Lok
Sabha
Elections
2004
Campaign Booklets
When people in the country starve, the impact on the health of its people would be obvious. The NDA government, to compound matters, has presided over the virtual dismantling of India’s health care infrastructure. Expenditure patterns on health care have always been grossly skewed in favour of urban areas. Savage expenditure cuts in the health sector have further distorted this picture with the axe on investment falling first on rural health services. The government admits today that health expenditure in India has declined in the past decade from 1.3% of GDP in 1991-92 to 0.9% of GDP in 2002. India has one of the most privatised health care systems in the world, with 84% of health care costs being paid for privately. This may be contrasted with 80-90% of health care costs being paid for by the government in most developed countries. Even in the US, 45% of health care costs are paid for by the government. In this context, a World Bank-funded report says that India spends less than 1% of its gross domestic product (GDP) on health, comparable to war-ravaged Congo that does not even have a government in place!
What
does
the
balance
sheet
of
achievements
of
the
NDA
have
to
show
in
the
Health
Sector?
It
is
a
sad
story
of
a
rolling
back
of
the
limited
gains
that
we
had
made
in
the
earlier
decades.
Let
us
look
at
some
of
its
“achievements”
:
·
Between
1997
and
2000,
routine
immunization
coverage
fell
from
60
to
40
per
cent.
· The reduction in Infant Mortality Rates has been virtually halted, with it remaining stagnant at around 70 deaths per 1000 live births.
· The national family and health survey revealed that the maternal mortality ratio in India has increased from 424 to 540 between 1992-93 and 1998-99.
· Between 1991 and 2001, the sex ratio of the child population (those aged between 0 and six years of age) fell sharply from 945 females per 1,000 males to 927 per 1,000.
· India bears 83% of the world’s polio burden, despite an annual expenditure of Rs. 500 crore on immunisation programmes; 60% of the amount constitutes a loan from the World Bank. It comes as no surprise then that international donor agencies are expressing grave concern at India’s failure to wipe out polio, that cripples children below the age of five for a lifetime.
·
Half
a
million
people
die
of
Tuberculosis
in
the
country
every
year
–
much
higher
than
in
any
other
country
in
the
world.
·
India
is
experiencing
a
resurgence
of
various
communicable
diseases
including
Malaria,
Encephalitis,
Kala
azar,
Dengue
and
Leptospirosis.
The
number
of
cases
of
Malaria
has
remained
at
a
high
level
of
around
2
million
cases
annually
since
the
mid
eighties
and
these
figures
are
a
gross
underestimation.
The
Malaria
Research
Centre
says
that
the
actual
figures
are
more
than
six
times
the
official
figures.
By
the
year
2001,
nearly
half
of
the
cases
are
of
Falciparum
malaria,
which
can
cause
the
deadly
cerebral
malaria.
Environmental
and
social
dislocations
combined
with
weakening
public
health
systems
have
contributed
to
this
resurgence.
·
Around
6
lakh
children
die
each
year
from
an
ordinary
illness
like
diarrhoea.
Most
of
these
deaths
can
be
prevented
by
universal
provision
of
safe
drinking
water
and
basic
sanitation
facilities.
These
figures
hide
even
larger
disparities:
· While 31% of government expenditure on health benefits the richest 20% of the Indian population, only 10% goes to the poorest 20%.
·
Child
mortality
(1-5yrs
age)
among
children
from
the
'Low
standard
of
living
index'
group
is
3.9
times
that
for
those
from
the
'High
standard
of
living
index'
group
according
to
recent
NFHS
data.
Every
year,
2
million
children
under
the
age
of
five
years
die
in
India,
of
largely
preventable
causes
and
mostly
among
the
poor.
If
the
entire
country
were
to
achieve
a
better
level
of
child
health,
for
example
the
child
mortality
levels
of
Kerala,
then
16
lakh
deaths
of
under-five
children
would
be
avoided
every
year.
This
amounts
to
4380
avoidable
deaths
every
day,
which
translates
into
three
avoidable
child
deaths
every
minute.
·
Tribals,
who
account
for
only
8%
of
India's
population,
bear
the
burden
of
60%
of
malarial
deaths
in
the
country.
·
The
ratio
of
hospital
beds
to
population
in
rural
areas
is
fifteen
times
lower
than
that
for
urban
areas.
·
The
ratio
of
doctors
to
population
in
rural
areas
is
almost
six
times
lower
than
the
availability
of
doctors
for
the
urban
population.
·
Per
person,
Government
spending
on
public
health
is
seven
times
lower
in
rural
areas,
compared
to
Government
health
spending
for
urban
areas.
Characteristic
Response
The
response
to
this
situation
by
the
NDA
government
has
been
characteristic.
While
the
rural
health
infrastructure
is
in
shambles
the
government
talks
about
setting
up
“AIIMS
kind
of”
hospitals
in
large
metropolitan
centres.
It
talks
of
promoting
“health
tourism”
in
the
country
to
benefit
foreign
patients.
It
promotes
the
levying
of
user
fees
in
government
health
facilities.
It
talks
about
its
grandiose
plans
to
help
the
private
sector
–
a
sector
that
is
known
to
be
callous,
indifferent
and
insensitive
to
the
real
needs
of
the
Indian
people.
It
further
decontrols
prices
of
medicines,
and
now
proposes
that
only
20-25
medicines
will
be
kept
under
price
control
–
down
from
74
in
1994.
All
the
recent
initiatives
of
the
BJP-led
NDA
Govt.
have
been
designed
to
favour
the
rich
and
heap
further
miseries
on
the
poor.
Corporate
hospitals
like
Apollo,
Escorts,
etc.
are
being
provided
land,
tax
breaks
and
easy
loans
while
Government
run
Primary
Health
Centres
are
allowed
to
decay.
The
pitiable
state
of
PHCs
can
be
seen
from
the
following
statistics:
On
top
of
this
pitiable
state
of
basic
health
services,
the
Govt.
is
encouraging
the
levying
of
user
fees
in
public
health
facilities.
This
is
being
done
in
a
situation
where
public
funding
of
health
care
expenditure
has
fallen
from
22%
in
the
early
nineties
to
16%
in
2000.
India
has
one
of
the
most
privatised
health
systems
in
the
world.
To
harp
on
user
fees
while
not
providing
for
a
quantum
jump
in
health
care
expenditure
by
the
government
is
a
ploy
by
this
government
to
abandon
its
responsibility
of
providing
health
care
to
the
people
of
this
country.
We
see
below
the
impact
that
rising
health
care
costs
have
on
the
people
of
this
country:
·
Forty
percent
of
hospitalised
people
are
forced
to
borrow
money
or
sell
assets
to
cover
expenses
incurred
on
health
care.
·
Over
2
crores
of
Indians
are
pushed
below
the
poverty
line
every
year
because
of
the
catastrophic
effect
of
out
of
pocket
spending
on
health
care.
In
callous
disregard
of
people’s
needs,
this
Govt.
now
wants
to
promote
“health
tourism”,
i.e.
promote
the
use
of
India’s
health
infrastructure
to
treat
foreign
visitors.
While
people
are
being
forced
into
destitution
to
meet
their
health
care
needs
and
die
on
the
streets,
in
villages,
in
their
homes,
denied
of
even
basic
facilities,
our
doctors
and
our
facilities
will
treat
foreign
tourists!
And
this
is
being
touted
as
the
new
vision
for
health
care
in
India!
Drug
prices
have
been
spiralling
upwards
and
the
NDA
Govt.
has
now
proposed
that
the
prices
of
all
drugs
will
be
decontrolled.
We
have
a
situation
where
only
one
in
five
persons
can
afford
all
essential
drugs.
Yet
the
New
Drug
Policy
has
called
for
further
decontrol
of
drug
prices,
reducing
the
number
of
drugs
in
the
controlled
category
to
20-25
from
74.
Even
the
drugs
available
in
the
market
are
of
dubious
quality
–
estimates
say
that
40%
of
drugs
in
the
market
are
either
substandard,
or
spurious.
The
NDA
Govt.
now
wants
to
shift
the
blame
for
its
non-performance
in
the
Health
Sector
by
passing
the
blame
on
to
the
states
based
on
the
play
that
Health
care
is
a
state
subject.
What
it
does
not
say
is
that
its
economic
liberalisation
programme
has
squeezed
the
finances
of
the
states
to
such
an
extent
that
they
are
unable
to
find
money
for
very
basic
services
like
health
and
education.
What
they
also
say
is
that
the
whole
policy
of
privatisation,
of
charging
user
fees,
of
dismantling
the
public
health
infrastructure,
is
being
done
in
many
states
under
instructions
from
this
BJP
led
Govt.
Yet the “India Shining” booklet prepared by the NDA Government talks about its commitment to “Health For All”. Can we think of a crueller joke at the expense of the sick and ailing in this country?