There are increasing signs that SARS-CoV-2 has started to spread to rural areas in India. It impacts people’s health, lives, and public health infrastructure that is already strained from a lack of resources. The emergence of the COVID-19 pandemic in rural India is a worrying trend; 50% of reported cases since the beginning of May 2021 are from rural districts. Long-standing systemic, functional, and health inequities have put people in rural communities at increased risk of contracting COVID-19 and suffering from the lack of essential healthcare services. Health disparities between rural and urban areas exist not only in terms of risk factors, such as poor diet and vaccine hesitancy, but also in terms of healthcare infrastructure, manpower, and testing facilities. We suggest some long-term and short-term measures to efficiently develop strategies to contain and control the pandemic in rural areas. Short-term measures include implementing health communication tailored in culturally sensitive ways, increasing vaccination by the usual immunisation pattern, increasing the number of testing facilities, and ensuring food security through the public distribution system (PDS). Long-term suggestions include strengthening the primary healthcare system, increasing funding in the health sector to 2.5% of the gross domestic product (GDP), introducing mid-level care providers, improving skills and training of ASHAs along with adequate financial incentives, and ensuring participation of multiple stakeholders in community health schemes
