More Stimulus Needed For Healthcare Delivery

Prime Minister Narendra Modi in his Independence Day speech referred to the 25-year roadmap of Independent India as Amrit Kaal and the Union Budget 2022 delivers on this vision. The Union Budget 2022 is a growth-oriented, reformist budget focused on infrastructure and development. The budget also announced a range of climate-friendly actions with green initiatives and policies. This works well because globally we are witnessing more investments diverted into projects based on ESG (environment, social, governance). The budget is also expected to have a positive impact on youth, women and the marginalised communities.

Moving on to the healthcare sector, the Union Budget announcement in 2021 starkly stood out as healthcare and wellness expenditure was hiked by over 137 per cent. Last year’s budget also saw a six-year outlay of over Rs 65,000 crore for the ambitious PM Atmanirbhar Swasth Bharat Yojana.   It laid a broader vision for health by merging nutrition, air pollution, sanitation and access to clean water. The budget also touched upon adding health and wellness centres, block-level laboratories, more medical colleges and more institutes like the National Institute of Virology. We not only need more expenditure on healthcare but also effective implementation, accountability and reporting milestones at regular intervals. We did expect that Budget 2022 will amalgamate these initiatives under the health ministry, taking health from a curative approach and disease management to promoting good health and wellness. 

The Big Picture 

The 2022-23 budget has an allocation of Rs 86,200 crore for healthcare, which is about 16 per cent more than 2021-2022 estimates. One of the heartening aspects of the budget is the increased allocation to the Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana. There is a significant increase as budget allocation is hiked to Rs 6412 crore from Rs 3199 crore last year. This is a welcome move and will benefit the most vulnerable sections of society to access healthcare. The announcements on Mission Vatsalya, Mission Shakti, Poshan 2.0 and the reinforcement of Saksham Anganwadis are significant to fulfil the health and nutrition needs of women and to ensure early childhood development.

Atmanirbhar Bharat also translates to the health of every citizen and therefore a renewed approach to preventive health and disease prevention is important. Apart from the Rs 5000 tax benefit of preventive testing, there is no incentive for the common citizens to safeguard their health. 

The Digital Mission
We welcome the FM’s announcement on the official rollout of the much-awaited Ayushman Bharat Digital Mission. This mission is a step towards improving access, efficiency, effectiveness and transparency of the healthcare delivery system in the country. This digital revolution is critical to support Universal Health Coverage through the provision of a wide range of data, information and infrastructure services, duly leveraging open, interoperable, standards-based digital systems, and ensuring the security, confidentiality and privacy of health-related personal information.

The government’s initiative on tele-mental health is encouraging, however, the implementation will require a multi-sectoral approach and we hope that the government will soon build a framework for this. The addition of 23 tele-mental health centres is the need of the hour, especially considering the impact the pandemic has had on the mental health of people. 

The R&D Push
The FM also announced that the government will support research and development in sunrise sectors including genomics. This is an excellent and much-needed move. Taking a cue from the Clinical Laboratory Improvement Amendments standards in the US for lab-developed tests, our regulatory bodies like Central Drugs Standard Control Organisation can open up the regulatory framework that will help laboratories build indigenous tests customised to the Indian population, encourage more research and foster innovation. 

This will reduce our dependence on imported kits for laboratory tests. India could become self-reliant in test kits in a few years with the right kind of support from the policymakers and the government. 

The pandemic has been a reminder of how much work needs to be done in healthcare, especially in terms of building the infrastructure as well as having a skilled workforce including doctors, nurses, phlebotomists and laboratory technologists. Universal healthcare can only be achieved when all citizens have timely access to good quality healthcare. This can only happen when healthcare expenditure is considerably increased and when there is more collaboration between the government, the private institutions and the academia to work together and build solutions.