Topic: National Health Policy 2002

Ques. 1 : Point out the focus of the National Health Policy – 2002.

Ans. The Focus of the new health policy :

1. The policy envisages the setting up of an organized urban primary health structure to meet increased needs. It suggests a two-tiered structure, with the primary health centre providing the first tier and the government general hospital the second tier.

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   For improvement of the public health infrastructure it suggests revival of the primary health system by providing essential drugs, levying of user charges for certain secondary and tertiary public health care services for those who can afford to pay, expanding the pool of medical practitioners and simplification of the recruitment procedures for contract employment.

3. For funding and upgrading existing government medical and dental colleges, it has suggested setting up of a Medical Grants commission. Even the curriculum should be modified to make it more need-based, the policy has stressed. It has also suggested specialization in public health, which has been a neglected area, both for medical doctors and non-medical graduates from allied fields.

4. To boost medical research, it has suggested that government-funded medical research be increased to a level of one per cent of the total health spending by 2005 and up to 2 per cent by 2010. Medical research in the country needs to be focused on the therapeutic drugs/vaccines for tropical diseases, which are normally neglected by international pharmaceutical companies on account of their limited profitability potential. The thrust will need to be in the newly emerging frontier areas of research based on genetics, genome-based drug and vaccine development and molecular biology.

5. It also emphasises on improving the ratio of nurses vis-a-vis doctors, the number of hospital beds and to improve the skill level of nurses. The report said the government would work towards gradually merging all health programmes under a single field administration.

6. The policy has also chalked out a special role for the private sector for providing health care considering the economic restructuring under ay in the country. Currently, the contribution of private health care is principally through independent practitioners. Also, the private sector contributes significantly to secondary level care and some tertiary care. In order to ensure quality standards, professional ethics and financial reasonableness, the policy suggests a regulatory mechanism for the private sector. The policy will address the issues regarding establishment of a regulatory mechanism to ensure the maintaining of adequate standards by diagnostic centres/medical institutions, as well as the proper conduct of clinical, practice and delivery of medical services.

7. The policy focuses on building up credibility for the alternative systems of medicine, by encouraging evidence-based research to determine their efficacy, safety and dosage and also encouraging certification and quality-marking of products to enable wider popular acceptance of these systems of medicine. Under the overarching umbrella of the national health framework, the alternative systems of medicine — Ayurveda,. Unani, Siddha and Homoeopathy — have a substantial role. Because of inherent advantages, such as diversity, modest cost, low level of technological input and the growing popularity of natural plant-based products, these systems are attractive, particularly in the underserved, remote and tribal areas. The alternative systems will draw upon the substantial untapped potential of India as one of the eight global centres for plant diversity in medicinal and aromatic plants. The policy also envisages the consolidation of documentary knowledge contained in these systems to protect it against attack from foreign commercial entities by way of malafide action under patent laws in other countries.

8. It points out that no incentive system attempted so fare has induced private medical personnel to go to less-developed and rural areas and even in the public health sector, the effort to deploy medical personnel in under-served areas, has usually been a losing battle such a situation, the policy stresses, it becomes imperative to entrust some limited public health functions to nurses, paramedics and other personnel from the extended health sector after imparting adequate training to them.

9. It points out that effort made over the years for improving health standards have been partially neutralized by the rapid growth of population. It is well recognised that population stabilisation measures and general health initiatives, when effectively synchronise, synergisti-cally maximise the socio-economic well being of the people. The government has separately announced the ‘National Population Policy-2002’. The principal common features covered under the NPP 2002 and NHP 2002 relate to the prevention and control of communicable diseases; giving priority to the containment, of HIV/AIDS; the universal immunisation of children against all major preventable, diseases; addressing the unmet needs for basic and reproductive health services and supplementation of infrastructure. The synchronised implementation of these two policies will be the very cornerstone of any national structural plan to improve the health standards in the country.

10. As regards the impact of globalisation on the health sector, the policy admits that there are same apprehensions about the possible adverse impact of economic globalisation on the health sector. Pharmaceutical drugs and other health services have always been available in the country at extremely inexpensive prices. India has established a reputation around the globe for the innovative development of original process patents for the manufacture of wide- range of drugs and vaccines within the ambit of the existing patent laws. With the adoption of Trade Related Intellectual property Rights (TRIPS), and the subsequent alignment of domestic patent laws consistent with the commitments under TRIPS, there will be significant shift in the scope of the parameters regulating the manufacture of new drugs/vaccines. The -policy observes that global experience has shown that the introducing of a TRIPS-consistent patent regime for drugs in a developing country results in an across-the board increase in the cost of drugs and medical services. In this context, the policy merely states that it will address itself to the future imperatives of health security in the country, in the post TRIPS era.

• Eradicate Polio and Yaws : 2005
• Eliminate Leprosy : 2005
• Eliminate Kala Azar : 2010
• Eliminate Lymphatic Filariasis: 2015
• Achieve Zero level growth of HIV-AIDS: 2007
• Reduce mortality by 50% on account of TB, Malaria and other vector and water born diseases : 2010
• Reduce prevalence of blindness to 0:5%: 2010
• Reduce IMR to 30/1000 and MMR to 100/100000: 2010
• Increase utilisation of public health facilities from current level of 20% to 75% : 2010
• Establish an integrated system of surveillance, national health accounts and health statistics : 2005
• Increase health expenditure by government from 0.9 per cent of the GDP at present to 3 per cent of GDP : 2012
• The states to increase expenditure on health sector from 5.5 per cent to 7 per cent of their budget: 2005

• And further increase to 8% : 2010

• Increase share of Central grants, to constitute at least 25% of the total health spending : 2010

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