The Telegraph
Saturday, November 18, 2017

Lack of ambition on health, says Lancet

New Delhi: An international medical journal has decried the Narendra Modi government's pledge made earlier this year to increase India's healthcare spending from the current 1.3 per cent to 2.5 per cent of the gross domestic product, calling it "lack of ambition".

"We are disappointed by the lack of ambition of Modi's government to invest only 2.5 per cent of its GDP into healthcare by 2025, when the global average for countries is about 6 per cent," The Lancet, among the world's leading medical journals, said.

The Union health ministry had in March this year outlined a new health policy setting the 2.5 per cent goal which, analysts have pointed out, merely iterates a target set 15 years ago without clarity on the roadmap.

The Lancet, in an editorial accompanying a research report that outlines India's burden of diseases for the first time at the state level, said state initiatives in health should not diminish the responsibility of the federal government to increase public investments in health. (See Page 8)

"The rise in India's economic fortunes and its aspiration to progress to the same level as its neighbour, China, is something of an embarrassment, given how improvements to health trail so far behind," the journal said in the commentary. "Until the federal government in India takes health as seriously as many other nations do, India will not fulfil either its national or global potential."

Analysts have pointed out that India's healthcare spending as a proportion of GDP is among the lowest in the world and that universal healthcare offering free diagnosis, medicines and treatment services will remain unachievable without dramatic spikes in spending.

However, the journal, appearing to align itself with former UN diplomat and now Congress politician Shashi Tharoor, has also suggested that Britain through its colonial history may need to share some responsibility for the state of healthcare in India today.

The journal cited Tharoor's 2016 book Inglorious Empire that it said "painstakingly documents" how Britain's rise for 200 years was financed by its depredations in India. The argument that Britain's enlightened despotism bestowed political unity, parliamentary democracy, rule of law, a free press, and a world-class railway system is "thoroughly disproven by Tharoor", the journal said.

"Most importantly, as one confronts today's burden of disease and disability in India, Britain showed little interest in building even the most rudimentary elements of a health or scientific research system during its period of colonial rule," the journal said.

The accompanying report in the journal highlights changing patterns of diseases over a quarter century, pointing out traditional challenges such as maternal, child, and nutritional diseases and emerging issues such as diabetes, heart disease, air pollution.

The report has found that malnutrition remained the top driver for premature deaths and disability among people in 23 of 25 states in 2016, just as it was in 1990. It has also identified diabetes and coronary heart disease as the fastest growing causes of serious ill-health in the country.

"The data shows that what we have been doing up to now is not enough," Lalit Dandona, professor at the Public Health Foundation of India, New Delhi, who led a group of 200 scientists from institutions across India to prepare the report.

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