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Which areas you feel have improved significantly and where do you see more scope of improvement ?
There’s not a lot of good news in the report in terms of year on year improvements. If anything, it underlines that the Covid crisis and the knock-on effects from the Covid crisis have really had a lingering impact, We really wanted to use the report this year to highlight how important it is to refocus attention, particularly on what we regard as some of the most important targets and indicators, which are maternal and child health, and say, actually it is possible to reverse that. But it needs to have much more focused political attention. We have highlighted seven new interventions, fairly low tech for the most part, that we think can make a transformative difference.
How widespread has the Covid disruption been on global public health? If you take a look more broadly at the economic challenges faced in any low-and-middle-income countries, the debt crisis, we now have over 50 countries that are having to pay more in debt service than they do on health care. In that kind of situation, it’s very difficult to make investments. Those are countries included in the region, countries, like Sri Lanka, which obviously has had a massive debt crisis, the challenges in Africa and places like Zambia and Ghana and Ethiopia. There is a significant proportion of challenges in Africa, but it is broader than that. There are also some challenges in Latin America. We’ve seen a drop in sort of resourcing and focus and ability to focus, and at the same time, there’s been a drop in international support. Again, if you focus on Africa, aid to Africa last year dropped 8%, at exactly the time needs were growing. When you have resources, or you have a lack of resources, it’s very difficult to make the necessary investments.How has India fared in addressing public health challenges when compared to global benchmarks ? One of the key areas, and we work particularly closely in UP and Bihar, where we have memorandums of understanding with both state governments and work, is there’s been big improvements in the training of community health workers in the focus on facility-based care, both the primary healthcare centers and the secondary and tertiary centers.I actually visited a centre in UP a little over a year ago and saw the improvements there, and you can see it in the outcomes, and you can see it in the measurements that UP has had some very dramatic improvements in maternal and child care. I think that’s exactly the kind of framework. I think there has been a continued prioritisation in India, more so than in many other countries, and that’s why India actually has performed relatively better compared to many other countries on exactly these indicators in the last few years. There has not been the same kind of slowdown in India that we’ve seen across much of the rest of Asia and Africa.
Has India’s recent progress in digital infrastructure impacted its public health offering?
We’re very excited about the digital public infrastructure. That was a large part of my discussions in my most recent trip to India, is how we could support it both through the G20 initiative, but then more broadly. I mentioned this initiative called MOSIP, which is based in Delhi, which actually builds off the Aadhaar program to have a digital identity program that other countries are scaling up. I think over two dozen countries have expressed interest. Countries from Morocco to the Philippines are now rolling out models that are similar. That’s on the digital identity platform, and then we’re hoping on top of that you can layer what you call the digital stack, sort of health interventions, education interventions. India is very much the leading edge of that experimentation, and the models. We think that’s a very exciting and ambitious agenda for the next three to five years, and it’s one of the key tools that we are optimistic about, going back to the SDG report, that can actually change the trajectory of the SDGs.
Growing wealth disparity in India is a concern. How can the private sector address this issue ?
Philanthropy in India has been growing and becoming more robust. We have a range of strong partnerships with a number of significant Indian philanthropists, and we’re very excited about those. There is a huge increase in significant private wealth there. We do think there are a number of strong partnerships, including in the health space. We have some recent ones with the Piramal Foundation and others that we think can be really great models. So definitely, yes, we would like to see more Indians join, we’d like to see more people everywhere join the Giving Pledge.