How bold political choices, aligning schemes can improve India's healthcare

India has to move from vertical to comprehensive programmes, improve quality and access, hire more mid-level health workers and increase funding to improve primary care for achieving universal health coverage, public health experts told IndiaSpend.

That health is not “merely the absence of disease or infirmity”, but “is a fundamental human right” was proclaimed 40 years ago in the Alma-Ata declaration in Kazakhstan in 1978. On October 25 and 26, 2018, the declaration was reiterated by 197 countries around the world as they signed the Declaration of Astana that vowed to strengthen primary healthcare as an essential step for achieving universal health coverage.

India, also a signatory to the Astana declaration, has to strengthen primary healthcare if it has to achieve health for all since it accounts for 17% global burden of maternal deaths, the highest number of tuberculosis cases and deaths in the world and the highest number of stunted children in the world. As many as 55 million Indians slipped into poverty in 2011-12 because of health catastrophes they could not afford.

“[Astana declaration] is very important for not just India but the world as a whole to be reminded of the importance of primary healthcare as the foundation of a health system and as the critical component for achieving universal healthcare. It’s a timely reminder,” said K Sujatha Rao, former union secretary of health, public health expert and author of Do We Care: India’s Health System.