India's Healthcare Interim Budget Discussion & Dissection 2024

MAIN CONTEXT OF DISCUSSION:

Health expenditure was 31,536 crore INR in 2014-2015 and it was raised to ~3 times to 89,155 crore INR this year. Eyebrows were raised after Union Finance Minister Nirmala Sitharaman in her Interim Budget ahead of the general elections of 2024 allocated 3,712.49 crore INR (37.12 billion INR) for Ayush ministry; which was more than the fund allocated for department of health research, which got 2,980 crore INR (29.80 billion INR). The move was criticized by many health experts as they felt that post COVID, India needed more money for health research on vaccines rather than spend on the AYUSH ministry which promotes Ayurveda, Naturopathy, Unani, Siddha, Homeopathy and Tibetan medicine.

BACKGROUND

Developed countries spend ~10% percent of their budget GDP on health while we only spend 1.2% on health. India's public spending on health is one of the lowest (just 1.2% of GDP). Can it be 3% of GDP in near future?

INDIA SHOULD NOT NEGLECT IT'S TRADITIONAL AYUSH KNOWLEDGE & COMPETENCY

• Yes, AYUSH is not an adjacency of INDIA. It is our competency.
• AYUSH has a lot to offer. Good that the government is giving it much needed priority. Yoga, for example, is getting increasingly accepted by all. However, health research will be served well by doubling of its budget. Depending on private research is not enough. Public funded research is critical if you look at global experience. Unwise to neglect that.

FYI, India exported AYUSH and herbal products worth $1,240 million which is a very significant amount.

• Ayush has its own strengths and limitations. India must play on its strengths via Ayush & it can co-exist; may even complement allopathy. However, it may not be a substitute for allopathy and modern medicine.

Medical colleges have almost doubled in India in the past decade.

• Patient/doctor or patient/hospital ratio must have definitely improved in the past decade in India. More transparent data needs to be shared on the same in the public domain.
• Finance minister's interim Budget speeches flag for special mention, reflect the government's thinking and priorities. And what were flagged? Vaccines for cervical cancer, Establishing 12 more AIIMS and covering front line workers under PMJAY.
• What are the gaps, cracks and shortcomings which still exist in our health system & got exposed during the recent COVID pandemic?
• The health secretary is considered the captain of the ship. Were there any ramifications since India had no health secretary for more than a month? Apurva Chandra was appointed as health secretary just few days ago.

INDIA NEEDS TO GET MORE GRIP ON TB, ELIMINATE LEPROSY, REDUCE VECTOR-BORNE DISEASE INCIDENCE, BRING AUTISM IN NATIONAL FOCUS, PRIORTIZE SUSTAINABLE TREATMENTS OF AUTOIMMUNE DISEASES & REFOCUS ON 'FOOD THY MEDICINE' CONCEPT

• India's primary health care system needs more investment & efficiency. It's affordability & accessibility should determine the performance of future healthcare systems in India.
• Merely increasing the sum assured under PMJAY is not enough.
• Health simply starts from good gut health but health in modern era of today is getting complicated.
• India should iron out any serious deficiencies if it exists in it's health policies and reforms so that it's better prepared if and when any next pandemic waves comes in future or near future.
• Not every country tracks prevalence of Autism in a robust way. Definitely, USA outshine every other country on the same. Their figures can't be ignored by other top countries of the world. Out of 10,000 child of 8-years of age in USA, 278 has autism features and the rate of increase in #autism is flaring-up to almost a tsunami level (~3%). India is also not faring batter in terms of autism prevalence but there is not much national level survey done in past 5 years. However, the number of autism centers are mushrooming across India at rapid pace.

• The Global Market Size for autoimmune disease diagnosis was valued at USD 4.48 Billion in 2021 and is expected to reach USD 9.98 Billion by 2030, with growth CAGR of 9.3%. Isn't these figures are indirectly scary for healthy policymakers? Check
• Gut-impacting foods does not comes under AYUSH but we should not forget the popular phrase 'Let thy food be thy medicine and medicine be thy food', often ascribed to Hippocrates (400 BC), and used to emphasize the importance of nutrition to prevent or cure disease

HEALTH & BEYOND HEALTH

India should also invest more on restoration of climate changes and haphazard development, especially at certain vulnerable hilly terrain like Leh, Ladakh, Himachal Pradesh, 7516.6 km coastline or densely populated cities like Mumbai.

We have huge opportunities, challenges and risks.

What India need today & beyond?

• to understand is the increasing complexities,
• simplify the existing complexities
• not to burden more creating unnecessary complexities
• not accept anything which jeopardize the life of poorest of the poor in India

REFERENCES:

Global Autoimmune Disease Diagnostics Market

Rediff.com (Disclaimer: The above article is inspired from the e-mail interview with Syed Firdaus Ashraf/Rediff.com & retired Union health secretary K Sujatha Rao. You can go through the original article as well.)

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