The announcement of the National Health Policy was eagerly awaited. For one, the country was going to have a new health policy after 15 years. Secondly, the draft National Health Policy that was put in the public sphere in 2015 had promised much. But the new policy announced on Wednesday disappoints on several counts.
It aims to eliminate kala-azar and filariasis by the end of this year, leprosy by 2018 and measles by 2020. But there is nothing new in these targets; they were part of Finance Minister Arun Jaitley’s budget speech. More significantly, the policy belies the promises of its draft version.
The country’s paltry public health expenditure has repeatedly drawn criticism from national and international experts. India’s current expenditure of less than 1.5 per cent of its GDP on health seems a pittance compared to what the WHO recommends — 5 per cent of a country’s GDP. The health policy of 2002 had promised that India would spend 2 per cent of its GDP on health by 2010. That never happened. The draft National Health Policy made an attempt to address this shortfall, if only partially. It recognised that while India’s GDP has grown significantly in the past decade, the share of health in the country’s public expenditure has not grown; the document stressed the “two-way linkage between economic growth and health status”.
The draft had said that the country would spend 2.5 per cent of its GDP on health by the end of 2017. The policy announced on Wednesday pushes back this deadline to 2025. It also climbs down on another important proposal in the draft policy — of a National Health Rights Act. The policy fails to make health a justiceable right and instead talks of an “assurance-based approach”.
The government’s argument that the states do not have the infrastructure to make health an entitlement seems weak in light of the fact that essential healthcare services such as diagnostics and drugs are free in many states. State governments have, however, failed to expand the workforce engaged in healthcare, train them and retain them. This has affected service delivery as well as research and development. The draft health policy recognised this shortfall and ascribed it to meagre spending.
The new policy, in contrast, makes very little attempt to correct past mistakes. It does mandate the creation of a National Healthcare Standards Organisation (NHSO) that will fix standards for healthcare institutions in the country. But given that health is a state subject, it’s not certain if this organisation will have the teeth to be effective — much like the new National Health Policy.