Context: Living with the pandemic for months together has had a desensitising effect on the collective psyche. Owing to such ‘desensitisation’, disasters that are not sudden and striking tend to be minimised. India’s disaster management framework also suffers from ‘desensitisation’.

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  • In 2005, India enacted the Disaster Management Act (DM Act), which laid an institutional framework for managing disasters across the country.
  • The Disaster Management Act is one of the few laws invoked since the early days of COVID-19 to further a range of measures — from imposing lockdowns to price control of masks and medical services.

Provisions in the DM act

  • The law laid down a legal framework for disaster response at the national, state, and district levels.
  • The Act paved the way for establishing Disaster Management Authorities at the national, state, and district levels .
  • It also provided for setting up the National Disaster Response and Mitigation Funds, and the formation of the National Disaster Response Force (NDRF).
  • The National Disaster Management Authority is chaired by the Prime Minister.

Concerns during medical disasters

More a reactive approach

  • Critics have indicated that the Disaster Management Act fails to identify progressive events as disasters, thus neglecting pressing public health issues such as tuberculosis and recurrent dengue outbreaks. 
  • Had they been identified as disasters, they would have attracted stronger action in terms of prevention, preparedness, and response. 
  • While the Disaster Management Act does require States and hospitals to have emergency plans, medical preparedness is inadequate.

Drawbacks in private sector

  • Weak regulations: The Indian private sector is characterised by weak regulation and poor organisation.
    • It is incapable for mounting a strong and coordinated response to disasters. 
    • A large majority of private hospitals in the country are small enterprises which cannot meet the inclusion criteria for insurance. 
  • Overcharging by hospitals: It illustrates how requisitioning of private sector services during disasters can hardly be a dependable option in the Indian context. 
    • This is important since the future development of hospital care services is being envisaged chiefly under publicly financed health insurance, which would very likely be private-sector led.
  • Business interests: They are generally averse to infectious diseases and critical cases with unpredictable profiles. 
    • Disaster preparedness does not make a strong “business case” for hospitals, which prefer to invest in more profitable areas.

Way forward:

  • Medical preparedness for disasters: Two important lessons emerge-
    • Health services and their development cannot be oblivious to the possibility of disaster-imposed pressures; 
    • The legal framework for disaster management must push a legal mandate for strengthening the public health system.
  • Strong public sector capacities are therefore imperative for dealing with disasters. There is a strong case for introducing a legal mandate to strengthen public sector capacities via disaster legislation, including relevant facets such as capacity-building of staff.
  • Integration of disaster management with primary care:  Primary care stands for things such as multisectoral action, community engagement, disease surveillance, and essential health-care provision, all of which are central to disaster management. 
    • Evidence supports the significance of robust primary care during disasters, and this is particularly relevant for low-income settings. 
  • Synergies with the National Health Mission: The flagship primary-care programme which began as the ‘National Rural Health Mission’ concurrently with the Disaster Management Act in 2005, could be worth exploring. 
  • The National Health Mission espouses a greater role for the community and local bodies, the lack of which has been a major criticism of the Disaster Management Act. 
    • Making primary health care central to disaster management can be a significant step towards building a health system and community resilience to disasters.

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