Neglect of public health leaves
millions of Indians vulnerable to non-communicable diseases (The Hindu)
Mains Paper 2: Health
Prelims level : National Health Profile
Mains level: National Health Profile survey highlights
The recent release of National Health Profile (NHP) 2019 is once again a
dismal reminder of India’s neglect of public health even by the standards of
other neighbourhood and low-middle income countries.
Highlights of the data
Its public health expenditure, at just 1.28 per cent of GDP, is way
below that of Maldives, Thailand, Bhutan, Sri Lanka and Indonesia.
The NHP has chosen to overlook a globally accepted indicator of health
access — direct out-of-pocket expenditure (OOPE).
The OOPE accounts for 62.5 per cent of total health expenditure in
In France, the government’s share is 78.2 per cent while in China, it is
above 56 per cent. Such expenditure pushes a staggering eight crore Indians
below the poverty line every year.
How to bridge the public funding gap?
The governments past and present have opted for an insurance-based model
of financing. While Ayushman Bharat and its State-level equivalents such as
Arogyashree have helped reduce OOP.
It would be a mistake to assume, as the NITI Aayog has done in an
earlier policy paper advocating a PPP approach to healthcare, that publicly
funded health infrastructure is not crucial.
In health, it is State-run models that have worked, from Scandinavian
countries and Sri Lanka, to Costa Rica and Cuba.
Even if India’s healthcare systems cannot be fully run by the
government, there is certainly a great scope for expanding the State’s
footprint not just in healthcare infrastructure, but also in medical
education, the root cause of unaffordable private healthcare in India.
In India, inclusive health is a contradiction in terms. The health
infrastructure divided into primary, secondary and tertiary, where primary
care is State-managed and tertiary care privately controlled is based on an
outmoded notion of morbidity.
The non-communicable diseases such as diabetes, cardiac ailments and
cancer are not elite, lifestyle disorders, but are increasingly claiming
their victims among the poor as well; yet their treatment falls in the
domain of expensive tertiary care.
NCDs account for 63 per cent of all deaths in India, and their effects
on the poor, underweight and malnourished, in the form of low weight
diabetes, for instance, can be lethal.
Recent Global Burden of Disease data shows that a rise in NCDs is
related to inadequate intake of fruit and vegetables.
The effects of India’s poor emphasis on State-run healthcare are quite
evident: even Bangladesh has done better.
If Bangladesh’s per capita income is fast closing up with India’s, it is
because it has focussed on the basics.
India has pursued growth in isolation of developing its human capital.
Q.1) With reference to the Submarines, consider the following statements: 1. Conventional submarines use a diesel-electric engine, and needs to take
in oxygen only once a week for fuel combustion.
2. Recently, the DRDO tested a land-based prototype of an Air Independent
Propulsion (AIP) submarine at the Naval Materials Research Laboratory in
Which of the statements given above is/are correct? (a) 1 only
(b) 2 only
(c) Both 1 and 2
(d) Neither 1 nor 2
Q.1) Describe the key highlights of National Health Profile survey. What steps
required by the government to bridge the public funding gap?