A milestone in the journey to universal health care

Expanding investments, collaboration between departments, fostering public-private partnerships, and engaging the community are crucial for health care in India

In a landmark move for India’s health care system, Prime Minister (PM) Modi inaugurated the 10,000th Jan Aushadhi Kendra under the Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) at AIIMS in Deoghar last week. The government outpaced its deadline, achieving the goal of opening 10,000 kendras (centres) well before the March 2024 target. This marks a significant achievement for PMBJP, an initiative aimed at providing affordable and quality medicines. During the inauguration, PM Modi emphasised the importance of these kendras, which offer medicines at 50%-90% lower prices than market rates, thereby benefiting the poor and middle class alike.

The road to Universal Health Care is not solely about medicine accessibility. (REPRESENTATIVE IMAGE)

Ten thousand is more than just a number; it is a reflection of India’s unwavering commitment to Universal Health Coverage (UHC). The journey towards UHC has borne witness to various innovations and interventions, with PMBJP emerging as a major pillar. While the media spotlight might not have brightly shone on this accomplishment, it’s a significant stride in India’s health care narrative.

The context of PMBJP’s origin is important. Despite its global stature as a leading exporter of generic medicines, India grappled with an ironic dilemma. A large segment of its population, especially the economically vulnerable, lacked access to affordable medicines. Out-of-pocket expenditure on health was high — almost 70% in 2004-05 — pushing many families into financial distress. It was against this backdrop that PMBJP was launched by the department of pharmaceuticals in 2008. The initial years of PMBJP were marked by modest growth, with only 80 kendras by 2015. However, the narrative began to shift thereafter. By December 2023, the scheme expanded to more than 10,000 kendras, bringing a remarkable range of close to 2000 drugs and 300 surgical items to the masses in almost all Indian districts. FY 2022-23 saw the PMBJP achieving sales of ₹1,236 crore, a robust growth of 38% YoY, surpassing even the government’s revised targets.

Out of pocket health expenditure in India significantly decreased from 64.2% in 2013-14 to 47.1% in 2019-20, according to national health accounts. But the true essence of PMBJP’s success isn’t just in these impressive numbers. It’s in the stories of millions who now have access to affordable health. The kendras, for many, symbolise a promise — a commitment to an India where quality health care is accessible to all. They challenge the entrenched belief in the Indian pharma sector that quality is invariably tied to high costs.

However, the journey towards UHC, with PMBJP as a pivotal pillar, is still an ongoing project. India’s health care challenges are multifaceted. Regional disparities, infrastructural deficits, and the shifting disease burden, marked by a rise in non-communicable diseases, add layers of complexity. The PMBJP needs to be seen within the broader framework of health initiatives in India. It’s one of the rare health initiatives outside the purview of the ministry of health and family welfare. This unique positioning offers both opportunities and challenges. It allows for a specialised focus on pharmaceuticals and drug accessibility but also necessitates seamless coordination with other health initiatives for holistic health coverage. Both ministries being led by the same minister at the Centre certainly helps.

The road to UHC is not solely about medicine accessibility. It’s about ensuring that the medicines are of top-notch quality. It’s about expanding the network of kendras to the remotest parts of the country and continuously updating the product basket based on the health needs of the population. It’s about tackling the high out of pocket expenditure that still burdens many households. Expanding investments, collaboration between departments, fostering public-private partnerships, and engaging the community are crucial.

In his 2023 Independence Day address, PM Modi articulated a vision that underscores the central role of Jan Aushadhi Kendras in India’s health care blueprint. Elevating the number of kendras from the current 10,000 to an ambitious 25,000 by March 31, 2026, is not merely an expansion; it’s a statement of intent, with a transformative impact. By making medicines available at a fraction of their usual price, the kendras have empowered the poor and the middle class, translating to savings of a staggering ₹20,000 crore. Consider the profound relief for a diabetic patient, who once grappled with a monthly bill of ₹3,000 for medicines costing ₹100, now finding the same medication at ₹10 to ₹15. As India progresses towards a more inclusive health care future, schemes like PMBJP will be the milestones we look back on, markers of a nation’s promise to its people — health for all.

Oommen C Kurian is senior fellow and head of health initiative at the Observer Research Foundation, New Delhi. The views expressed are personal