Is this the time to rethink about the Restructuring in global health system?

Kathmandu : Health system is a channel or network for the delivery of health service from the top level to the grassroot people to achieve the minimum health standards. The components of health system are
Health policy, human resource for health, Finance, Leadership, Logistics and commitment from all stakeholders.

The COVID‐19 pandemic has challenged health systems around the globe and exposed a myriad of fault lines, demonstrating how critically important the healthcare supply chain is to health systems and as a consequence, to the well‐being of individuals, families, and communities.

Supply chain inefficiency and its brittleness in times of crises have been a well‐noted barrier in low‐ and middle‐income countries, but the graphic descriptions of preventable death through absence of effective personal protective equipment (PPE) in developed economies is both chastening and
confronting.

Currently The vaccination against covid-19 is moving on the rapid scale in developed countries, and is Tortoise pace in developing countries like Nepal.

In order to gain the herd immunity, vaccination should be in 1 Standard deviation of population i.e. at least 66% of the population needs to be vaccinated which still requires much time to reach that threshold.
Previously we used to think Clinicians and Nurses are sufficient to drive the health system but this pandemic teach us we are absolutely wrong because, we are facing a huge morality among the hospitalised cases.

At the beginning the US scientists and experts had predicted that the mortality will be in the range of 0.25-0.26 million but today it is nearly in the range of 0.6 million. Similarly see the figure in Brazil, Italy, Germany, France,UK, Mexico which we have been taught as the best health care system of the world. Epidemic forecasting has a dubious track-record, and its failures became more prominent with COVID-19.

Poor data input, wrong modeling assumptions, high sensitivity of estimates, lack of incorporation of epidemiological features, poor past evidence on effects of available interventions, lack of transparency, errors, lack of determinacy, consideration of only one or a few dimensions of the problem at hand, lack of expertise in crucial disciplines, groupthink and bandwagon effects, and selective reporting are some of the causes of these failures.

Does this indicate the global failure of the global health system?

The answer is yes. It is because if the Global health system is much better the second wave and the third wave must not be much devastating. Global health system failed because clinicians and nurses are overrated and other
human resource for health are underrated.

This clearly indicates something is missing in our health system which tells us to restructure global health system. This pandemic will remain for years and Years and the current mortality is nearly 3% which gives the mass mortality and is a public health emergency.

The biomedical model of health is a very narrow concept because health is
multidimensional concept and is a multifactorial causation. Health isn’t only determined by body physiology ,causative agent and body immunity . It has a lots of immediate, underlying and root causes. and Until and unless the root cause is identified complete diagnosis and treatment isn’t
possible.

Conclusion: As Health is the multidisciplinary concept so it should be addressed in a comprehensive approach not in a selective way. Globally preventive approach should be the primary focus rather than treatment of disease. It doesn’t mean preventive approach is one and only solution but is cost-effective and should be prioritized matter. All the health professionals
have their own role and if we expect a lot form clinicians we are going to the hell.

This pandemic tell us countries having better health system isn’t the determining factor to control covid, it’s the health politics and leadership that plays the vital role too (eg China , Cuba,) .Still coordination, cooperation between and among health professionals ,NGOs ,INGOs and Government agencies is a must to fight against second and third wave of covid since we need to increase the vaccine
coverage.

Indra Prashad Acharya (Health Professional)
Student at IOM (MPHN )