Lancet Citizens’ Commission offers recommendations on COVID-19 surge

The recommendations span a wide gambit of actions that must be taken to manage the situation

In response to the alarming resurgence of COVID-19 in India, authors drawn from The Lancet Citizens’ Commission and its network of fellows have proposed eight urgent recommendations in an article in The Lancet.

The Lancet Citizens’ Commission on Reimagining India’s Health System was launched in December 2020 to lay out a roadmap to achieving universal health coverage in India over the next decade.

These recommendations are focussed on the immediate steps central and state governments must take to help curtail the loss of life and suffering caused by COVID-19 amid the recent surge in cases. The article synthesises and amplifies the suggestions already being made by grassroots workers and experts across the country. 

The recommendations span a wide gambit of actions that must be taken to manage the situation: first, the organisation and financing of essential health services must be decentralised to districts; second, there must be a transparent national pricing policy and caps on the prices of all essential health services; third, clear, evidence-based information on the management of COVID-19 be widely disseminated, including guidance on what not to do; fourth, all available human resources, including the private sector, must be marshalled for the COVID-19 response and adequately resourced and supported; fifth, central systems to procure and distribute COVID-19 vaccines free of cost should be established in a departure from the current policy of decentralised procurement through state governments; sixth, community engagement and public participation must lie at the heart of India’s COVID-19 response, with no restrictions on civil society organisations to access resources; seventh, there must be transparency and sharing of government data to enable districts to proactively prepare for the likely caseloads in the coming weeks and surveillance needs to include urgent investment in genomic sequencing; finally, the profound suffering and risk to health caused by loss of livelihoods should be minimised by making provisions for cash transfers by the state to workers in India’s vast informal economy who have lost their jobs and requiring businesses not to lay-off their workers. 

These recommendations reflect the collective wisdom of twenty-one experts (full list of authors appended below) from India across academia, civil society, and the private sector, including many who have played leadership roles in India’s health system.