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.
23.03.2017
The best thing about the future
is that it comes one day at a time
Abraham Lincoln
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