The population with non-communicable diseases in India is quite large. There are at least two major implications this has for the Covid-19 pandemic. The first is, the overall Covid-19 mortality rate might be very high in India, and even more so among poorly-managed diabetics and hypertensives, of whom the population in India is especially large. This underscores the need to dampen overall infection rates.

The second potential challenge is immunizations and care for those with diabetes and hypertension, such as dialysis or insulin. Because the underlying mortality rate is higher in poor countries, these types of negative spillovers of Covid-19 care onto care for other diseases could be problematic.

On private sector involvement

A high share of care in India is delivered through the private sector. While there are often concerns about involving the private sector too heavily in required care because of the lack of regulation of this sector, in a time like this, India will need to rely on the private sector heavily because it represents such a large share of the sector. That is, given the strain the health care system will be placed under, the country will need health care “boots on the ground” so to speak. Hence, finding ways to leverage the private sector effectively will be critical.

The patients will need care from the private sector, and so it will be important for the public sector to not alienate private sector providers or take a purist view that all care should be delivered through the regulated public sector. Rather, trying to upskill the private sector to be able to deliver the necessary functions will be critical to an effective response.