The current outbreak of a global pandemic once again highlights the inherent structural deficiencies in India’s health system. Now, one can argue that it takes a tragedy to realize the indispensable force of lifeblood of a nation- a healthy population but then, it would hardly be justified in light of the India’s historical trend of low government spending in the health sector. As per the past few National Health Profile (‘NHP’), India’s public expenditure on health as percentage of GDP has been continually low ( NHP, 2019-1.28%; NHP,2018-1.02%, NHP,2017-1.12%). In fact, the Economic Survey, 2020 acknowledged that India’s spend on healthcare as percentage of total expenditure has remained flat at 5.3% in the last two consecutive financial years.
It is then quite alarming that despite of knowing that it is its healthy citizens, which drive the nation to growth and development, the government spending across most political spectrums on health infrastructure remains low. The case of making health care universally accessible and affordable to all the citizens cannot be enough emphasized specifically in a pandemic situation, where the lower and middle income group are personally motivated to keep safe not just because of the risks association with the illness but the fact that they cannot afford to fall ill, at all.
It would be then surely disappointing that the government continues to constantly spend less in the social sectors including the public health infrastructure.
It is very well known that the expenditure in social sectors have a relatively longer gestation period with no visibly immediate returns. To give an example, in order for an individual to be ably skilled, he has to undergo about a two decade long education which will harness him with the requisite skill to have a gainful employment and contribute to the nation’s growth.
Similarly, in case of health, the perceptible effects of government spending at the community level can be only seen in presence of elaborate, ceaseless and unwearied efforts of the health institutions at the grass root.
And obviously, this is possible only over a longer period of time compared to say, a tax policy decision, which triggers immediate activity in the economy. It is then no wonder that the leaders and policy makers who contribute to health and education sectors are called ‘visionaries’ for they have a long term plan to enable the community structurally by making them fit and able to contribute to the national development.
When we examine the low expenditure and longer gestation periods in the health infrastructure our country, it would not be a long way to conclude that the gap arising due to the above factors can only be fulfilled by the citizens and the community at large.
It thus becomes an essential duty of the government to enable community involvement on the issues of public health, which though underfinanced, can be brought to its feet with establishing a link between the two. One way to go about this would be to empower the community on the issues relating to public health. Involving the community in the decisions relating to the public health, impacting the community is a good point to start. To illustrate, a national campaign against an infectious disease can be best implemented if people from the community are involved in various policy stages.
This can be by community flagging off the sensitive parts of the community against such disease enabling health providers, providing a localized solutions to deter the disease, leading the awareness campaigns for prevention and cure against the disease at the grass root level, making the generic and affordable medicine market more popular, et all.
The giant leap from our concerns for our fellow citizen’s health in public discourse to the manifestos reflecting higher government spending in the health infrastructure for realization of health benefits by the last man standing in a community can be strengthened by involvement of the community in the public health system. After all, each and every member of a community is entitled to the basic humanitarian rights i.e. right to live a healthy life under our Constitutional regime.
At the end of the day, one can only hope that in the clangor of the construction of a high rise sky scrapper, the wails of our impoverished citizens are not lost for want of basic and affordable healthcare.
The writer is Associate Corporate Counsel with the Legal and Compliance of Team of Wipro Limited.