By Robin Banerjee
With 2024 having commenced, the memories of COVID have receded. But have you noticed that one of the COVID times habits of using face masks has remained amongst some of us, a habit that was non-existent earlier?
While times have become rather normal, an abnormal headache has emerged. Mental health illnesses are sweeping the world. You will perhaps be surprised to know that the World Health Organisation estimates that an estimated 12 billion workdays worth $1 trillion (~Rs 83 lakh crore) per year are lost due to depression and anxiety across the globe. Providing mental healthcare helps prevent long-term illness.
Given this background of the changing times, let us look into the Indian Government’s ‘Interim’ Budget in the ‘healthcare sector’. Though not the final budget, it will yet show the thinking that the government is enunciating.
Key strategic areas of healthcare thrust
Health has indeed found a major focus in the budget document. The government would spend on health Rs 90,000 crore in 2024-25, up from Rs 79,000 crore in 2023-24. Showing an increase of 14 per cent. Is it adequate or inadequate? You may decide from the enumeration below.
Let me now explain the big picture.
- Health is wealth: A significant strategy in this budget is to develop the ‘pharmaceutical industry.’ It is one of the few industries with a separate allocation for its development, assigning Rs 1300 crore next year against spending of Rs 265 crore this year (it was almost non-existent earlier). The Pharma sector is one of the very few sectors the government has ever given a special strategic treatment. In addition, it is also spending heavily on PLI (provides incentives to industries to boost local production). A healthy mind and body are the ultimate power!
- Nari Shakti is svaasth and sehath:
- Prevention is better than cure: Cervical cancer is a deadly disease. India loses about 75,000 women owing to this illness. To prevent the catastrophe, the budget has planned to encourage the vaccination of girls between 9 and 14 years old. This will be done by making vaccines cheaper by including the human papillomavirus vaccine (HPV) in the country’s immunisation program.
- Nutrition is key to health: An integrated nutrition supplier scheme has been planned. This is through the Saksham Anganwadi and Poshan 2.0 scheme. It is focused on children, adolescent girls, pregnant women, and lactating mothers. The scheme will involve a strategic shift in nutrition content and delivery and creating a convergent ecosystem to develop and promote practices that nurture health, wellness, and immunity. The scheme (budgeting Rs 21,000 crore) existed but was not working adequately. What the government is planning now is to reorganise it under the Poshan 2.0 scheme, pushing it into primary verticals like:-
- Nutrition Support for children of 6 months to 6 years, pregnant women, and lactating mothers; and for adolescent girls between 14 to 18 years in Aspirational Districts and North Eastern Region;
- Early childhood care and education [3-6 years] and early stimulation for (0-3 years).
- Earning power provides good health: I have a friend with the ‘Adlakha’ surname. In olden times, anyone with even half a lakh was rather rich. They would get a title surrounding it. So were ‘lakhpatis’. The government, catching on to this terminology, had announced the ‘Lakhpati Didi’ scheme. Rather thoughtfully, the scheme empowers women in rural areas to encourage them to start micro-enterprises and training in skills such as plumbing, tailoring, etc, enabling them to earn at least Rs 1 lakh per annum. The target is to increase from 2 crore to 3 crore women ‘lakhpatis’. The strategy is to provide a fair income, leading to better living and health.
- Health eco-system: Good health cannot be practiced unless the environment encourages us to remain healthy. It needs clean air, water, and an accessible medical system. Let us see how the current budget has focussed on eco-system building.
- Bio-technology R&D: This is thinking of the future. It involves human resource development, bioinformatics, and biotech facilities. There is bad and good news. The not-so-good part is that this year (2023-2024), the government underspent its original budget of Rs 1350 crore, not spending even half of it this year. Ended up spending Rs 500 crore. The good news, it is still targeting a high number next year (2024-25), with a budget of Rs 1100 crore. Hope the government spends it usefully.
- Technology usage hastens healthcare dispersal: The government plans to roll out the newly designed U-WIN platform for managing immunisation and intensified efforts of the Mission Indradhanush (immunisation for children).
In addition, the ‘Ayushman Bharat Digital Mission’ scheme exists to develop the backbone necessary to support the integrated digital health infrastructure. It will now extend to ‘anganwadi’ (women employed to provide additional healthcare) workers and helpers.
- Cleanliness helps healthy living: The government will spend a total of Rs 12000 crore next year, delivering a 25 percent increase over this year, on its Swachh Bharat Mission.
Misses in Healthcare sector strategy
There is nothing on this earth that cannot be improved. So is the budget strategy in the healthcare sector. However, this sector would need some renewed efforts and certain strategic initiatives to make India the best place to live. Let me tell you the key areas which need quick focus (may the final Budget for 2024-25 consider these):
- Shortage of Health Care personnel and centers: It is understood that there is almost a 10 per cent shortage in Primary Health Care Workers and over 50 percent in Community Health Care Centres. The worst is there seems to be over 75 per cent shortage of surgeons, physicians, gynecologists, and pediatricians in these rural centers. That’s a large shortfall. A lot more needs to be done by the government.
- TB is a major risk: 3 out of every 10 TB cases in the world are in India. This needs immediate remediation.
- Cancer, a major killer: A 2023 Lancet study shows India lost 9 lakh lives to cancer in 2019, the second highest among 49 Asian countries. This needs special focus.
- Hospital beds not enough: It is understood that India needs another 25 lakh hospital beds. This would ensure that for many poor of our country, floors of hospitals would not become beds anymore.
- Benevolent healthcare Regulator: The healthcare sector has a regulator in the form of NABH (a national accreditation body for healthcare providers). However, a government-sponsored Regulator overseeing the myriad of permissions, single window clearance, quality delivery, transparent pricing, etc., would make the healthcare delivery system credible and accessible. This must be implemented sooner rather than later to make a global standard health ecosystem.
Last few wordsThe strategy for a healthier India enunciated through the interim budget is laudable. India is getting into the groove of becoming a ‘developed’ country in the not-too-distant future. Health is wealth – is one of the most common adages. The government, together with the private enterprises, are trying to make this come true.
Some tinkering, a few broad strategic shifts, and a philanthropic healthcare regulator sponsored by the government would go a long way to making all of us healthy, wealthy, and wise!
Robin Banerjee, Chairman, Nucleon Research Pvt Ltd
(DISCLAIMER: The views expressed are solely of the author and ETHealthworld.com does not necessarily subscribe to it. ETHealthworld.com shall not be responsible for any damage caused to any person/organisation directly or indirectly).
