Lok Sabha Question No. 1859 (UNSTARRED), answered on 2021-07-30
Subject: Improving Health Infrastructure to Counter Pandemics
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Geetha Viswanath Vanga, Kotha Prabhakar  Reddy, Manne Srinivas Reddy, Komati Reddy Venkat Reddy

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED Q. No 1859 TO BE ANSWERED ON 30 th JULY, 2021

## IMPROVING HEALTH INFRASTRUCTURE TO COUNTER PANDEMICS

## 1859 SHRIMATI VANGA GEETHA VISWANATH :

SHRI KOTHA PRABHAKAR REDDY

SHRI MANNE SRINIVAS REDDY

SHRI KOMATI REDDY

SHRI VENKAT REDDY

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- ( a) whether  the  Union  and  States  have  taken  steps  for  the  improvement  of  heal infrastructure to brace successive waves of the COVID - 19 pandemic;
- ( b) if so, the details thereof and the future action plan thereon, phase/State/UT -wise; and
- ( c) the  details  of  improvement  in  health  infrastructure  pre  and  post  COVID - 19  pandemic covering public and private hospitals along with funds sanctioned and utilized th State/UT/year - wise?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE

(DR. BHARTI PRAVIN PAWAR)

(a) to (c) : Although Health is a state subject, Government of India has provided the requ technical  support  and  has  also  supported  the  states  through  logistic  and  financial  su further strengthen the existing health infrastructure to tackle COVID - 19 pandemic.

Some of the ongoing initiatives to further strengthen healthcare infrastructure include:

- With the intent to reduce the risk of cross infection to non - COVID  patients  as  well  as  to maintain  continuity  of  no n- COVID  essential  health  services  in  the  country,  a  three - tier arrangement of dedicated COVID - 19  health  facilities [(i) COVID Care Center (CCC); (ii) Dedicated COVID Health Centre (DCHC) and (iii) Dedicated COVID Hospital (DCH)] has been implemented in the country.

- Government of India, to supplement the hospital facilities has roped in tertiary care under ESIC, Defence, Railways, paramilitary forces, Steel Ministry etc. Further, many temporary  treatment  facilities  were  established  by  DRDO  t o  manage  surge  in  COVID - 19 cases in the country.
- The isolation bed capacity and ICU bed capacity which was only 10,180 and 2,168 before first lockdown (as on 23 rd March 2020)in being enhanced continuously and is currently at 18,02,949 isolation beds a n  1,24,514 ICU beds (as on 28 th July 2021).
- The  daily  liquid  medical  oxygen  (LMO)  supply,  which  was  about  1292  MTs  per  day  in February 2021 increased to 8593 MTs in April 2021. On 28th May 2021, a total of 10,2 MTs of LMO was allocated to the states. This was done by enhancement of LMO production in steel plants as well as in other LMO plants. Restrictions were imposed on industria oxygen.
- A dynamic and transparent framework for allocation of medical oxygen in consultation States/UTs and all the stakeholders such as relevant Ministri es, manufacturers/suppliers of liquid oxygen etc. was prepared.
- Online  digital  solutions  viz.  Oxygen  Demand  Aggregation  system  (ODAS)  and  Oxygen Digital Tracking System (ODTS) have been developed to ascertain the demand for medica oxygen from all medical facilities and to track their transportation.
- To avoid wastage of medical oxygen, guidelines on rational use of oxygen were issued 25 th September 2020, and further revised and disseminated to States on 25 th April 2021.
- 1,02,400 oxygen cylinders were p rocured in April and May of 2020 and distributed to States. Further  orders  for  additional  1,27,000  cylinders  have  been  placed  on  21.04.2021  (54 jumbo cylinders (D type) and 73,000 regular cylinders (B type). Deliveries of the same started and 53,0 56 (40,729 B - type and 12,327 D - type) cylinders have been delivered as on 26 th July 2021.
- To  generate  oxygen  at  the  health  facility  level,  PSA  plants  are  being  established district hospitals, especially in far flung areas enabling the hospitals to b ecome self - sufficient in generation of oxygen for their needs and thereby, reduce the burden on the medical o supply grid across the country.
- Further, to fast - track the availability of Medical Oxygen in rural and peri - urban areas, more than 39,000 oxy gen concentrators have been allocated to various States.
- A  COVID  Drugs  Management  Cell  (CDMC)  has  been  set  up  in  the  Department  of Pharmaceuticals  (DoP)  to  oversee  the  management  of  smooth  supply  of  drugs  used  i COVID - 19 management.
- A Drugs Coordination Committee (DCC) has been constituted as an institutional mechanism under Department of Pharmaceuticals for efficient decision making on all the issues respect  to  COVID - 19  related  drugs  including  availability  through  inter - departmental consultations.
- Remdesivir is a patented drug, manufactured in India under voluntary licenses grant Gilead  Life  Sciences  USA  (the  patent  holder)  to  7  Indian  pharmaceutical  compani Manufacturing  capacity  was  augmented  from  38  lakh  vials  per  month  in  March  2021  to nearly 122 lakh vials per month in June 2021. In addition, 40 additional manufacturin

were approved by the CDSCO, thus increasing the manufacturing sites from 22 (in Marc 2021) to 62 (June 2021).

- All States/UT and State Drugs Controllers have been r equested to verify stock of drugs and check other malpractices and take effective steps to curb hoarding and black marketi some drugs like Remdesivir.
- Department  of  Pharmaceuticals  and  the  Drug  Controller  General  of  India  (DCGI)  hav actively  coordi nated  with  the  industry  to  enhance  availability  of  Amphotericin  B  throu identification of manufacturers, alternate drugs and expeditious approvals of manufacturing facilities.
- Besides, the existing five manufacturers, DCGI had issued permissions to manufacturing / marketing of Amphotericin B Liposomal Injection to six additional firms.
- Ministry of Health & Family Welfare continues to provide technical guidance for manag various aspects of COVID - 19. So far more than 150 guidelines/advisories/SoPs/p lans have been provided to States/UTs. Taking note of ingress of COVID - 19 pandemic in peri - urban and rural areas, Ministry of Health & Family Welfare on 16 th May 2021 issued an SOP on COVID - 19 Containment & Management in Peri - urban, Rural & Tribal areas.
- Further COVID- 19 treatment protocols and advisories both for adults as well as pediatri groups were issued and widely disseminated to promote rational use of drugs and oxygen.
- During  the  F.Y.  2019 -20.  funds  to  the  tune  of  Rs.1113.21  crore  was  released to  the States/UTs  under  NHM  towards  management  and  containment  of  COVID - 19  pandemic. Details are given at Annexure - I.
- In September 2020, the Union Government further allowed use of SDRF by the States f oxygen  generation  and  storage  plants  in  hospitals; strengthening  ambulance  services  for transport of patients; and setting up containment zones, COVID - 19 care centres. States were allowed to spend maximum 35% of annual allocation of funds under SDRF for the financi year 2019 - 20. The ceiling was further e nhanc d to 50% during the financial years 2020 - 21 and 2021 - 22 for containment measures of COVID - 19.
- During  the  FY  2020 - 21,  funds  to  the  tune  of  Rs.8257.88  crore  has  been  released  to  t States/UTs towards the India COVID - 19 Emergency Response and  Health  Sy stem Preparedness Package. Details are given at Annexure - II .
- In addition, 'India COVID - 19 Emergency Response & Health System Preparedness Package: Phase II' has also been approved by the Cabinet with Rs 23,123 crores (with Rs. 15,000 Cr as Central Componen t & Rs 8,123 Cr as State component) and is to be implemented from 1st July 2021 to 31" March 2022.

It includes support to State/UT level for ramping up Health Infrastructure including rural, tribal and peri - urban areas closer to the community, pr oviding support for procurement of drugs and diagnostics to enhance service delivery at district and sub district management of COVID-19 cases (including pediatric care) and for maintaining a buffer drugs,  support  for  IT  Interventions  such  as implementation  of  Hospital  Management Information System and expanding access to tele - consultations in all districts, and support for capacity building and training for all aspects of management of COVID - 19.

- Further, u nder the National COVID Vaccination P rogram, Government of India is procuring vaccines and providing them free of cost to States and UTs. As on 25 th July 2021, a total of about 44.91 crore doses have been supplied to States/UTs from all sources i.e Governme India's Covid vaccine supply f ree of cost to all States/UTs, State/UTs and Private Hospita procured Covid vaccine.

## Central Release of Grants in aid for management and containment COVID - 19 (in Rs. Crores)

| S. No.   | Name of the State /UTs             | Central Releases 2019- 20   |
|----------|------------------------------------|-----------------------------|
| 1        | Andaman & Nicobar Islands          | 0.74                        |
| 2        | Andhra Pradesh                     | 37.11                       |
| 3        | Arunachal Pradesh                  | 8.91                        |
| 4        | Assam                              | 72.73                       |
| 5        | Bihar                              | 66.79                       |
| 6        | Chandigarh                         | 1.04                        |
| 7        | Chhattisgarh                       | 25.97                       |
| 8        | Dadra & Nagar Haveli               | 0.52                        |
| 9        | Daman & Diu                        | 0.45                        |
| 10       | Delhi                              | 22.26                       |
| 11       | Goa                                | 1.48                        |
| 12       | Gujarat                            | 29.69                       |
| 13       | Haryana                            | 37.11                       |
| 14       | Himachal Pradesh                   | 18.55                       |
| 15       | Jammu & Kashmir (including Ladakh) | 29.69                       |
| 16       | Jharkhand                          | 25.97                       |
| 17       | Karnataka                          | 59.37                       |
| 18       | Kerala                             | 74.21                       |
| 19       | Lakshadweep                        | 0.22                        |
| 20       | Madhya Pradesh                     | 55.66                       |
| 21       | Maharashtra                        | 74.21                       |
| 22       | Manipur                            | 5.94                        |
| 23       | Meghalaya                          | 5.94                        |
| 24       | Mizoram                            | 3.71                        |
| 25       | Nagaland                           | 3.71                        |
| 26       | Orissa                             | 37.11                       |
| 27       | Puducherry                         | 0.74                        |
| 28       | Punjab                             | 40.82                       |
| 29       | Rajasthan                          | 85.35                       |
| 30       | Sikkim                             | 2.98                        |
| 31       | Tamil Nadu                         | 48.24                       |
| 32       | Telangana                          | 33.40                       |
| 33       | Tripura                            | 7.42                        |
| 34       | Uttar Pradesh                      | 132.09                      |
| 35       | Uttarakhand                        | 18.55                       |
| 36       | West Bengal                        | 44.53                       |
|          | Grand Total                        | 1,113.21                    |

## Note:

1. For the FY 2020 - 21, the UT of Dadra & Nagar Haveli and Daman & Diu have been combined.

Annexure - II - 19 Emergency Response and

## Central Release of Grants in aid under the India COVID Health System Preparedness Package during the FY 2020- 21 (in Rs. Crores)

| S. No.   | Name of the State /UTs           | Central Releases   |
|----------|----------------------------------|--------------------|
| 1        | Andaman & Nicobar Islands        | 14.80              |
| 2        | Andhra Pradesh                   | 422.67             |
| 3        | Arunachal Pradesh                | 21.96              |
| 4        | Assam                            | 216.69             |
| 5        | Bihar                            | 193.94             |
| 6        | Chandigarh                       | 35.92              |
| 7        | Chhattisgarh                     | 109.21             |
| 8        | Dadra & Nagar Haveli & Daman Diu | 4.67               |
| 9        | Delhi                            | 787.91             |
| 10       | Goa                              | 17.65              |
| 11       | Gujarat                          | 304.16             |
| 12       | Haryana                          | 187.71             |
| 13       | Himachal Pradesh                 | 54.48              |
| 14       | Jammu & Kashmir                  | 194.58             |
| 15       | Jharkhand                        | 70.84              |
| 16       | Karnataka                        | 409.63             |
| 17       | Kerala                           | 573.96             |
| 18       | Ladakh                           | 44.77              |
| 19       | Lakshadweep                      | 0.79               |
| 20       | Madhya Pradesh                   | 286.57             |
| 21       | Maharashtra                      | 1,185.12           |
| 22       | Manipur                          | 19.92              |
| 23       | Meghalaya                        | 14.82              |
| 24       | Mizoram                          | 8.86               |
| 25       | Nagaland                         | 10.27              |
| 26       | Orissa                           | 146.44             |
| 27       | Puducherry                       | 23.35              |
| 28       | Punjab                           | 165.28             |
| 29       | Rajasthan                        | 426.39             |
| 30       | Sikkim                           | 7.16               |
| 31       | Tamil Nadu                       | 868.09             |
| 32       | Telangana                        | 386.37             |
| 33       | Tripura                          | 23.21              |
| 34       | Uttar Pradesh                    | 541.56             |
| 35       | Uttarakhand                      | 72.25              |
| 36       | West Bengal                      | 295.28             |
|          | Total                            | 8,147.28           |
|          | Health Insurance                 | 110.6              |
|          | Grand Total                      | 8,257.88           |