
- Labour laws, including the Inter-State Migrant Workmen (Regulation of Employment and Conditions of Services) Act, 1979 should be revisited by the government to strengthen and implement the legislation in letter and spirit.
- Due to inter-state movement of persons and in such times of crises, the committee recommended that interstate operability of ration cards be permitted until One- Nation One Ration Card is implemented since no one should be left out from PDS of food grains.
The committee noted that there should be proper implementation of the schemes and interventions of the government and the benefits should reach all. The Home Ministry told the committee that it would record the lessons learnt and best practices for reference in case of future pandemics.
Featured Image: Standing Committee on Home Affairs on Covid-19