Expenditure for health care

There was much hope that the National Health Policy 2017 (NHP) would give a new impetus to the healthcare delivery system in our country. The Health Policy is a document for assessment of the contemporary health situation, the issues involved and the way forward to ameliorate the prevailing problems so that citizens get the required health care. The NHP 2017 has to be analyzed in that context.
The vast majority of our people are devoid of basic healthcare, what to talk of advanced quality tertiary care. The government of India has been a signatory to the Alma Ata declaration whereby we had committed to providing healthcare to all by the end of the century. It is 17 years since the dawn of the new century, but healthcare to all remains a dream for our people. Our public healthcare expenditure is the lowest among the BRICS nations (Brazil, Russia, India, China and South Africa). Our public health spending is around 1.1 percent of the GDP. In comparison, other members of BRICS spend much higher. South Africa spends around 8.8 percent, Brazil spends 8.3 percent and the Russia allocates 7.1 percent of GDP on health. Even the SAARC countries spend more than us. Maldives spends 13.7 percent, Afghanistan 8.2 percent and Nepal 5.8 percent of its GDP on health. This has caused large scale disparities and inequity on access to healthcare. In many ways our health indicators are lower than other SAARC countries barring Pakistan. But should we always take satisfaction by declaring that we are better than Pakistan on several counts? This at a time when we aspire to be a world leader in economic performance while Pakistan is nowhere near.
The NHP is silent on the drug policy. Expenditure on drugs is around 67 percent of the total healthcare cost to a person. This cost has to be brought down substantially to make these within the reach of common man. Indian drug companies had made and supplied cheap drugs not only to our population but also to other countries, including some developed countries. The foundation of cheap bulk drugs was laid by our first Prime Minister Jawahar Lal Nehru, who laid stress on the production of drugs by public sector companies. He was of the opinion that drugs cannot be left to private concerns because their sole motive is profit and it will affect affordability by vast majority of population. This approach led to the opening up of prestigious units like the Indian Drugs and Pharmaceutical (IDPL), which supplied drugs for national health programmes and during national calamities. It is unfortunate that the present government is out to close the public sector pharmaceutical units. Drug prices, particularly of the newer drugs, have already been hit after the WTO regime came into force and product patent became the rule. With the closure of pharmaceutical public sector units (PSU) there will be total reversal of policies making the task of universal health care even more difficult. (IPA)

Tuesday, 21 November, 2017