Why India's governance needs to delink public health from bureaucracy
Public health is too large a problem to be managed by the Indian Administrative Services. Therefore, identifying new and emerging talent, voices, and thoughts than sticking to the old guard is more than necessary now to inject fresh energy into the national veins
Image: Uma Shankar MISHRA / AFP
I have some of the finest friends in the bureaucracy across Karnataka, at the national capital and those flying our flags around the world. I admire them and have a fond affection for them. Bureaucracy holds up the complex fort of noisy politics and delivers results despite it, albeit sometimes at a snail's pace, it does a good job overall.
However, I also feel public health is too large a problem to be managed by the Indian Administrative Services. Covid-19 has exposed the hiccups that the civil service has stumbled upon, much of it because the nation is run by a bureaucracy that is not trained in public health.
I would recommend in broad strokes a three-pronged solution to this problem. Mind you it is going to get worse from here—beyond Covid-19—and the IAS will not be able to hold guard. India faces a cascading risk emerging from natural disasters, extreme weather events, climate change, and future pandemics. The public health consequences of this nature will be beyond the comprehension of the bureaucracy.
Give it a thought—a bureaucrat who moves from department to department can only grasp as much. A secretary in shipping moves to become the secretary in finance and then to women and child or as secretary to the top boss. How can you establish competency and creativity? This is equal to a jack-of-all-trades-master-of-none model.
Here’s what we must do:
You may be the best captain of the ship, but in a tsunami, you will still lose the battle to the shores. There are too many good officers in the IAS system, but they may not be well-equipped to handle public health problems—a prerogative of public health professionals.
Therefore bringing in public health competent secretaries to the government or joint secretary to the department or ministry is very necessary now.
Alternately, visionary governments of the day can set this up and champion community development in a structured manner by bringing public health into all policies through the permanent commission. This is a small investment that will reap 100X rewards over the years. After all, life is all about planting trees under whose shade we may never sit. Right?
If after decades of mid-day meal programs, we still haven’t eradicated malnutrition, it is not a fault in the stars, but the glaring fault lines of our approach, strategy, and persuasion to innovate and delink the clutches of caste and oppression that still reigns supreme.
If the politics of motherhood kills mothers today, it is a public health problem. If years of development get wiped out with a disaster, it is a public health problem. For this and much more, we need to act now.
These initiatives, if pursued with utmost seriousness, will set India rolling on the right path and secure generations that will come after us. The time to implement is now.
The writer is a community health physician and CEO of CHD Group