INTERVIEW

Will raise health budget to 2.5 per cent of the GDP

63-avoid-lengthy Healing touch: To avoid lengthy waiting time at tertiary care hospitals like AIIMS, Nadda says the government is making services locally available to the poor at affordable cost | Sanjay Ahlawat
62-Nadda J.P. Nadda, Union minister of health and family welfare | Sanjay Ahlawat

Deteriorating air quality in New Delhi, caused by a thick envelope of smog, has ignited fresh health concerns. A recent Lancet report estimated that more than half a million Indians died prematurely in 2015 due to particulate matter (PM) 2.5 air pollution. Union Minister of Health and Family Welfare J.P. Nadda has called for inter-ministerial intervention in the issue. Excerpts of his conversation with THE WEEK

Going by National Sample Survey Office (NSSO) data, out-of-pocket expenditure for healthcare in India is quite high. What measures are being taken to make the services more affordable?

Under the ministry of health's flagship initiative—National Health Mission (NHM)—several schemes have been implemented to ensure universal health, with special focus on reducing out of pocket expenditure (OOPE). Take the cases of Pradhan Mantri Dialysis programme [1.43 lakhs patients have availed the services], free drugs and diagnostics programme, and AMRIT outlets. To ensure healthy mothers and children across their life cycle, we have implemented schemes such as Janani Shishu Suraksha Karyakram (JSSK) and Rashtriya Bal Swasthya Karyakram (RBSK). We plan to upgrade 1.25 lakh sub-centres to wellness centres for comprehensive primary care, including screening of NCDs; this year 6,000 will be upgraded. In addition, population-based preventive screening for five common NCDs [hypertension, diabetes, and cancers of oral cavity, breast and cervix] will be carried out free of cost in 125 high priority districts.

India has the highest burden of tuberculosis in the world. How is the government planning to deal with the disease?

The ministry is committed to eliminating tuberculosis by 2025. You will be surprised to know that, compared to the global average, India has made greater progress tackling the disease. We have rapidly expanded diagnostic services with 628 Cartridge Based Nucleic Acid Amplification test [CB-NAAT], and 69 quality assured laboratories across the country. Moreover, we have commenced programmatic management of drug resistant TB [DR-TB] services across the country, with more than 10,86,437 presumptive DR-TB cases examined, more than 88,608 diagnosed, and more than 83,899 cases put on treatment in the last three years.

The National Health Policy emphasises on preventive model of healthcare. What specific measures are the government taking on that front?

The government has accorded the highest focus to preventive healthcare. We are on track to achieve targets as per the NHP. We launched Mission Indradhanush (MI), one of the largest global public health initiatives in 2014. To date, MI has successfully reached 25 million children in over 528 districts. Recently, this was given an extra fillip. In October this year, Prime Minister Narendra Modi launched the Intensified Mission Indradhanush (IMI) with increased focus on the highest burden districts, urban and slum areas with the slowest progress. The deadline for achieving 90 per cent immunisation coverage for pregnant women and children under two-years-old has been advanced to 2018. We are also focused on increasing the basket of vaccines. Since 2014, my ministry has launched Rotavirus vaccine, Pneumococcal Conjugate Vaccine (PCV), and the Measles-Rubella (MR) vaccine, as also the JE vaccine for adults.

Public health experts say that India needs to focus on its primary and secondary care hospitals to ease the burden on tertiary care units. What are the government's efforts towards focusing on primary and secondary care?

We are strengthening primary and secondary care. We are converting our 1.5 lakh sub-centres into ‘wellness centres’ in a phased manner to provide the promised universal healthcare. During the last three years, new constructions and renovations of health facilities have been sanctioned. We have increased the number of ASHAs and provided them with health kits; additional health human resources have been added under NHM. More AYUSH doctors have been engaged. More Emergency Response Services (ERS) have been operationalised. A total of 22 medical colleges with 1,715 MBBS seats have been approved.

Several studies have noted that India bears the twin burden of under-nutrition and over-nutrition

We have taken up a joint mission with the ministry of women and child development (WCD), towards a life-cycle approach for interrupting the inter-generational cycle of under-nutrition, called the National Nutrition Mission (NNM). The cabinet, chaired by Prime Minister Narendra Modi has approved setting up of a National Nutrition Mission (NNM) last week with a three-year budget of Rs 9,046.17 crore, commencing from 2017-18.

The major focus area of NNM is to reduce the level of stunting, under-nutrition, anaemia and low birth weight babies. The mission aims to benefit more than 10 crore people.

Apart from this, several interventions are already in place. Immunisation is a key priority area. We are promoting appropriate Infant and Young Child Feeding (IYCF) practices, and facilitating treatment of sick children with Severe Acute Malnutrition (SAM). We have set up public health facilities, placed the spotlight back on micro-nutrient supplementation, and more.

Newer challenges such as climate change and air pollution are emerging as a threat to public health. How is the government planning to address them?

The increase in air pollution has become a major cause of concern and requires inter-ministerial intervention. We need to work closely with other ministries on the issue. However, as an immediate step, all hospitals have been directed to take all measures to deal with the patient load due to air pollution. They have been directed to keep nebulisers and other related equipment in good condition and to be prepared to meet with any exigency.

The National Health Policy (NHP) talks about an increase in the health budget. What are the government's plans on that front?

The policy proposes to raise public health expenditure to 2.5 per cent of the GDP in a time-bound manner. NHP 2017 has been duly supported by the government through a provision of Rs 47,352.51 crore towards our ministry under the 2017-18 Union Budget. The amount is a 27.7 per cent increase in allocation over previous year. We are trying to provide a larger package of assured comprehensive primary healthcare through the health and wellness centres. We have launched several initiatives, like Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA), Pradhan Mantri National Dialysis Programme, Health Protection Scheme, Kayakalp, and Swachh Swasth Sarvatra towards fulfilling our healthcare goals.

There is a lot of debate around ready-to-use therapeutic food in the country. Do you feel that it is a good strategy to tackle severe to moderate malnutrition?

A Technical Board under NITI Aayog has been set up to look into the matter of therapeutic food, which will study the matter and come out with technical recommendations soon.

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The Week

Topics : #Healthcare

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