The UPA government’s guidance, as in the case of the National Rural Health Mission (NRHM), has made a significant impact in strengthening the healthcare delivery system in India. However, public health programmes are a state subject, where state governments must implement, innovate and ensure their sustainability.
No state is capable of paying for every piece of beneficial medical technology. Hence, difficult decisions of choosing life-saving technologies over other public health problems have to be made. So the most effective way of reducing mortality rate and healthcare spending is through prevention and increased access. The most successful mode of prevention is immunisation. Increasing access to vaccines is an essential tool in saving lives and eliminating the higher costs that come with treating diseases like polio.
The Indian vaccine industry is capable of producing the vaccines we need and are public-minded enough to offer them at a price that makes universal immunisation programmes viable. Recently, two Indian vaccine manufacturers announced cuts in the price of pentavalent vaccine that protects children against five diseases in just three shots. In Goa, this vaccine is available in five taluks, with plans to expand it to 11 taluks soon. Another manufacturer announced that by 2015, it would be ready with a vaccine for rotavirus, a diarrhoeal disease that kills over 1,00,000 children each year. It is taken orally, and if available for just R45 per dose, it could be a useful preventive tool.
Aggressive steps have been taken to prevent cancer too. To combat breast cancer, Goa acquired two mobile mammography units that will enable women to get routine examinations. Prevention methods are not all-encompassing, so resources and attention have to be turned to treatment as well. Chronic diseases require a traditional approach but access, affordability and early detection should remain priorities. To fight diabetes, the Goa government has partnered with the private sector to establish a registry of diabetics, established a mobile unit to provide blood glucose testing in areas without modern facilities and provided insulin to patients who require it free of charge. These measures of progress are not limited to Goa. Since the introduction of the Janani Suraksha Yojna (JSY) programme, safe deliveries, particularly in hospitals, have increased around the country. A concerted effort to eradicate polio has also reduced the number of cases from over 600 two years ago to a single case so far this year.
Continuous and sustainable efforts are critical to reduce poverty, expand education and improve access to healthcare for all. The opportunities offered by modern health technology must be used as an indispensable complement to the gains made in economic development.
Vishwajit Pratapsingh Rane is minister of health, Goa. The views expressed by the author are personal.