Healthcare: A Collective National Agenda

The sad death of a 7-year old boy allegedly from dengue recently made the entire nation sit up and another enquiry commission has been set by the government to check who is at fault. When such unforeseen deaths raise the emotional quotient of the masses, the government orders a probe, issues a show-cause notice or even makes an announcement to arrest the guilty on charge of negligence or refusal to admit a patient.

Vector-borne diseases have been on the upswing in India since 2012, many people have succumbed to them and many will while we continue to question the data.

On the back of this outbreak, shortage of hospital beds in the country has suddenly emerged as a key debate over the last few days, the fact that India has just 1.3 beds per 1,000 people amongst the lowest in the world and significantly lower than the WHO guideline of 3.5 beds per 1000 is well documented and the basis of many studies on demand for healthcare infrastructure in the country.

The big question however is not only about how many more hospital beds we need in this country but whether healthcare for India is a key national agenda. A country which pulled off the remarkable feat of eradicating polio where it had 4-5th of the world’s polio cases in 2002 is today grappling with deaths from dengue and the conversation needs to get targeted towards the efficacy of the whole healthcare system.

As responsible and well-informed Indians we need to raise questions on the basics and foundation of our healthcare system. India accounts for 21 per cent of the world’s burden of disease and the healthcare supply chain across funding, talent, infrastructure remains in short supply and so do strategies around prevention and sanitation for good health.

We need to attack at the grass root level, so as to envision a flawless healthcare delivery system in the country. Its neither about the private hospitals lacking adequate number of beds for epidemic diseases, nor about the public hospitals being ill-equipped. Its about an agenda that brings healthcare to the forefront collectively.

Let’s take the budgetary allocation to healthcare this fiscal. Under the leadership of a dynamic and visionary Prime Minister, could India expect healthcare to be at the core of its agenda? With the Govt allocating a mere 1.2 per cent GDP on healthcare, India has again missed its bus this year. China spends 3 per cent of its GDP on public healthcare. For a country of 1.28 bn people which accounts for 17.5 per cent of total world population this is an abysmally low allocation for healthcare.

Shortage Of Doctors, Nurses
India currently has 600,000 doctors and 1.6 million nurses, a ratio of 1 doctor to 1,800 people against a WHO recommendation of 1 doctor to 600 people. Where is the agenda to address a short supply of 1.4 million doctors and 2.8 million nurses in the country. This resource crunch is not public versus private but a national dilemma which needs complete transformation of our clinical and paramedical education system with equal participation.

According to a report published by Prof Donald Shepard of Brandeis University which was done by researchers in India and US, dengue effects more than 5.8 million Indians each year which is the highest in the world and costs India over $ 1.1 billion each year. The main cause of this vector borne disease is poor sanitation. Rapid urbanization leading to insufficient sewage treatment plants and more than 100 million tonnes of solid waste a year needs urgent attention. A world bank report states that India’s sanitation deficit leads to losses worth 6 per cent of its GDP by raising the disease burden on the country.

Swachh Bharat Mission is an effort by the government in the right direction to address India’s poor sanitation system which in turn should make India healthy and protect many 7-year-olds from succumbing to this disease. Hopefully this will not remain another slogan but will translate into firm reality with dogmatic implementation.

Intervention at a macro level has become imperative at this stage so that socio-economic issues can be contained for building a healthy India. Till healthcare is treated as a national agenda by India, the population will continue to be plagued by diseases and blame-game at micro-levels will distract the country from concentrating n larger missions like disease prevention. Wake up India.