Neeraj Jain is the Country Director of Program for Appropriate Technology in Health (PATH) India, an international, nonprofit global health organization based in Seattle.

In his previous role as the Chief Executive of WaterAid India, Jain helped establish the India Sanitation Coalition, which brings together organizations and individuals to find sustainable sanitation solutions. Jain also worked for the Children’s Investment Fund Foundation, where he worked for child development, with a focus on nutrition, early learning, and child survival in the perinatal period.

In an interview with HealthLeads, Jain says that India has the infrastructure in place to deal with a health emergency twice as virulent as the Delta wave.

“There’s been a huge amount of ecosystem building that’s happened in terms of infrastructure,” he said. “The challenge will be to keep this infrastructure together till the next pandemic.”

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Q. How has the pandemic impacted healthcare access in India?

A. All attention was directed toward responding to the pandemic, which actually turned attention away from other diseases. Immunization went down, TB patients were not getting services and HIV too went off the radar. But what we realized also during the pandemic was that we were able to reach out to many more people, much faster.

Besides, the pandemic also brought out a lot of glaring gaps in the health system, revealing its inadequacies that we needed to work on. COVID also brought health, to the forefront of politics, and economics, making it an important subject that people should be focusing upon.

Public health has really come front and center at this point, and we need to use this moment to really go forward, try and make as much change as we can, while we still remember COVID.

Q. Digital health diagnostics has witnessed a huge jump in the last two years thanks to the pandemic. Is there a reason to worry about the quality of diagnostics that is provided?

A. Firstly, we need to make a distinction between screening and diagnosis. We are a large country with 1.4 billion people. We will not be able to get a good quality diagnosis to everyone. We need to do population level screening from a health and wellness perspective. So we really need to screen as much of our population as possible. For this, we need a lot of health workers. We have got a health worker shortage. So technology is really going to be the only way that we will be able to reach the kind of population that we have and to bring some amount of health equity in this whole conversation. Otherwise, the poor will never get the services that they so much deserve.

Q. Has India’s vaccination drive addressed the rural-urban divide and made healthcare access more equitable?

A. India’s vaccination drive for COVID-19 has really broken the rural-urban divide. We have really gone across the country. I’m not sure if that’s actually showing up in other areas. It’s only for the COVID vaccination that we actually saw that coming together. Thanks to all the information and the push from the government. I’m really hoping that this will now start showing up in other areas of health. We should be be able to see this happening in the larger immunization program.

Q. At the peak of the pandemic, India saw some real horror stories in terms of oxygen availability. Have we learned our lessons well and are we better prepared now for the next health emergency?

A. Absolutely. I think we saw some challenges. It was also the population, the number of people that got infected. Our facilities have multiplied, across the country. There’s been a huge amount of ecosystem building that’s happened in terms of infrastructure. The challenge will be to keep this infrastructure together till the next pandemic. The challenge will also be to make sure this infrastructure is working when that happens. But yes, I think we are better prepared from a pandemic perspective.

I remember that after the Delta wave, we put in place a lot of infrastructure, and by the time Omicron came along, we were quite comfortable that if it was even double the size of Delta, we would be able to manage it. But we’ll see how it pans out over the next few years.

Q. What, according to you, are still the challenges in the maternal and newborn health sector? How do you suggest we deal with this?

A. I would say the largest challenge is really the issue of nutrition, which starts from adolescent girls, goes across to early birth or early pregnancies. When we map that, it becomes a circular situation that we cannot escape. Then the services side of it, do we have good antenatal care? What are our facilities like?

We still face maternal mortality and neonatal mortality. Those numbers are just not decreasing. That means we are losing many mothers and small children during childbirth, which is quite sad. That’s a challenge for the Indian health system at the moment.