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How To Control Pandemics At The Grassroots Level? Decentralisation.

We are living in the 21st century, the century of climate change. With the rise of mean global temperature and anthropogenic activities, the population of disease-causing vectors will also increase. These vectors are carriers of many deadly diseases like diarrhoea, dysentery, plague, Nile virus, cholera, chikungunya, dengue, Covid-19 etc. According to IPCC’s Special Report on Global Warming of 1.5ºC (October 2018), there will need to be an increase in global forest cover equal to the land area of Canada (10 million sq.km) by the year 2050 to avoid temperature rise by more than 1.5 degrees above pre-industrial levels.

In 2019, atmospheric CO2 concentration was 47% above the pre-industrial level. At present, Earth is under severe pressure due to the emission of greenhouse gases (GHGs). The world is on the brink of ‘household explosion’. The total number of global households are growing much faster than the growth of the world population. The average size of household in India as per 2011 census was 4.8 members per household, while in the 2001 Census the size of household was 5.3. Increasing the number and decreasing the size of households means the same number of people are living in more than one home and causing more pressure on forests and the environment.

Representational image.

The world is facing COVID-19 pandemic. Humans are confined to their homes. This epidemic is destroying the socio-economic framework of nations. It is said that environmental degradation and ecological imbalance are responsible for this pandemic. It is the result of anthropogenic climate change and deforestation. It is said that the disease spillover to humans may increase as the climate becomes warmer. The current human population of about 7.6 billion people is expected to be 10 billion by 2050. Such a growing size will create pressure on our ecosystems. Further degradation of habitats, forests and biodiversity will result in more such pandemics and epidemics. 

Deforestation is making the situation worse and accelerating the transmission of infectious diseases by vector displacement. Such vector animals, which carry viruses, move into regions where they’ve never existed before and increase our vulnerability to diseases. This creates a greater possibility of dispersion of zoonotic diseases like HIV, Ebola, Nipah, Zika, current COVID-19 etc. 

We Cannot Change Our Past But We Can Change Our Future

It is now the perfect time to think about the future we want to live in. Our future planning and development should be able to fight against climate change, global warming, environmental degradation, biodiversity and habitat loss, lethal diseases and economic loss due to anthropogenic impacts of humans on planet earth.

For this, India and the world need decentralisation of health facilities and ‘health democracy’ at grassroots level; especially at the village council level. In India, it will be a big revolutionary step after ‘sanitation democracy’. According to the Liberal Democracy Index, which is produced by the Varieties of Democracy project at the University of Gothenburg, democratic regimes obtain higher scores. For example, in 2015, each of the 36 countries with a Liberal Democracy Index of at least 0.7 had a life expectancy of at least 72 years; and conversely, all 21 countries whose life expectancy was less than 60 years had a Liberal Democracy Index under 0.55. 

Here is a suggestive model by me to control pandemics and epidemics at the grassroots level. At the village council level, in India, health democracy can be achieved through ‘Health Parliament or Village Health Council’. Such Parliament may comprise of villagers, elected village Council Head, village Council’s Secretary, school headmasters, sanitary workers, Asha, Anganwadi, Auxiliary Nurse Midwife (ANM), Doctor of the near Primary Health Center (PHC) or Community Health Center (CHC), revenue officer and representative of the agriculture department. Such Parliament will work on ‘Awareness, Education and Campaign’ (ACE) to establish a healthy society, at the village council level. This Parliament will also be responsible for primary and immediate health services and transfer of serious patients to advanced hospitals for medical help.

Members of ‘Health Parliament’ will work collectively and voluntarily to encourage villagers for sanitation, better health through yoga, use of traditional Ayurvedic medicines, following social distancing, use of masks, immunization and better nourishment. This Parliament will help to ensure high ‘Green Governance’, ‘Carbon Negativity’, ‘Forest Cover’, ‘Sustainable Development’, ‘Household Size’, ‘High Yielding Varieties (HYVs)’, ‘Agriculture Mechanisation’, ‘Agriculture Production’ and ‘eco-friendly society’. This will help to change climate change and fight pandemics and disasters. 

Members will act as ‘Health Ambassadors’ and ensure a healthy life at the grassroots level. Every week, members will organise a ‘health drive’ to aware people and surveys of sick people. Female members will encourage the use of ‘sanitary napkins’ by young girls and women. Doctors will look after the patients, provide the necessary medicines and cause awareness. 

Members will cooperate with ANM, Anganwadi, Asha, government officials and doctors to ensure ‘Clean and Healthy Society’, and will help to bring ‘social and behaviour change’ in daily rural life in every household. ‘Health Parliament’ will help ‘Swasth Bharat Mission’ and District Administration to make ‘Disease Free and Healthy society’ at the grassroots level. It will be a revolutionary step. Globally, this model will be helpful for making a ‘healthy society’. 

The most authoritarian aspects of the Chinese political system is the main reason behind China’s failure to control the famine of 1958–1961, severe Acute Respiratory Syndrome (SARS), HIV/ AIDS epidemic of 2003 and recently COVID19. But, India represents a successful, strong and biggest democratic system at a global level. The democratic system of India will be helpful to make an eco-friendly, sustainable and healthy India. 

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