New Delhi: India’s new national health policy underlines the government’s role in shaping health strategy, proposes to increase public health spending to 2.5% of gross domestic product (GDP) from the current 1.4% in a time-bound manner and improve life expectancy from the current 67.5 years to 70 years by 2025.
The contours of the new policy, 15 years after the last one, were revealed by Union health minister J.P. Nadda on Thursday, a day after the Union cabinet cleared the policy.
The policy calls for a “stronger partnership” between the public and private sectors to leverage “their strengths to achieve national health goals” and seeks to move away from meeting the disease burden challenge to a more proactive “thrust on prevention and health promotion”.
The new policy puts emphasis on reorientation and strengthening of the public health systems, Nadda said in a statement to Parliament.
“The policy is patient-centric and empowers the patient for resolution of all their problems. The policy also looks at reforms in existing regulatory systems, both for easing manufacturing of drugs and devices, to promote Make in India, and for reforming medical education. The policy has at its centre, the person who seeks and needs medical care,” he said.
It advocates allocating a major proportion (two-thirds or more) of resources to primary care.
“It aims to ensure availability of 2 beds per 1000 population distributed in a manner to enable access within golden hour. In order to provide access and financial protection, it proposes free drugs, free diagnostics and free emergency and essential healthcare services in all public hospitals,” Nadda said.
Later speaking at the Ministry of Health and Family Welfare, Nadda said, “There will no health cess to finance this policy. Instead, we will convert 1.5 lakh health centres to wellness centres. In addition, we will also provide free drugs and diagnostic facilities till the district level hospitals.”
Nadda also added that the approach would be made more patient centric, whereby the National Health Care Standards Organisation will be set up, which will lay down patient-oriented protocols, that will be acted upon by a tribunal.
According to health experts, the policy is “a forward looking one” in overall terms.
“In the past five years we have made progress in improving our health parameters despite being behind some countries in South Asia and others in the world. To make up the gap, it will take time,” said Srinath Reddy, president of the New Delhi-based Public Health Foundation of India policy body.
“These are substantial targets and they will take a considerable amount of time to reach these goals,” Reddy said. Describing the intention of the government to increase GDP spend on health to 2.5 %, Reddy said this was “a good sign” — that there was a recognition that this is the minimum spend needed.
Among the new health policy’s major goals are increasing life expectancy at birth from 67.5 years at present to 70 years by 2025 and a reduction in the total fertility rate—i.e., the number of children who would be born per woman through the childbearing years— to 2.1 from the current 2.3 by 2025.
“The policy is aimed at reaching healthcare in an assured manner to all, particularly the underserved and underprivileged,” the minister said earlier in parliament.
The policy also sets as a priority a reduction in the under-five mortality rate (of children) from current rate of 45 per thousand births to 23 by 2025, maternal mortality rates—the number of resident maternal deaths within 42 days of pregnancy termination—from 174 per 100,000 to 100 by 2020 and reduce infant mortality rate (i.e., the number of deaths under one year of age occurring among the live births in a given geographical area during a given year, per 1,000 live births) to 28 by 2019. The corresponding number at present is 39.
It also seeks to reduce neo-natal mortality or deaths among newborns to 16 from the current rate of 26 per 1,000 live births and the “still” birth rate to “single digit” by 2025. According to the British medical journal Lancet, the still birth rate or the number of infants born dead after 24 completed weeks of pregnancy is 23 per 1,000 births. In case of diseases like leprosy, the policy aims to achieve the complete elimination of the disease by 2018, kala-azar by 2017 and lymphatic filariasis in endemic pockets by 2017.
In the case of tuberculosis, the aim is to achieve and maintain a cure rate of greater than 85% in new sputum-positive patients and reduce incidence of new cases, to reach elimination status by 2025. Blindness is to be reduced by one third from current levels.
The policy also aims to reduce premature mortality from lifestyle and other non-communicable diseases like cardiovascular diseases, cancer, diabetes or chronic respiratory diseases by 25% by 2025.
According to Nadda, the policy aims to increase the role of yoga and traditional medicines in disease prevention. The government also aims to boost the production of drugs and medical equipment under the Make in India flagship campaign of the Narendra Modi government, the minister said, adding that in the case of medical devices alone, India was importing almost 70% of its requirements.
