I-Day Special | Atmanirbharta: Crucial for health security

As the country cautiously attempts to get back on its feet and be prepared for another possible surge in Covid-19 cases, the anxieties are very real.

Parents worry about getting their children back in school, young people are hopeful of better prospects beyond these gloomy months and the onerous responsibility of restoring normalcy, in a sense, rests with India’s healthcare administrators. Grapple as they do, with the tricky SARS-CoV-2 virus that caused the Covid-19 pandemic, even as other healthcare challenges mount.

Looking back 75 years, to look forward, healthcare veterans say the successes have been “enormous”. “India has eliminated small pox and polio, for example, and health indicators like infant and maternal mortality rates in States like Kerala are as good as any developed country,” says JVR Prasada Rao, former Health Secretary at the Centre.

But there is much ground to cover.

“In a football match, you cannot just dribble well, you need to score a goal. We need to score more goals,” says Rao, pointing to health interventions that get-off to a good start, only to have complacency set in and slowdown the pace.

Programmes to control malaria and tuberculosis, for instance, are making progress. “They have reduced mortality and morbidity, but not eliminated it,” he says, stressing the need to finish the race. Future challenges lie in non-communicable diseases like diabetes and hypertension, besides cancer, as they compound the rising healthcare costs.

Test for health infrastructure

The pandemic put India’s public health infrastructure to a severe test, he says, adding that “we have not done enough to put the first line of defence in place, a robust primary healthcare network.”

The Centre’s insurance support through Ayushman Bharat has supported hospitalisation costs, but more needs to be done on prevention and out-patient costs, he says.

A country’s success lies in investing in health and education, he says, pointing to the long pending promise of increasing healthcare spending to 2.5 percent of GDP, now expected by 2025.

Investment needs to be made in public sector manufacturing of drugs and vaccines, he says, a crucial feature in protecting the country’s health security.

Tracing the growth of the pharmaceuticals sector, Cipla doyen Dr YK Hamied says, 1972 to 1995 was a golden era when process patents were allowed. The industry grew to become a pharmacy to the world.

Today, he says, companies are entering into licensing deals because new technologies are expensive to develop. The Government needs to decide whether it wants companies to keep medicine prices low and affordable or support the industry in making newer products that could be more expensive, he points out.

Tools to educate

Dr Devi Shetty, cardiac surgeon, and Founder-Chairman Narayana Health, says the country has done a “great” job on several fronts, but has erred in not investing in education. A mechanism must be created to allow young people to earn while they learn (as they do abroad) and be able to send home some money, he explains.

No bail-outs

S Srinivasan, a member of the All India Drug Action Network and founder LOCOST (a non-profit organisation making essential medicines), says a key learning from the pandemic is the need to invest in health and education and to innovate and manufacture to support the country’s needs.

Government spending needs to increase to at least 5 percent of GDP, he says. “No one will bail us out. We need to invest in research and manufacturing for our health security,” he points out.

COMMENT NOW