The Modi administration has pledged massive reforms to healthcare, with its National Health Policy (NHP) being perhaps one of the most ambitious healthcare projects in the world. However, providing adequate healthcare to a population as large as India’s calls for a phenomenal budget.
The results of the NHP programme, as well as the Swachh Bharat (Clean India) initiative, which addresses India’s significant sanitation problems, have thus far been mixed. Ground has been gained in the Clean India program, following huge investments of 62,000 crore (620 billion rupees). This has resulted in the building of thousands of toilet facilities across rural India, though reports suggest in many cases they are being ignored by citizens.
Before this nationally focused policy by Modi, healthcare has typically been a matter handled on a state by state basis. This may explain why progress is typically being seen on a state level, rather than nationally. Initiatives such as those in Gujarat – opening 52 state run pharmacies with the intention to distribute cheap, government certified generic medication – could directly aid those in poverty. The state aims to increase this number to between 500 to 1000.
By contrast, direct healthcare funding is being cut. In a previous article by Health Issues India (HII) it was noted that spending has been reduced for organisations such as the National AIDS Control Organisation (NACO). New legislation in regards to HIV treatment has also been introduced that has fallen under international criticism due to wording that suggests treatment is no longer a guarantee.
Regardless of this less than perfect track record for healthcare improvement, the Modi administration remains remarkably ambitious. Re-assessment of the distribution of healthcare facilities and the consequent gulf between urban and rural areas in terms of access to healthcare has been mentioned as a foremost issue. The report accepting the issue states that it is largely due to population density as well as wealth distribution, massively favouring the wealthy cities in terms of medical resources as opposed to impoverished rural areas.
How the government aims to tackle the issue of rural healthcare is up for debate, with recent policies such as demonetisation affecting the poor and those in rural communities considerably more than their wealthier counterparts. Typically rural communities deal in cash, with many working as day labourers, some not even owning a bank account. This recent move to encourage digitalisation and to clamp down on corruption has left some who are reliant on private health care without access to medical treatment, as private healthcare facilities are exempt from the government’s calls to accept old currency.
In other areas, the Ministry of Health and Family Welfare intends to place a higher focus on the eradication of mosquito-borne diseases. The “National framework for malaria elimination in India: 2016-2030” will emphasise the reduction of environments in which mosquitos prosper. This seems a reasonable approach as it is a policy linked closely with Swachh Bharat and may benefit from the heightened sanitation measures Swachh Bharat promotes. The policy for the clamp down on malaria also makes several promises in terms of country wide centres for malaria prevention and treatment. At a time when health care budgets are often being cut, this may not be achievable, especially on a national scale, though the policy does outline a prioritisation of high transmission areas.
The aims of Modi’s healthcare policies are vast, to boast of large scale changes at a national level, particularly in a country as large as India is a brave claim. The Indian healthcare expenditure in 2014 was only a measly 4.7% of the GDP according to The World Bank, compared to a global average of 9.945%, despite increases since it is not yet high enough to achieve the goals the government intends. Emphasis has been placed on investments from the private sector as well as foreign investment to prop up this budget, though it is likely that without a large degree of health care reform the policies are set to become idle promises.