Need for Strong Public Health Policy
THE experience of the Covid pandemic has demonstrated the need for strong and responsive public health system. The Indian experience in the pandemic exposed the shortcomings of the public health system in the country and the robustness of the government health sector in Kerala.
India has one of the most privatised public health systems in the world, with minimal government investment in health. The combined expenditures of the union and states on health have been around 1 per cent of GDP. The BJP led union government’s health policy stated that this figure will be increased to 3.5 per cent, but it is still only around 1.1 per cent of GDP.
Health should be recognised as a basic human right. The infrastructure and services of government hospitals should be expanded and strengthened to ensure health care for all. Public health system should be strengthened by prioritising primary health care, preventive health care, palliative care, child care and maternal care. The doctor-population ratio and doctor-nurse ratio, has to be improved by ensuring equitable access to medical and nursing colleges.
Public health system in Kerala is a role model for the entire country. In Kerala, due to the efforts of the LDF government and improvement in the public health system, the proportion of the population using the government health facilities has increased from 28 per cent in the 1980s to 70 per cent now. In addition to the state government budget allocation, local self government funds, MLA funds, the MPLADS funds and the Corporate Social Responsibility Funds are also utilised to improve the functioning of health sector in Kerala. Because of these factors, Kerala continues to be at the forefront of the National Health Index. The latest Niti Aayog report showed that the health indicators of Kerala are the best in India and have continued to improve over the years.
Covid is likely to continue as an endemic disease. It may end up creating a huge disease burden in the society. At least 20 per cent of people with Covid are at risk for post covid syndromes. Despite severe financial constraints, Kerala has set up Post-Covid Clinics from primary health centres to medical colleges. Union government must provide adequate financial support for the efficient operation of such clinics, which require expensive diagnostic equipment and human resources, for Kerala and for all other states and union territories.
The Indian pharmaceutical sector has achieved the status of pharmacy of the developing world by providing quality medicines at affordable prices to other developing countries as well. India has achieved this through the effective functioning of public sector companies such as Indian Drugs and Pharmaceuticals and Hindustan Antibiotics. The union government must strengthen the public sector pharmaceutical enterprises instead of trying to close them down as is the case at present.
The union government has completely surrendered to the demands of the pharmaceutical companies, allowing10 per cent and higher rise in prices of more than 800 medicines, including life-saving medicines, and health products for emergencies such as angioplasty and dialysis. The MNCs charge exorbitant prices for their patented products. People with chronic illnesses such as diabetes, high blood pressure, lung disease and cancer, who have to take medication for a lifetime, will be hit hardest by the rise in drug prices.
Therefore, the 23rd Congress of the CPI(M) demands that the union government should immediately implement the following policy approaches to improve the public health system in the country.
1. The health budget should be at least 5 per cent of GDP
2. All measures for a robust universal public health system should be taken by providing infrastructure, human resources and other modern facilities to the government hospitals, medical colleges and health institutions.
3. Union government should allocate special funds to the states for setting up post-covid clinics in government hospitals.
4. Corporate and profit oriented private hospitals should be subjected to social control to prevent exploitation of the patients by such hospitals.
5. The public sector pharmaceutical companies and vaccine factories should be strengthened and provided adequate financial support.
6. The new drug pricing policy should be withdrawn. Government should impose price control on all essential medicines. Medicines and health products at affordable prices should be made available through Janoushadi and fair priced drug stores.
7. Compulsory licensing should be invoked in the cases of all essential and expensive patented drugs to make them available at affordable prices.