"A time of crisis is not just a time of anxiety and worry. It gives a chance, an opportunity, to choose well or to choose badly." - Desmond Tutu
Today is the fifth day of the lockdown. Prime Minister Narendra Modi has declared a 21 day long lockdown amidst the coronavirus pandemic across the country starting from 24 March. The situation is quite grim. People are panic buying and many migrant workers are stranded in different parts of the country due to the unprecedented shutdown of transportation mediums.
Health has never been a priority for a diverse, heterogeneous and developing country like India. This can be ascertained by the fact that our first National Health Policy came in the year 1983, 35 years after the existence of the Indian republic. Till now, we have seen only three National Health Policies in place, released in 1983, 2002 and 2017.
India still spends less than 2 % of its GDP on health when it has 18% of the world’s population. Not only does India give health a low priority but even our national political parties have relegated health as a non-issue when it comes to policy priorities for the development of the country.
As a country, India holds an alarmingly low Human Development Index (HDI), placing 129 out of 189 countries in the global 2019 HDI Rankings. Our HDI has further stagnated in recent years despite India being the fastest growing economy in the world.
The primary health care infrastructure of the country is in shambles due to a lack of financing and an acute shortage of medical personnel. 65% of health expenditure is out of pocket and some 57 million people are sent to poverty every year due to this expenditure. India has a severe shortage of trained medical professionals. As per the Economic Survey 2019-20, the doctor-population ratio is 1:1456 against the WHO recommendation of 1:1000. The largest number of malnutrition children are found in India.
The substandard performance of India’s healthcare system is out in the public amidst the coronavirus outbreak. However, this crisis is an opportunity for India to make India’s healthcare system one of the best in the world. Systematic overhauling of health infrastructure is the need of the hour. Heath as an issue needs to be prioritized. It needs to become a priority politically, economically and socially.
Politically, the ‘right to health’ needs to be recognized as a fundamental right through an act of Parliament. Some of the Indian states have better healthcare indicators. Heath is a state subject under the Constitution of India. Therefore, best practices from these states need to be replicated across India. Panchayati Raj Institutions can play a major role in providing leadership to deal with any health crisis.
Economically, health expenditure to India’s GDP should reflect the proportion of the population living in India. The current expenditure is inadequate. The Government of India must increase its expenditure by at least 5 % of its GDP from this year itself. Other measures like public-private partnerships, increasing health penetration etc. should go on simultaneously.
Socially, awareness towards cleanliness, sanitation, and hygiene needs to increase in our country. Maintaining hygiene and cleanliness should be declared as ‘issue of national importance’. People should also vote for those representatives who give importance to the issues of education, health, employment, etc.
This is high time to realize the value of health as we can see how the coronavirus outbreak has affected every aspect of human lives. Health is one of the most important ingredients in the ‘human development approach’. Healthy human beings can only bring overall development and growth in the world.
The ongoing pandemic is an opportunity for India to create world-class health infrastructure, strengthen public institutions, adopt best practices from other countries, increase public health expenditure by 5 % of its GDP, and declare “right to health” as a fundamental right for the people of India.
These are personal views of the author.
(Ritambhara is Director of Advocacy at Center for Law & Policy Research, Bengaluru. She tweets at ritambhara4)
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