Covid showed that India’s healthcare system was frail – yet it was not on the agenda this election

In India, during the Covid-19 pandemic three years ago, it was almost impossible to overlook how health had been turned into a political battlefield. The government was accused of underplaying the number of deaths in the country, it used the disease as an excuse to target members of the Tablighi Jamaat group in Delhi and even vaccination certificates became the opportunity to project Prime Minister Narendra Modi’s personality.

In the aftermath of the pandemic, it was reasonable to assume that in the subsequent elections, debates and questions on public health would be central. Yet, in spite of the series of state elections between 2021 and 2023 and the Lok Sabha election now underway in India, public health did not seem to find a mention in electoral discussions.

Though the pandemic brought into focus the severe inadequacies of public health infrastructure, recent national budgets in India have not significantly increased health expenditures. In fact, data and reports indicate that health allocations in the budgets following Covid-19 have actually declined.

In rankings of health and health systems ranking around the world, India came in at 112 out of 191 countries. India has one of the lowest health spending rates in the world, at about 2.1% of its GDP, according to World Bank data. The National Family Health Survey-3 shows that 70% of households in urban areas and 63% of households in rural areas still get most of their health care from the private sector. This makes India one of the countries with the highest out-of-pocket health care costs in the world.

Why does public healthcare remain such a neglected arena for political parties in India? Post-Covid, no major political party has attempted to make public health a major item on the electoral agenda.

In fact, as was evident during the second Covid wave between January and June 2021, the period with highest rate of infection and death, pandemic protocols were blatantly disregarded during the assembly elections in Assam, Kerala, Tamil Nadu, and West Bengal. None of the political parties either called for postponing the election, nor did they talk about the need for a comprehensive public health reform as part of the electoral agenda.