Lesser allocation for health over the years also indicates that we need to go a long way to reach the target of spending 2.5 per cent of GDP for health by 2025
On the heels of the COVID-19 pandemic, health has failed to become a priority for the Indian government yet again. Rs 89,155 crore have been allocated to the sector under the Union Budget for 2023-2024, tabled by Finance Minister Nirmala Sitharaman in Parliament on February 1, 2023.
Of this, Rs 86,175 crore has been allocated to the Department of Health and Family Welfare, while Rs 2,980 crore has been allocated to the department of health research.
Also read: Economic Survey 2022-23: Health not a priority? Just over 2% of GDP spent
In 2022-2023, Rs 86,001 crore was allocated to the Ministry of Health and Family Welfare. The current allocation has marginally increased from that of the previous financial year. But it is insufficient to cover the cost of inflation, Pratheeba J, health financing specialist with the Health Systems Transformation Platform, a non-profit, told Down To Earth.
The health budget is targeted to achieve 2.5 per cent of the Gross Domestic Product (GDP) by 2025, according to the National Health Policy (NHP), 2017.
“Lesser allocation for health over the years also indicates that we need to go a long way to reach the target of spending 2.5 per cent of GDP for health by 2025 as envisaged in the NHP,” she added.
Budget allocation to the National Health Mission (NHM) has mostly maintained the status quo, increasing marginally by 0.8 per cent — to Rs 29,085 crore in 2023-2024 from Rs 28,859 crore in 2022-2023.
“This would impact the quality of primary care services and our efforts to reduce the disease burden, especially Non Communicable Diseases (NCD),” Prateebha said.
Also read: Global health spending at record high post COVID-19, but can this be sustained?
The COVID-19 pandemic highlighted the critical role Accredited Social Health activists (ASHA) workers and Auxiliary Nurse Midwives (ANM) play in providing healthcare to all. Their importance is only growing now with respect to the rise in NCDs and mental health issues.
“There is a need to double their numbers and that money will only flow in from the NHM. The increase in its budget is much lower than what is needed,” Srinath Reddy, president of the Public Health Foundation of India (PHFI), told DTE.
There is a desperate need to strengthen the drug regulatory system in light of the cough syrup-associated deaths in The Gambia and Uzbekistan, which bought the medicines from India. However, spending for strengthening states’ drug regulatory authorities has reduced to Rs 72 crore in 2023-2024 from Rs 100 crore in 2022-2023.
“We need to seriously align our intentions to scale up not just diversity but also the quality of our products and for this, drug regulation is critical,” Reddy said.
Other key health-related initiatives include the plan to eradicate sickle cell anaemia — a blood disorder with a high prevalence in the tribal population — by 2047.
The finance minister stated in Parliament:
The mission will entail awareness creation, universal screening of seven crore people in the age group of 0-40 years in effective tribal areas and counselling through collaborative efforts of central ministries and state governments.
Sitharaman also announced the plan to increase the number of nursing colleges — adding 157 new ones alongside the 157 existing medical colleges since 2014. This could be to fulfil two requirements — meeting shortages in the distribution of personnel across the country and looking at the possibility of other countries seeking our resources, Reddy explained.
Also read: Science and technology to get over Rs 16,000 crore in Budget 2023-24, experts say not enough
However, ramping up the number of institutes alone is not enough; students must also receive a quality education.
The finance minister also announced a new pharmaceutical programme to promote research and innovation, which will be taken up through centres of excellence. “We shall also encourage industry to invest in research and development in specific priority areas,” Sitharaman said.
These are signs of India moving from a manufacturing and exporting hub to being an innovator in a global scenario where new products are required but are unavailable at an affordable rate.
It is clear that attention has moved away from health to economic development and growth. There is a big focus on millets, water and sanitation, green technology for environment, education and skill development, which will have a downstream impact on health, Reddy added.
Former Union health secretary Sujatha K Rao took to Twitter and noted: “Most boring budget so far as the health sector is concerned. Barring setting up 157 nursing colleges nothing else for health that is crying for huge capital investment and some financial risk protection for the lower middle classes. Yet another year has gone by. Very disappointing.”
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