In a hard-hitting letter, the Indian Medical Association (IMA) has slammed the Union ministry of health and family welfare (MoHFW), saying it is "astonished to see the extreme lethargy and inappropriate actions" from the department in combating the agonizing crisis caused by the devastating second wave of the Covid-19 pandemic.
In the letter, IMA says, the equitable, accessible, and affordable vaccination for all above 18 years were demanded by the Association based on scientific facts from 6th April onward and after persistent call of prime minister Narendra Modi with his innovative qualities assured the nation, the vaccination drive was started from 1st May.
"It is unfortunate, the health ministry has failed to make the necessary required roadmap and ensure vaccine stock, resulting in most of the places where vaccination could not be rolled out for people above 18 years," the IMA says, adding, "When the Prime minister notification is not implemented scrupulously, who is to be blamed?"
"Wake up from slumber and respond to mitigate the growing challenges in covid pandemic," says, IMA, which has about 327,207 members.
Considering differential Covid vaccine pricing system as un humanistic, the IMA says people in the age group between 18 and 45 years are forbidden to get the free vaccination from the Central share of 50% and they are placed under the mercy of the state governments. "The jeopardy of private practitioners and states to negotiate with manufacturers for pricing and stock resulted in exorbitant price rise and vaccine shortage."
Noting that the collective consciousness, proactive cognizance, and requests made by the IMA and other professional learned colleagues are put into the dustbin, the association says, the decisions are taken without realising the ground realities.
During the past 20 days, IMA says it has been insisting on the need for complete, well- planned pre-announced national lockdown rather than few states declaring lockdown ranging for 10 days to 15 days - for getting breathing time for the health care infrastructure to recoup and replenish both the material and manpower.
"Lockdown will break the chain of devastating spread," IMA says. However, the Union government had refused to implement the lockdown resulting in mounting of new patients beyond four lakhs every day and the number of moderate to severe cases are increasing to nearly 40%, it alleged.
Mentioning that "sporadic night curfews have not done any good", the IMA stressed, "Life is precious than the economy."
Giving example of eradication of smallpox and polio in 1997 and 2014, the IMA said it could only happen by adopting the universal free vaccination and not by differential pricing system.
When Rs35,000 crore was allotted in the budget, the IMA said, with which the maximum required 200 crore vaccine doses are purchasable.
"Why the central government is shedding its responsibility?" asks IMA, adding "unless the government comes out and implements with willingness and steadfastness for equitable distribution, we will not be able the achieve the goal".
For the last seven days, it says no vaccine is available in small and medium private hospitals.
"The crisis of oxygen is deepening every day and scores of people are succumbing to Oxygen mismatch supply and it is creating panic both among patients and fraternity. Though there is enough production, it is often the distribution which is not proper," the Association says.
According to IMA, even after 15 days of the crisis the Union government is not seen at the forefront to solve these issues and resulting in people knocking at the doors of courts to get justice, resulting in judicial activism.
"Health care professional organisations are neither consulted nor the health minister in this whole pandemic had time to interact with modern medicine professional organisations to solve this issue. Imported oxygen concentrators and oxygen plants are yet to reach the beneficiaries."
As the time is running out with the impending crisis lest we deepen the crisis, solve it on a war footing, the Association appeal, saying "Though various mutants are identified yet the real hazard is not explained in actual terms. Dedicated experts shall be designated to study this and propose mitigation measures at the earliest."
The IMA also raised question over the government hiding actual Covid deaths. "Why are we trying to hide actual deaths? If the public comes to know about the actual deaths, their seriousness to adopt Covid-appropriate behaviours will rise."
The IMA demanded to revamp the entire health care administration with Indian Medical Service (MS) cadre who are well versed with the technical and administrative skill for effective execution of healthcare.
"We also demand to establish a new integrated ministry to serve in this pandemic with a dedicated, proactive, vibrant, innovative, and altruistic minister and alleviate the fear of people by leading from the front.
"We propose for augmentation of infrastructure, materials, and manpower by enhancing health care budget to be raised from 1% of gross domestic product (GDP) to minimum 8% to 10% of the GDP, and judiciously use the earmarked budget amount for ensuring equitable and affordable universal vaccination," IMA concludes.