Public healthcare, in the last decade, has been a low priority for India with just 1.29% of the country’s GDP in 2019-20 spent on healthcare. Contrast this with the global average of 6%. In fact, India’s public expenditure on health as a percentage of the GDP is far lower than countries classified as the “poorest” in the world, as admitted by the Union Ministry of Health and Family Welfare.

Ironically, we are the same country that is known for our success in eradicating small-pox and polio through targeted public intervention.

India’s Universal Immunization Programme is renowned as one of the largest public health interventions in the world.

However, we are today struggling to cope with the healthcare requirements of the country’s burgeoning population. Our decadent lifestyles, unhealthy eating habits, sedentary routine, lack of hygiene and abuse of alcohol, tobacco and drugs, combined with lack of awareness has led to the creation of what McKinlay refers to as “illness factories”. These illness factories are impacting the lives and health of the populace at large, slowly pushing people down the stream into “intervene and repair” mode at our hospitals and healthcare facilities.

The growing number of people requiring medical intervention is putting relentless pressure on the healthcare system, hospitals and public healthcare agencies who are hard pressed for time, investments, equipment and facilities, and trained resources in successfully treating people.

Here are four ways the government and policy makers can effectively shift the focus back to upstream, preventive healthcare in the country;

1) Increase public health spending – Community doctors, community dentists, social healthcare workers, particularly in rural and remote areas service over 65% of the country’s population. They lack access to basic medical tools, diagnostic equipment and technology, and proper funding and resource support, and this must change. There is a pressing need to increase public health spends to be closer to the global average of 6%, focusing on preventive care in the primary and secondary sectors.

2) Invest in research and training – Community healthcare professionals (CHPs) lack access to the latest in research and medical advancements. Their inputs are not represented at the decision-making table while they probably have the best knowledge of health realities on the ground. We need to address this gap with periodic training programs and provide CHPs with access to the latest in technology, research and medical knowledge to enable better care giving at the primary level.

3) Enable foreign investment in medical education – Even as every other industry has embraced globalization in education, the medical fraternity, bound by regulatory restrictions, has been the exception. Unfortunately, this has set us back in medical education in the country by decades, largely relying on theoretical study and graded examinations with little practical application. Policy makers need to take a hard look at this and open up the medical system to foreign collaborations and partnerships, enabling empirical problem solving and hands-on exposure for medical students on the latest in medical science.

4) Earmark a disaster management budget – COVID-19 is only one of many epidemics we are likely to see in the coming decades. There is an urgent need to establish a separate, long-term disaster management program with dedicated care centres across the country. We need to scale up public health services, number of beds and physicians, medical equipment, medicines, and care packages. Alongside, we must provide our front-line healthcare workers and medics with the requisite intensive training if we really need to save lives and prevent a catastrophe of this proportion again.

While the above will perhaps require a uniquely designed monetary stimulus policy, it must be done at the earliest to safeguard the lives and livelihoods of a billion and a half Indians.

by Prof. Dr Srivats Bharadwaj
Special Needs , Pediatric and Preventive Dentist
Founder Chairman & CEO Vatsalya Dental, B’lore