India and COVID-19 - RCPCH statement of solidarity

The Royal College of Paediatrics and Child Health represents a large body of paediatric clinicians from and in India. As we see the devastating impact of a second pandemic wave across India, with infections passing 21 million and deaths conservatively estimated at 230,000, the College stands in solidarity with our colleagues, their patients and the wider Indian community.

Through the British Association of Physicians of Indian Origin (BAPIO), we are already seeing direct assistance being delivered – 1,000 oxygen cylinders, 122 non-invasive ventilators, 95 oxygen concentrators and a shipment of medicines.1 But much more is needed – urgently and over the longer term.

We urge the Government of India (GoI), at Union, State and District levels, to take necessary measures, including national lockdown, to bring COVID-19 in the country under control, at the same time redoubling efforts to ensure basic livelihood support, including adequate food, reaches rural and marginalised communities experiencing high levels of deprivation.

India is home to some of the most advanced medical and clinical skills in the world; but it is also home to some of the largest health inequalities. Morbidity and mortality are likely to be considerably higher than current data suggest as COVID-19 spreads into deprived rural communities where health provision is weaker and availability of critical services much scarcer.

We urge GoI, UK Government and partners in the international community to reinforce health system capabilities – oxygen cylinders, connectors and concentrators, oxygen production units, PPE and supplies of dexamethasone, remdesivir and other effective COVID-19 medicines – across the hospital network ensuring inclusive action in urban and rural settings. RCPCH in the UK and across India stands ready to aid this COVID-19 response with appropriate clinical guidance and technical advice, delivered through innovative virtual, remote and telemedical models. In particular, RCPCH in the UK and India will continue to monitor potential risks to children presented by COVID-19 as they evolve.

We remind GoI and partners internationally that the concentration on pandemic COVID-19 puts at risk routine clinical and care services on which the health and survival of mothers, newborns and children depend. We urge all relevant parties to ensure that routine services, as well as the critical national immunisation programme receive appropriate support to ensure their continuing provision.

India is a world leader in vaccinology and vaccine production. Yet global vaccine inequality puts at risk progress on the COVID-19 pandemic for all of us. We urge the UK Government to support the UN proposal to waive intellectual property rights conditions on COVID-19 vaccines, as proposed by India, South Africa and around 100 low- and middle-income countries, now supported by the United States administration with positive signs from the European Union and the World Trade Organisation.

What happens in India today may become a pattern for outbreaks in countries and regions with fragile health systems and vulnerable populations. How we respond in India should set the standard for response globally.