Five years after Covid-19: Lessons in agile health care innovation
This article is authored by Dr Balram Bhargava.
It is five years since Covid-19 crossed borders and it is time to revisit the lessons learnt from its catastrophic nature. The pandemic did put a strain on the global healthcare system, but at the same time, brought the best out in terms of resilience, adaptability and innovation. One of the key aspects that the pandemic brought to light was the dire need for agile innovations, particularly in diagnostics, which played an important role in mitigating the virus to a large extent. The ability of our nation to create a robust testing infrastructure overnight was a decisive factor in preventing an even worse catastrophe.
Starting with testing of 27,824 samples daily in April 2020, testing efforts intensified as the year progressed. And by October 31, 2020, India had conducted a cumulative total of approximately 110.93 million tests. This expansion positioned India among the top countries globally in terms of total tests conducted by the end of 2020. By end of 2022, India had conducted around 935 million tests, reflecting its commitment and proactive efforts in enhancing its testing infrastructure to effectively manage the pandemic.
The development and deployment of indigenous testing platforms, such as the Truenat system—a portable, battery-operated RT-PCR platform—enabled rapid and accurate testing in both urban and rural settings. At first restricted only to a few government laboratories, rapid testing was quickly scaled to thousands of locations utilising the point-of-care system, ensuring that even the remotest of locations had access to Covid-19 detection facilities.
Not only did this enable early diagnosis and treatment but it also optimised epidemiological surveillance and assisted policymakers to decide upon containment and treatment plans.
Going beyond diagnostics, India's innovative approach of handling the pandemic was indicative of its problem solving and adaptability skills. India was one of the first countries to develop indigenous vaccines for Covid-19 prevention and also export them to more than 100 countries. The integration of technology with large-scale immunisation drives, the rapid deployment of mobile point-of-care testing, drone-assisted vaccine delivery in remote areas and Artificial Intelligence (AI)-powered predictive analytics for outbreak forecasting played a significant role in mitigating the pandemic’s impact.
India's digital health infrastructure, including the development of the Aarogya Setu app and telemedicine services, enabled contact tracing and real-time health monitoring at an unprecedented scale. Furthermore, public-private partnerships accelerated research and development in therapeutics, with companies innovating new drug formulations and monoclonal antibody treatments.
The pandemic highlighted the world’s necessity to create very prompt regulatory processes for emergencies. The swift validation and approval of RT-PCR and Truenat diagnostic tests ensured that accurate testing kits were widely available. Truenat was transformed from a tuberculosis screening device to a Covid-19 test machine that could issue quick results in underdeveloped regions.
Regulatory agencies worldwide collaborated with researchers and manufacturers to fast-track approvals while maintaining stringent quality controls. The speed and ease with which the Indian health care ecosystem adapted to the pandemic, strengthened the perception of India as a leader in providing affordable and scalable healthcare solutions, offering a model for future health crises worldwide.
In August 2020, India revised export policies to allow shipments of Covid-19 diagnostic kits, enabling manufacturers to supply test kits to Latin America, East Asia, and Eastern Europe. These measures enabled India to bolster global testing capabilities by exporting RT-PCR test kits and diagnostic solutions like Truenat globally, thereby establishing itself as a major contributor to global pandemic management.
The innovation of healthcare diagnostics greatly contributed to managing the pandemic; however, the pandemic also exposed some gaps in the global health care infrastructure. Overburdened hospitals, supply chain disruptions, and workforce shortages highlighted the need for robust health systems capable of scaling up in emergencies.
As we move forward, the lessons from Covid-19 must guide us in fostering a culture of continuous innovation in health care. There is an urgent need to invest in more mobile health systems, decentralised healthcare models, improve laboratory linkage and train frontline staff for pandemic preparedness. The road ahead demands resilience, foresight, and an unwavering commitment to scientific progress. With increased investment in research spending, technology use, and global collaboration, the world can be better prepared for any future health crisis.
This article is authored by Dr Balram Bhargava, former director general of Indian Council of Medical Research (ICMR) and secretary of department of health research.
