India, which is one of the lowest healthcare spenders in the world, has proposed to double its healthcare budget this fiscal as well as take a more “holistic” approach towards health by strengthening the preventive, curative, and well-being aspects. Finance Minister Nirmala Sitharaman also committed ₹35,000 crore for the Covid-19 vaccine in the annual Budget presented on Monday, February 1.
The Budget outlay for health and well-being saw an increase of 137% to ₹2,23,846 crore for the fiscal year 2021-22. Sitharaman said the government would increase the funds if necessary. This allocation includes the one-time spend on vaccination, as well as drinking water and sanitation as part of the health expenditure.
India's total healthcare spending (out-of-pocket and public) has been less than 4% of its GDP. Meanwhile, China’s health spending is over 5% of the GDP, and that of the U.S. is well above 16%, according to World Bank estimates. When the Covid-19 pandemic struck, it overwhelmed India's health system and exposed many existing gaps. Separately, the disparity in terms of access to healthcare is also huge. According to Oxfam, India accounts for 17% of global maternal deaths, and 21% of deaths among children below five years. The organisation says that every year, 63 million Indians are pushed into poverty because of healthcare costs. Last year, India ranked as one of the lowest in an Oxfam index measuring countries’ healthcare spending as a percentage of the GDP.
To tackle India’s many health-related issues, spending on infrastructure, access, awareness, and affordability is essential. It also has to increase progressively, this year can’t be an exception just because of a pandemic.
Pandemic and more
In this Budget, the finance minister announced a new centrally-sponsored scheme—PM AtmaNirbhar Swasth Bharat Yojana—to develop capacity of the primary, secondary, and tertiary healthcare systems. Under the scheme, with an outlay of ₹64,180 crore to be spent over six years, the government proposes to cater to detection and cure of new and emerging diseases. “This will help in rolling out the vaccination programme as well as strengthen the delivery system and build better capability and capacity to combat any future pandemics,” says Rana Mehta, partner and leader, Healthcare, PwC India.
This is especially important at a time when scientists have warned that Covid-19 is not going to be the last pandemic. There are going to be more if countries don’t take collective and timely action on climate change and address risk drivers like deforestation and wildlife trade. A recent report on biodiversity and pandemics by 22 leading experts from around the world said that future pandemics will be more frequent, spread faster, and “do more damage to the world economy and kill more people than Covid-19 unless there is a transformative change in the global approach to dealing with infectious diseases”. The report highlighted that there are an estimated 1.7 million currently ‘undiscovered’ viruses that exist in mammals and birds. Out of these, a startling 827,000 can infect people.
“India's health challenges are huge and require a high degree of collaboration between the public and private health sectors to improve healthcare access, increase insurance cover, bring down out-of-pocket expenses and ensure a good supply of new innovative drugs,” argues Suresh Pattathil, MD, Allergan India.
Eat, drink, and breathe healthy
The Budget, refreshingly, also recognised that healthcare needs to be seen holistically, and air pollution—a major problem in Indian cities—is a leading contributor of respiratory diseases. In order to mitigate this, the government has proposed to spend ₹2,217 crore for 42 urban areas with a population of over a million. The finance minister also proposed the merger of the Supplementary Nutrition Programme and the Poshan Abhiyan and launch the Mission Poshan 2.0, and a strategy to improve nutritional outcomes across 112 aspirational districts. According to research, about 1.7 million people died of air pollution in India in 2019, accounting for 17.8% of the total deaths in the country. Whereas, about 70% of surface water resources in India are polluted, according to the Asian Development Research Institute (ADRI).
For clean water, the government has proposed a new scheme to instal 2.86 crore household tap connections, as well as liquid waste management in 500 Atal Mission for Rejuvenation and Urban Transformation (AMRUT) cities. The Jal Jeevan Mission (Urban) will be implemented over five years, with an outlay of ₹2,87,000 crore.
