Ailing public health, no acche din

The poor state of health services in India, especially public health services available to the common people, is well-known. So, the findings of the study done by the world’s leading medical journal, the Lancet, which do not show India’s healthcare facilities in a good light, may not surprise anyone. The survey, undertaken and written by renowned international experts, is to be published in the December issue of the journal. The editor-in-chief of the journal, Richard Horton, has in an interview criticised the government, and Prime Minister Narendra Modi, for not taking healthcare seriously. He wants India to take health as an issue of national security but finds that there are no new policies, ideas, public commitment or necessary financial support to the health sector. He has warned that India’s economy will become unsustainable when increasing population combines with poor health services.

The issues highlighted by Horton and to be discussed in detail in the survey are crucial to the country. India spends only about 1 per cent of its GDP on public health while other countries spend even multiples of that. The allocations, low as they are, are not well spent, with wrong priorities and corruption taking away much from their utility. Reducing child and maternal health mortality, prevention of communicable diseases, access to basic and affordable health facilities for even the poorest and availability of specialised attention whenever needed are important requirements of a sound healthcare policy. But the country’s record on them is not creditable. Horton has pointed out the contrast between the lack of investment in the public health system and the unregulated growth of the private health sector, which creates an imbalance and works against the interests and needs of the common people.

The government has tried to counter the criticism by denying all points made by
the Lancet editor. But its claims are not convincing. Marginal improvements in certain areas do not mean a general improvement in healthcare. It is true that some initiatives have been taken and they may continue, but they are not enough. Anyone living in India would rather agree with Lancet than with the government on the issue. More importantly, there is a clear perception that healthcare has slipped in the government’s priorities. Some of the magazine’s contentions are supported by the findings of other agencies. Unfortunately, the government tends to see them as part of an international conspiracy to create political controversies. But no country can aspire for “acche din” if it ignores public health.