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Free drugs plan paradox

New Delhi, July 10: The allocation for the health sector has left sections of experts disappointed and wondering how the government will meet its own pledge to scale up free medicines and free diagnostic services.

Finance minister Arun Jaitley said in his budget speech today that the government would take up “free drug service and free diagnosis service on priority”, but health experts say the funds allocated to the sector make the proposed scale-up unlikely.

The outlay for health and family welfare is Rs 35,163 crore, only Rs 1,885 crore (5.6 per cent) higher than what the UPA government had earmarked for 2013-14.

Public health experts have estimated that scaling up a programme to provide free essential medicines through all government clinics — a plan announced by the UPA in 2012 but unimplemented — should start ideally with an annual allocation of at least Rs 4,000 crore.

“Where will the money for free drugs come from?” said Selvaraj Sakthivel, a health economist with the Public Health Foundation of India, New Delhi, a research and training institution. “We were hoping to see a clear allocation for this plan,” Sakthivel told The Telegraph.

“The free drug and diagnosis service was mentioned as a priority, but this hasn’t been substantiated enough from a procurement perspective,” said Utkarsh Panitkar, partner and head of life sciences in the Mumbai office of KPMG, a global consulting firm. “I’m intrigued with this — it’ll be interesting to see how the medicines will be procured.”

K. Srinath Reddy, a senior cardiologist and president of the PHFI, said one option for the government would be to scale up the free drugs programme gradually, relying on funds allocated to other heads under the health sector such as the national health mission.

But a health economist said using up funds from other health initiatives to support a free drugs and diagnostic programme could end up hurting those initiatives.

The budget also doesn’t appear to have allocations for the proposal to introduce three new vaccines — an injectible polio vaccine, a vaccine against rotavirus infections and a vaccine against rubella — to the estimated 27 million new-borns across the country each year.

Prime Minister Narendra Modi had last week announced that the government would introduce these vaccines as part of a programme to expand the number of infections covered by the universal immunisation programme.

A senior health official, however, said the absence of a substantial increase in the funds allocated for immunisation need not cause concern. “We’re introducing the injectible polio vaccine only by the end of 2015, and it’ll take us at least nine months to procure the vaccine against rubella,” the official said.

The budget has proposed Rs 500 crore to establish four AIIMS-like institutions in Andhra Pradesh, Bengal, Maharashtra and Uttar Pradesh. It has also proposed to set up 12 new government medical colleges.

Jaitley also announced that the Centre would establish 15 model rural health research centres in different states to take up research on local health issues relating to the rural populations. He said two National Institutes of Ageing would be established at the AIIMS, New Delhi, and at the Madras Medical College, Chennai.