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Bureaucracy and budget revision: how spending cuts are affecting India’s public health programmes

BMJ 2015; 350 doi: (Published 09 April 2015) Cite this as: BMJ 2015;350:h1734
  1. Leena Menghaney, lawyer working on public health law and policy, New Delhi, India
  1. leenamenghaney{at}

Healthcare in India needs more funding, not less, says Leena Menghaney, reflecting on services for people with HIV after cuts to some health budgets of as much as 20%

I have seen huge insufficiencies in India’s HIV programme recently, perhaps unprecedented since I started working as an AIDS treatment activist in 2002. It is sobering to witness people, particularly children, getting sick because the drugs and diagnostics that are mostly taken for granted in the developed world are not available.

Two factors are slowing India’s progress on health indicators and access to drugs. Firstly, the government’s health spending has stagnated at just over 1% of gross domestic product (GDP), when the World Health Organization recommends 5%; secondly, the Ministry of Health and its programmes are unable to use much of the funding that has been allocated.

Revision and reduction of allocated spending

For example, the National AIDS Control Organisation (NACO) was allocated a domestic budget of Rs2861 crore (£309m; €420m; $460m)1 from 2007 …

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