Is our response to pandemics and health emergencies missing organized medicine?

Bobby Ramakant *

When health emergencies occur it is the doctors and other healthcare providers who are on the frontlines in responding to the humanitarian and public health crises. But they along with those impacted are not just part of the ‘problem’ but also key to effective solutions. Along with most affected people, it is the frontline healthcare providers who should be shaping responses to the pandemics and health emergencies.

Associations of different medical specialities must join forces to give input to the government to help improve responses to pandemics like COVID-19 and other health emergencies. Same holds true for networks of other healthcare providers and key actors who have a critical role to play in such crises. Failing on organized medicine will only defeat us on the goals that public health and sustainable development initiatives are trying to achieve. Also let us remember that it was healthcare workers who were on the frontlines in the severest phases of the COVID-19 pandemic.

The 13th national conference of AIDS Society of India (13th ASICON) in Hyderabad, India, opened with an important session hosted by Organized Medicine Academic Guild (OMAG) of India – a network of over 15 professional medical associations in the country including Association of Surgeons of India (ASI), Indian Academy of Paediatricians (IAP), AIDS Society of India, Indian Associations of Opthalmologists, Orthapaedicians, Anaesthesiologists, INDUSEM, NCDC, among others. This OMAG session at the 13thASICON was chaired by noted HIV leaders Dr Basavraj Sajjan and Dr Prakash Bora.

Dr Suneela Garg, President of OMAG and Professor of Excellence (Community Medicine) at Delhi’s Maulana Azad Medical College (MAMC) said that Organized Medicine Academic Guild of India was founded in 2018 mandated to support the UN Sustainable Development Goals agenda of the Indian government. “It is our collective vision that will help accelerate progress towards achieving health of our societies,” said Dr Garg.

“Global health security is one of the biggest challenges for a highly diverse and populous nation like India. That is why OMAG is already unifying different medical experts’ associations to improve responses to antimicrobial resistance, TB, trauma, non-communicable diseases (NCDs), infectious diseases, health emergencies and pandemics. “These health emergencies and pandemics need clinical and public health solutions” emphasized Dr Suneela Garg.

Dr Suneela Garg reiterated the commitment made for global health security six years ago (2016) when Indian Prime Minister and then USA President had jointly endorsed the global health security agenda. “Need of the hour is to bring people’s health centrestage with measurable impacts at national level” said Dr Suneela Garg.

One world one health

Ensuring quality healthcare services for everyone worldwide is so vital. Dr Garg highlighted the commitment for expanding the universal healthcare coverage to one billion, protecting another one billion people from health emergencies, and ensuring one billion are enjoying better health and wellbeing worldwide. These are interim goals towards health for all worldwide. “One World One health agenda must be the unifying force” reinforced Dr Garg. Global Work Plan of The World Health Organization (WHO) also echoes the priorities listed by OMAG leaders.

Prof Sagar Galwankar, Director for Research and Development, Florida State University; Scientific Chair of OMAG; and former Director of American College of Academic International Medicine, said although past infectious disease outbreaks like ZIKA and EBOLA had crossed geographic boundaries giving the first taste of fast infection-spread and raising global health security concerns when organisms and infections spread. Infections like COVID-19 had hampered the security of a nation. Infections are among the greatest risk to health security, said Prof Galwankar.

Prof Sagar Galwankar echoed Dr Garg’s commitment to work on antimicrobial resistance and multidrug resistant organisms. Lack of public health convergence in terms of education, research and care is a challenge. Deeply entrenched disparities and inequalities are another major challenge when it comes to ensuring health for all. He also said that emergency medicine, family medicine, infectious diseases, toxicology, or other such disciplines are in infancy currently. If we do not develop them quickly enough then it will severely limit our response.

Coordinated response is key. Connecting care, competencies and culture is a challenge, he said.

Dr Ishwar Gilada, Secretary General of OMAG and President of 13th ASICON said that “OMAG responded during COVID-19 and continues to do so for ensuring our response is backed by science and evidence, and takes into account important recommendations emerging from OMAG member associations of different medical specialities. In a country with over 1.4 billion population, we have 8944 serious and critical COVID-19 cases as of this week, though even one case is a case too many.

We need to stick to reason, science and evidence. Instead of comparing number of cases or deaths in a country, we should stick to number of cases or deaths per million population for comparative analysis and emerging disease trends. India stands at 2nd position worldwide in number of cases, or no.3 in total COVID-19 deaths globally. But if we look at number of cases per million, then India stands at 149th position worldwide and number 135th position if we look at deaths per million population.

With 97% of eligible population having received the first dose of COVID-19 vaccine and 85% of these fully vaccinated, and almost similar part of the population having been exposed to the virus, immunity against COVID-19 is reasonably high in India, thereby risk of another catastrophic wave is perhaps minimal – though we need to be vigilant against emerging variants, said Dr Gilada.

Dr Gilada said that we should expect infectious disease like COVID-19 to be with us for few years, but hopefully as an endemic and we better learn to live with it. Disaster management and preparedness plans and those addressing global health security must also include organised medicine.