As India reports record high daily covid-19 cases and deaths, a group of leading doctors say India must stop mass gatherings and consider postponing its forthcoming elections.

In an open letter to The BMJ, Trustees of the South Asian Health Foundation say it is time to consider whether the benefits of a lockdown outweigh the benefits of an immediate election.

Perhaps it is also now time to reprioritize India’s commitment to universal healthcare (care based on need and not ability to pay) and to reinvigorate its public health spending, they write.

Their response is part of a wider call to action on global inequalities, including:

Criteria-based access to the hospital and intensive care beds to make the best use of limited resources and ensure the best chances of survival for as many as possible
Up to date, evidence-based treatment for all people with covid-19
Good governance to protect the most vulnerable citizens from impoverishment
Workforce planning to balance the forces of economic workforce migration with the needs of health systems
Coordinated action against non-communicable diseases, such as diabetes and hypertension
Empower patients across the globe to preserve their own health through trusted communication and harness social media in the medical community to rapidly share evidence, guidelines, and protocols

“Total indirect deaths related to covid-19 due to disruptions in care, access to care and poverty are likely to kill more patients than the pandemic itself,” they argue.

“Whilst history tells us that action and inaction has resulted in global inequity and iniquity, it is now time to define which actions and inactions we prioritize to drive equity and prosperity during and following the pandemic,” they conclude.