A shocking 17,000 lives were lost to malnutrition in Maharashtra's tribal belts in the last one year alone, according to an RTI reply. Acting on the Bombay High Court's directives, the Maharashtra state government submitted a report on 21 September 2016, which stated it did not have enough gynaecologists, general practitioners and other doctors in tribal areas to improve the health condition of people, particularly women and children. When public health facilities fail to reach the most vulnerable, these people do not have much of a choice but to die, their bodies later taken home on bamboo poles, carried by family members for 10km or more.
Right to Health could drastically improve the access of millions to a healthy life.
Towards the end of September 2015 at the UN Sustainable Development Summit in New York, world leaders committed to achieving the Sustainable Development Goals (SDGs). Reaching the furthest so that "no one will be left behind" was the most important agenda of the SDGs. By 2030, the ambitious UN goals aim to "free human race from the tyranny of poverty and heal and secure the planet." By 2030, these 17 aspirational goals will determine the development course each country, and the consequentially the world, will take.
India was a key part of it all. The country was moderately, if not successfully, on course in achieving a few of the Millennium Development Goals (MDGs), the precursor of the SDGs. It did remarkably well in meeting the goals on poverty, access to drinking water and in reducing gender disparity in education at the close of MDGs last year. But when it came to the goals on the health of mothers and children, India was way off-track. The story is not vastly different in the case of SDGs, as indicated by the SDG index, which was created by Bertelsmann Stiftung and the Sustainable Development Solution Network (SDSN) to assist countries in getting started with implementing the new goals. India ranked 110 out of 149 countries. When it comes to Goal 3—ensuring healthy lives and promoting well-being for all at all ages—India is either in the "caution lane" or "seriously far from achievement", according to the SDG index.
While trying not to downplay the significant progress India has made in health over the past few years, concerns still persist. The biggest is the rich-poor divide, especially in accessing health care. According to Countdown's Equity Analyses Report 2015 for India, mothers from the wealthiest quintile were 65% more likely to receive healthcare during pregnancy as opposed to the poorest quintile. Various other indicators on health also showed similar differences, clearly showing how disparate health care access is.
"The true test of our commitment as a global community to the 2030 Sustainable Development Agenda will be in its implementation," UN Secretary-General Ban Ki-moon had said. Implementation continues to be the biggest challenge in the world's largest democracy. Ensuring health equity requires a drastic revision of priorities at the highest level. For India to improve its standing when it comes to reaching the most vulnerable, the Draft National Health Policy, 2015 is of monumental significance. Health needs to be made a legally enforceable framework, with universal coverage and backed by the proposed and much-needed budgetary allocation of 2.5% GDP, if India is to reach the last mile.
If India needs to keep its word on the global stage on the first anniversary of the SDGs this month, it needs to remind itself that improving equity in healthcare is essential...
The country could take a leaf out of its Right to Education Act (RTE) implementation, which enabled a near-universal access to education, especially for the most vulnerable. Of the children enrolled in schools between 2007-2008 and 2012–13, 56% were girls, and 32% from disadvantaged groups of Scheduled Castes and Scheduled Tribes. The number of children out of school and dropout rates reduced substantially, though not evenly, across all social groups. Right to Health, similarly, could drastically improve the access of millions to a healthy life.
The draft National Health Policy formulated by the government in December 2014 aims to address the "urgent need to improve the performance of health system", especially to address the high inequity in health outcomes and the healthcare costs that push over 63 million Indians to poverty. The policy proposes that the Centre enact a National Health Rights Act which will ensure health as a fundamental right, the denial of which will be justiciable. Now, the Centre needs to take seriously the Supreme Court's directive to take a final call on the National Health Policy. If India needs to keep its word on the global stage on the first anniversary of the SDGs this month, it needs to remind itself that improving equity in healthcare is essential so that "no one is left behind." The National Health Policy will be a step towards realizing this goal.
By Sarojitha Arokiaraj, Manager, Policy Research at World Vision India.