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The second wave of COVID-19 infections in India has caused unprecedented stress on the existing public health infrastructure in the country, inflicting grave human and economic costs. This experience serves as a critical reminder for Governments and policymakers around the world to exponentially scale up vaccination efforts and help provide universal access to vaccines to stem the spread of the infection further.

To better understand the current situation in India, HPPI posed some questions to Dr. Lalit Kant, former Sr. Deputy Director General of Indian Council of Medical Research (ICMR), India’s nodal health research body.

Dr. Kant’s responses are listed below:

Lalitkant 07012021 1HPPI: The second wave of infections has made India the epicentre of the global Covid-19 pandemic. What do you think were the main contributing factors that caused this situation?

Dr. Kant: It was a combination of factors that resulted in a huge spike of cases and deaths in the second wave:

I.  A false sense of victory over the coronavirus in January/February 2021

II.  Everybody, including the Government, lowered their guards, almost all restrictions were over,  COVID-appropriate behaviour was not being followed

III.  Several strains of SARS CoV-2 virus emerged in India and (the authorities) failed to appreciate the gravity of the mutations and prepare appropriately

IV.  State level and local elections were held in some States, that brought a large number of people together  without practising preventive measures

V.  Large religious gatherings happened; in one of them about 9 million people participated  

HPPI: While what we see in the news is mostly stories of public health challenges and shortages of medical supplies, what is your take on the response by the Indian Health system as such, and its Doctors, Nurses and other frontline workers?

Dr. Kant: That is very true. We can create extra beds, get additional supplies of oxygen and medications. But they cannot manage patients. We need trained people behind the machines, next to the bed, to take care of the patients. The doctor to patient, and nurse to patient ratio gets worse. Getting trained people is a bigger challenge.

HPPI: Now it seems the wave is turning (or at least plateauing). What in your opinion has enabled this to happen?

Dr. Kant: Plateauing of the wave and subsequent decline is a function of the immunity (developed in people who got infected including asymptomatic and  mild) coupled with the non-pharmacological measures like the lockdowns and wearing of mask. Both  have contributed to the decline.   

HPPI: What can India and Indian public do to avoid or prepare itself for a potential third wave?

Dr. Kant: The pandemic will only cease when all of us have developed immunity to SARS CoV-2. This could be as a result of the illness or acquired after vaccination. As long as there are susceptible people in the population, the waves will continue to come. For a wave to come three things are important. First, the virus, perhaps a mutant variant. Second, susceptible population. And third, infected persons intermixing with the susceptible population and making them sick. Our actions have to be also on these. Don’t take your eyes off the virus, keep checking for mutations. If this happens we should look for the effect of the mutation. Does it become more transmissible, or the illness is more severe, does the vaccine work against it? The next thing to do is to convert the susceptible population into non-susceptible by increasing vaccinations against the SARS CoV-2 virus.  Finally, to prevent infection transmission from an infected person to a susceptible person we must practice  COVID-appropriate behaviour like using a mask, keeping a safe distance, and washing hands frequently. For people who get infected and need hospitalisation, we should plan for an adequate number of beds, supplies like oxygen and medicines, and mechanical ventilators. And not to forget the trained doctors, nurses, and frontline workers who will be needed.  

HPPI: In order to overcome the pandemic globally, public health experts around the world, including the WHO, point to mass vaccination. What is our opinion of India’s planning for vaccinating its people? 

Dr. Kant: The Government’s planning was very good. Priority groups were identified like the healthcare workers, frontline workers, people over 60 years and those over 45yrs  with underlying health conditions, and then all 45 and over. The Government also had an adequate number of vaccines doses for all of these groups. The concern was the slow pace at which the vaccination was being done. Under pressure, the Government made everybody above 18 years eligible for the vaccination. That created problem of vaccine supplies. It would take time for the resultant issues to get resolved. 

HPPI: What is needed to obtain general (if we can call it that) immunity in the population and reduce the spread of the Novel Coronavirus to a minimum?

Dr. Kant: For the development of immunity taking the vaccine is the only solution. To reduce the spread it is the Covid-appropriate behaviour (as mentioned above) is best. As of now, there are no approved immunity boosters. A healthy and balanced diet is best.  

HPPI: How can India produce/obtain sufficient vaccines? What are the various factors contributing to this?

Dr. Kant: My opinion is that India would have to rely on vaccines manufactured/produced in the country. Of all the vaccines which have received emergency use authorisation (EUA) and produced in foreign countries, none may be available to India as countries have made advance purchase commitments and they total more than the manufacturing capacity of the companies. These commitments would have to be honoured first. However, some manufacturers are making efforts to increase their production capacity.  The vaccine manufacturers in India are also increasing their capacity either in the existing plant or transferring technology to other companies to manufacture. Some of the newer vaccines like Sputnik V will become available as it is also being manufactured by more than one company. Novavax has also completed the Phase 3 trial, India was also one of the sites, application for emergency use authorisation is being examined by the European regulators (EMA). This vaccine will also be produced by the Serum Institute of India.  Thirdly, some new vaccines developed in India might also become available by the end of 2021.

HPPI: The mechanism for providing vaccines to poorer countries is COVAX. How many vaccines have been distributed so far under COVAX and what is expected by the end of 2021? 

Dr. Kant: As of 25th May 2021,  the COVAX has shipped over 71 million doses of COVID-19 vaccine to 125 countries. The initial aim is to have 2 billion doses available by end of 2021.

Since he joined as a headmaster in the government primary school (GPS) Barki Kheri, in the impoverished Shravasti district of Uttar Pradesh 6 years ago, Aftab Ahmed has always been striving to innovate new methods in his classrooms to improve the learning levels of his students. And the examples of his efforts are aplenty.

In July 2019, a road was built near the school. However, as is often the case, come the rainy season and the newly built road would get completely inundated and make access to the school impossible. Waiting for the fault to be corrected would have taken time and cause the loss of children’s education and possibly also cause some of the students to drop out. Therefore, as a temporary solution, Aftab immediately decided to use some bricks to make a makeshift path for the children to access the school building.

aftab teacher

These efforts were highly well-received by the local community and the parents, who could see that the school staff are working beyond their call of duty to ensure that their children don’t miss out on education. Soon, some of the community members joined in the efforts of laying the path and secured access to school for the local children.

In the village where the school is located, most of the parents are illiterate and the children attending the school are first-generation learners. Knowing well that quality education is the only opportunity for these children to emerge from the intergenerational cycle of poverty, Aftab has started to provide extra support to some selected children to have the option to enrol in the residential Navodaya schools. He has also created a google sheet with the contact details of all the children to track how far have they achieved their age-appropriate learning. With this, he aims to support those who lag behind and encourage them to progress ahead.

In March 2020, after the onset of the COVID-19 pandemic and the declaration of the national lockdown, the situation for the children worsened. Earlier, under the government’s midday meal scheme, one meal was always ensured at the school, but with the schools closed and no work for their parents, even the next meal became uncertain. Anticipating these hardships, Aftab started an initiative to mobilize the community members to support each other. He involved the local leader (the village pradhan) and supported the families in receiving benefits from the government schemes.

water

Further, he re-formed the School Management Committee and started conducting basic literacy classes for the parents, with the idea to conduct mohalla classes and reach the children through the WhatsApp groups.

Having conducted Humana People to People India’s Kadam accelerated learning programme in his school the previous year, and still receiving their support, helped Aftab immensely in his endeavour. With support from the HPPI team, he was also able to distribute essentials such as masks and sanitiser to the local community members. Further, the HPPI team also helped him implement pedagogical ideas like ‘My home, my school’, which promotes children getting educated at their homes with the support of education volunteers.

The true hallmark of a quality teacher is their ability to go that extra mile beyond surmounting the challenge they face. And teachers such as Aftab Ahmed are leading by example for the next generation of teachers as we enter the era of the new normal with its own unique challenges.

I was born in Moradabad, Uttar Pradesh into a family of six members.I came to New Delhi in 2011 and joined Humana People to People India (HPPI), a non-profit which works across India to empower and support people to get out of poverty. I worked for four years on an HIV/AIDS project as a field officer in North Delhi. In 2016, I became the Team Leader in a TB project called Project Axshya which HPPI implemented across all 11 districts in Delhi with support from the Union. The project aimed at creating awareness on Tuberculosis (TB) and linking people and getting access to information, diagnosis, treatment and counselling at any time.

TB Survivors to TB Champions

The Project required me to travel to the TB centres (kiosks) as early as 5.00 am in the morning so that I would be there when our kiosks opened at 6:00 am till 9:00 am and provided medicine to TB patients outside the normal opening hours. The government staff would take over after 9:00 am until 9:00 pm after which we again provided our kiosk services. This was done so that people and patients could still attend their job or education without compromising on their treatment and access to information.

Often I would be there on an empty stomach, leaving so early that I compromised my own health and immune system. I was already working in a high-risk place and when my body was at its lowest, I caught the TB bacteria.

One of my first symptoms was regular fever which started after sundown and would go away during the day. I would feel weak and not have an appetite. As part of my job, I had to go door-to-door under Axshya Samvad to educate people about the symptoms and link them to the earliest treatment. I realised my symptoms were no different. However, it was a lymph node on my neck that rushed me to see my doctor who confirmed I had Category 1 Extrapulmonary Tuberculosis, a type of TB where the disease affects any part of the body other than the lung.

I got tested, started my treatment and for a year, I dedicatedly took my medicines, improved my diet and focused on getting better. Though in the beginning there were some side effects and it took a month for my body to adjust to the medicines, I never skipped them. I got tested regularly to check if I had any drug resistance and the status of my treatment.


Along with science, you also need the support and love of your family and friends. When I first found out I had TB, I hesitated to take treatment from the centre that was close by because I also worked there. I thought what would people think and it made me choose a treatment centre that was 15 kilometres away. But, one day when I told the people close to me that I had TB, I felt the power of their support that not only helped me get better soon but helped me keep them safe.

Slowly as I got better, my confidence in the treatment got stronger and I used my experience to help almost 1,700 TB patients in their journey of treatment and counselling under the Project.

Early detection is key in all illnesses and I would advise everyone who notices symptoms such as cough for two weeks, a lymph node, appetite loss etc., to go visit their nearest clinic for diagnosis and treatment. You may start to feel better once you start your medicines, but you should never stop your course of treatment unless your doctor gives you clearance.

Today, we as a country are working towards eliminating TB by 2025, five years before the global goal to end TB by 2030. This is only possible if we support TB patients and remove any stigma attached to it. Anybody can get TB. It is said almost 40% of people in India have TB - whether active or inactive. The Government’s National Tuberculosis Elimination Program is working on medicines that will help us diagnose inactive bacteria as well which will help many people to stop TB before it gets active.

I am positive that we will be able to end TB but it is a collective effort. We will have to fight the bacteria, the stigma and help raise awareness that TB is just another illness. It is completely treatable and you can bounce back and be healthy once you complete your treatment.

Every year on March 8, the world celebrates International Women’s Day. It is the date on which women in Soviet Russia started protests for the right to vote which they were granted in 1917. Every day, women around the globe are fighting for equal access to opportunities, to be free from stereotypes, gender inequality and violence.

This International Women's Day, the theme is "Women in Leadership: Achieving an equal future in a COVID-19 world”. The theme identities the amazing efforts by women around the world towards shaping the future, even as we are recovering from the COVID-19 pandemic.

tejaswini womens day 1

Humana People to People India aims at empowering women and girls at school, to start their income-generating enterprises and encourages them to know and access their rights and benefits. Through our different community development and women empowerment projects, HPPI focuses on the health, economic and social development of the young girls and women under our project intervention areas.

This Women’s Day, several projects celebrated the day by raising awareness as well as applauding the women at work who are leading change in society.In the Tejaswini Project, being implemented in Jharkhand, adolescent girls and young women took to the streets to rally messages of women power and empowerment. They also performed, received awards and participated in different activities.

In the Action Against Child Labour project, the Child Rights Protection Forum awarded 60 women with ‘Nari Ratna’, an award for those who helped eradicate child labour in Panipat and connected out-of-school children and child labourers to education.

In the Nandghar Project in Jodhpur, the chief guest of the women’s day celebration event, MLA Mrs. Manisha Panwar inaugurated an equipped Anganwadi/ Nandghar and visited the nutritional gardens developed there. The chief guest also handed over the ‘key’ to the Nandghar to the Sarpanch of the village and applauded the Anganwadi workers who are key to the smooth functioning of the Nandghars.

nand ghar womens day

Under the ‘Adopt a School’ programme, a CSR initiative of Goodyear India Limited, a renovated building of Government Girls Primary School, Sector 3 Ballabhgarh was inaugurated by  Ms. Sonali Khanna, Head-Legal, Compliance & Company Secretary, Goodyear India Limited. Ms. Khanna expressed her delight to be able to support the education of girls of the school and participated in a tree plantation drive on the occasion.

Similarly, in the Udyogini project, 160 women beneficiaries from 12 villages participated in the event where 55 entrepreneurs who had started their own businesses were encouraged and awarded for their hard work and contribution to their societies. They also participated in quiz competitions and dance performances.

When women lead, they also lead their families and communities and women across our projects are slowly leading their ways to reduce the gap in opportunity, pay and participation in the community.

India is the second-largest food producer in the world. However, despite that, we are also the world’s second-largest undernourished population (195.9 million).  As reported in the National Family Health Survey 4, the stunting levels are 38.4 percent and underweight numbers are 35.8 percent. The incidence of stunting in children also tends to be higher in rural areas than in urban, possibly due to the generally lower incomes in rural areas.

With an objective to enhance nutritional intake and to provide a way to save money as well as a source of income to some, Humana People to People India (HPPI) has integrated the establishment of kitchen and nutritional gardens across several of its projects.

Story 1 

In the Udyogini Project, being implemented in Haryana, women in Self-Help Groups came together to be a part of the planning, implementation and maintenance of nutritional gardens. Women who did not have land got together with someone who did and started a garden together.

These nutritional gardens promote year-round access to fruits and vegetables and allow women to save money as well as provide an opportunity for income generation. The availability of seasonal vegetables also adds to the balanced and nutritious diet of the women as well as their families. As of January 2021, 672 nutritional gardens were established under the Project amongst 748 women.

Pinky, a first-time gardener from the Udyogini Project, Sasroli, says, “This is the first time my family and I are consuming fresh carrots, spinach and radishes right from our own garden. We sold off the extra produce and people loved the freshness of our organic products. I also cultivated 16 kgs of potatoes in one season. My family is equally involved and are happy to help me water the garden twice a day. I look forward to planting more seasonal vegetables this spring and summer.”

Simultaneously, in several of HPPI’s Community Development Projects (CDP), nutritional and kitchens gardens play an important role in increasing participation and awareness among the community members. In the past year, more than 600 gardens were established across different CDPs.

According to the recent Comprehensive National Nutrition Survey, Jharkhand is one of the Indian states with a high prevalence of malnutrition among children and women. The state government’s Tejaswini Project, being implemented by Humana People to People India, aims at socio-economic empowerment for adolescent girls and young women (AGYW) in the age group of 14-24 years in six selected districts of Jharkhand, with an added focus on improving their health and nutrition levels as integral to their development.

AGYW in Tejaswini Clubs has developed gardens in their backyard and clubs. In the Tejaswini Project, between April 2020 and February 2021, AGYW established 54,530 nutritional gardens.Story 1.1jpg

To inculcate environmental education from a young age, HPPI integrated environmental education in 84 government schools and five teacher training institutes where the organisation’s Necessary Teacher Training Programme (NeTT) is being implemented. The ‘Improved Nutrition through Fruit Gardens’ Project, implemented across 4 districts (Patna, Nalanda, Vaishali and Arrah) in Bihar and one district (Ranchi) in Jharkhand directly impacted 9,372 students and 625 student-teachers who were provided training on Nutrition and Environment so that students from a young age learn the importance of planting trees and establishing fruit gardens in their schools.

Our country continues to grapple with malnutrition and poverty. When women are educated and given the power to make decisions, they decide the welfare of the entire family and society. Under HPPI’s projects, they continue to raise awareness and enhance nutritional intake in their homes and communities.

About HPPI

Humana People to People India is a development organization registered as a not-for-profit company under section 25 of the Companies Act, 1956 as of 21st May 1998. It is a non-political, non-religious organization. Its mission is to unite with people in India in order to create development in the broadest sense through the implementation of the projects that aim at transferring knowledge, skills and capacity to individuals and communities who need assistance to come out of poverty and other dehumanizing conditions.

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