As globalisation has grown, local epidemics tend to spread faster across the world. We are seeing this in the case of the coronavirus disease (Covid-19). While the poor are generally the hardest hit, this time it is the developed countries which have been most affected. In India, the poorer states have not been affected as much as initially believed.
The spread of the virus, while not insignificant, has been relatively less in Bihar. Bihar also faces periodic challenges from other infectious diseases such as tuberculosis, kala-azar and encephalitis. Given this, it must deal with the current pandemic at five levels: Historical, financial, infrastructural, issues related to migrant labour, and the revival of the economy.
Historically, Bihar was part of the Bengal presidency. The quality of governance in this region was poor because of the inefficient zamindari system. A memorandum submitted by the then state government to the Simon Commission in 1930 rued the fact that per capita expenditure on health was much lower in the Bengal presidency when compared with the Bombay and Madras presidencies. Even within the Bengal presidency, expenditure on health was the lowest in Bihar, compared to other regions. Unfortunately, even after Independence, this trend continued.
The total public expenditure on health in Bihar is budgeted at Rs 8,788 crore (2020-21), which is 4.1% of the total budget. In per capita terms, public expenditure on health in Bihar is only Rs 690. In contrast, the corresponding figure in Kerala is three times that, at Rs 2,092. Health care infrastructure in Bihar is only one-fifth of the national average, measured in terms of hospital beds per 1,000 people. Bihar has not had any major infusion of funds to create the necessary health infrastructure for almost two decades.
Since the corporate sector is all but absent in Bihar, the responsibility for infrastructure development is mainly with the state government. But the state government can do little if its finances are chronically weak.
Source: Hindustan Times