The warped state of Indian healthcare

The Aedes aegypti mosquito may be the carrier of a virus but it is by no means the sole culprit behind the dengue scare that has India’s National Capital Region in its grip and is seen spreading its wings to Mumbai.

The very presence of the mosquito is like the proverbial tip of the iceberg and symbolic of the state of degradation of public health, which again is a testament to the shambolic state of municipal governance in almost every part of the country. If the drains worked, if the garbage did not pile up, if the administration were efficient enough to conduct fogging operations to contain mosquitoes regularly and ensure earmarked funds are not misused, our citizens’ health would be not be such that we face near epidemic proportions of every strain of virus that carries a disease.

The overcrowding in the hospitals of New Delhi, which has led to a spate of horrific stories of desperate people taking, and, sometimes, even carrying kin from one place of treatment to another praying for admission, is again a symptom of our disease of inadequacies in getting the priorities of life right. A country that spends less on public healthcare per capita than several sub-Saharan countries — worldwide only Guinea-Bissau, Lao PDR, Myanmar, Nigeria and Timor-Leste spend less than India’s 1.3 per cent of GDP on health — and is cutting back further on annual allocations cannot expect to fare better when it comes to tending even to the periodically sick citizens of a very populous nation, leave alone the weak, the infirm and the genetically affected people.

The malaise is indicative of the warped thinking of successive governments at the Centre and in the states in scaling down public healthcare services while deliberately allowing the private medical care sector to flourish. The latter’s predilection to put in air-conditioners to raise the return on investment is quite the reverse of commitment to providing quality care in terms of medical equipment and diagnostics. While a profit motive is not anathema, there is a clear need for official India to raise spending on healthcare not only in keeping with the size of its economy but to serve those millions who have been known to despair about money for taking care of one’s health.

An independent commission to assess the state of public healthcare as well as the state of municipal governance, and to gather the reasons for failure, alone can tell us where we stand. Only by getting rid of a substantial number of reasons for epidemic and seasonal ill health by tending to grassroots-level problems can we guarantee that our people as a whole can lead healthier lives. Public hygiene must be the prime focus area as it is failure on this front which is the root cause of the diseases that plague us.