Expressing extreme disappointment with the Health Ministry’s inadequate response to the Covid-19 pandemic, the Indian Medical Association (IMA) on May 8, 2021 demanded the ministry wake up from its slumber.

The organisation condemned the Centre for ignoring the recommendations of experts along with a plea for a well-planned, pre-announced national lockdown to allow time for the health infrastructure to recoup, replenish both material and labour, and break the chain of infection.

“However, the central government had refused to head to implement lockdown resulting in the mounting of new patients beyond four lakhs every day and the number of moderate to severe cases are increasing to nearly 40 percent. Sporadic night curfews have not done any good. Life is [more] precious than the economy,” said IMA President J A Jayalal in a press release.

The IMA also called for equitable, affordable, universally available vaccines for individuals above 18 years. However, the central government failed to ensure sufficient vaccine stock of vaccines for the same. People from the 18-44 age group cannot avail the free vaccines from the central share of 50 percent, as per the differential pricing system proposed by the union government.

IMA asked, “The jeopardy of private practitioners and states to negotiate with manufacturers for pricing and stock resulted in exorbitant price rise and vaccine shortage. When Rs. 35,000 crores were allotted in the budget, with which the maximum required 200 crore vaccine doses are purchasable, why the central government is shedding its responsibility?” 

It reminded both that small and medium private hospitals have had zero stock of vaccines over the last one week. Further, the IMA talked about the lack of oxygen supply for patients despite adequate production. Members appealed to authorities to address this issue of distribution on a “war footing” as imported oxygen concentrators and plants are yet to reach beneficiaries.

The panic has resulted in judicial activism, even though no medical professionals or organisations were consulted while this situation worsened. Accordingly, Jayalal called for increased testing and tracing, genome sequencing to identify and respond to variants. Voicing a concern that such studies were decreasing, it called for dedicated doctors to focus on the virus mutants and propose measures at the earliest.

Regarding the fatality rate, he argued that the inaccurate counting is affecting Covid-appropriate behaviours and denying insurance benefits for families. He said, “We have lost 756 doctors in the first wave and in the second wave more than 146 doctors have died within a short period. Hundreds of deaths happening in big hospitals are shown as non-Covid deaths and crematoriums are showing housefull boards. RTPCR negative, but CT positive cases are not counted. Why are we trying to hide actual deaths?” 

The IMA also talked about issues of shortage of drugs including steroids, its illegal marketing, hoarding and sale. It mentioned that price capping and systemic tracking could help matters however the government has not removed GST on masks, PPE kits and lifesaving drugs.

Similarly, the IMA demanded that IPC provisions protect health care workers from increasing violence. Further, the health care administration should be revamped with Indian Medical Service cadets, well-versed with technical and administrative skills for effective execution of healthcare.

Notably, the medical association demanded a new integrated Ministry with a dedicated Minister to deal with the pandemic. Members also demanded an increase in the healthcare budget from one percent to 8-10 percent of GDP and to use earmarked budgets to ensure universal vaccination.

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The Ministry of Health and Family Welfare’s decision to suspend compliance requirements under the Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) rules was met with widespread criticism. On April 4, the Union Ministry of Health and Family Welfare issued a notification that effectively suspended implementation of Rule 8, Rule 9(8) and Rule 18A(6) of the Rules,1996 until June 30, 2020. These requirements were related to renewal of registration of genetic labs and imaging centres as well as submission of reports by these labs and imaging centres to Appropriate authority and further obligations of the Appropriate Authority.

The notification states that this is being done “in view of the emergency situation arisen due to pandemic COVID-19, whereby entire country has been put under lockdown.”

A mere reading of the notification gives an impression that these requirements, which are the main facets of the law which keep these imaging centres and genetic labs in check and prevents the nuisance of sex selection, were being completely suspended until June 30. After the widespread criticism it received and the raising concerns over the menace of sex determination and impending threat of female foeticide, the Ministry has issued a notification for clarifying its stand. The Press Information issued a clarification which states,

“It is reiterated that each Ultrasound clinic, Genetic Counselling centre, Genetic Laboratory, Genetic Clinic and Imaging Centre would have to maintain all the mandatory records on day to day basis, as prescribed under the Law. It is only the submission deadlines to respective Appropriate Authorities which have been extended till June 30, 2020. There is no exemption (to the diagnostic centres) from compliance to the provisions of the PC&PNDT Act. All records are mandatory and have to be maintained as per the Rules and the said Notification in no way impacts the requirement of stringent implementation of the PC&PNDT Act and Rules.”

This makes the government’s stand very clear now about maintenance of records by labs and imaging centres, while only postponing the submission date of such records. This clarification is welcome especially serving as a more clear directive to these labs and imaging centres that are running as Essential Services amidst the nation wide lockdown.

The PIB press release can be read here

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