November 05th 202
Prime Minister of India,
South Block, Raisina Hills,
New Delhi 110 011
Appeal to launch a national scheme of ‘free essential medicines to all’
Dear Prime Minister:
As you may well be aware, citizens of India spend exorbitant amount of money out of their pocket to seek health care, pushing every year more than 30 million citizens below poverty line. An expense on a single hospitalization is an enough ground for 40% patients to sell assets or be indebted. About 70% of this expense is on medicines. According to the CES 2009, about 29% patients cannot afford to seek any kind of medical care and expenses on a single hospitalization is an enough ground for 40% patients to sell assets or be indebted. Cost of medicines is the biggest slice in out of pocket health spending more for ambulatory but significantly to hospitalized patients. In addition, spiraling rise of prices of medicines is keeping away vast number of people out of reach to essential medicines. About 65% countrymen do not have access to essential medicines while India exports drugs to about 200 countries.
In the Independence Day speech of 2011, you had mentioned that the 12th Five Year Plan will be the ”Health plan” and you mentioned “A scheme to provide free medicines to all in public hospitals is being formulated” in your address to the nation on Independence Day 2012. But, unfortunately both of your announcements have yet to see the light of day even when the 12th Five Year Plan period has begun from 1st April 2012. Notwithstanding the fact that the ultimate solution to burgeoning health problems of the majority of India’s citizens
lies in “Universal health coverage through state funding” as recommended by the Planning Commission instituted High Level Expert Group (HLEG) and various working groups constituted to formulate 12th FYP, but even the implementation of any national scheme for free medicines to all is uncertain. Statements of many senior officials of the Union Ministry of Health & FW at various platforms imply that the Central Government has no plans to initiate a scheme of free medicines to patients but will promote this concept by persuading state governments to carry it out by seeking additional funds and incentives under the NRHM from the Centre. The Central Government has released a budget of Rs. 1300 crores for it which is grossly insufficient in contrast to the recommendation of the Working Group on Drugs and Food Safety of the Planning Commission for the 12th FYP. This group has suggested an annual budgetary contribution from the Centre of Rs. 5500 crores to ensure free medicines to all the patients accessing health care in the Public Health Facilities. It may be noted that this is much less than Rs. 30,000 crores suggested by the HLEG. Yet, even this smaller amount is not being budgeted!
In the absence of any national scheme, the objective of universal access to essential medicines is lost. At the moment, barring the states of Tamilnadu, Rajasthan and Kerala, all other states have very truncated schemes in which either some medicines are provided free from limited categories of health facilities or families of certain socio-economic categories are eligible for all kinds of free medicines. This has resulted into no qualitative or quantitative improvement from the previous state of affairs. In fact, previous experiences convince us that till universality of access is not ensured, patients who require free medicines will be deprived the most.
We the undersigned, therefore, appeal to you that a national scheme of ‘free essential medicines to all ‘ is immediately initiated with an annual budget of Rs. 5500 crores & allocation of required human resource & facilities without any further delay. If it is not launched throughout India, ‘free essential medicines to all ‘ which is the easiest of the components of UHC (Universal Health Care), then citizens would legitimately question any official talk about UHC. We hope, the Government of India will abide by your pronouncements and send a message to all citizens.
It is important that while launching a national scheme, elements of transparent methods of procurement, quality assurance, promotion of essential drugs and rational drug concept as adopted by Tamilnadu and Rajasthan would be followed.
(Dr. Narendra Gupta)
On behalf of all National Organisers , Jan Swasthya Abhiyan
Prayas, 8, Vijay Colony, Chittorgarh 312 001
Amit Sen Gupta
National Co-ordination Committee:
All India People’s Science Network (AIPSN)
All India Drug Action Network (AIDAN)
Asian Community Health Action Network (ACHAN)
All India Democratic Women’s Association (AIDWA)
Association for India’s Development (AID)
Bharat Gyan Vigyan Samiti (BGVS)
Breastfeeding Promotion Network of India (BPNI)
Catholic Health Association of India (CHAI)
Centre for Community Health and Soc. Medicine, JNU
Christian Medical Association of India (CMAI)
Community Health Cell (CHC)
Forum for Creche and Child Care Services (FORCES)
Fedn. of Medical Representative Assns. of India (FMRAI)
Health Watch Forum
Joint Women’s Programme (JWP)
Medico Friends Circle (MFC)
National Alliance of People’s Movements (NAPM)
National Federation of Indian Women (NFIW)
National Association of Women’s Organisations (NAWO)
Voluntary Health Association of India (VHAI)
Over 1000 organisations concerned with health careand health policy from both within and outside
the above networks.
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