Can India's COVID-19 emergency be fixed without politics?
Authors: Kunal Saha
Journal: The Lancet (2021)

Although the 2021 surge of COVID-19 infection and death in India was aptly analysed by the Editors,1The LancetIndia's COVID-19 emergency.Lancet. 2021; 3971683Summary Full Text Full Text PDF PubMed Scopus (95) Google Scholar the two-pronged strategy strategy suggested to fix this problem overlooked a crucial aspect: the widespread corruption that has plagued the Indian health-care system for a long time.2Sachan D Tackling corruption in Indian medicine.Lancet. 2013; 382: e23-e24Summary Full Text Full Text PDF PubMed Scopus (20) Google Scholar From the beginning of the pandemic, the Indian Council of Medical Research (ICMR), an apex body responsible for the handling of the COVID-19 pandemic, approached the pandemic with a method of non-transparency, and some of the therapies it promoted appeared to be influenced more by political reasons than scientific evidence. For example, early in the pandemic, the ICMR went on a massive campaign to promote hydroxychloroquine for COVID-19, echoing similar political clamour made by Donald Trump. More shockingly, even after WHO stopped the multinational Solidarity trial of hydroxychloroquine against COVID-19 (because of serious adverse effects) and a large meta-analysis reported that hydroxychloroquine not only has no positive effect but also might increase mortality in patients with COVID-19 when used with azithromycin (a common practice in India),3Fiolet T Guihur A Rebeaud ME et al.Effect of hydroxychloroquine with or without azithromycin on the mortality of coronavirus disease 2019 (COVID-19) patients: a systemic review and meta-analysis.Clin Micro Infect. 2021; 27: 19-27Summary Full Text Full Text PDF PubMed Scopus (210) Google Scholar the Indian National Task Force of the ICMR issued clinical guidance on April 22, 2021, recommending that doctors in India use hydroxychloroquine for the treat­ment of home-bound patients with COVID-19.4Indian Council of Medical ResearchClinical guidance for management of adult COVID-19 patients.https://www.icmr.gov.in/pdf/covid/techdoc/COVID19_Management_Algorithm_22042021_v1.pdfDate: April 22, 2021Date accessed: May 9, 2021Google Scholar It is questionable why Indian authorities have continued to promote the use of hydroxychloroquine in combating COVID-19 while ignoring overwhelming medical evidence against it. The Indian Health Minister, himself a registered physician in allopathic medicine, caused huge national upheaval when he claimed on national television, without any scientific basis, that Coronil, a herbal drug, can actually prevent and cure COVID-19.5Menon S Coronavirus: the misleading claims about an Indian remedy.https://www.bbc.com/news/56172784Date: March 2, 2021Date accessed: May 9, 2021Google Scholar Even the Indian Medical Association, usually a close ally of the Indian Health Ministry, had to criticise such reckless promotion of a questionable therapy by the health minister.5Menon S Coronavirus: the misleading claims about an Indian remedy.https://www.bbc.com/news/56172784Date: March 2, 2021Date accessed: May 9, 2021Google Scholar There is no doubt that India urgently needs to change its course to curb the ongoing rampage by the second wave of infections by boosting the existing vaccination policy in a transparent manner and implementing meaningful measures to minimise virus transmission. Unfortunately, these crucial changes to save tens of thousands of Indians are not likely to happen until the deep-rooted corruption in the Indian medical system is eradicated. KS isthe founding president of People for Better Treatment. Further details of competing interests are available in the appendix. Download .pdf (.08 MB) Help with pdf files Supplementary appendix India's COVID-19 emergencyThe scenes of suffering in India are hard to comprehend. As of May 4, more than 20·2 million cases of COVID-19 had been reported, with a rolling average of 378 000 cases a day, together with more than 222 000 deaths, which experts believe are likely to be substantial underestimates. Hospitals are overwhelmed, and health workers are exhausted and becoming infected. Social media is full of desperate people (doctors and the public) seeking medical oxygen, hospital beds, and other necessities. Yet before the second wave of cases of COVID-19 began to mount in early March, Indian Minister of Health Harsh Vardhan declared that India was in the "endgame" of the epidemic. Full-Text PDF