Lok Sabha Question No. 3168 (UNSTARRED), answered on 2021-08-06
Subject: Policies to Prepare for Future Pandemics
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Lalubhai Babubhai Patel, Bheemrao Baswanthrao Patil, Khagen Murmu

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

## LOK SABHA UNSTARRED Q. No 3168 TO BE ANSWERED ON 6 th  AUGUST 2021

## POLICIES TO PREPARE FOR FUTURE PANDEMICS

## 3168. SHRI LALUBHAI BABUBHAI PATEL:

SHRI B.B. PATIL:

SHRI KHAGEN MURMU:

Will the Minister of Health and Family Welfare be pleased to state:

- a) whether  the  Government  has  taken  cognizance  that  apart  from  strengthening  the vaccination  drive,  there  is  an  urgent  need  to  develop  health  policies  to  improve preparedness for third wave or future pandemics;
- b) if so, the initiative(s) taken/being taken by the Government in this regard; and
- c) the measures taken/being taken by the Government to strengthen coordination between natural and social scientists to enable translation of scientific findings into public health policies and practices?

## ANSWER THE MINISTER OF STATE IN THE MINISTERY OF HEALTH AND FAMILY WELFARE (DR. BHARATI PRAVIN PAWAR)

(a) to (c)

Health is a state subject. Government of India has provided the required technical support and has  also  supported  the  states  through  logistic  and  financial  support  to  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  non-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 hospitals under ESIC, Defence, Railways, paramilitary forces, Steel Ministry etc. Further, many large temporary  treatment  facilities  were  established  by  DRDO  to  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 the first lockdown (as on 23 rd March 2020) in being enhanced continuously and is currently at 18,03,266 isolation beds and 1,24,598 ICU beds (as on 3 rd August 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 28 th May 2021, a total of 10,250 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 industrial use of oxygen.
-  A dynamic and transparent framework for allocation of medical oxygen in consultation with States/UTs and all the stakeholders such as relevant Ministries, 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 medical oxygen from all medical facilities and to track their transportation.
-  To avoid wastage of medical oxygen, guidelines on rational use of oxygen were issued on 25 th September 2020, and further revised and disseminated to States on 25 th April 2021.
-  1,02,400 oxygen cylinders were procured 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  (54,000 jumbo cylinders (D type) and 73,000 regular cylinders (B type). Deliveries of the same have started and 73,352 (56,108 B-type and 14,244 D-type) cylinders have been delivered as on 3 rd August 2021.
-  To  generate  oxygen  at  the  health  facility  level,  PSA  plants  are  being  established  in  each district hospitals, especially in far flung areas enabling the hospitals to become self-sufficient in generation of oxygen for their needs and thereby, reduce the burden on the medical oxygen supply grid across the country.
-  Further, to fast-track the availability of Medical Oxygen in rural and peri-urban areas, more than 39,000 oxygen 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  in 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  with respect to COVID-19  related drugs including availability through inter-departmental consultations.

-  Remdesivir is  a  patented  drug,  manufactured  in  India  under  voluntary  licenses  granted  by Gilead  Life  Sciences  USA  (the  patent  holder)  to  7  Indian  pharmaceutical  companies. 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 manufacturing sites were approved by the CDSCO, thus increasing the manufacturing sites from 22 (in March 2021) to 62 (June 2021).
-  All States/UT and State Drugs Controllers have been requested to verify stock of drugs and check other malpractices and take effective steps to curb hoarding and black marketing of some drugs like Remdesivir.
-  Department  of  Pharmaceuticals  and  the  Drug  Controller  General  of  India  (DCGI)  have actively  coordinated  with  the  industry  to  enhance  availability  of  Amphotericin  B  through identification of manufacturers, alternate drugs and expeditious approvals of new manufacturing facilities.
-  Besides, the  existing  five  manufacturers,  DCGI  had  issued  permissions  to  manufacturing  / marketing of Amphotericin B Liposomal Injection to six additional firms.
-  The guiding principle to avert/ minimize the risk of future resurgence of COVID-19 cases in the country remains the five-fold strategy of test-track-treat-vaccinate  and  COVID appropriate behavior.
-  Ministry of Health & Family Welfare continues to provide technical guidance for managing various aspects of COVID-19. So far more than 150 guidelines/advisories/SoPs/plans 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 pediatric age 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.
-  In September 2020, the Union Government further allowed use of SDRF by the States for 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 financial year 2019-20. The ceiling was further enhanced 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  the States/UTs towards the India COVID-19  Emergency  Response and Health System Preparedness Package.
-  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 Component & Rs 8,123 Cr as State component) and is to be implemented from 1 st

July 2021 to 31 st March 2022. So far Rs. 1827.78 crore has been released to States/UTs in 2021-22 under ECRP Phase-II in FY 2021-22.

It includes support to State/UT level for ramping up Health Infrastructure including those in rural, tribal and peri-urban areas closer to the community, providing support for procurement of  drugs  and  diagnostics  to  enhance  service  delivery  at  district  and  sub  district  levels  for management of COVID-19 cases (including pediatric care) and for maintaining a buffer of 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, under the National COVID Vaccination Program, Government of India is procuring vaccines and providing them free of cost to States and UTs. As on 3 rd August 2021, a total of about 50.21 crore doses have been supplied to States/UTs from all sources i.e. Government of  India's  Covid  vaccine  supply  free  of  cost  to  all  States/UTs,  State/UTs  and  Private Hospitals procured Covid vaccine.

The  COVID-19  response  strategy  since  inception  is  supported  by  expert  groups  comprise  of epidemiologists,  scientists,  microbiologists,  clinicians  etc.  drawn  from  eminent  institutions including  World  Health  Organization.  Further,  the  research  community  and  pharmaceutical industry  including  vaccine  manufacturers  have  supported  COVID-19  response  in  terms  of research and development of vaccines, as well as their production.

Union Ministry of Health through Department of Health Research has also been commissioning studies to find answers to pressing research questions related to COVID-19. These projects have been awarded and funds provided to ICMR and non-ICMR scientists in various important areas.

In  addition,  recently  Indian  Council  of  Medical  Research  had  put  out  a  call  for  proposals, inviting concept proposals in various areas related to COVID-19. These include clinical research, epidemiology, operational & socio-behavioral research and diagnostics & biomarkers. Selected proposals with public health translational value will be funded after scientific review by ICMR.