Former Union health secretary K. Sujatha Rao's book, Do we care? India's Health System, is a candid treatise on the ways in which health policies are formulated in India, and the challenges therein. The book is divided into two parts—the first part presents a detailed picture of India's health system, its evolution, financing and governance. The second part describes the two recent success stories of reduction of HIV incidence and the National Rural Health Mission.
The case study on AIDS control is particularly interesting, and Rao, who served as the director general of National Aids Control Organisation (NACO) between 2006 and 2009, provides interesting insights into the processes of policy making.
The strength of her thesis lies in not only describing the specific strategies, but also conceding to its inadequacies—beginning with a shortfall of funds, patchy civil society engagement, and even a lack of experience. Her descriptions are peppered with interesting anecdotes that might interest a range of readers interested in the subject. There's one about the dilemma of "communicating" safe sex, where Rao says that the slogan promoting safe sex and condom usage drew the moral brigade's ire, even as it left others wondering whether NACO was dissuading people from "procreation".
In another anecdote, the former bureaucrat recalls meeting with sex workers for the AIDS control programme. She was surprised by the fact that the women were not embarrassed of their profession, and she reflects on her reaction as a consequence of her "middle-class upbringing".
Rao's book is much more than a mere discussion of the processes though. Her analysis places the present health systems in their historical context, argues for increased state responsibility, and, above all, makes a case for healthcare as a human right.
Do we care? India's Health System
Published by OUP
Price Rs 850