Medical Infrastructure of 38 Institutions across 31 States/UTs strengthened
The Government of India is leading the fight against the COVID19 pandemic in collaboration with the States and UT through a “Whole of Government” approach. There has been an unprecedented surge in the number of COVID19 cases across the country. The health infrastructure of several States and UTs has been overwhelmed by the very high number of daily cases and increased mortality.
The global community has extended a helping hand in supporting efforts of Government of India in this collective fight against the global COVID19 pandemic. Medical equipment, medicines, oxygen concentrators, ventilators etc., are being provided by many countries.
A streamlined and systematic mechanism for allocation of the support supplies received by India has been put into place, for effective distribution of the medical and other relief and support material.
The Indian Customs is sensitive to the need for availability of COVID related imports including Oxygen & Oxygen related equipment etc., and are working 24 x 7 to fast track and clear the goods on arrival and lead to expeditious clearance within hours. The steps taken for expeditious clearance on fast track basis are as follows:
- The Goods are given high Priority for clearance by the Customs Systems for processing over other goods.
- Nodal Officers also gets alert on email for monitoring and clearance.
- Monitoring by senior officers for pendency of COVID related imports is also being undertaken.
- The Handholding to the trade is given for complying with the requirements beforehand.
- Outreach activities and Helpdesk enables Trade to get the goods cleared on arrival.
In addition to faster clearance,
- Indian customs has waived Basic Customs Duty and Health cess on goods identified for defending Covid.
- When imported free of cost and distributed freely, based on the state govt. certification, IGST is also waived.
- Further, for import of oxygen concentrators for personal use, IGST has been reduced from 28% to 12%
A cell was created in the Ministry under Addl. Secretary [Health], MoHFW to coordinate the receipt and allocation of foreign COVID relief material as grants, aid and donations. This Cell started functioning on 26th April 2021 and comprises of one Joint Secretary on deputation from Ministry of Education, two Addl. Secy level officers from MEA, Chief Commissioner Customs, Economic Advisor from Ministry of Civil Aviation, Technical Advisor Dte. GHS, Representatives from HLL, two Joint Secretaries from MoHFW and Secretary General along with another representatives from IRCS.
The medical items started coming in as donations from different countries after the rise in sudden cases of Covid across the different parts of the country from the last week of April, via MEA.The materials are being given by countries due to the immediate and urgent requirements in different parts of the country. This help is over and above what Govt of India is already providing, and is thus an additionality for the states and UTs.Later on, supplies coming from private companies, entities etc also started routing through the NitiAyog and are handled by this cell.
The group meets virtually at 9.30 AM every morning to sort out all pending issues. During the day, all information by MEA and its resolution by MoHFW, as well as follow up by Technical Advisor Dte. GHS, HLL and IRCS is done onWhatsApp group.
Apart from this, a high-level committee under CEO, NITI Aayog and comprising of Secretary Expenditure, MEA and officials of Niti Aayog and MoHFW has also been formed to oversee the whole operation.
The Ministry of External Affairs is the nodal agency for channeling offers of help from foreign countries and coordinates with Missions abroad. The MEA has issued its own SOPs which are applicable across board.
Indian Red Cross Society
For all consignments received via MEA and coming as donations from foreign countries; the consignee is the Indian Red Cross Society. Upon receipt of the papers outlined in the process flow chart, IRCS issues the necessary certificates immediately to HLL for processing customs and regulatory clearances at Airports. IRCS also ensures liaison with MoHFW and HLL so that delays are reduced and quick turnarounds are achieved.
HLL Lifecare Limited (HLL) is the customs agent for IRCS, and the distribution manager for MoHFW. The consignments are processed at airport and transported for distribution by HLL. In case of consignments arriving at military airports, or bog items like oxygen plants, Dept. of Military Affairs (DMA) assists HLL.
Accessibility and the immediate use of resources to save the lives drives the need for immediate allocation of short-notice incoming consignments. The materials from abroad are currently coming in different numbers, specifications and at different times. Hence there is a need to reconcile the distribution logistics with the need to reach the materials as expeditiously as possible to the states. Donor countries consignment details get confirmed only after the consignment gets booked in the country of origin. In many cases the items received are not as per the list, or the quantities differ, which needs reconciling at the airport. The final list gets confirmed after the detailed reconciliation. Thus, it leaves less than a quarter day to manage the cycle including allocation, approval and dispatch. Under these circumstances since these are time sensitive supplies, all possible attempts have been made to distribute them immediately and to ensure optimal use in the best possible way.All possible efforts are done to unpack, repack and dispatch these with the least possible turn-around time.
The allocations are done keeping in mind equitable distribution and the load on tertiary health care facilities. In the first few days, the states were covered via the AIIMS and other central institutions where the critical care patients load is high and where the need is highest. Besides, the Central Govt hospitals, including DRDO facilities in and around Delhi and in the NCR region were also supplemented through the aid. It has been seen that tertiary health care facilities normally have higher number of cases with severe symptoms of Covid and are often the only succour to people in the region for quality tertiary care.
As per the standard Operating Procedure for allocations taken out by the Health Ministry on 2nd May, 2021:
- Since such grant in aid would be limited in quantity, therefore it has to be optimally utilized by allocating it to high burden states [states with higher number of active cases], where the requirement for such equipment/medicines is more.
- Spreading such grant in aid thinly each time, over a large number of states may not bring forth the desired results. It will also lead to small packages travelling large distances, high turnaround times and possible wastage of resources.
- The requirement of the high burden states in the context of number of persons admitted in hospitals as well as prior distribution done from GOI resources would also be considered. Special focus can also be on states considered as medical hubs of the region, which have a patient in-flow from neighbouring states/cities. In some cases, resource low states such as North Eastern and hill states where tankers etc., don’t reach, can also be covered to shore up their needs.
Based on the above criteria and principles, 24 different categories of items numbering nearly 40 lakhs have been distributed to 86 Institutions in different States.
Major categories of equipment include BiPAP Machines, Oxygen (Oxygen Concentrators, Oxygen Cylinders, PSA Oxygen Plants, Pulse Oximeters), Drugs (Flaviparivir and Remdesivir), PPE (Coveralls, N-95 masks and gowns),
These States/UTs which have either received or where the equipment has been dispatched are :
- Andhra Pradesh
- D&N Haveli
- Himachal Pradesh
- Madhya Pradesh
- Tamil Nadu
- Uttar Pradesh
- West Bengal
As the different tranches are coming in, the rest of the States and UTs will also be covered in the coming days.
The following institutions (region-wise) have received the equipment:
1. LHMC Delhi
2. Safdarjung Hospital Delhi
3. RML Hospital
4. AIIMS Delhi
5. DRDO Delhi
6. 2 hospitals in Delhi (Moti Nagar & Pooth Kalan)
7. NITRD Delhi
8. ITBP Noida
9. NEIGRIHMS Shillong
10. RIMS Imphal
11. AIIMS Bathinda
12. PGI Chandigarh
13. DRDO Dehradun
14. AIIMS Jhajjar
15. AIIMS Rishikesh
16. AIIMS Rae Bareli
17. AIIMS Deoghar
18. AIIMS Raipur
19. AIIMS Bhubaneswar
20. AIIMS Patna
21. DRDO Patna
22. AIIMS Kalyani
23. DRDO Varanasi
24. DRDO Lucknow
25. District Hospital Pilibhit
26. AIIMS Jodhpur
27. DRDO Dehradun
28. DRDO Ahmedabad
29. Govt. Satellite Hospital Jaipur
30. AIIMS Bhopal
31. AIIMS Mangalagiri
32. AIIMS Bibinagar
33. JIPMER Puducherry
Central Govt. & PSU