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India’s BJP and health : after one year

An article  in the Lancet looks at the BJP government and what it plans to do for health in India. It also voices concerns from health experts in the field and about what the slashing of the health budget really means for India. According to the author, Dinesh Sharma, “in the first year of the Modi Government, India might have taken a few steps back in public health after having previously made a commitment to public sector-led universal health care”.

Excerpts from the article :

  • The annual budget for 2015–16 presented in parliament earlier this year, reinforced the government’s new thinking by slashing central government’s health spending by 15% compared with last year
  • The lack of support displayed by the Modi Government for a publicly funded health sector has raised fears that health programmes will be severely underfunded. NHM, under which central government provides funds to states for reproductive, maternal, newborn, child, and adolescent health programmes, has received almost a quarter less money for 2015–16 than last year.
  • Experts don’t share the government’s optimism that more funds will be at the disposal of states under a new tax sharing formula or that states will spend more on health
  • As many as 15 of the health ministry’s national programmes, including tobacco control, mental health, prevention of blindness, trauma care, elderly care, and human resource development have not been allocated a single rupee
  • The National AIDS Control Programme (NACP), which helped to keep overall prevalence of HIV below 1 percent with prevention strategies, also faces a shortage of funds.
  • Experts, however, doubt if the construction of toilets alone is sufficient to ensure better health. “In order to achieve health gains from sanitation, it is essential to put resources into effective behaviour change strategies, so that latrines are used correctly and consistently by all”, said Thomas Clasen, professor of environmental health at Emory University, GA, USA, who led a study on effectiveness of rural sanitation in addressing diarrhoea and child malnutrition in India.

According to Dr. Sridhar Venkatapuram,  the Lancet article brings to urgent attention–both within and outside India–the crucial events occurring in India regarding health.  There is a clear reduction of health spending by the Centre, and a greater reliance on the private sector to finance and likely provide health care.   We know that the amount of money spent on healthcare is not a good or sufficient indicator of health improvements, as the spending on healthcare in the USA shows clearly.  However, spending on healthcare is a necessary part of part of health improvements. The reduction of public spending on health by the Centre as well as unjustified optimism that the state governments will give more attention to health is truly confounding and disheartening as the poorest people will suffer the worst consequences.”

Dr Venkatapuram is a Lecturer in global health and philosophy, and Director of the MSc in Global Health & Social Justice. Sridhar’s research and expertise is in global/public health, human rights, ethics and philosophy.  We conducted an interview on his views on the status of health in India. To read that , please click here.

There is another really informative article called Modi-fying India’s health: Health in the times of India’s new prime minister.

According to authors , Prashanth NS and Upendra Bhojani, if financing of healthcare is any indicator of government’s commitments to health of its people, the signals are not (yet) so positive.Modi government’s slogan of “minimum government, maximum governance” fails India on two counts. There is the actual need of quite some “government”, at least with respect to sectors like health, education and environment, where we know from several global experiences that reducing government’s stake to mere stewards while handing over organisation, management and delivery of these systems to non-governmental entities is a dangerous trend. The need for building a strong partnership with states and investing in multi-level governance system and effective regulation of private sector in health, especially the provision of healthcare by private entities is a crucial need for Indian public health.

To read this article, click here.

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