24/02/2015 7:57 AM IST | Updated 15/07/2016 8:24 AM IST

Modi, Obama and Healthcare: A Tale of Two Leaders

Leukemia patient Aamir Sheikh sits outside Tata cancer hospital in Mumbai, India, Tuesday, April 2, 2013. India's Supreme Court on Monday rejected drug maker Novartis AG's attempt to patent a new version of a cancer drug Glivec, in a landmark decision that healthcare activists say ensures poor patients around the world will get continued access to cheap versions of lifesaving medicines. (AP Photo/Rafiq Maqbool)

"Bromance": that word became synonymous with the Modi-Obama bonhomine during Obama's recent visit to India. The roads were sanitised, everybody dressed-up in their (self-named bandhgala) best, and even the Taj Mahal got a much needed clean-up. (Unfortunately the promised visit did not materialise. Turns out: Oil is the preferred commodity over marble). There was a push to showcase similarities, however, the two men's records differ on a basic human tenet: health care.

Obama was sworn-in as the 44th president of the United States on January 2009 when America was in the throes of a great recession. In spite of this, one of his first acts in office was to sign the American Recovery and Reinvestment Act (also referred to as the stimulus) which amongst other initiatives, designated millions of dollars towards healthcare and medical research. In addition, he immediately started a debate on universal healthcare which led to the passage of the Affordable Care Act (also referred to as Obamacare). He paid a heavy political price with some top leaders in his own party hinting that Obamacare may have been one of the major reasons the Democrats lost both the Congress (in 2012) and the Senate (in 2014) to the republicans. Inspite of political setbacks, Obama recently announced an investment of 215 million dollars on "precision medicine" to better understand genetic data and tailor drugs specific to patients.

Contrast this with the record of the Modi Government. Dr. Harsh Vardhan, a widely respected crusader against tobacco lasted only five months as the health minister, with some speculating that one of the reasons was that he took on the powerful tobacco lobby.

India performs poorly on healthcare, ranking even below Bangladesh and Nepal with public spending on health amongst the lowest in the world. "BJP accords high priority to health sector, which is crucial for securing the economy" stated the manifesto for the 2014 general elections. However, instead of increasing spending on healthcare, the government slashed nearly 20% (or 948 million dollars) from the 2014-2015 healthcare budget. This reduction can severely hamper efforts to provide affordable healthcare to the masses and tackle pressing issues like diarrhoea, tuberculosis and non communicable diseases like diabetes and cancer. In addition, the finance ministry ordered a 205.4 million dollar cut in India's HIV/AIDS program that could adversely impact the fight against this deadly disease. These moves may cut the fiscal deficit in the short term, but indirect costs of poor health (in addition to medical bills) can result in billions of dollars in lost productivity. It is still early days and the Swachh Bharat Abhiyaan is an important initiative, but hopefully the Modi government will take a page out of Obama's playbook and take serious steps towards improving India's dismal health parameters. If you truly want to improve the "wealth" of your people, it is imperative to focus on health.

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