India’s journey towards improving health for all

Published on Nov 11, 2022 04:23 PM IST

The article has been authored by J V R Prasada Rao, former health secretary, Government of India.

Recently, the Union health minister, Mansukh Mandaviya, underlined the need for adopting a more holistic approach in health.
Recently, the Union health minister, Mansukh Mandaviya, underlined the need for adopting a more holistic approach in health.
ByHindustan Times

In the past few decades, research, science, innovation, policy initiatives and collaborations across public, private and social sectors around the globe have led to considerable progress in prolonging and improving life. Between 1800 and 2017, average life expectancy globally, has more than doubled, from 30 years to 73 years. Since 1960, there has been a significant increase in average global life expectancy. In India, major breakthroughs in vaccination and new therapies have brought in eradication and reduction in the burden of diseases such as smallpox and polio. We have also seen breakthroughs in human genomics, improved survival rates in cancer, and several forward steps in tobacco control.

The Covid-19 pandemic was a major disruptor, that hit us hard, however, measured steps and collective action helped and changed how we perceive and choose treatment solutions. We proved naysayers wrong when we managed to tackle the community spread of Covid-19, deftly and effectively. Stakeholders across the system realised that emergency response systems need to be in place as a standard protocol. In addition, alternative pathways of health care delivery propelled by technology, deepened reach of quality care. The government’s eSanjeevani portal, connected millions from the remote corners of the country, with doctors in major cities. More than two billion people have been administered vaccinations in India via convenient registrations and centre allotments on the CoWIN portal. Health-tech has today opened up massive opportunities in telemedicine, Artificial Intelligence-based diagnostics and remote health care management.

Recently, the Union health minister, Mansukh Mandaviya, underlined the need for adopting a more holistic approach in health. He also asserted that the new Atmanirbhar Bharat is prepared to deal with any threat in the healthcare sector. And progress parameters will be driven by life expectancy, shifts in disease burden, quality of life and new treatment solutions.

The progress on health care in India since Independence has overall been impressive. We eradicated polio and smallpox and are using advanced treatment therapies in the treatment of cancer, cardiovascular diseases and diabetes. We have also made efforts to reduce the disease burden of malaria, HIV and leprosy. The government has set new goals to end tuberculosis in India by 2025 and fast track the HIV response to achieve 2025 goals. The India Hypertension Control Initiative (IHCI) was awarded the 2022 UN Interagency Task Force and the WHO Special Programme on Primary Health Care Award recently.

In addition, India not only manufactured but also supplied medicines and vaccines to fight Covid-19, to more than 150 countries under Vaccine Maitri, while meeting its domestic needs. This was similar to India’s efforts at the turn of the millennium to supply to the world affordable antiretroviral drugs for HIV after global pharma majors had priced them exorbitantly. It saved millions of lives, most of them in Africa, by bringing down the cost of treatment substantially. India’s pharmaceutical industry has played a major role in improving health care, rising from relative obscurity at the time of the country’s independence, to becoming a global leader in the last 75 years. Heavily reliant on imported drugs for more than two decades after Independence, (we produced only 5% of the medicines we needed), India now produces almost 85% of its domestic requirement.

The Indian Patents Act of 1970, the Drug Policy, 1978, and the Price Control Order, 1979 were the catalysts that boosted the industry’s growth, gradually paving the way for production of bulk drugs locally, thus, reducing dependence on imports, and encouraging local industry. The economic reforms in 1991 too integrated India with the global economy by ending the licensing regime and allowing domestic players to operate freely.

The pharma industry’s progress has contributed to better cures for many diseases, increased access to affordable medicines, and improved the quality of life. In economic terms, it contributes almost 2% of India’s Gross Domestic Product and employs over 2.7 million people. We supply over 60% of the global vaccine demand. India contributes 40 to 70% of the WHO demand for DPT and BCG vaccines, and 90% of the WHO’s demand for the measles vaccine. India is also a major supplier of anti-TB drugs, and the world’s largest producer of generic drugs. During Covid-19, we made generic versions of many essential medicines soon after their launch. We were also able to manufacture indigenous, cheaper diagnostic kits and prophylaxis drugs at affordable prices. The pharmaceutical industry had a major role in helping us with surveillance, prevention and health promotion, as much as in clinical care. An example is India’s cervical cancer vaccine, slated to be a gamechanger in preventive care for India.

The government’s policy is aligned to structural and sustained reforms to strengthen the health care sector which is expected to grow to a size of $50 billion in size by 2025. The combination of low-cost skilled manpower and a well established manufacturing base means that we are poised for an even bigger role, including drug security. Fiscal incentives for research and development (R&D) of new drug molecules, clinical research, new drug delivery systems with Good Manufacturing Practices, (GMP) and compliant infrastructure, make India an attractive destination for 100% foreign direct investment.

The key element in the industry’s push to climb up the global value chain is innovation, for which we will need industry-academia partnerships, favourable policies, an enabling regulatory authority, robust funding for R&D that is not risk-averse, and high quality infrastructure. The Prime Minister has emphasised the need to include the private sector in making India Atmanirbhar, and a national private-public partnership blueprint for health would be needed for an effective follow up. With the government’s commitment to increase public expenditure on health as a percentage of GDP, and digital health bolstering service delivery, health care partners across the spectrum need to seize the opportunity and come together to build a longer-term strategy to redefine health care for India.

The article has been authored by J V R Prasada Rao, former health secretary, Government of India.

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