5 Grim Facts India Needs To Tackle As It Moves To Make Health A Fundamental Right

The draft National Health Policy is likely to be sent for Cabinet approval early next month.

25/07/2016 3:14 PM IST | Updated 25/07/2016 10:23 PM IST
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Representative image.

In India you could get grievously hurt, if not killed, for consuming beef, or even for speaking your mind, but soon you may be entitled to Right to Health.

Welcome to fundamental rights 101, GOI-style.

On the last day of 2014, a draft National Health Policy was introduced by the Union government as a stepping stone towards an ambitious goal: universal healthcare coverage through the institution of Right to Health as a fundamental right of every citizen of India. After more than a year and a half's delay, the proposal is about to be submitted to the Cabinet for approval, The Times of India has reported.

The draft policy makes a slew of promises, most significantly to make "denial of health" a punishable offence and to increase public spending on healthcare from 1.2% to 2.5% of the GDP. No doubt, there is an urgent need for such a policy in a country like India, where public healthcare is abysmal and diseases rampant. But the government must overcome a couple of obstacles before getting any closer to achieving its aims. It could, for instance, use a reality check, and also develop a sense of irony, before going ahead with its audacious plans.

So here are a few home truths, FYI:

1. You've heard about mismanagement of funds, failing infrastructure and lack of accountability among medical professionals and you're probably bored with the same old rant. But let's pause over the word health for a moment.

The World Health Organisation (WHO) in its constitution does not define health negatively -- that is, as the absence of disease -- but rather as a state of mental and social wellbeing. Even the most textbook theories of welfare economics will reiterate this fact. An unhealthy life, therefore, is not exclusively the result of a disease or a bodily condition but could equally be precipitated by mental afflictions triggered by social exclusion, harassment and related traumas.

Think of the millions who live below poverty line, the persecution of lower castes, minority communities, women and children in India, the staggering levels of malnutrition, the continued struggle to implement Right to Food - and Right to Health begins to sound like a farce.

2. Healthcare is a state subject. So the implement of Right to Health will necessitate compliance from all the states. Well, good luck with that is all we can say.

3. Can healthcare be delivered without basic amenities and infrastructure? State-run hospitals in urban areas are plagued with mismanagement, neglect and appalling levels of hygiene. A couple of days ago, 21 people died in a government hospital in Hyderabad, allegedly, because of a power cut had interrupted the working of life-saving devices for a few hours. In spite of the self-congratulatory noises made by the government on the success of the rural electrification programme, thousands of villages, which have been electrified on paper, continue to remain in darkness -- the less said of the state of healthcare in those parts the better.

4. In spite of the government's grand Swachh Bharat scheme, manual scavenging and disposal of refuse by individuals remain a reality in this country. Mosquito-borne diseases kill thousands every year, open defecation is rampant and 21% of communicable diseases in the country, according to a World Bank estimate, is linked to the absence of clean drinking water.

India also has one of the highest rates of infant mortality and maternal deaths in the world, most of which occur due to obstetric methods far removed from safe practices prescribed in modern medicine. Add to this the thousands of female foeticide and infanticide everyday.

Before one forgets, a couple of other facts: one, most urban Indians now live in some of the world's worst polluted cities. And two, about one-third of the world's population suffering from mental health problems live in India and China. And a majority of them are unaware of their condition or are ignored and mistreated by their families and supposed caregivers, because the latter know no better.

5. Universal healthcare will involve strict regulation of pricing by various pharmaceutical companies and finding ways of supplying medical to the remote corners of the country. Both are daunting challenges, a fact which even the most resolute optimist would admit.

These constitute only the tip of the iceberg and, of course, we'd love the government to prove us wrong.

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