Health is right, not charity

The Union Cabinet has given its approval to the National Health Policy 2017. A new health policy was long overdue as the present one is at least 15 years old. The NHP 2017, has several positives to it. For one, it proposes increasing public health expenditure to 2.5% of the GDP from the current 1.3%. This is still far short of the 5% of GDP recommended by the World Health Organisation. Given the magnitude of India’s health concerns, one wonders how far the proposed increase in public health expenditure will go in improving public health in the country. The new health policy prioritises primary healthcare; more than two-thirds of the expenditure will be on primary care. It also envisages increasing public access to quality healthcare through provision of free drugs, free diagnostics and free emergency and essential healthcare services in public hospitals. It is well known that expenditure on health drives many Indian families into severe debt. That can be expected to reduce with the implementation of the new policy. Non-communicable diseases, which account for the bulk of India’s illness-related expenditure and fatalities, will get more attention under the new health policy. In the pipeline is a new comprehensive healthcare package to cover cardiovascular diseases, diabetes, cancers as well as mental health, palliative and rehabilitative care at the primary healthcare level.

Still, the NHP 2017, is disappointing. It appears to be a rehashed version of the 2002 policy. The proposal to raise public health expenditure to 2.5% of the GDP figured in the old policy too. The 2017 policy is also a weaker version of the 2015 draft. The 2015 draft promised that public health expenditure approximating 2.5% of GDP would be implemented by end-2017. The 2017 policy defers that deadline to 2025. Many of the targets that NHP 2017 sets out to achieve are not new. Both NHP 2002 and 2017 set the target for maternal mortality ratio at 100. The NHP 2002 had set the deadline at 2010. The maternal mortality ratio (MMR) target was not achieved. Indeed, in 2015-16, India’s MMR was 167. The NHP 2017, has now set the deadline at 2020. Will these and other targets be achieved this time around? Much will depend on the political will to implement the policy. In this regard, the NHP 2017, does not bode well.

The policy lays bare the government’s irresolute commitment. Instead of making health a fundamental right, as the 2015 draft promised, it advocated an “assurance-based approach.” Assurances that are not justiciable often end up being empty promises. The people of this country should not have to depend on the government’s goodwill for access to health services. This should be a right they are entitled to.