In January, India celebrated three years without a single case of polio.On March 27, the country was officially certified polio-free by an an independent commission under the World Health Organisation certification process.This is one of the biggest public health successes of India. From being one of the top three countries reporting polio, there hasn’t been a single polio case in the country for the last three years.
That landmark achievement is now prompting the question ‘What next?’ This is the subject of a very interesting WSJ article by Dr, Srinath Reddy (president of the Public Health Foundation of India) and Zia Khan (vice president for initiatives and strategy at The Rockefeller Foundation).
One of the points constantly emerging during our interviews with health experts on the status of health in India is its ridiculously low spending on health. The government spends just 1.4% of GDP on healthcare which is the lowest of the group of emerging economies (the BRICS). India is facing several challenges in health as it is burdened with a high incidence of preventable diseases and simultaneously facing a rapid rise in the incidence of cardiovascular diseases. India has earned the nickname “pharmacy to the world” but access to these same medicines for its own population is severely limited.
As mentioned in this article, “Indian health officials have talked for years about instituting universal health coverage as a way to remove barriers to good health and expand access to quality, affordable care. The government’s five-year plan for 2012-2017 includes a goal of assuring “access to a defined essential range of medicines and treatment at an affordable price” so that no one faces a choice between financial stability and seeking health care. But turning intention into action has been another matter. Health in India is traditionally a state concern – while the national government sets the general policy direction, each state has wide discretion in implementation.”
There are a few exceptions however, where a few Indian states have been experimenting with universal health coverage reforms that offer a model for the rest of the country. Tamil Nadu is one such example. The provision of free or low-cost health services to the entire population has produced terrific results: 90 % of newborn deliveries are assisted by a skilled birth attendant, and more than 80% of children are fully immunised by the time they are one year old. Between 2000 and 2012, Tamil Nadu reduced its infant mortality rate by nearly two-thirds, compared to the national average reduction of just one-third over the same period.
So what has Tamil Nadu done right? “It made investments in primary health care centers, well-trained health workers and fully-stocked pharmacies, and used public financing to make these services accessible to all, regardless of the ability to pay. Importantly, this commitment persisted across frequent changes in political leadership or all.” This is the model that the entire country must follow if it wants to rise above the serious challenges that continue to plague the health care system.
As very rightly put by them, “ achieving universal health coverage in India will not be easy – but then again, neither was the elimination of polio. Success depends on smart planning, mobilisation of entire communities and strong political leadership. No matter who wins in the next election, the health of India’s people must come out on top.”
Throughout the month of April, we will be asking experts, activists and media experts on health- what they think should be on the agenda and what is sorely missing ? We will be sharing this on our website.
Do stay tuned with HII’s coverage on the 2014 elections and what it means for health in India