Paving way for a Public Health Revolution in India

By EH News Bureau On Apr 7, 2016

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(An Indian Express Group and Express Healthcare initiative)

Over 100 policy makers and stakeholders of public health came together at the first edition of Healthcare Sabha – The National Thought Leadership Forum on Public Healthcare. The two-day conference saw an interdisciplinary group of professionals working in public healthcare deliberate, discuss and debate on cohesive, unified and innovative ways to achieve the National Health Mission of providing ‘Universal Access to Equitable, Affordable and Quality Healthcare Services.’ Public health champions in India were also honoured at the Express Public Health Awards held concurrently Glimpses of the event …

Healthcare Sabha 2016 Day 1

Inaugural ceremony
Address by the Chief Guest
Keynote address: Investing in health is investing in India’s growth
Models of financing public healthcare to aid the masses
Genomics in precision medicine
Emerging threat of lifestyle diseases and their risk factors – Where are we today and the way forward to deal with NCDs as a public health priority
Importance of evidence backed public health strategies
Panel Discussion: Implementation of Universal Health Coverage/ Assurance: 4-point road map
Improvising healthcare by implementation of Health Informatics Solutions
Medicine procurement: Assumption versus assurance of quality
Panel discussion: Best practices in Quality Procurement Management in the public health system

Inaugural Ceremony

Caption: (L-R) Viveka Roychowdhury, Dr Srinath Reddy, Dr Henk Bekedam, Dr Kenneth Thorpe and Navin Mittal

The 1st edition of Healthcare Sabha commenced on an auspicious note with the ceremonial lamp lighting ceremony by the Chief Guest, Navin Mittal, Secretary Finance & Commissioner & Ex-Officio Secretary, Information & Public Relations Department, Government of Telangana, and the Guests of Honour, Dr Henk Bekedam, WHO Representative to India, Dr Srinath Reddy, President, Public Health Foundation of India, Dr Kenneth Thorpe, Chairman, Partnership to Fight Chronic Diseases. Viveka Roychowdhury, Editor, Express Healthcare also joined them on the dais.

Supported by the National Health Mission (NHM) and the Government of Telangana, the two-day event was filled with interesting presentations and discussions to enhance the public health sector in India. It was attended by policy makers and stakeholders of public health from across the country.

Address by Chief Guest

In his inaugural address, the Chief Guest, Navin Mittal, Secretary Finance & Commissioner and Ex-Officio Secretary, Information & Public Relations Department, Government of Telangana, welcomed the delegates to the city of Hyderabad and said that it is the ideal location to hold a healthcare conference as Telangana’s pharma and healthcare sectors are flourishing with leading players setting up base in the state. He also informed that Telangana was working towards augmenting its infrastructure, bettering its health indicators and implementing initiatives which would help in providing quality healthcare to everyone in the state. He said that the two-day conference would be a great opportunity for the health experts who had gathered at the event to find workable and scalable solutions which would help mitigate the challenges in the healthcare sector and create a roadmap for the future.

– Navin Mittal, Secretary Finance & Commissioner & Ex-Officio Secretary, Information & Public Relations Department, Government of Telangana

Investing in health is investing in India’s growth

In his address, Dr Henk Bekedam, World Health Organisation’s (WHO) India representative called for more investments in healthcare and highlighted how essential it was to sustain India’s economic progress.

He pointed out that huge inequities exist in Indian healthcare. While a section of the population has access to top-quality healthcare facilities, a sizeable number of its citizens do not have access to even basic health amenities. He also lamented the fact that India, a rapidly growing country, still has a life expectancy rate of only 66 years and fares badly in comparison with its neighbours. In Bangladesh it is 71 years, while China had a life expectancy rate of 68 years back in the 1970s. He drew attention to the fact that India’s investment is just over one per cent of its GDP while drawing parallels with the investments made in its neighbouring nations. In China, it has risen to 3.5 per cent while Brazil, a BRICS country, invests five per cent of its GDP in health.

Dr Bekedam cautioned that if India’s doesn’t invest in health, there will be serious adverse consequences. People dying prematurely is not only a big loss to the family but also to the society. He also opined that India should have more emergency preparedness to deal with sudden health challenges. He revealed statistics from a study which proves that one additional year of life expectancy contributes to a rise in the GDP by four per cent. Analysing India’s Union Budget for 2016-17, he said that the increased investment in health was an encouraging sign. He also lauded the move to launch around 3000 generic medicine stores in the country (Jan Aushadhi stores) as well as the support extended to improve dialysis care in the country. He also appreciated the move to provide Rs one lakh coverage per family and additional coverage of Rs 30,000 for its senior citizens. However, he also pointed out that there has been no increase in the budget for NHM and no significant measures to deal with diseases like kala azar, malaria, TB etc.

He also advised improving public health and social health insurance to prevent people from slipping into poverty due to out-of-pocket expenses. He concluded by saying investing in human capital is very important to continue India’s growth story.

– Dr Henk Bekedam, World Health Organisation (India) Representative

Models of financing public healthcare to aid the masses

In this session, Chhitiz Kumar, CEO, Philips Capital & Head–Govt Affairs, PPP, Philips India spoke on the financing models that can be adopted to improve public healthcare in India. He also spoke on the quantum of investment that might happen in the coming times and highlighted three broad areas which needs significant financial investments in the next 10 years. The first area for investment is healthcare infrastructure since India requires more number of hospitals and more beds. It also needs to refurbish the existing healthcare set-ups. He said that this would require at least 10 per cent of funding from the government with the rest coming from the private sector.

The second area for investment is insurance. As per Kumar, many state governments in India are introducing health insurance programmes to the poor, but India has to achieve Universal Health Coverage (UHC). He informed that though the government has begun efforts to achieve the same, this area require a huge amount of investment. Kumar says that the third area is the primary care system in India. He feels that the basis of any healthcare system is its primary care and huge investments are needed to strengthen this system.

Kumar opined that we require good models of financing to ensure the inflow of such investments. He said that the government should increase spending on healthcare but also suggested that CSR is a good model to fund healthcare. He revealed that currently CSR contributes to around Rs 20,000 crores in India of which around 26 per cent of this amount is spent on healthcare. Thirdly, he said that the private sector should be encouraged to invest in public health. He then pointed out the significance of public private partnerships (PPP) in healthcare. Pointing out that PPP-led healthcare delivery is currently only 10 per cent in India, he advised that all stakeholders in healthcare should work towards increasing this share to improve healthcare access.

– Chhitiz Kumar, CEO, Philips Capital & Head – Govt Affairs, PPP, Philips India

Genomics in precision medicine

Girish Mehta, CEO, MedGenome India spoke on the developments in the field of genomics and went on to say that most of the risk factors for non – communicable diseases are in the human genes. He also explained the correlation between genomics and precision medicine. He further spoke about how genomics can bring down the cost of next generation sequencing.

He also elaborated on the trends in healthcare, and opined that personalised precision medicine has the capability to change the face of healthcare. He laid special focus on how genomics is driving drug discoveries across the globe.

He also emphasised that precision medicine backed by genomics will be the way forward. He provided insights on how genomics can be utilised in sectors like clinical research, pharmacogenomics, patient stratifaction, therapeutic monitoring, family screenings, prenatal and neonatal screenings, as well as other areas of diagnosis as well as prognosis. He said, there is an emerging ecosystem of innovative companies tackling specific problems related to human diseases using genomics-based approach.

Mehta also spoke on the genomic-led drug discovery market that is rapidly growing. Lastly, he stated that this market is estimated to be a $15 billion market in the next five years.

– Girish Mehta, CEO, MedGenome India

Emerging threat of lifestyle diseases and risk factors – The way forward to deal with NCDs as a public health priority

In his session, Dr Damodar Bachani, Deputy Commissioner (NCD), Ministry of Health & Family Welfare, Government of India called attention to the growing threat of NCDs, India’s preparedness to deal with it and the immediate measures to tackle this challenge effectively which otherwise would have serious adverse effects. He spoke on the rise of premature deaths. i.e. before the age of 70 years due to increasing incidence of NCDs such as cancer, diabetes, heart diseases and strokes and attributed it to causes such as tobacco use, unhealthy diets, alcohol consumption and physical inactivity, air pollution, stress etc. He accentuated that the huge NCD burden faced by India is not only a serious health concern but also an issue which has adverse implications on India’s economic growth. He also called for concerted efforts and strategic measures such as targeted awareness programmes about the need for a healthy lifestyle, early detection through screening programmes, infrastructure development and capacity building in terms of human resources, better emergency medical services, more effective health legislations and evidence-based as well as population-based interventions, as well as encouraging research etc. for better NCD management in the country. He also gave an overview about the various programmes and initiatives undertaken by the Government of India to deal with NCDs. He concluded with the advice that the allocation for NCDs need to be increased and hoped that the National Health Mission and the 13th five year plan would see improved allocation for NCDs as it would be crucial to win the war against this health menace.

– Dr Damodar Bachani, Deputy Commissioner (NCD), Ministry of Health & Family Welfare, Government of India

Importance of evidence backed public health strategies

Dr Soumya Swaminathan, Director General, Indian Council of Medical Research, Government of India started off her session by highlighting the importance of making healthcare decisions based on facts and evidences. She emphasised on the need to have a sound recording system to determine the cause of death as it would help in better decision making and help track disease trends. She pointed out that earlier deaths caused by communicable and infectious diseases such as diarrhoea, malaria, pneumonia, AIDS and tuberculosis constituted to 60 per cent. But today, there has been a shift and the leading cause of deaths in India are non-communicable diseases (NCDs) that constitute to 60 per cent. Currently. she said that the three important diseases currently causing deaths in India are cardiovascular diseases, lower respiratory diseases and tuberculosis. She also pointed out that we have missed our millennium development goals (MDGs) for maternal and child deaths by a considerable margin. Nevertheless she said that the government is hoping to achieve the sustainable development goals (SDG) through its various efforts.

Moreover, she reminded that India does not have a good system to record the real causes of death of a person. The data that the government receives from hospitals and corporations on the birth and death registered is not properly documented. She then referred to the ‘million death study’ and said that India needs to undertake a verbal autopsy method to arrive at the proper cause of death of a person. Later she informed about ICMR’s measures to put a system in place with the help of information technology. ICMR intends to train doctors from atleast 50-100 medical colleges from across the country to properly and systematically record the real causes of death within the country. She also informed that ICMR is working with various experts to derive at the disease burden estimates within the states to help decision makers take informed and responsible healthcare decisions for their people based on proper facts and evidences. Finally, she laid emphasis on the value of Big Data and its application in healthcare decision making. She summed up her session by talking about an endeavour that the ICMR has embarked on to develop a repository to store different data sets from across the country to help facilitate better healthcare decisions in India.

– Dr Soumya Swaminathan, Director General, Indian Council of Medical Research, Government of India

Implementation of Universal Health Coverage: 4-point road map

Caption: (L-R) Dr Gullapalli N Rao, Chairman, LV Prasad Eye Institute; Mirai Chatterjee, Director, Social Security at Self-employed Women’s Association (SEWA); Dr Srinath Reddy, President, Public Health Foundation of India (PHFI); Dr Henk Bekedam, WHO Representative to India; and Dr PV Ramesh, Principal Secretary (R&E) Finance, Government of Andhra Pradesh

The first panel discussion at Healthcare Sabha 2016, focussed on the various ways and means to ensure Universal Health Coverage (UHC) for the citizens of India. The moderator of the session, Dr Srinath Reddy raised pertinent points such as the need to make UHC a pivotal part of the policymakers’ agenda, raising public health financing in India, implementing effective PPPs in healthcare, improving primary care in the country, mobilising communities to become significant stakeholders in their own health etc.

The panelists too drew inferences from their experiences of working in the public health sector and recommended measures that can be implemented to achieve the goals of UHC. Dr Henk Bekedam, WHO representative to India shared insights from his extensive experience in the public health sectors of different countries and spoke on the steps introduced by various countries. He also highlighted the unfortunate fact that in a fast growing economy like India, 60 million people are living in poverty as they have to foot their own healthcare bills. He also reflected that the case was similar in countries like China and Cambodia as well. Stressing on the importance of health and education for a country’s progress, he emphasised that improving public health in a country is essential for achieving UHC.

Dr PV Ramesh, Principal Secretary (R&E) Finance, Government of Andhra Pradesh highlighted the need to step up expenditure on public health and informed that it is happening at the state levels gradually. He also opined that health does not feature at the top of the policymakers’ list because we still do not have a magic bullet for the sector. In healthcare, return on investments take a long time. However, he agreed that healthcare needs renewed focus and stated that at the state level they are experimenting with different ways and means to improve the care delivery system. At the same time, he said that India needs to tackle several healthcare concerns such as the growing double burden of communicable and non – communicable diseases. He urged the stakeholders to come together to arrive at a consensus on the solutions to tackle the challenges in India’s public health sector and drive public health investments.

Dr Gullapalli Rao, Chairman, L V Prasad Eye Institute, explained how the private and public sectors in health can collaborate for the greater good of the people. Stressing on the importance of innovation, he said that while innovation in any sector usually originates in the private sector or the social sector, it is upto to the government to scale it up. He also opined that public private partnerships (PPPs) need to be understood, planned and implemented in the true spirit. He went on to say that PPPs are failing because there is no clarity about what’s expected from each partner at the outset of the project. He also explained LVPEI’s model and how it helps offer equitable and comprehensive care to the populace while highlighting that it can be replicated across projects and different specialities of medicine. He recommended engaging the community in improving the efficacy of health initiatives. He also advised that there is a need to be constantly innovative, look at the real problems and tailor-make solutions which can then be tested and replicated to improve the healthcare scenario in the country.

Mirai Chatterjee, Director, Social Security at Self-employed Women’s Association (SEWA) spoke on the importance of mobilising communities to be active participants and take charge of their own health than being just passive recipients. She said that there is a need for a major mind set change to ensure that UHC is achieved. She also informed that in her experience of working with people at grassroot levels, especially the vulnerable population like the adivasis, dalits and women are very ready to be active participants. She pointed out that NHM has structures like the Mahila Arogya Samiti, village sanitisation and nutrition samitis etc where people can be mobilised. Thus, she recommended that we need to add one more ‘P’ to PPPs, to signify ‘people’. She also said that multiple fora and platforms can be built and re-energised to engage people in the care-giving process and highlighted that many states are already mobilising their populace to improve health determinants.

The panelists also deliberated on the measures to strengthen the primary care mechanisms in the country, utilising the available resources to do so. They also drew parallels between the initiatives implemented by various countries to improve access to medicines, wherein Dr Bekedam recommended subsidisation and cross subsidisation measures to improve healthcare access. The importance of capacity building and creating effective partnerships was also emphasised. Thus, several crucial points were highlighted and discussed at the panel discussion.

Dr Reddy concluded the discussion by saying that all said and done, these measures can be implemented in reality only if we build PWC i.e. political will and commitment.

Improving healthcare with Health Informatics Solutions

In this session, Dr BK Murthy, Executive Director, CDAC, highlighted the various administrative and operational challenges in healthcare facilities and elaborated on the role of ICT in simplifying the processes while amplifying the benefits. He said that India is a leader in providing ICT solutions in the world and gave an overview on his organisation’s offerings for the healthcare sector. He also informed that various public health stakeholders like state governments of Rajasthan, Maharashtra, Telangana, etc use CDAC’s products. He also emphasised that healthcare delivery systems can be made more efficient and effective through implementation of health informatics solutions like HMIS, EMRs/ EHRs, blood bank management systems, supply chain management systems etc. He detailed the different benefits offered by each of these systems to the healthcare providers and the patients in the long run. He also advised that people/ companies/ governments opting for these solutions should take ownership for them and upgrade the systems to keep them working efficiently.

– Dr. BK Murthy, Executive Director, CDAC

Medicine procurement: Assumption versus assurance of quality

Dr Suresh Saravdekar, Ex Assistant Director & Consultant – Procurement, Ministry of Medical Education and Health, Maharashtra addressed the need to ensure equity in the quality of medicines, in his presentation. He pointed out that despite being a crucial factor, it is often not achieved in the current scenario. Terming them as ‘therapeutic tragedies’, he drew attention to the fact that there have been several instances across the world where people have lost their lives due to poor quality of drugs or medicines. He reminded the audience that quality is not a static but a dynamic concept and emphasised how essential it is to constantly upgrade quality standards formedicines. He also outlined the various measures recommended by WHO to upgrade the quality of drugs. Quality, safety and specificity are the prerequisites that need to be considered in the procurement of medicines, according to Dr Saravdekar. He also urged India to actively pursue cGMP as it is done in the developed countries. The session also comprised a comparison of quality standards and drug regulations followed in different countries and the best practices that India can inculcate to improve its own drug quality standards. He pointed out that we don’t have a one-for-all standard to accredit the quality of medicines. Medicines that are exported are of superior quality to those provided in the domestic markets. He also enlarged on the various other aspects which prevent quality standards from being met. Thus, he spoke on the need to change our mindsets from quality assumed to quality assured, when it comes to medicine procurement.

– Dr Suresh Saravdekar, Ex Assistant Director & Consultant – Procurement, Ministry of Medical Education and Health, Maharashtra

Best Practices in Quality Procurement Management in the Public Health System

Caption: Prof AK Gupta, Medical Superintendent, PGIMER, Chandigarh; Dr Suresh Saravdekar, Ex Assistant Director & Consultant – Procurement, Ministry of Medical Education and Health and Dr Avinash Supe, Director, Medical Education & Dean, KEM Hospital

This session centred on ensuring equity in medicines and took its cue from Dr Suresh Saravdekar’s presentation. It went on to discuss the best practices to be adopted to create an effective procurement management system in the public health sector. Several significant aspects were highlighted by Dr Saravdekar, the moderator for this panel discussion and the panelists, Prof AK Gupta, Medical Superintendent, PGIMER, Chandigarh and Dr Avinash Supe, Director, Medical Education & Dean, KEM Hospital. They discussed and debated on the ways to ensure quality and equity of medicines, efficacy of generic drugs, measures implemented at KEM and PGIMER to meet quality requirement when it came to medicines etc.

Dr Supe informed that the health sector in India is seeing the emergence of newer and more efficacious drugs on one hand, while huge disparities or inequities in drug quality continue to exist. Hence, public health professionals have the challenge of striking a balance wherein they have to ensure that patients receive the best care at the most reasonable prices possible. So, as an administrator, he tries to ensure that both, cost and quality are given their due importance at his hospital. Dr Supe also elaborated on the different aspects to be considered while checking the quality of medicines, especially while opting for generics.

Dr Gupta also outlined the measures undertaken at PGIMER to ensure quality while procuring medicines. As PGIMER buys medicines worth Rs 25 crores each year, the hospital follows a rigorous process wherein drug manufacturers and suppliers have to register themselves with the hospital. Then the applicants have to meet certain criteria such as they should be actually manufacturing the medicines, have their own R&D unit and an audited turnover of Rs 100 crores. Dr Gupta claimed that these measures have helped to ensure quality to certain extent.

The panel also discussed various challenges faced by medical practitioners and hospitals in verifying and guaranteeing the quality of drugs, over prescription of antibiotics and methods to prevent it, role of e-commerce platforms, dangers of self-medication, and the need to strengthen regulations and laws to safeguard quality.

Healthcare Sabha 2016 Day 2

Power discussions on drug procurement process
Keynote Address: SANKALP – DISHA SWASTHA BHARAT KI: Implementing a national blueprint on NCDs
Mobile and Cloud Solution for comprehensive Primary Health Management
Power of Open Source Software within the public health space
Digitisation of public healthcare institutions: Challenges and successes
Hospital administration: Challenges and innovations
Digital medical imaging in public healthcare – Way forward
PANEL DISCUSSION: Models of financing public healthcare
Need for frugal innovation in medical technology
Skill enhancement programmes to bridge the workforce deficit
Models of financing oncology medicines
PANEL DISCUSSION: PPPs in public healthcare: Expanding role of NGOs, Foundations and Corporate Hospital Outreach Programmes in TB control
PANEL DISCUSSION: The role of frugal innovations in medical technology

Dignitaries discuss on drug procurement process at Healthcare Sabha

Healthcare Sabha 2016 also saw two power discussions, presented by Glenmark Pharmaceuticals. The discussions offered several insights and food for thought. The first one kicked off with AG Prasad, Vice President – Sales and Marketing, Glenmark Pharmaceuticals welcoming the 15 dignitaries from Mumbai. The topic before the house was ‘Partnering in Quality Procurement.’

The discussion began with Dr Suresh Saravdekar, Ex-Assistant Director and Consultant (hospital supplies procurement), Ministry of Medical Education & Health, State of Maharashtra pointing out the need for quality medicine procurement processes within public hospitals. He went on to say, “Equity in quality of medicine is of utmost importance. We, as key stakeholders working in the public health domain, need to come up with solutions that can harmonise the standards for medical procurement. Today, we have gathered here to come up with those solutions that can make a difference.” This comment got the ball rolling for the rest of the interaction.

Tarun Goel, Assistant Manager, KPMG, and Advisor to Maharashtra government said, “To ensure quality drug procurement, it is necessary to revisit the tenders that come in. Apart from this, quality checks is a must without which medicine procurement process is incomplete.”

Dr KBK Dora, Additional Chief Medical Director, Central Railways immediately responded to these suggestions and said, “We need to have a filtration process in place for (purchases of) all kinds of medicine and surgical equipment. This will ensure quality procurement.” Agreeing with this view, Dr Nirmala Barse, Deputy Dean, LTMG Sion, said, “This needs a change in mindset.”

Dr Prateek Rathi, Special Executive Officer and Surgeon, Employees State Insurance Scheme, Public Health Department, Government of Maharashtra then emphasised that the medical procurement process must be kept transparent. “Transparency can be maintained by bringing in a third party to check for quality and then uploading the results on the Internet for everyone to see.”

Sanjay Deshmukh, Additional Municipal Commissioner W S, Mumbai Municipal Corporation agreed with Rathi. He also endorsed the idea of using e-commerce to maintain transparency. Ram Bhau Dhas, Dy Municipal Commissioner (Z-III), Mumbai Municipal Corporation, replied saying, “We have to find all the loopholes in the current procurement mechanism and fix them so that we can improve the quality of drugs and equipment supplied to public healthcare institutes.”

Further, Dr Avinash Supe, Dean, KEM Hospital, Mumbai recommended that a random inspection system be introduced by the government to ensure quality procurement processes. He also suggested that the price control mechanism should be reviewed once again. This suggestion by Dr Supe was lauded by all.

Dr Alaka Deshpande, Former HOD – Dept of Medicine & Director, Center of Excellence, HIV/AIDS Management, JJ Hospital, said, “Quality is maintained within public hospitals as qualified doctors and healthcare staff conduct the procurement of medicines and surgical equipment.” Nevertheless, she pointed out that there is an
urgent need to have a cap mechanism to ensure highest standards.

Dr Yogesh Patil, Co-Founder & Director, Biosense Technologies, also criticised the raised turnover criteria in the medicine procurement process. He was of the opinion that there is a need to find a new mechanism (other than turnover) to identify innovation-based companies to provide high quality products at affordable rates.

To add more insight to the discussion and inform the dignitaries about the developments at the state government level, Dr Pravin Shingare, Directorate of Medical Education & Research, Government of Maharashtra, said, “Decentralisation of medical procurement should be stopped. There should be one agency who will look after the standardisation of the procurement process. Also, post procurement scrutiny is also required to ensure quality maintenance. Currently there is no control on the ageing of drugs.” He also pointed out that pharmacovigilance is crucial to provide good quality drugs to the people.

Goel chipped in, “Maharashtra will soon come up with its HMIS model to maintain transparency. The government is also adopting 5S and Kaizen for process improvement.” This news was appreciated by all at the discussion.

The next suggestion came from Ganesh Kanate, General Manager- Corporate Affairs, Glenmark. He urged the need for a dedicated PRO for each public health facility/ hospital as negative news about public hospitals is highlighted often, while positive news seldom get covered in the media. He therefore felt that if an agency is hired or a committee is formed, this could help disseminate the right information on the state of affairs within the public healthcare sector.

Prasad concluded the discussion by thanking all the dignitaries for sharing their views on this extremely sensitive subject and coming up with ideas that can give rise to apt solutions.

The success of the first power discussion set the tone for the second one which attracted state government officials from various states. The conversation was once again led by Dr Saravdekar, who asked the other dignitaries to talk about the drug procurement process in their own states. Dr Manjunath B, Medical Superintendent, KC General Hospital, Malleshwaram, Bengaluru under the Government of Karnataka, spoke about the drugs procurement mechanism maintained within his state. He also highlighted the problems which his organisation is faced with currently and requested for a solution to overcome it. “Money is allocated for increasing access to medicine; however, we are not able to utilise it properly,” he added.

Prasad agreed that under-utilisation of funds by state health departments is a real concern. He then touched upon the budget allocation for the healthcare industry in the Union Budget 2016-17 and made a point that in India we whine about the scarcity of funds but it is equally important to know whether these funds are efficiently utilised. “Most of the funds allotted to state and national programmes do not even get utilised. So to avoid such situations, both government as well as the private players should identify how to utilise it,” he stated.

Moving on, Dr Pradeep Naik, Dean, Goa Medical College explained the procurement mechanism followed by his hospital. He informed that in 2014, the Goa government formed a common drug purchase committee to ensure quality drug procurement process and maintain high standards. “The core responsibility of the committee was to follow the National List of Essential Medicines (NLEM) list and procure medicines. However, the committee has also prepared non-NLEM drugs list and shared this with all public hospitals located in Maharashtra”.

Adding his views, Dr Shankar L Vig, Deputy Medical Commissioner, ESIC, briefed about the criteria adopted and followed by the ESIC for ‘Not of Standard Quality’ drugs and non supply of drugs. “We have a centralised committee that looks after this process. We follow a two-step standardisation process for quality checks,” he informed.

During the discussion panelists also discussed how pharma manufacturers are not willing to manufacture certain drugs under price control which leads to scarcity of medicines in the market. For instance, Dr Atul Kharate, State TB Officer & Joint Director Health Services, Government of Madhya Pradesh raised concerns on the drug procurement process for TB treatment. He revealed that some TB drugs are not available in Madhya Pradesh and hence even the Revised National Tuberculosis Control Program (RNTCP) is facing many problems when arranging for certain drugs to treat TB. Dr PK Devadass, Dean and Director, Bangalore Medical College and Research Institute echoed Kharate’s point that he and his institution find it difficult to procure drugs.

At the end of discussion, the participants were unanimous in their conclusion that functional integration is key to quality drug procurement in India. Dr Prathajyoti Gogoi, Director, Regional Drug Testing Laboratory, CDSCO, DGHS, Ministry of Health & Family Welfare, Government of India, summed up the discussion saying, “Healthcare Sabha has highlighted several problems being faced by stakeholders working in the public health domain. I assure you that I will discuss these issues at the ministerial level and present some solutions that have surfaced during our discussion.”

Sankalp – Disha Swasth Bharat Ki: Implementing a national blueprint on NCDs

The second day of Healthcare Sabha began with a key note address by Dr Kenneth Thorpe, Chairman, Partnership to Fight Chronic Disease (PFCD). He spoke on the rising incidence of NCDs in the world and highlighted India’s burden of NCDs. He also pointed out that unless NCDs are brought under control, they will be a serious dampener to India’s growth story. He also highlighted that the country is set to lose $4.58 trillion between 2012-30 due to the growing burden of NCDs. Dr Thorpe also gave an overview of PFCD’s initiatives to curb the advance of NCDs in India. At the same time, he also imparted the good news that NCDs are preventable and can be brought under control with clearly outlined strategies. He also drew attention to the unholy nexus between poverty and NCDs. Moving on to the measures required to tackle the danger of NCDs from the country’s horizon, he spoke on the need for effective partnerships between key stakeholders of healthcare in India. Dr Thorpe also urged cross-functioning of the ministries for effective interventions such as reducing tobacco consumption, spreading awareness on the dangers of sedentary lifestyles, integrated chronic disease networks, stronger public healthcare systems etc. He ended his presentation with recommendations that would help create a blueprint to successfully tackle NCDs and better India’s health indicators.

– Dr Kenneth Thorpe, Chairman, Partnership to Fight Chronic Disease (PFCD)

Mobile and Cloud solutions for primary care management

In this session, Sunita Nadhamuni, Head – Healthcare Solutions, EMC Software and Services India, gave an overview on the potential of mobile and cloud based solutions to make primary care, the first frontier of a healthcare system, more efficient as well as effective. She also spoke on the various offerings by EMC in this arena. Pointing out the benefits of an efficacious primary healthcare system, she said that a stronger primary healthcare will take the pressure away from the secondary and tertiary healthcare systems. She also mentioned the different care areas that can be improved with the implementation of mobile and cloud solutions such as improved disease surveillance, management of communicable and non-communicable diseases, enhancing reproductive, maternal, newborn, child, and adolescent health services etc. Nadhamuni also spoke on the various initiatives they have embarked on with state governments such as Karnataka and Andhra Pradesh to create better primary healthcare systems.

– Sunita Nadhamuni, Head – Healthcare Solutions, EMC Software and Services India

The power of open source software in the public health space

Vivek Singh, Technical Architect, ThoughtWorks began with defining open source software and its significant benefits. He went on to say that knowledge should not be kept within closed doors, it should be accessible to all. Singh also explained the difference between open source software and free software. He said that open source software makes the source code available to all. The users can utilise it and even change it to suit their requirements. Whereas, a free software is developed and provided for free but for any changes need to be made to the software, one has to go back to the developer.

Secondly, Singh spoke about the economics of utilising open source within the public health domain. He explained the myriad advantages offered by the open source platform if it was efficiently adopted and managed. He also spoke on how open source can be utilised in the digital health space by comparing three well-known softwares used for maintaining electronic health records, healthcare management and health information exchange.

Singh also presented a case study from Bangladesh that highlighted how open source software enhanced a healthcare information platform. He summed up saying that India certainly needs to go the open source software route to provide better healthcare delivery to its people.

– Vivek Singh, Technical Architect, ThoughtWorks

Digitisation of public healthcare institutions

Dr Deepak Agrawal, Head IT, AIIMS shared his experiences in implementing ICT in a hospital. He began by referring to an article from a leading newspaper which mentioned that the government’s healthcare system was on life-support. He said that the reasons for this situation was that though ICT is being deployed in a lot of government service areas, it has not been able to permeate the healthcare sector.

Dr Agrawal said that ensuring transparency and accountability were the key problems in hospitals. Hence, the focus while digitising the operations at AIIMS were on these two areas. The team also developed a model that can be replicated across the country. The other focus of this team was to improve patient satisfaction, an area which is often neglected in the public health domain. He also spoke on the various challenges faced by him and his team during the project.

Dr Agrawal also enumerated on a few strategies that he and his team implemented at the hospital. One among these, was starting a call centre at the hospital to improve patient satisfaction. The other strategy was to have an audit in place to improve efficiency of the doctors and support staff. The hospital also developed a system that was tamper-proof to handle medico-legal cases, medical records of patients. He claimed that this strategy was appreciated by many state governments in India and the model will soon be replicated at many government hospitals across the country. He spoke on the patient display system they installed in the emergency ward and AIIMS’ patient appointment system which have helped improve their operations and care delivery. He summed up by saying that these strategies have helped the hospital to benchmark its services.

– Dr Deepak Agrawal, Head IT, AIIMS

Hospital administration: Challenges and innovations

In his session, Prof AK Gupta, Medical Superintendent, PGIMER Chandigarh, emphasised that innovation is way to go to tackle challenges in hospital administration. He urged hospital administrators to come up with creative solutions to improve the administration process in a hospital. He then provided a case study from PGIMER Chandigarh hospital wherein it faced certain challenges connected to a court summons from the High Court of Punjab and Haryana and shared how solutions such as tele-evidence (video-conferenceing network) helped to resolve the issue effectively. He also spoke about how the hospital leveraged information technology to enhance tele-conferencing and build medical evidences. Prof Gupta further informed that PGIMER Chandigarh had requested the High Court of Punjab and Haryana to grant the hospital permission to produce medical evidences in the court of law to support their cases. This move helped to strenghten their case further. Moreover, Prof Gupta also provided data on the number of tele-evidences scheduled and conducted within the hospital between 2014-2016 and explained how this move helped them save money. He also presented the measures which have helped the hospital to bring down its carbon footprint.

Prof Gupta presented another case study which helped them reduce the average length of stay within the hospital and explained how a decision support system (DSS) helped the hospital to optimally utilise their resources and thereby reduce the patients’ hospital stay while offering them better care. He concluded by recommending the adoption of smart innovations as they positively impact the hospital’s functioning.

– Prof AK Gupta, Medical Superintendent, PGIMER Chandigarh

Digital medical imaging in public healthcare – The way forward

Sabu Jose, General Manager, Government Accounts, Carestream Health India, started off by talking about the acute shortage of resources in the healthcare sector. He pointed out that only 30 per cent of India’s population has access to healthcare with 1:1833 bed ratio in the public sector and 1:100000 ratio when it came to radiologists in the country.

Jose also highlighted the challenges in increasing access within the public health domain. Providing solutions to these challenges, he elaborated on how India can make the best use of the available resources by making them more productive and recommended doing it with the help of digitalisation. He cited an example of how a radiology department can be efficiently run with less number of technicians through digitalisation. He said that it would also help in getting optimal results and diagnose more number of patients.

Jose also opined that digitalistion is a building block for creating an effective healthcare delivery system in India. Further, he presented a video that explains how a digital radiology system works. He also elaborated on how it enhances the productivity of a radiology department and how the digitalised data from the three to four hospitals’ radiology departments can be integrated using a cloud platform. Moreover, Jose spoke about effective digitalisation of a PACS unit to increase efficiency within the hospital and how PACS can be integrated with cardiology, endoscopy, dental and many other vital departments within a hospital. He summed up the session by explaining Carestream Health’s offerings in the public health space.

– Sabu Jose, General Manager, Government Accounts, Carestream Health India

Models for financing public healthcare

Caption: (L-R) K Srivatsava, VP Marketing and Sales, NATCO Pharma; Dr Anant Phadke, Senior Advisor, SATHI-CEHAT; Dr Prateek Rathi, Special Executive Officer, ESI Scheme, Department of Public Health, Maharashtra; Kavita Singh, Director NHM (Finance), MoH&FW, GOI; Chhitiz Kumar, CEO Philips Capital& Head-Government Affairs, PPP Philips India;

This panel discussion revolved around solutions to finance public health in India. Dr Prateek Rathi, Special Executive Officer, ESI Scheme, Department of Public Health, Maharashtra was the moderator for this session. He touched on pivotal issues in financing public healthcare and examined the efficiency and effectiveness of the current models of financing healthcare in the country. The panelists also highlighted several strategies to finance public health in India, challenges faced during implementing these strategies and the way forward. They also shared their recommendation to improve financing in public health.

Dr Rathi commenced the discussion by asking Kavita Singh, Director, NHM (Finance), MoH&FW, Government of India about current strategies adopted by the government to finance public health. Singh explained how the budget allocations are made by the government and revealed that getting more money for health is always a challenge. She said that the total spending on health by both government and private sector amounts to four per cent of our GDP out of which government spending stands at one per cent. She also said that if the government spending in public health increases by 2.5 per cent, India could have better health indicators. She also informed that our current budget allocation is 33 per cent of the entire Union Budget for 2016-17 which is a good move as healthcare allocations earlier have been restricted to 20 per cent of the overall allocation. With this, she pointed out that healthcare is slowly getting its due and that it is no more just a state subject. Singh indicated that the increased allocation of funds can be effectively utilised to bring down MMR and IMR rates in India. Analysing the current budget allocations she said that the most impressive part of the government announcements for this year was the devolution of taxes. Although this move has not yet taken off, its mandate will help the state governments to provide more allocations of in their budgets toward health. Apart from this, Singh also drew attention towards the growing incidence of communicable diseases (TB) and non-communicable diseases (diabetes, CVDs and cancers) which has led to increased out-of-pocket spending on healthcare. She then recommended that India needs a basket of models that includes different ways of financing public health.

Dr Rathi also pointed out that drug costs are also increasing out-of-pocket expenditure for patients. K Srivatsava, VP Marketing and Sales, NATCO Pharma took up the conversation and said that it’s important for Indian companies to challenge patents as these patented drugs become unaffordable to the common man in India and sometimes even to the rich. Nevertheless, he said that government’s compulsory licensing policy has made it mandatory for pharma companies to provide 600 medicines for free to cancer patients. Additionally, there are a lot of schemes that are floated by the state governments that provide free medicines to poor patients but the only problem in oncology is that there is a limit beyond which the firms cannot provide free drugs as patients require targetted therapy. Srivatsava also spoke about the role of philanthropic institutes and their contributions in this regard. However, he felt that the government’s effort in providing overall cancer treatment to patients are significantly less. He laid emphasis on the rising service taxes for various commodities and said that these accumulated taxes can be utilised in providing healthcare to the poor patients.

Moving further, Dr Rathi said that the government is falling short of resources and there is an urgent need to augment these resources. He asked Chhitiz Kumar, CEO Philips Capital& Head-Government Affairs, PPP Philips India to share his thoughts on the same. Kumar pointed out that there is need for better understanding of health economics in our country. Referring to a Lancet report he informed that if we invest 1x amount of money on health, the returns on investment over a period of time and across countries would be around 10-12x. This fundamental is still not understood by the government. He went on to say that the government needs to understand that any investment in healthcare will not yield returns in 5-10 years and might take decades to do so. Kumar reiterated Singh’s recommendation of have multi-financing options for healthcare.

Taking the discussion forward, Dr Rathi mentioned that investing money alone will not suffice, we need to develop systems and capacities. He stated that we need to have an equitable, accessible and affordable healthcare system for India. He then urged Dr Anant Phadke, Senior Advisor, SATHI-CEHAT to take the discussion further and share his views on this subject. Dr Phadke asserted that Universal Health Coverage is impossible to achieve without predominant government funding in health. Increasing private sector financing will not help according to Dr Phadke as this will only lead to added out-of-pocket expenditure. He said that we can use some insurance areas funded by the private sector but a major source of funding in health has to come from the government. Moreover, he emphasised on the importance of public procurement of drugs and devices to bring down the costs. In this way we can use our capabilities efficiently to tackle the problem of financing in healthcare. He also accentuated on the need for transparency within the public healthcare system.

The panelists also discussed on the inefficiencies within the system and finally came to a conclusion that a multi-financing model will be beneficial to build a strong healthcare system in India. Dr Rathi summed up the discussion by saying that the government has to increase its spending, decrease inefficiencies within the system, maintain transparency and create synergies.

Frugal innovations in healthcare

Gyanesh Pandey, CMD, HSCC began his session by elaborating on HSCCs contributions in the public health sector in India. He spoke about HScc’s role in increasing healthcare access through its chain of hospitals and building healthcare infrastructure at a lower cost. He also threw light on how HSCC has been using frugal innovations to expand healthcare access in ophthalmology through its low cost medical devices such as intraocular lens which is often used in cataract surgeries.

Pandey stressed that there is a dire need for frugal innovation in healthcare as they not only help the poor patients to get access to healthcare at a cheaper cost but also fosters a healthy ecosystem for start ups in India. Further on, he mentioned that India’s start up culture is growing, especially in the healthcare sector with several good example sof frugal innovations coming up in this space. Start ups in the healthcare space are continuously working hard to come up with innovative devices which would bring down costs yet improve health access. He opined that most of these innovations are coming up in the fields of ophthalmology, cardiology, diabetes and infectious diseases.

Pandey also pointed out to the measures by the Chinese government to start ups and other medical devices companies to come up with medical innovations. Lauding the efforts, he said that today, China has a thriving medical innovation culture. He concluded his session with a call to all stakeholders to come together and encourage frugal innovations in healthcare. He said that this will also boost medical tourism is India, solve many healthcare challenges and improve the quality of life of the people in India.

– Gyanesh Pandey, Chairman and Managing Director, HSCC

Skill enhancement programmes to bridge workforce deficit

Prof P R Sodani, Dean (Training), IIHMR University spoke on how India can enhance its existing workforce in healthcare to bridge the current deficit of skilled manpower. He touched upon significant subjects such as importance of skilled workforce in healthcare, nature of the healthcare workforce crisis, causes for the scarcity, measures to overcome this challenge, and the way forward.

Prof Sodani began with informing that the WHO has recommended six essential building blocks for strengthening the healthcare system of countries across the globe. Governance, health information, financing, human resources, medical technologies and medicines are the six building blocks that can strengthen any healthcare system, he informed. According to Prof Sodani, an effective workforce is that which is available when needed, competent enough to perform their duties, responsive enough to the task given to them and be productive. Human resource occupies around 47 per cent of the health budgets globally. Therefore, managing the health workforce in country is very important. He referred to a study and said that less motivated workforce delivers poor quality of healthcare service.

Prof Sodani also spoke about the need to create a good density of workforce and said that when a country has a high density of workforce, the nation has a strong healthcare system. Further, he pointed out that India needs to increase its workforce within the National Health Mission and focus on getting the right mix of people to work in this area. He also advised that India needs to increase the number of skill development centres within the healthcare space and changing the training content of skill development programmes to improve their efficacy.

– Prof PR Sodani, Dean (Training), IIHMR University

Models of financing oncology medicines

K Srivatsava, VP-Marketing & Sales, NATCO Pharma raised concerns on the rising burden of cancer and the rising cost of treatment. He underlined that though there are several government health schemes, not many provide full coverage to cancer treatment in our country. He mentioned that the contribution of philanthropic organisations is also not enough to deal with the huge burden posed by cancer and a lot more has to be done for the treatment of oncology patients.

Srivatsava further urged the audience to focus their efforts on building a strong healthcare system for cancer care in the government sector. He then suggested the introduction of equated monthly installment (EMI) schemes for cancer care. He said that currently 25-30 per cent of patients get cancer treatment, but with the introduction of EMI schemes, more percentage of cancer patients will be in a position to avail treatment. This will also provide better adherence to cancer care in India and ensure completion of the therapy, he stated. Additionally, he explained how the EMI scheme works within the healthcare sector. Srivatsava also informed that so far the EMI scheme is working well in cardiac care, early 550 loans have been availed in India for cardiac care. If this scheme is implemented effectively in oncology care, it can certainly make a huge positive impact and more patients can be cured of cancer in India.

– K Srivatsava, Vice President – Marketing & Sales, NATCO Pharma

Expanding role of NGOs, Foundations & Corporate Hospitals’ outreach programmes in TB control

Caption: (L-R) Dr Sreenivas A Nair, National Professional Officer-Tuberculosis, WHO, Country Office for India; Dr Atul Kharate, State TB Officer/ Joint Director Health services, Government of Madhya Pradesh; and Dr Aravind Swaminathan, Paediatrician, MSF

This panel discussion focussed on the enormity of TB as a public health concern and the role that prolific partnerships between private and public stakeholders of health can play in tackling this threat effectively.

This session’s moderator, Dr Atul Kharate, State TB officer/ Joint Director Health Services, Government of Madhya Pradesh commenced the discussion by highlighting that in India, there is hardly anyone who can say with certainty that no member in his/ her entire family suffers from TB. Yet, despite its growing incidence, TB often does not receive the attention that it deserves as a public health priority. He called it a ‘stigmatised disease’, but also admitted that with effective health campaigns, the awareness about the disease is rising and TB is losing its stigma. However, he emphasised that there is a long way to go before we vanquish the disease and stated that effective public private partnerships (PPPs) can be of immense help in this endeavour. He also discussed on the various ways that private and public sectors can combine their resources and expertise to eliminate the scourge of TB with his panelists.

Dr Sreenivas A Nair, National Professional Officer-Tuberculosis, WHO, Country Office for India spoke on the role of the private players in TB management. He said that efforts to control TB would not have the requisite effect unless the private sector is successfully engaged in the public health programmes. He said that the government should become an efficient facilitator of good TB treatment and not just the provider. For each TB patient handled in the public sector, two patients are handled by the private sector. He also elaborated on the various models being used to expand access to TB care and improve its efficacy, including the use of ICT to improve treatment of TB.

The other panelist, Dr Aravind Swaminathan, Paediatrician, MSF who has worked in a drug-resistant TB programme in Tajikistan, shared learnings from his experiences in handling paediatric TB and pointed out the measures that could be replicated in India as well. He also spoke on the challenges in diagnosing TB in children and lobbied for better diagnostic procedures and effective screening programmes to handle the disease better. He also urged the government to increase budget allocation for TB management and also elucidated on the ways the private sector could be involved in enhancing TB care in the country. He also rooted for developing innovative and yet affordable models of care with workable and scalable PPPs to treat TB.

The panel also discussed the challenges in TB care and the way forward for managing the disease in the best possible manner. The moderator concluded the session with an appeal to the media to be more sensitive and responsible when it came to TB reporting.

Role of frugal innovations in medical technology

Caption: (L-R): Dr Yogesh Patil, COO, Biosense; Mihir Shah, Founder and CEO, UE LifeSciences; Dr Jitendra Kumar Sharma, Director, WHO collaboration Centre for Priority Medical Devices & Head, Division of Healthcare Technology, National Health Systems Resource Center, MoH&FW; and Dr Pankaj Parashar, Director & General Manager. MP Public Health Services Corporations

The last panel discussion of Healthcare Sabha 2016 focussed on increasing healthcare accesibility and affordability with the help of frugal innovation. The moderator of the session Dr Jitendra Kumar Sharma, Director, WHO collaboration Centre for Priority Medical Devices & Head, Division of Healthcare Technology, National Health Systems Resource Center (NHSRC), MoH&FW highlighted how frugal innovations can mitigate the challenges that hinder us from achieving Universal Health Coverage. He touched upon subjects related to effective implementation of health diagnotics programmes, use of teleradiology in increasing access to public health, importance of public private partnerships (PPP) in healthcare and what role frugal innovations play in optimising public healthcare delivery.

The panelists shared their insights on the kind of innovations available for enhancing public health delivery and also provided some examples of public healthcare programmes that have been efficiently implemented using frugal innovations. Dr Sharma began the discussion by speaking about Universal Health Coverage and how providing diagnostic care should be the primary focus. He said that Universal Health Coverage in the true sense should cover every vertical of diagnostics. He shared some inferences from his experience of working with some renowned public health programmes where they have used frugal innovations to provide effective care to a large volume of patients. He also raised questions about the procurement process for innovations in the government sector. He said that innovations have to be unique and should be easy to adopt or implement. He further suggested that the government should have a single trade contract for any innovation to be procured and funded by the National Health Mission. He questioned to the other panelists on how their innovations have been successfully uitlised in the public health domain.

Dr Yogesh Patil, COO, Biosense spoke about his innovation and provided information on the national health programme in Andhra Pradesh wherein his innovation has been used to provide healthcare services to the rural poor. He also mentioned that apart from the public sector, his innovation has been used in the private sector, especially within the pharma industry. Further, he spoke about the challenges he is currently faced with. The biggest challenge is to increase the scale of the product.

Mihir Shah, Founder and CEO, UE LifeSciences pointed out that India is slowly building a start up ecosystem which is receiving a lot of encouragement from all stakeholders of healthcare. He said that in the past few years many avenues have opened for start ups in the healthcare space. NHSRC, NGOs such as Wish Foundation and Path, partners such as Tata Trust and state governments such as Rajasthan have encouraged the utilisation of innovations in the public health domain and create the impact that they wished for. He then talked about his innovation which is a point-of-care device for breast cancer screening. He said that this device can be used by a primary healthcare worker easily and efficiently. He also mentioned that this device has been made available to nearly 10,000 healthcare workers in rural India through various philanthropic organisations.

Dr Pankaj Parashar, Director & General Manager. MP Public Health Services Corporations spoke about his innovation on detecting proteins in the urine which would be useful to detect, hypertension and preeclampsia in pregnant women. He said that his innovation is in the protype phase and will soon begin its clinical trials. Also, this device can be utilised for detecting kidney disorders. Further, he disclosed that he wishes to collaborate with the government to work on its dialysis programmes.

Finally, the panel came to the conclusion that Indian innovators, along with other stakeholders of health, will have to work together to mitigate the challenges in scaling up innovations and increasing their reach to the masses.

EXPRESS PUBLIC HEALTH AWARDS

Welcome Address
Chief Guest Address
The future of public health in India: Suggestions for moving from MDGs to SDGs
Felicitation Ceremony

Public Health Champions honoured at Express Public Health Awards

Public Health Foundation of India and Glenmark join The Indian Express Group and Express Healthcare in this endeavour

The first edition of Express Public Health awards was held at Mariott, Hyderabad on March 5, 2016. It was a part of Healthcare Sabha, a two-day conference which was attended by policymakers and stakeholders of public health to deliberate on cohesive, unified and innovative ways to achieve the vision of the National Health Mission.

The Express Public Health Awards sought to honour the visionaries, innovators, and game changers in India’s public healthcare. It began with a welcome address by Viveka Roychowdhury, Editor, Express Healthcare. She spoke on the vision behind the awards and expressed her thanks to Public Health Foundation of India, the Knowledge Partner and Glenmark, the Presenting Partner.

Dr Srinath Reddy, the Chairperson of the jury for Express Public Health Awards took the stage to explain the concept and the need to encourage initiatives that help improve public health in India.

Dr Akun Sabharwal, Director, Drug Control Administration, Telangana was the Chief Guest at Express Public Health Awards. He spoke on the initiatives to improve healthcare in his state and emphasised on the need to improve access to medicines in the country.

This was followed by the felicitation ceremony. The winners were as follows:

Express Public Health Award for Efficiently Run Public Health Programmes by a State: It went to the State Government of Chhattisgarh for innovative initiatives in developing human resources for health aimed at improving outreach of services to difficult to reach populations, exemplified by the Mitanin programme, operationalisation of SNCUs and incentivising health personnel in extremism affected areas.
Express Public Health Award for the Most Effective Public Private Partnership: It was given to HLL Lifecare, Tamil Nadu for their exemplary initiative in producing low cost sanitary napkins, for promoting affordable menstrual hygiene for adolescent girls and women.
Express Public Health Award For The Most Effective Healthcare NGO: Nari O Shisu Kalyan Kendra, Howrah received this award for effective community action to overcome resistance to polio vaccination and routine immunisation, and increasing coverage rates through impactful behaviour change.
Express Public Health Award for the Most Effective Health Technology System: All India Institute of Medical Sciences (AIIMS), Delhi won this award for operating an efficient online appointment system for OPD services, resulting in high levels of patient convenience and satisfaction Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh received it for developing innovative health information management software for optimising average length of stay for patients in hospital, thereby decreasing costs and increasing turnover.
Express Public Health Award for Lifetime Achievement Award for Contribution in Public Health: It went to SEARCH, Gadchiroli for path breaking contributions to community – based healthcare of children and women, with impactful research-led programmes of health service delivery in a developmentally backward region of rural Maharashtra.
Jury Choice Award For Socially Responsive Healthcare Delivery by Private Institution: It was jointly awarded to Aravind Eye Care System, LV Prasad Eye Institute and Sankara Nethralaya for inspirational leadership in providing high-quality eye care to millions through pro-poor services extending from hospitals to communities.
Jury Choice Award For Corporate Contributions To Public Health: GVK-EMRI was given this award for providing emergency health transport services across the country, through an innovative PPP model.

Piramal Swasthya Management Institute also won in this category for providing health information helplines and mobile diagnostic services in several states, through PPP models.

The evening came to a close with a Vote of Thanks to all the jurists, Dr Srinath Reddy, President, PHFI; Keshav Desi Raju, Former Secretary, in MoH&FW; Dr Jayaprakash Narayan, former Member of National Advisory Council (NAC), and Second Administrative Reforms Commission (ARC); Dr Leila Varkey, Senior Advisor-RMNCH, Centre for Catalysing Change as well as all the dignitaries who were part of the two-day summit.

The most Efficiently Run Public Health Programmes by a State