KOCHI: Soumya Swaminathan, the former chief scientist at the World Health Organisation, was in Kochi on Friday to speak at the 5th Kulapathi Dr K M Munshi Memorial Oration. She spoke to TNIE on the challenges faced by the healthcare system in India, the Kerala model of dealing with infectious diseases and the significance of universal health coverage in improving the health of populations.
Q. Kerala has been facing challenges relating to infectious diseases. What might be the reason? How can we tackle the situation?
We are seeing infectious diseases everywhere. It is a trend due to climate change. Especially vector-borne diseases, the patterns are changing, the prevalence is increasing, and are diagnosed in new areas. We need to investigate in detail why Nipah is reported in Kozhikode. One Health (WHO initiative for an integrated, unifying approach to balance and optimise the health of people, animals and the environment) is important.
Q. Where do you rank Kerala in dealing with health emergencies?
Kerala has a good system of surveillance. The public health response is good. It is partly because of the devolution of responsibilities and powers to the local bodies and panchayats. That is very unique to Kerala. Community participation in all matters, including health issues, allows decisions to be taken and carried out effectively. Because of high literacy, people are also well-informed.
Q. Several attempts have been made to create awareness about HIV in India. However, many misconceptions persist. What are your thoughts on India dealing with the situation?
HIV is an infection which has a stigma around it as it is a sexually transmitted disease. When we have a stigma around the disease, it is an additional barrier. The new cases of HIV are mostly reported among the high-risk groups -- homosexual individuals and intravenous drug users. These are communities that are marginalised and afraid of being punished. Therefore, they remain hidden. That is the biggest challenge in dealing with HIV.
Q. India has a long way to go in achieving Universal Health Coverage (UHC). How can we improve the health system through UHC?
Universal health coverage is the only way that can improve the health of the population. UHC needs continued and increased financing. The Ayushman Bharat programme has come a long way in addressing the public health aspects, focusing on primary healthcare. A certain amount of universal health coverage is the delivery of health services. We often forget the prevention aspects of universal health coverage. Health promotion and disease prevention are important. Because, otherwise, people are going to be sick. In India, we know people have a life expectancy of 70 but a healthy life expectancy of only 60. People spend 10 years with a lot of comorbidities and diseases. That puts a big burden on the health system.
Q. What’s the biggest takeaway in 2023 for you?
In 2023, I got out of the field of curative health and got more into the field, where I can do more to improve wellness and well-being by attending to other factors that determine our health.