India needs to invest more in public healthcare and build a robust health delivery system in all aspects, including infrastructure and human resources,with special focus on rural areas, the WHO said. “We know that nations need a healthy population to prosper. Stepping up investment in public healthcare is pivotal to sustaining India’s economic growth. Investing in health is investing in India’s growth story,” Dr Henk Bekedam, WHO Representative to India, told PTI.
“We, therefore, need to and swiftly advance and accelerate progress towards Universal Health Coverage (UHC) and the Sustainable Development Goals, especially the health goal,” he suggested.
According to Bekedam, though India has made enormous progress in the healthcare sector in recent past, still “60 million people are in poverty through paying healthcare bills mainly because of the country’s low investment in health, inadequate financial protection and high out-of-pocket expenditure”.
He said many more abstain from health services or delay seeking healthcare due to financial difficulties.
In this context, the WHO proposed a few steps of working with the government to position health higher on the agenda, both at the national and state levels.
Besides investment, strengthening the systems to detect and respond to outbreaks and new emerging diseases, accelerating effective financial protection to ensure no one goes into poverty as a result of using health services and finally, ensuring that there is a strong monitoring and evaluation system in place are also required, Bekedam said.
He also praised India for combating HIV, TB and malaria as as well as the avertable maternal and child mortality, saying the country’s major challenge is “safeguarding the population from slipping into poverty due to healthcare bills”.
“All these require increased investments, as has been demonstrated from global experiences with SARS, pandemic A/H1N1, H5N1, Nepal earthquake and Ebola. Strengthening the surveillance capacity is a key step forward. We still have a high burden of communicable diseases.
“Adding to this is increased noncommunicable diseases (NCDs) and we need to invest more in creating awareness about prevention of NCDs,” Bekedam said.
On whether India is ready to face the emerging threat of lifestyle diseases, he said, “The NCD agenda is complex, requires a call for a coordinated multi sectoral response through a ‘whole of government’ and ‘whole of society’ approach.” In the absence of UHC — the promotive, preventive, curative, rehabilitative and palliative health services people need — in general and financial protection in particular, treatment of NCDs could mean catastrophic out of pocket expenditure for many.
India’s initiative of National Multisectoral Action Plan provides an excellent framework to support and strengthen integration of NCD prevention strategies and programmes of the non-health sector.
Elaborating on WHO’s role in implementing the UHC in India, Bekedam said, “We are working closely with the government in this area and will continue to share global best practices and lessons learnt from other countries.”
The Dutch national who is a doctor took up his role in India in November 2015. Earlier, he was the WHO Representative to Egypt where and his team had focused on scaling-up treatment and prevention of Hepatitis C, strengthening the response to the largest outbreak of Avian Flu and maintaining Egypt’s polio-free status.
Emphasising on the three fundamental aspects to achieve UHC which were to invest in public health; strengthen health service delivery and quality, and improve financial protection Bekedam said, “For progressing towards UHC, we know from experiences of other countries that you do not have to be rich for getting started on the journey.
“It means the development of a national framework and roadmap that defines the roles of the Centre and the states, besides that of both public and private sectors. It is important, therefore, to define and agree on the vision and goals for 2030.”
Bekedam welcomed the Centre’s proposed move to increase the expenditure on health to 2.5 per cent of GDP by 2020 and went on to praise the ‘Draft National Health Policy 2016’ when asked whether India needs to rethink on its health policies.
“The government must also be commended for implementing the National Health Mission that has strengthened the government public health delivery systems. On the policy front, the 2016-17 health budget suggests positive developments. But a national framework is needed to ensure convergence and portability etc and there are many opportunities at the state-level to develop this further.”