Recent editions of health journal The Lancet have continued what has amounted to a long standing feud with the Modi administration. Continued criticisms have been made regarding India’s health policies, low spending on healthcare and lack of publications by a majority of India’s research institutions.
An editorial released on January 14, 2017 is overwhelmingly critical. One of the issues it elaborates upon first is the performance of India’s clinical research institutions. Only 1.5% of global clinical trials take place in India. In addition, fewer than half of India’s medical institutions have published a single peer reviewed research paper.
Though critical, this section of the article is phrased more as wasted potential, citing large scale and high quality studies taking place in India such as the Health Activity Programme (HAP) as examples of well constructed research. Numerous Indian studies have recently been reported on by Health Issues India, with many producing groundbreaking research in fields such as cancer detection.
The Lancet says that the lack of research output could be associated with a lack of health care resources. This neglect of funding for research projects is failing to capitalise on the potential for high quality research in the country, and its ability to provide information to benefit healthcare reform policies.
Most scathing of all the remarks, the article claims the government is “Perhaps oblivious to the facts” with regards to healthcare funding. The Modi administration promises universal healthcare (UHC) but shows no indication of an increase to the health budget to accommodate this, making the goal impossible in the near future.
Praise was given to the Aam Aadami Party (AAP), taking power in Delhi, given their prioritisation of healthcare. UHC has long been a policy left at the state level, with some states closer to achieving this than others. As of yet, Modi’s administration is no closer to making this a nationwide policy. However, the authors of the article neglect to mention states other than Delhi that have prioritised health — arguably with more success and certainly over a longer period. Tamil Nadu, Andhra Pradesh and Rajasthan are obvious examples.
The dispute with India’s government, in particular with Modi’s government, has gone on since 2015. The same manner of criticism was issued, with a focus on lack of financial commitment to tackling non-communicable disease.
These criticisms were dismissed by the Indian Health Ministry, with letters issued to The Lancet’s editor-in-chief Richard Horton. In a point by point rebuttal the Health Ministry deemed the previous article “derogatory” and “not based in evidence”
Most telling is that two years on, the same issues are still being raised. Despite rebuttals the Lancet has continued its claims that India is not doing enough to improve healthcare. This view is echoed by the international community at large. With statistics such as the 1.4% of GDP spent on healthcare, one of the lowest in the world, it is difficult to deny these claims.