As the number of confirmed cases of Zika virus infection crossed the 20,000 mark in Columbia, the World Health Organization (WHO), called an emergency meeting on February 1. The WHO is expected to classify the Zika outbreak, which has already been detected in 25 countries and territories, as a “public health emergency of international concern” which will hopefully spur more funds into the search for a vaccine against the infection. 2116 pregnant women are among the 20,297 confirmed cases of the disease in Colombia itself and with the current outbreak being linked to microcephaly, in which infants are born with smaller than normal heads and under-developed brains, the fallout is bound to be both heart-rending as well as a public health nightmare.
Public health authorities in India are closely monitoring the spread of the Zika virus, as Aedes aegypti, the mosquito which transmits Zika, is the same one that transmits dengue. Given that India spends just around four per cent of GDP on healthcare, with public health accounting for just a little over one per cent of this total, it is a foregone conclusion that a Zika outbreak in India will be catastrophic. Its only saving grace so far is that Indian samples have last showed traces of this virus way back in 1952-53 and there are hopes that there might be some kind of passive immunity to the infection. But, viruses are wily creatures and the strain causing this outbreak could be a very different one from the one last seen in India.
It is against this backdrop that the healthcare sector prepares for yet another budget presentation from Finance Minister Arun Jaitley. Last year’s allocation of Rs 33,150 crores for the healthcare
sector was similar to the previous year’s. This was a major disappointment as it did not up the health spend to the anticipated two per cent, even though this was the expectation, given the intentions spelled out in the National Healthcare Policy. Will Budget 2016-17 be a let down again?
Industry body NATHEALTH has proposed that the healthcare sector should be exempted from the impending GST regime at least for a decade, in effect continuing the service tax exemption the sector currently enjoys. In fact Anjan Bose, Secretary General and Sushobhan Dasgupta, President, NATHEALTH recommend that government withdraw service tax on health insurance premiums as well. It also makes a case for setting up a healthcare infrastructure fund and a medical innovation fund in order to create a long term ecosystem for the sector to thrive.
The medical devices sector has been clamouring for a separate ministry so that policy making can be tailored to the specific needs of this segment making the point that this is very important for the sector to be part of the ‘Make in India’ programme. While the recently released policy for start-ups will definitely encourage healthcare start-ups, the fact is that this sector has a social goal as well as a longer than usual gestation period. Thus special incentives will be required to see true benefit reach the masses.
The government needs to incentivise efforts in the preventive and primary healthcare stage, as these will reduce healthcare spend in the long run. With India’s burden of non-communicable diseases (NCDs) like diabetes only increasing by the day, corporate hospital chains have a business strategy to tap into this patient pool. Apollo Sugar Clinics is just one such example but can the government leverage their expertise to detect diabetes among India’s rural poor? Early diagnosis prevents early onset and could also put a brake on disease progression.
Diagnosis will be a key link in reducing disease burden and thus it was not surprise that the Dr Lal Path Labs IPO was a resounding success. As the first NSE-listed diagnostics company, the company could set the trends for its peers to follow suit. Read more about the company’s aggressive expansion plans in our cover story. (Ushering a new era, pages 28-32)
Most of the industry leaders who have put forth their recommendations to the FM in the pre budget section in this issue stress the urgency of the need for a more benign gaze on this sector. (Union Budget 2016-17: Roadmap for healthcare, pages 12-19). A healthy population is crucial for a nation’s progress. According to a 2011 World Bank Health, Nutrition and Population Discussion Paper on the Chronic Emergency: Why NCDs Matter,” NCDs are set to steadily increase the number of healthy years (or disability-adjusted life years—DALYs) lost in middle – income countries, but the loss will increase very quickly in low-income countries. By 2030, low-income countries will have eight times more deaths attributed to NCDs than high-income countries.
How do we arrest this slide? By lobbying for more forward looking health policies. Getting the government to crack down on corporations in the business of unhealthy food options. Such consumer-driven activism has succeeded in burger chains and other fast food conglomerates launching healthier options. Likewise, cola giants have reduced the sugar content in their flagship products. But the battle is very nascent in India. We need to move on all fronts if we want to secure the health of future generations.
Viveka Roychowdhury
Editor
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