The Covid-19 Pandemic has mercilessly pointed out the vulnerability we all share. Our shared vulnerability to a global crisis like a pandemic is beyond borders, beyond the global North-South disparity and some would argue it is beyond the development dichotomy. The reason, I believe, most countries failed to cope with the sudden outburst of Covid-19 is the unpreparedness of their health system. Be it the United States of America, or Russia most countries prioritize their economy or military over the health sector. Whereas innovation and development in the military sector get a high state priority, the health sector does not receive the same. And the consequence of such biases is what we had to endure in the past two years. Some upgrading was needed in this sector for quite some time. The pandemic accelerated the need to do so. But how effectively it has been able to do so? And to what extent?
The Post-Pandemic Health System: A Global Perspective
Domesticating Medical Supplies
Ngozi Okonjo-Iweala, the Chair of the board at Gavi, the Vaccine Alliance, and former Nigerian Finance Minister, believes that Covid-19 will force countries to do some serious re-examination of their supply chains for critical health and livelihood products. The realization that the medical and pharmaceutical costs of a pandemic can surpass the investments in research and prevention will lead to a surge of nationalism. Especially, nationalism in terms of supporting domestic production of medicines, vaccines, medical equipment, etc. Moreover, as of June 2022, 72.09% of people in high-income countries had been vaccinated at least once whereas only 17.94% of people have been vaccinated in low-income countries. This status quo is defined as ‘vaccine apartheid.’ Due to WTO’s intellectual property rights rules, high-income countries were able to stockpile Covid-19 vaccines and treatments. This in return delayed the response of low-income countries to buying vaccines and accounted for a huge loss of life. As a response, a lot of countries in the global South attempted to make their vaccine to curb the domestic demand. Bangladesh also tried its luck in vaccine production. Beximco Pharmaceuticals Ltd built a facility for the Covid-19 vaccine by corresponding with entities like Serum Institutions of India, Pfizer, and Moderna. Incepta Pharmaceuticals also signed a deal with a Chinese company to manufacture vaccines. However, this trend of manufacturing local vaccines that has been introduced by Covid-19 is not only limited to it. Recently, Incepta introduced Bangladesh’s first cervical cancer vaccine, ‘Papilovax.’ 
Doctors Without Borders
There is an ongoing debate about whether isolationism will prevail in the post-pandemic world or trans-nationalism will transform it. No matter what side you are on, there is no way of denying that a global problem like a pandemic needs global assistance. This was clearer than ever when countries supported each other by supplying health front liners, vaccines, and other necessities. Organizations like Médecins Sans Frontières (Doctors Without Borders) have changed the traditional health care scenario. They executed their operations in Europe, America, Hong Kong, and other Southeast Asian countries. Their team is still conducting projects in more than 70 countries to respond to Covid-19. The success and wide acceptance of MSF tell that transnational and global healthcare organizations similar to it are likely to increase in the near future to tackle unforeseen pandemics and create a pool of global doctors without borders.
Flexible Hospital Designs
This pandemic has shown the importance of critically utilizing every space available. Tents in the parking lot, and patients lying on a bedsheet in the corridor in need of assistance were common scenarios in 2020 when the pandemic was at its peak. Many lives have been lost due to the absence of proper assistance because the hospitals were filled to the brim and had no other option but to let patients wait outside. Therefore, a flexible design with adequate arrangements now should be a priority for hospitals. Covid-19 was not a one-time situation. More pandemics as such are prophesied to arrive sooner than we can imagine. Therefore, the rooms need to be flexible and able to morph into emergency units in times of crisis. The ventilation systems should be able to transform the rooms into negative pressure ones so that no harmful airborne particles can travel through them to other rooms. The pathways also need to be redesigned to allow minimum traffic and work independently to ensure isolation when needed.
Digitization and Private Sectors
Annie Batson, an executive director of WomeLift Health and Stanford Global Health, believes that Covid-19 will transform the global health community’s acceptance and use of digital health technologies. She expressed her opinion through this phrase- “You can’t put the genie back in the bottle.” Global health systems around the world are accepting and utilizing technologies that only a few months ago were side-lined and were thought impossible to adopt. Once adopted, the use of technology will only increase, not specifically to solve Covid-19 but also to resolve the problems we were facing prior to it.
However, such advancement in technology is not possible only through public initiatives. Especially in a country like Bangladesh where only 5.43% of the budget is allocated for the development of the health sector. In such circumstances, private initiatives are the best alternative. Private and corporate ventures introduce new health technology and products into the market. Moreover, they also provide grants for research in this sector.
The Post-Pandemic Health System: Innovations in Bangladesh
Many new technologies were introduced during the pandemic. And with great surprise, the mass welcomed those technologies without any prior experience of using them. This welcoming response acted as a great incentive for companies to experiment with more technologies. Moreover, the flaws in the public health system made it crystal clear that the government alone cannot digitize the system and requires great support from the private sector, either in the form of public-private partnerships or private investments. A lot of independent ventures and start-ups started to focus on various pain points during the lockdown. For example, Crack Platoon Transport Service took an oath to ease up the hardship faced by the frontliners during the national lockdown. The lack of transport availability made it difficult for them to provide their valuable services. As a solution, Crack Platoon Transport Service deployed 22 buses for 22 individual routes exclusively for healthcare workers. They authorized and provided services for 100+ hospitals. And 1796 frontline workers were transported with more than 19204 trip requests.
The reason to believe this practice will sustain even after Covid-19 is the fact that the technologies are currently being used to address the challenges that preoccupied us before it.
For instance, Robi launched a co-branded digital insurance service app to offer hospital cash back, in-app doctor consultations, and health-related information services. During the pandemic, it offered up to 36,000 Bangladeshi takas for one year. Other in-app health services were only 2 takas per day. This venture was mainly targeted at the mass audience of low-income sections who generally cannot enjoy these types of health facilities. Another such use of telemedicine is done by Apex-Nino Rossi for breast cancer awareness. They created digital content to teach women the breast cancer self-check process and created a website for one-on-one doctor’s consultations where almost 13,000 women registered. And through the doctor appointments, they were able to save 250 lives. This positive trend of making access to quality health care more inclusive can be attributed to Covid-19. If anything, Covid has shown us that health care in our country is approached as a luxury, not a necessity. Luckily, the number of such ventures that work towards more inclusive health care is on the rise. Such a venture is Coraid’s Smart Healthcare Services for Extreme-Poor Households. As an initial target, they chose the people of Sunamganj.
Sunamganj has a very high mortality rate of 425 deaths per 100,000 live births compared to the national average of 194. And 89% of pregnant women have home deliveries assisted by non-professionals. Realizing the grave need, Cordaid with technical support from Sajida Foundation offers financial support through voucher schemes to 800 extremely poor households. Currently, they have 3,200 beneficiaries. They partnered up with two private hospitals in Sunamganj where the beneficiaries can get various healthcare services ranging from OPD to IPD of 20,000 BDT per year. To make healthcare a more modern and swift process in Bangladesh, MetLife has launched its 360Health app. The vision is to provide the most relevant knowledge, support, and services based on their needs in the palm of their hands. MetLife 360Health is an app-based digital solution that comprehensively focuses on five critical illnesses: prevention of diseases, early diagnosis, access to treatment, ongoing care, and financial protection with insurance to help users through a simple and engaging experience. All these small and large-scale ventures and ideas just point out the upcoming horizon in the Bangladeshi health sector that a global pandemic has introduced.
-Nayeema Nusrat Arora
