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WHO cautions India against slashing health spending


Health sector ‘should not be seen as a black hole of expenditures’, says WHO director general Margaret Chan

Photo: Indranil Bhoumik/Mint

Photo: Indranil Bhoumik/Mint

The Narendra Modi government should not treat the health sector as a “black hole of expenditures” at a time when India is confronted with rising disease burden, worsening pollution and growing shortage of basic amenities, particularly clean drinking water and sanitation, a top World Health Organization (WHO) official said.

“For me, as a director general of the World Health Organization, I would advocate appropriate investments in the health sector,” Margaret Chan said in an interview during a breakfast meeting with reporters at the United Nations on Monday.

The health sector “should not be seen as a black hole of expenditures”, she said, referring to the manner in which federal spending on health was slashed in India.

In this year’s Union budget, the government allocated Rs.33,152 crore for health and family welfare for fiscal 2016.

But this was a reduction from the budget for fiscal 2014 when the government had allocated Rs.37,333 crore for health.

“Health is an investment,” Chan emphasized. “Leaders of the countries must understand that without health and educated people, it is very difficult to talk about sustainable development,” Chan said.

India spends about 1.2% of its gross domestic product on public health.

It missed the United Nations Millennium Development Goals targets for infant mortality, under-five mortality and maternal mortality.

Prime Minister Modi, in his speech at the United Nations Sustainable Development Summit in September, said India is focusing on the basics: “housing, power, water and sanitation for all and that our development is intrinsically linked to empowerment of women and it begins with the girl child”.

Many of India’s health challenges are linked to the poor state of sanitation. It tops the world in open defecation.

Governments must have reasons for increase or decrease in budgetary outlays for the health sector but they need to understand the consequences,” the WHO director general said.

India has 938,861 registered allopathic doctors, or just seven doctors per 1,000 people; while one government hospital bed serves 1,833 people on an average, according to data published by the health ministry.

The ministry also faces the problem of underutilization of funds and in December 2014, the government slashed the 2014-15 health budget by nearly 20%, in the revised budget estimate.

She cautioned the government for giving a short shrift to improving the “health-infrastructure” while increasing the outlays for roads, dams and other sectors.

About “70% of the world’s poor live in the middle-income countries”, she said.

India has the highest number of people living below poverty line of $1.6 per day, according to the World Bank.

“More of the same will not work”, Chan argued, suggesting “a people-centered approach (to health).”

Governments must implement comprehensive and integrated approaches in the health sector for improving the availability of health-related workers, nurses, and doctors in the primary health centres.

She commended the generic drug industry in India for providing affordable medicines to patients across Africa and other countries. She said it is unacceptable to see a pill cost $1,000 and it is important to pare prices. “However, I’ve never seen any breakthrough in health without innovation and we must protect the foundation and mechanism to invest for development.”

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