India@2047 – From Heal in India to…September 21, 2022 2022-09-21 21:42
India@2047 – From Heal in India to…
India@2047 – From Heal in India to…
By Ashwajit Singh
As India celebrates 75 years of independence and the beginnings of Amrutkaal, its healthcare system, enriched by a 5000-year legacy has much to offer to the world.
From eradicating diseases to pioneering healthcare initiatives, the country has witnessed big advancements in healthcare. Known today as pharmacy of the world, India has earned a global respect in the sector by becoming the largest producer of generic medicines and vaccine supplier by volume and having launched Ayushman Bharat-PMJAY, the world’s largest public health scheme that aims to cover the bottom 50% of people in the country.
Now at the threshold of its centenary, expectations to see a healthier, resilient India, are high. Let’s find out how …
As per 2022 Economic Survey, India’s public expenditure on healthcare stood at 2.1% of GDP in 2021-22 lower than the baseline target of 5%, against OECD average of 8%+. While some health experts have highlighted the need to increase public health spending to support healthcare transformation, others have emphasised on the need to have alternative financing models to ensure Universal Health Coverage (UHC) for all.
The recent success of Public-Private Partnership (PPP) models in India’s healthcare space, especially with COVID-19, presents an opportunity to provide both affordable and accessible healthcare to all. With an ever-widening SDG Financing Gap (from $2.5 trillion in 2020 to $4.2 trillion in 2021), PPPs can play a key role in further advancing the health infrastructure of the country for a more resilient and robust care delivery. It is here that role of forums such as NATHEALTH which engages private healthcare providers becomes critical in pushing private sector investments for creating a resilient healthcare ecosystem.
USAID-funded blended finance facility, SAMRIDH, serves as a leading example in India. It combines public, private and philanthropic resources to provide market-driven health solutions providing access to quality healthcare in tier-2 and 3 cities. It has so far mobilised a pool of $300 million plus for its agenda of sustainable, resilient and innovative healthcare in India.
The growth of PPP models is also expected to narrow down doctor-patient ratio by providing healthcare staff and building their skills for quality health services. The private sector can be engaged for continuing education programmes for healthcare workers. India can capitalise on its demographic advantage to create a robust health infrastructure that can drive the 21st century economy. By merely training 5 million doctors, nurses and technicians, the sector can earn $100 billion a year.
India envisions to achieve UN SDG target 3.8 of Universal Health Coverage to make its population disease-free, systems resilient and citizens empowered to overcome current and future health challenges. And, has been working towards it since independence. This is most overarchingly reflected in the doubling of life expectancy from 32 years in 1947 to 70.9 years in 2022. Its large-scale programmes, including Pulse Polio Immunisation, National Leprosy Eradication Programme, National Rural Health Mission, Mission Indradhanush, etc. along with the hygiene commitments under the Swachh Bharat Abhiyan, have gained a place among prominent global health success stories. These have also been significant in reducing infant and maternal mortality rates across the country.
Economic Survey 2020-’21 by Ministry of Finance highlighted that the share of out-of-pocket expenditure in total health expenditure in India will decline from 65% to 30% if there is an increase in government spending on health from 1% to 2.5-3% of GDP. With this in mind, a range of health insurances are now subsumed under Ayushman Bharat-PMJAY (AB-PMJAY).
The active thrust of AB-PMJAY towards continuum-of-care model, shifting the locus of healthcare towards primary and preventive care, is revolutionary. This model recognises the many abilities of primary health practitioners, like family doctors, in nipping the disease at its very onset. It also lays emphasis on precaution rather than cure, as well as protocols of global standards, in helping India emerge better prepared for new disease patterns of the future. A holistic, personalised touch to healthcare that includes neglected areas like geriatric health, mental health, etc., will help disease-prevention and treatment sooner than 2047.
Current fast-paced technological developments are also facilitating healthcare progress. An extension of AB-PMJAY, the Ayushman Bharat Digital Mission (ABDM) is also geared to lay the foundations of a digitally-equipped health infrastructure for a future-ready India.
The rapid upsurge in the use and convenience of digital data management and information systems makes integration of Big Data and healthcare inevitable in the near future. With R&D, this is expected to not only make diagnosis and treatment efficient but also the overarching health patterns in India easy to trace and forecast. An indication is the recent boom in connected and wearable health devices, like bluetooth-enabled watches, implants, etc., which will help individuals monitor their personal health needs and build predictive and preventive models in the future.
This far-seeing vision, however, needs to be supported through grassroots penetration of digital technology with emphasis on equitable access. Fortunately, with rural access to the internet picking pace, India’s digital divide is expected to reduce significantly by 2047.
Globalising India’s healthcare
India is rapidly becoming the ‘go to’ destination for medical tourism globally with conversations around big-ticket health projects – ‘Heal in India’ and ‘Heal by India’ already underway.
The pandemic disrupted the traditional global supply chain. However, this also provided opportunities for countries like India to drive new integrations within the global economy. The global acclaim received by CoWIN validated India’s digital capabilities in healthcare. Initiatives like Vaccine Maitri not only helped India on the geopolitical front, but also opened new opportunities for the sector to gain access to resources, collaboration and knowledge at the very peak of the pandemic.
With its high growth potential in data analytics, device and equipment manufacturing, drug trials, etc., going forward the country can forge mutually increased partnerships with developed world and share expertise on current and predicted health challenges to become the global hub of health services.
Increased FDI relaxations by government across healthcare projects can introduce pathbreaking healthcare innovations. The private startup ecosystem is already leading the way domestically on the use of the latest technology through the use of AI, IoT, robotics and data analytics to aid existing solutions in healthcare, increasing access and reducing costs. With 3500+ startups in India in 2021, public and private investments in tech-enabled solutions which facilitate remote diagnosis and consultation, wellness, early detection is already gaining ground. The health-tech market in India is expected to grow at an annual rate of 39% over FY20-FY23, touching $50 bn by 2033.
Public and private institutions can further collaborate to set up accelerators and incubators to further an innovative discourse around healthcare in the country. Increased focus on ‘Make in India’ and ‘Invest in India’ can also enhance existing pharma and manufacturing gains.
With a near 1.7 billion people; raised in life expectancy and drop in proportion of young people by 2050, the shift in demographic and lifestyle patterns will necessitate preventive healthcare to reduce out-of-pocket expenditure on healthcare. India is already working towards it.
And, as it commits to the goal of becoming developed by 2047, far-seeing policies along with the willingness and ability to spend on health sector will be critical to defining the quality of our future to meet the aspirations of Vision@2047.
Ashwajit Singh, Founder & Managing Director, IPE Global
(DISCLAIMER: The views expressed are solely of the author and ETHealthworld does not necessarily subscribe to it. ETHealthworld.com shall not be responsible for any damage caused to any person / organisation directly or indirectly.)