India's Path to Health Leadership

The US withdrawal from the WHO and global health reforms present an opportunity for India to establish itself as a leader in global health governance by leveraging its expertise, innovations, and inclusive healthcare initiatives.

India's healthcare landscape has seen remarkable advancements through initiatives like Ayushman Bharat, digital health solutions, and leadership in vaccine production. However, to assert its health leadership on the global stage, India must overcome challenges like disparities in healthcare infrastructure, limited R&D capacity, and underfunding. This article examines India’s achievements, challenges, and opportunities in global health governance, emphasizing its potential to drive equitable and sustainable healthcare solutions globally.

• Democratization of Healthcare

  • Ayushman Bharat (2018): Covers over 36 crore beneficiaries as of 2024, ensuring free hospitalization for economically weaker sections.
  • Contributed to a 21% reduction in out-of-pocket expenses and an 8% decline in emergency loans for health-related needs.
  • Bridged urban-rural gaps in secondary and tertiary healthcare access.

• Vaccine Coverage and Disease Elimination

  • Eradicated polio and neonatal tetanus while effectively tackling diseases like measles and hepatitis.
  • Mission Indradhanush increased full immunization rates from 62% (2015-16) to 76.4% (2019-21).
  • Achieved 97% COVID-19 vaccination coverage for at least one dose by January 2023.

• Strengthening Rural Healthcare Infrastructure

  • Operationalized 1.72 lakh Ayushman Arogya Mandirs by March 2024, improving primary healthcare delivery.
  • Enhanced maternal health services and non-communicable disease (NCD) screenings in underserved areas.

• Health Digitization through NDHM

  • Launched in 2020, the National Digital Health Mission (NDHM) enables electronic health records and telemedicine.

  

  • Saved 3.3 crore person-hours through QR-code-based OPD registrations, benefiting over 6.64 crore patients.

• Focus on Traditional Medicine

  • Hosted the WHO Global Centre for Traditional Medicine (2022) in Gujarat.
  • The AYUSH sector, valued at $18 billion annually, grows at 17%, promoting yoga, Ayurveda, and preventive healthcare.

• Health Financing and Expenditure

  • Increased public health expenditure from 1.6% of GDP (FY21) to 2.2% (FY22), narrowing funding gaps in welfare programs.
  • Despite rising healthcare expenditures, challenges persist in achieving equitable funding for critical programs.

• Localized Governance Models

  • Kerala’s participatory health programs and Rajasthan’s Right to Health Act (2022) exemplify innovative governance.
  • Achieved a Maternal Mortality Rate reduction to 97 per lakh live births in 2020, a 25% decline since 2014-16.

• Insufficient Health Expenditure

  • India’s health spending (2.2% of GDP) falls short of the WHO recommendation of 5%.
  • Implementation gaps in schemes like PMJAY impact efficiency and global perception.

• Weak R&D in Healthcare

  • India ranks 40th in the Global Innovation Index 2023.
  • Limited R&D spending (0.64% of GDP) hinders progress in vaccine development and precision medicine.

• Regulatory Challenges

  • Fragmented regulatory frameworks cause inefficiencies, as highlighted by the 2023 cough syrup controversy.
  • Rising antimicrobial resistance (AMR) undermines global credibility.

• Infrastructure Disparities

  • Northern states like Uttar Pradesh face high infant mortality rates compared to Kerala’s advanced healthcare systems.
  • Geographic disparities persist, with life expectancy varying from 56 years in Madhya Pradesh to 74 years in Kerala.

• Pandemic Preparedness

  • India ranked 66th in the Global Health Security Index (2021) due to fragmented surveillance systems.

• Dual Burden of Diseases

  • Non-communicable diseases accounted for 61.8% of deaths in 2016, exacerbated by urban lifestyles and changing demographics.

• Global Health Diplomacy Gaps

  • Limited participation in alliances like Gavi contrasts with China’s proactive global health initiatives.

• Environmental and Climate Health Issues

  • Air pollution caused 1.67 million deaths in 2019, undermining India’s environmental health targets.

• Brain Drain of Health Professionals

  • Migration of skilled healthcare workers reduces India’s domestic capacity to lead globally.

• Strengthening R&D in Healthcare Innovations

  • Expand biotech hubs and increase funding for precision medicine and vaccine research.
  • Foster public-private collaborations to drive breakthroughs in medical technologies.

• Promoting Digital Health

  • Extend the NDHM framework to neighboring nations and integrate AI-driven diagnostic tools.
  • Encourage health-tech start-ups through seed funding and international partnerships.

• Integrating AYUSH with Modern Medicine

  • Establish additional research centers to validate traditional medicine through scientific studies.
  • Promote the AYUSH sector globally via diplomatic channels and cultural outreach programs.

• Expanding Affordable Vaccines and Medicines

  • Scale up programs like Vaccine Maitri, enhancing collaborations with organizations like Gavi.
  • Support vaccine production in African nations to strengthen global partnerships.

• Addressing AMR and Public Health Gaps

  • Spearhead global policies to contain AMR through responsible antibiotic use.

• Climate Action and Public Health

  • Align climate change policies with healthcare resilience, emphasizing sustainable infrastructure.

• Women’s and Children’s Health

  • Scale up successful initiatives like Poshan Abhiyaan, reducing maternal and infant mortality globally.

India’s ability to lead in global health governance depends on its commitment to equitable, sustainable, and innovative healthcare practices. By leveraging successes in health leadership, digital health, and traditional medicine, India can address global challenges, including health equity, pandemic preparedness, and climate resilience. These efforts will not only enhance the healthcare system in India but also establish the nation as a frontrunner in shaping inclusive global health solutions. Increased investments in healthcare expenditures will remain pivotal to achieving these goals.

What is the National Health Policy?

• The National Health Policy (NHP), 2017 aims to achieve Universal Health Coverage by strengthening healthcare systems, reducing out-of-pocket expenses, and promoting preventive healthcare.

What is the Ayushman Bharat Mission and its components?

• Ayushman Bharat is a flagship health initiative launched in 2018 to provide comprehensive healthcare through two components:

1. Health and Wellness Centres (HWCs): Strengthening primary healthcare. They have been renamed as Ayushman Arogya Mandirs.
2. Pradhan Mantri Jan Arogya Yojana (PM-JAY): Providing health insurance of ₹5 lakh per family per year to economically vulnerable sections.

What is the Ayushman Bharat Digital Mission?

• Launched in 2021, it aims to create a digital health ecosystem by providing unique health IDs, electronic health records, and seamless interoperability across healthcare facilities.

Where is the WHO Global Centre for Traditional Medicine located?

• The WHO Global Centre for Traditional Medicine is in Jamnagar, Gujarat, established to promote research, innovation, and global collaboration in traditional medicine.

1. “Besides being a moral imperative of Welfare State, primary health structure is a necessary pre-condition for sustainable development.” Analyze (2021/10M).
2. Appropriate local community-level healthcare intervention is a prerequisite to achieve ‘Health for All‘ in India. Explain (2018/10M).
3. Public health system has limitations in providing universal health coverage. Do you think that the private sector could help in bridging the gap? What other viable alternatives would you suggest? (2015/12.5M).

Consider the following statements: (2023)

• Statement-I: India’s public sector health care system largely focuses on curative care with limited preventive, promotive and rehabilitative care.
• Statement-II: Under India’s decentralized approach to health care delivery, the States are primarily responsible for organizing health services.

Which one of the following is correct in respect of the above statements?

A. Both Statement-I and Statement-l are correct and Statement-II is the correct explanation for Statement-I.

B. Both Statement-I and Statement-II are correct and Statement-is not the correct explanation for Statement-l.

C. Statement-l is correct but Statement-II is incorrect.

D. Statement-I is incorrect but Statement-Il is correct.

With reference to Ayushman Bharat Digital Mission, consider the following statements: (2022)

1. Private and public hospitals must adopt it.
2. As it aims to achieve universal health coverage, every citizen of India should be part of it ultimately.
3. It has seamless portability across the country.

Which of the statements given above is/are correct?

A. 1 and 2 only

B. 3 only

C. 1 and 3 only

D. 1, 2 and 3