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Advice for the new government to accelerate health care in India… What should they focus on?

It is no surprise that India lacks a well-defined health care system and needs better governance and access towards health care. The rural-urban divide in health care facilities is representative of the dichotomous nature of almost all aspects of living in India. We have one of the heaviest burdens of lifestyle diseases and then we have our infant and maternal mortality rate that remain among the highest in the world.


We also have heavy disease burdens of completely preventable conditions like malaria, dengue, malnutrition and anaemia. In light of all of this, we at Health Issues India felt it was important to ask some of the health specialists, activists and media working in the field about the areas in health that the new government should focus on.It was also interesting scan our own Exclusive Interviews section and the social media for comments on this subject.

Firstly, we wanted to know if the BJP/NDA comes into power, what does it mean for health in India?

Bachi Karkaria,  a senior Indian journalist and columnist, hopes that when the party talk about ‘growth’ it will take health care into its embrace.

Dr. Saroj Pachauri, Former Country Director- Population Council said that the BJP coming into power will not have any ramifications for health in India.It will not get a big boost, nor will it get a big blow .  In her words “it remains to be seen whether they (the BJP/NDA) are totally committed to improving health and its outcomes but I am not so sure about this”.

“Narendra Modi was the Health Commissioner  in Gujarat a long time ago so he may well be familiar with all the key issues if he becomes the next PM” says Anjali Nayyar- Global Health Strategies. Additionally, if Gujarat is an example, then they have a good immunisation record and have been very open to introducing new health commodities. However, the health section in their manifesto has been very disappointing and quite limited.’

There is nothing new in the BJP manifesto on health and it promises to open AIIMS-like institutes in each state and  extend ambulance services available on dialing toll-free number 108 to all states as mentioned in Down to Earth, India’s Science and Environmental portal .(The UPA government, incidentally, has been extending the services in a phase-wise manner- emergency ambulance service launched in 15 states so far and has also established AIIMS in six states.)The BJP manifesto has promised to provide for all through “health assurance” and reduce out-of-pocket spending on healthcare, but it has not clarified the percentage of GDP to be spent on health .Ashok Malik, a senior Indian journalist says that the BJP has promised health access and “health assurance” in its mandate. It has also talked of sanitation and hygiene as priority missions. It has referred to the increasing challenge of non-communicable/lifestyle diseases. Given Mr Modi’s record in Gujarat, he suspects “it will also push immunisation and use of technology to address public health needs”.

“We need a clear road map and not election-time claims.” In a recent article in the Deccan Herald, K Srinath Reddy, president of Public Health Foundation of India (PHFI) said that “the public financing has to go up with strong focus on primary care, rather than subsidising secondary or tertiary care.’ PHFI, is a public private initiative (which includes Indian and international academia, state and central governments, multi & bi-lateral agencies and civil society groups) for strengthening training, research and policy development in the area of public health in India.

Kiran Mazumdar Shaw is more positive about the BJP coming into power and blogged recently on 5 reasons why BJP’s manifesto stands apart. She is the chairman and Managing Director of Biocon Limited, a biotechnology company based in Bangalore India and the current chairperson of Indian Institute of Management in Bangalore. According to her, “ if the BJP is able to show the necessary political will in implementing these bold measures in a time-bound manner when it comes to power, the party will be rewriting the political paradigm in India”. She has been critical in the media of the past government’s approach to regulations of clinical trials in the country as she felt that  “especially for large trials, there were ridiculous requirements” and therefore, hopeful that a BJP government will handle things differently.

For more comments by experts, you can also read Health gets greater attention in the 2014 Indian elections by Dinsa Sachan.

Secondly, what should be the top three health priorities in India in the coming years?

This is a question we always ask in our Exclusive Interviews section every month.We have listed some of the most popular responses to this question

– an approach that can deal effectively with the communicable diseases burden, this includes prevention mechanisms, including vaccines for common killers such TB , HIV and malaria

an embed NCD prevention in every sphere of social activity which is a silent epidemic such as cancer and heart disease

– an urgent need to address the issue of trained human resources in all fields of health care

increase our spending on health and at the same time carefully monitor where and how the increased money is spent

-regulation of the private sector  as it seems growing in a very unregulated and unethical manner

more private- public sector partnerships as we need to cater to not just the middle class but our entire population

 –improving women’s reproductive and general health urgently which includes but is not limited to primary health centres and obstetric care and to address gender based violence

creating many more government provided health facilities including AIIMS like institution in every state

basic immunisation for every child which is a social and economic imperative given India’s young population,  new childhood vaccines for high burden diseases);

tackle water borne diseases and malnourishment

  Lastly, how will the new government be able to accelerate growth in health care systems in India?

Here are the top six responses

– in order to strengthen the health system, there needs to be much more accountability as this will help in effective implementation of health programmes and policies.We definitely need to focus more on the northern states of India

a commitment to increase GDP allocations to health with perhaps a separate budget for introducing innovations to address high burden diseases

a very strong, leakproof, dedicated  primary health care network with increased and trained human capital at the village level

issues of access have to be tackled and this includes addressing the issues of human resource shortages and limited capacity in medical and nursing colleges

-the regulatory confusion so felt by the pharmaceutical industry has to be addressed for the sake of the patient\

-incentives for private health care to be tiered and more affordable for the poor

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