The link between poverty and health

The Indian healthcare market is growing at an astounding pace of 22.9%. Its present worth is around $ 100 billion and is expected to grow to $ 280 billion by 2020. The Indian pharmaceutical industry is the third largest in the world and accounts for 20% of global exports in generic drugs.
India is a prominent centre of medical tourism with about 1.27 million patients from countries such as Sri Lanka, Bangladesh, China and even from developed countries such as Canada, the US and UK flocking the super-speciality hospitals in the country. But this impressive growth story does not mean anything to millions of Indians for whom even primary healthcare is neither accessible nor affordable.

According to a study published in September 2016 by “International Collaboration on the Global Burden of Disease,” India ranks 143 in the list of 188 countries on a range of health indicators.
Though successive governments introduced various schemes and spent hundreds of crores, ‘Health for All’ remains a distant dream. What is preventing the achievement of this much-cherished goal?
Addressing the 54th World Health Assembly in 2001, Kofi Annan, the then UN secretary general, said, “The biggest enemy of health in the developing world is poverty”. The policymakers would do well to remember this stark reality while trying to achieve the goal of Health for All. It is necessary to take a hard look not only within the health sector but beyond it.

According to “The People’s Health Movement”, a global network of grassroots health activists, civil society organisations and academic institutions which are relentlessly campaigning for Health For All, the main cause of poor health of millions across the world is poverty. Poverty is both a cause and a consequence of poor health.

Apart from an accessible and affordable public healthcare, proper living and working conditions, safe drinking water, adequate nutrition and hygienic sanitation are essential for good health.

But poverty and discriminatory customs and practices prevent millions in India from accessing these essential services and resources.

Another major consequence of poverty is malnutrition. Though our GDP has increased 50% since 1991, one-third of the world’s malnourished children live in India. Malnutrition affects the immune system, increases the incidence and severity of diseases and results in poorer cognitive function and learning ability in children. Though “Integrated Child Development Services” started in 1975 has succeeded in reducing malnutrition to some extent, much more needs to be done.

It is reported that almost 2,000 Indians die every day due to diarrhoeal diseases. Non-availability of safe drinking water and poor sanitation are the major issues. Most rural households have no latrines.

Emphasis on hygiene
Swachh Bharat mission of the present government is a big initiative and has raised high hopes for hygienic sanitation. It needs to be extended to more villages and slums and complaints like lack of provision for water, lack of proper arrangements for maintenance etc., should be addressed.

Poor people often live in overcrowded, ill-ventilated houses in unhygienic neighbourhoods, exposing them to indoor and outdoor air pollution. They either do not have or have limited access to safe water and sanitation. Infections and contagious diseases spread faster in such an environment.
A large number of poor work in hazardous occupations such as textiles, dyeing, foundry, chemical, mining, agarbatthi, leather and cracker industries where they are exposed to grave health risks.

Improving the staff strength, cleanliness and availability of medicines in Primary Health Centres and government hospitals, timely immunisation and vaccination, creating awareness about health and illness are necessary to ensure Health for All.

Expert studies have shown that the increase in life expectancy and general health in European countries in the late 19th and early 20th century have more to do with a raise in standard of living, clean water, better sanitation and nutrition than with the advances in medical science.

Eradication of poverty should be seen not merely as a welfare measure but also as a means for progress as healthier workers will contribute more to the economy.