India proposes new health policy but admits flawsBMJ 2001; 323 doi: https://doi.org/10.1136/bmj.323.7313.592d (Published 15 September 2001) Cite this as: BMJ 2001;323:592
India's health minister, Dr C P Thakur, last week unveiled the draft of a new proposed national health policy—the first in 18 years.
Although it lists gains in the intervening period, the document candidly admits various lapses and distortions that have come to dog the healthcare system. As a result, it says, “the morbidity and mortality levels in the country are still unacceptably high.”
Abysmally low investments in health have led to a poor quality and uneven healthcare delivery system across the country. In the public health facilities the availability of medicines is frequently negligible. The equipment in many public hospitals is often obsolete and unusable, the draft policy has admitted, and the buildings are in a dilapidated state. It means that less than 20% of the population seeks outpatient services and less than 45% use inpatient treatment in public hospitals—despite the fact that poor people seek private health services at the cost of essential expenditure, such as nutrition.
The current annual per capita health expenditure is 160 rupees (£2.30; $3.40). Mr Thakur says that under the new policy the aggregate health expenditure in the health sector would be increased to 6% of the gross domestic product by 2010 (from the current 5.2%).
Primary health care will receive increased attention. It will get 55% of the total public health investment, while secondary and tertiary sectors would get 35% and 10% respectively. Government expenditure on medical research will be raised from currently 0.3% of total health spending to 1% by 2005 and 2% by 2010.
The proposed policy also sets specific goals. These include eradication of poliomyelitis and yaws by 2005, leprosy by 2005, kala-azar (visceral leishmaniasis) by 2010, and lymphatic filariasis by 2015. It also targets achievement of zero growth of HIV/AIDS by 2007 and a halving in the mortality from tuberculosis, malaria, and vectorborne and waterborne diseases by 2010.
“This policy is surely a step forward,” said Dr Ketan Desai, president of the Indian Medical Association. But the proposed increase in health expenditure in the new policy from 5.2% of GDP to 6%, though badly required, was still not enough, Desai told the BMJ. “There is nothing wrong with levying of user charges proposed in the new policy where people can afford them”, he added.
India's draft national health policy can be accessed at www.mohfw.nic.in/np2001.htm