The Lancet Citizens’ Commission on Reimagining India’s Health System that was launched in December 2020 has proposed eight urgent recommendations in response to the alarming resurgence of Covid 19 in the country. Among the key recommendations includes that central systems should procure and distribute COVID-19 vaccines free of cost . This would be a departure from the current policy of decentralised procurement through state governments. There is still time to stem the haemorrhage of life and the suffering caused by COVID-19 in India. We call on the central and state governments to act with urgency and in solidarity with each other and across sectors to address one of the greatest humanitarian crises facing the country since its independence, the Commission authors have written in an article published in The Lancet today. Among the Commission's authors are 21 experts including Gagandeep Kang, Professor in the Department of Gastrointestinal Sciences, Christian Medical College, Devi Shetty, Chairman, Narayana Hrudayalaya Limited, Bengaluru, Vikram Patel, Professor, Harvard T.H. Chan School of Public Health, Cambridge, USA and others The recommendation that the central systems should procure and distribute Covid 19 vaccines free of cost would minimise cross-state inequities that may result from differential fiscal and capacity contexts. By May 19, 2021, only 3% of India’s population was fully vaccinated;16 up to 250 million COVID-19 vaccine doses are estimated to be needed each month to equip vaccination drives to full capacity and the country only has around 70–80 million doses per month, the Commission authors have observed. Vaccination is a public good and should not be left to market mechanisms, they have said. There must be a transparent national pricing policy and caps on the prices of all essential health services apart from clear, evidence-based information on the management of COVID-19 should be widely disseminated, including guidance on what not to do, the Commission has recommended. Among other recommendations include, community engagement and public participation at the heart of India’s COVID-19 response, with no restrictions on civil society organizations to access resources; there must be transparency and sharing of government data to enable districts to proactively prepare for the likely caseloads in the coming weeks and surveillance needs to include urgent investment in genomic sequencing. The authors have also said that the profound suffering and risk to health caused by loss of livelihoods should be minimised by making provisions for cash transfers by the state to workers in India’s vast informal economy who have lost their jobs and requiring businesses not to lay-off their workers. According to Prof Patel, “The humanitarian crisis the resurgence has precipitated requires all persons in central and state governments to set aside their political differences and work in solidarity with each other, and with civil society, to implement the eight clearly articulated recommendations in our article”.
