‘Need to spend a lot more on public health’

In health, we have a population growth of 1.6 per cent, almost one-third of the people are young, and we have an elderly population of about 100 million — posing a big new challenge for policy makers. Despite challenges, the health sector has done quite well.

The National Health Policy (2017) set the agenda. The comprehensive policy document addresses several aspects, including social determinants of health (contributing factors to good or bad health).

Ayushman Bharat includes health and wellness centres, and insurance coverage. The Jan Aushadhi stores, which sell affordable medicine, help bring down out-of-pocket expenditure. On infant mortality and maternal mortality, we have made very impressive gains.

The government health expenditure as a percentage of GDP has gone up. But there is a controversy because international agencies peg the figure at around 1.35 to 1.5 per cent. However, the government says it’s about 2.1 per cent.

In pharmaceuticals, the total turnover is about $43 billion (including $25 billion exports, to developed countries as well).

I would rate pharma at 4-4.5, and health at 4.

There have been important legislative initiatives — the Mental Health Act; the Poshan Abhiyaan (targeting nutrition) and the Maternity Benefits Act 2016. The Ayushman Bharat Health Infrastructure mission is also a good initiative.

Health expenditure is a major challenge; we need to spend a lot more on public health expenditure. Health expenditure has to be 2.5 per cent of GDP — the actual money spent has to be 2.5 per cent, or more. It should be spent on primary health infrastructure. Also, there should be coordination between Ayushman Bharat coverage, the Wellness Centers and Jan Aushadhi stores.

Pharmaceuticals need to be careful about quality control, and we need to strengthen the drug control organisation.