The National Health Policy 2017 has come not a day too soon. The last such policy was announced in 2002. The NHP makes all the right noises on getting affordable healthcare across to citizens, beefing up primary healthcare, involving the pharmaceutical industry and the dire need to strengthen medical education and human resources to staff the ever growing hospital infrastructure. But it disappoints on two key issues. It stops short of assuring the right to health, a promise that the draft policy of 2015 had ambitiously proposed. NHP argues that it is “conscious” that finance and infrastructure threshold levels are not enabling enough to support such a right. As a result, the aim is to progressively create such an environment towards ensuring the right to health in future.

Successive governments have promised an increase in healthcare spends — hovering around 1 per cent now — to about 2.5-3 per cent of GDP. In fact, the 2011 report by the high level expert group had set a target of 2.5 per cent of GDP by 2017 and 3 per cent by 2020. These have now been pushed back. According to the NHP, public spending on healthcare will reach 2.5 per cent of GDP only by 2025. A commendable hike would have been to 5 per cent of GDP but the problem, as Health Minister JP Nadda pointed out, is that even existing allocations are not fully utilised. This is a sorry comment on the state of administration of healthcare, mainly by State governments. Shockingly, some States even return funds unutilised to the Centre. Though 2.5 per cent is better than the present levels, it is not good enough when mapped against the country’s disease burden. India is home to a spectrum of diseases ranging from malnutrition-related to lifestyle ones, and they require active state procurement of drugs, medical intervention, diagnostics, follow-up and surveillance.

The NHP talks about supporting AYUSH (alternative sciences such as ayurveda, homoeopathy, yoga, etc) but for alternative systems to take off, insurance companies need to extend coverage to treatment done through these systems by government-registered practitioners. The NHP’s promise on treatment guidelines, grading of clinical establishments and increasing support to domestic medical device companies that make products of quality are all well intended. Its pledge to enable supply of free drugs and diagnostics is something that some States are already doing. The NHP can infuse fresh energy into the crumbling leviathan that is the healthcare system in the country — if processing and procurement are kept clean, transparent and accountable. But with health being a State subject, it is finally up to local governments to pick up the ambitious policy framework and run with it. And that’s where the challenge lies for the Centre in getting the NHP to deliver on the promises it makes.

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