Taking healthcare down India interiors’ dusty lanes

Far from the hustle and bustle of Varanasi, long-winding, tree-lined dirt tracks lead to a health awareness gathering at UP’s Dhaura Hara village.

As a town-crier wakes up the somnolent village, women amble in dressed in colourful sarees draped over their heads, children in tow. The men in dusty white kurtas and dhotis also listen in as Premchand Maurya, a health educator with the `Arogya Parivar' initiative, uses an illustrated book to tell them tales on health.

Ignoring mooing cows or noisy mortocycles, Maurya explains seasonal diseases like respiratory illnesses, fever and pneumonia and encourages the people to meet the doctor who by now has arrived and set up shop at a nearby school.

As the session ends, a few women come forward with a request, something that comes up repeatedly in the hours spent at this location: “We need a primary health centre here,” says Munni Devi, an anganwadi worker along with fellow worker Jautri Devi. The nearest doctor, a private practitioner, is several kilometers away and is expensive, they say. The nearest Government hospital is in Benaras (Varanasi) or Mirzapur and it is difficult for people to travel that far, Jautri adds.

If that wasn't indicator enough of the sparce health facilities here, the women explain that fellow anganwadi workers were presently participating in a dharna (protest) to seek higher wages from the government.

Convincing people to not ignore their health and listening to their complaints are all in a day’s work for the field-staff at Arogya Parivar, a social business initiative by Swiss drugmaker Novartis.

As the initiative completes its 10th year in India this year, Jawed Zia, Country President, Novartis India, says Arogya Parivar is a sustainable initiative and not a Corporate Social Responsibility project.

Explaining the difference, a company official says, “Social business is a for-profit model whereas CSR is not-for-profit. Given the magnitude of the healthcare challenge in India, donations and philanthropy are not enough. We need scalable business models that take into account the needs of society.”

Addressing conflict of interest concerns, Deborah Gildea, Head (APAC) of Novartis Social Business (NSB), clarifies that Arogya Parivar is structured to have a “separation” between its social and commercial arms. The social activities (health education and camps) are independent of the commercial operations, yet are financed through product sales.

“We have no control on what the doctors prescribe and do not influence them to prescribe any of our products,” says Lokesh Kumar, NSB India Head. Infact, 95 percent of the local prescriptions are for lower-priced medicines from other companies, he points out.

Nevertheless, Novartis is optimistic about the initiative, with plans to expand in the country, besides replicating this social business model in other countries. A similar project in Vietnam (from 2012) is self-sustaining and Kenya (2013) is expected to breakeven this year. Plans are on to expand to Uganda and Cameroon.

In India, Arogya Parivar broke even in 30-plus months, says Lokesh,without giving the financial details. The new year could see the launch of low-priced generic medicines under the Arogya Parivar brandname, he says. The medicines are presently supplied under Sandoz, the generic drugs business of Novartis. Lokesh adds there are no overlapping products between Novartis' pharmaceutical business and Arogya Parivar.

Explaining the initiative, Arogya Parivar medical head Monique Kamat says the awareness generated in remote villages is followed-up with a doctor close by or by connecting via the internet to a doctor at a larger hospital who helps with diagnosis.

In UP's Chandauli village, Arogya Parivar links up through a technology platform created by Tech Mahindra at an ITC Chaupal site. This health-loop is closed at Mata Anadamayi Hospital and General Superintendent Dr Jannavi Tandon is optimistic about taking healthcare to more people through such a model. Difficult cases are further referred to a larger Government hospital in Varanasi, for example, she says.

“We need to rethink in the next decade, Arogya Parivar 2.0,” says Jawed Zia, as the programme gets evaluated and expansion plans are drawn up. The initiative provides but a small indicator of the increased efforts required from both the private and the public sector to take healthcare down many more dusty roads into interior India.

The writer was in Varanasi on an invitation from Novartis.

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