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As the dust settles on the general elections, green shoots of expectations sprout among pro-patient groups, that their concerns could receive a fresh approach from the differently-minted Government that takes charge this week.
Health did not find a major mention on the election agenda of political parties, says Amulya Nidhi, co-convenor, Jan Swasthya Abhiyan. With a coalition government at the helm, there is “hope and public pressure” that they will work to strengthen primary care and public health systems, and revisit decisions to “handover district hospitals to private organisations,” says Amulya, who’s also with the Rashtriya Swasthya Adhikar Abhiyan, a platform for grassroot level organisations working in health.
Speaking of the Central government’s flagship health insurance programme, Ayushman Bharat, Amulya says the scheme has several opportunities in terms of expanding the scope of illnesses covered under it, and challenges including correcting irregularities mentioned in the Comptroller and Auditor General of India’s (CAG) report. The CAG had outlined instances of multiple beneficiaries linked to a single or invalid phone number and treatment for people already declared dead, for example. While the irregularities pointed out by the CAG need to be corrected, the Centre needs to take note of successful State health insurances too, he says. They could align the Central scheme (providing ₹5 lakh coverage) with successful State health insurances like Rajasthan’s (that provides ₹25 lakh coverage) or popular ones like Odisha’s, he says, concerned over the fate of these schemes with changing political winds.
Pointing to tuberculosis drug shortages being reported from some States, he called for better procurement for national programmes. The Centre needs to speak and listen to the people working on the ground (for the middle class as well) to understand and resolve issues and deliver healthcare to all, he says.
Meanwhile, haemophilia patient Rupal Panchal is hopeful that “the right to treatment” will be centre-staged.
About five years ago, Rupal had urged Indian drugmakers to make therapies for people living with haemophilia, a condition where the blood does not clot, as it should. There are a couple of local companies making these therapies, but some States still face shortages, says Rupal, urging the Centre to bring out a comprehensive policy for bleeding disorders that are “on the brink of a cure”.
Rupal has long been involved in advocacy efforts for access to treatments and livelihood for this group. People with haemophilia are capable, but would require support, given the nature of their disability, he says, pointing to administrative hurdles they routinely face. His demands resonate with patients and civil society groups who have had to deal with drug stock-outs or pay exhorbitant bills for cancer drugs, hospitals treatments and newer therapies, for example. He calls for more domestic drug makers to get involved with newer therapies, which can bring down the cost of treatment for patients.
Democratise treatment
Industry-watchers, meanwhile, expect more support for emerging technologies that can help democratise treatment.
The Centre has indeed increased the numbers of the Jan Aushadhi stores (that sells medicines at affordable prices), expanded the scope of Ayushman Bharat, pushed for generic prescriptions from doctors, etc, observes Sujay Shetty, PwC’s Global Health Industries Advisory Leader.
“There is no need for disruption,” he says, since directionally the initiatives have been set out to reduce the burden on people. While these initiatives need to be strengthened, newer technologies such as Artificial Intelligence, for example, need to be leveraged to develop health solutions for a larger number of people, he says. And to support these emerging opportunities, people will need to be trained to be employable in these sectors.
The Government will need to invest more in R&D and in frontier technologies to move the pharmaceutical industry up the innovation chain, besides also keeping the focus on quality, he adds.
‘Need Hospitals, not just airports’
Healthcare needs “enablement”, and the new dispensation should push the pure-play health-spend to at least the promised 2.5 percent of GDP, says healthcare veteran Vishal Bali, Executive Chairman of Asia Healthcare Holdings. The demand-supply gap between hospitals and skilled staff is reaching “alarming levels”, he says, echoing a concern expressed by many in healthcare institutions, and calling for a fresh look to plug this shortfall.
The Centre should focus on expediting work on the many hospital projects promised, he says, besides pushing for more projects in Tier-2 cities, for example, he adds. “It should not be just about building new airports in cities, but fundamental healthcare infrastructure should also be created,” Bali says, voicing a concern that resonates among middle and lower income groups that struggle to access quality healthcare.
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