‘Till We Win’ provides comprehensive analysis of India’s journey and response to COVID-19 pandemic and documents and deliberates how India, fought and continues to fight against novel coronavirus, SARS- CoV-2. This book is as much for general readers as it is for health policy makers. The book was brainchild of Dr. Chandrakant Lahariya, public policy and health systems expert, and has benefitted from involvement of two key personnel in India’s responses — Dr. Gagandeep Kang, renowned vaccine researcher and virologist, and Dr. Randeep Guleria, director of All India Institute of Medical Sciences, New Delhi. It is a book by three medical experts at forefront of India’s fight against Covid-19 who say that what prompted them to write this book was the misinformation that surrounded the pandemic and the need to provide key information to citizens about how the pandemic emerged and grew – what was done, what continues to be done, and what future may hold for India. They also aimed to capitalise on increased interest in health system, as India readies for ‘new normal’. All three authors are ‘insider outsiders’. Even while being part of government’s pandemic response, they have not shied away from expressing divergent opinions, and nudging policymakers towards course-correction.
The book has four sections and eleven chapters. In first section, the authors provide very useful overview of viruses, their long association with human beings and how they influence coevolution – along with an in-depth discussion of the novel coronavirus in particular. This section focuses upon why viruses are likely to cause pandemic and how human activities are increasing risks of outbreaks and epidemics.
In second section, authors deliberate on initial government response including test-trace-treatisolate routine, nationwide lockdown and challenges that heterogeneous health systems across states faced. Case studies of state-level responses are also presented. This section deliberates on India’s pandemic response and how policies and strategies had evolved, with every emerging situation. The authors argue that no country was fully prepared to respond to pandemic of such magnitude, which has disrupted every ‘health system’, across the world. The authors have dedicated the book to frontline healthcare workers of India – in particular 3.6 million women workers, including 900,000 ASHA workers, 200,000 auxiliary nurse midwives, 1.3 million anganwadi Workers and 1.2 million anganwadi helpers and others who spearheaded pandemic response starting with contact tracing in most states.
The third section deals with challenging aspect of pandemic for practitioners: a dynamic evidence base. The policies have evolved with changing situation. Ranging from preventive measures to treatment options, evidence has kept shifting on regular basis. This section covers what people need to know about COVID-19 vaccines and therapies. A broad range of frequently asked questions addresses key queries, which any readers may have in his/her mind and works as great explainer for general audience.
The final section titled “Getting future ready” looks at possible options towards endgame itself and beyond. One of the chapters in this section is on health system strengthening and universal health coverage. The suggestions in this chapter on how to strengthen India’s health systems are very practical and would be useful for policy makers and public health experts. The authors assert that the pandemic is a good opportunity to strengthen capacity of India’s health system and that strengthening health system is systematic and comprehensive process and involves more than tweaking one or two aspects of system based on immediate need. The book concludes with authors offering long-term template for citizens to help minimise risk they face from Covid-19.
The book touches on all key aspects of crisis, including nature of viruses, corona virus family, upgradation of health infrastructure, health systems and funding, treatment protocols, raises and answers questions about quarantine, safety protocols, vaccines. The book also touches upon migrant crisis due to lockdown and its social economic implications. The story of pandemic is also story of people who went through those tough times, whether they were migrants or frontline workers and doctors treating COVID-19 or patients, or people who lost incomes during lockdown. A chapter dedicated on frontline health workers and essential services workers and their selfless fight against the virus is a must read. Last chapter in the book would be of special interest for every family member, as it describes, how to remain safe and healthy during the pandemic and beyond.
This book is timely analysis of India’s public and private health systems by Dr Lahariya, Dr Kang, and Dr Guleria offering high-quality primer on India’s contemporary health policy – for broad audience of policymakers, researchers, civil society, media and citizens. As policies around health and its social determinants are becoming mainstream, this book offers much-needed initiation into the fascinating world of Indian health policymaking, through all-important vantage point of the pandemic. Many recent books on health policy aimed at more specialist audience and most of them managed to put off the general reader. This book manages to give much more lucid and objective assessment of a very dynamic situation. The writing style of this book is lucid and concise and makes it very readable for both general readers as well as people with subject expertise, in health sector and public policy.
Deep insights into what was happening in crucial pockets such as Dharavi, Kerala, and Delhi and exemplification of what worked well during the pandemic are crucial as documentary evidence. We are not yet free of COVID-19 and by now, having steeled ourselves to witness the fulfilment of prophecies of future epidemics, these lessons from the past are invaluable.
Main strength of the book is that it provides balanced account of success and challenges of efforts made by union and state governments and non-governmental organisations, in unbiased manner. The book offers balanced assessment of India’s collective response where central government, states, private sector and citizens played their part. The book is about responding to pandemic as it is about strengthening health systems. The authors have underscored need for increasing government investment on health services, urgent need for scaling up of mental health services, need for community participation in health services and focus on public health services. The book takes a balanced, nuanced approach to assessing India’s Covid-19 response and be useful foundation of any further analyses on Covid-19. The analytical overview of COVID-19 pandemic responses and lessons to strengthen India’s health systems reflect breadth and depth of expertise of authors. ‘Till We Win’ is a timely publication, which provides much needed information about health sector response to COVID-19 pandemic in India.
