20 January 2025 : Indian Express Editorial Analysis

1. For better health

(Source – Indian Express, Section – The Editorial Page – Page No. – 08)

Topic: GS2 – Governance

Context

India’s roadmap to achieve a robust, equitable, and digitally integrated healthcare system by 2047.

Analysis of the news:

India’s Health Aspirations for 2047

• India’s vision of becoming an economically developed nation by 2047 hinges on the foundation of a healthy and productive population.
• While addressing the ongoing health challenges in 2025, it is crucial to anticipate and counter emerging threats to public health.
• A dual strategy is needed: prioritizing health promotion and disease prevention at the population level, alongside ensuring timely and equitable delivery of diagnostic and therapeutic services.
• To achieve this, a robust health system must take shape by 2025, fueled by sustainable financial and human resources that form the backbone of its growth and vitality.

Universal Health Coverage as the Path Forward

• Primary healthcare-led Universal Health Coverage (UHC) is central to India’s journey toward a healthier future.
• Achieving this requires increased public healthcare financing, with enhanced budgetary allocations at both central and state levels.
• UHC demands progress on two fronts: financial protection and comprehensive service coverage.
• Ensuring quality health services that address the needs of all age groups requires a multi-layered and evenly distributed health workforce.
• While addressing the shortfall of highly skilled doctors may take time, immediate efforts should focus on training a technology-enabled cadre of frontline health workers and allied professionals.

The Ayushman Bharat Mission:

• The Ayushman Bharat mission encapsulates critical components for a health system that is effective, equitable, and empathetic.
• Its key pillars—strengthened primary care infrastructure, health financing for vulnerable populations, and the integration of digital health technologies—must be harmonized into a cohesive system.
• The digital health mission holds particular importance, offering tools for epidemiological intelligence, program monitoring, and system integration.
• Leveraging these components cohesively can propel India toward its goal of a healthy and resilient population.

Addressing Disparities with Data-Driven Insights

• India’s health indicators often mask regional and socio-demographic disparities.
• Disaggregated data at district and block levels are essential for evidence-based, culturally adaptive, and equity-promoting interventions.
• Existing fragmented data systems must evolve into integrated frameworks capable of providing timely, representative, and accurate insights.
• This is especially critical as non-communicable diseases (NCDs) and mental health disorders surpass infectious diseases in their contribution to the disease burden.
• Real-time surveillance systems for infectious diseases and NCDs, combined with data on risk factors, are needed for targeted action.

Surveillance Systems for Emerging Health Threats

• Advanced surveillance systems are vital to address the growing threats of zoonotic diseases, antimicrobial resistance, and climate change-induced health risks.
• Real-time monitoring techniques, such as wastewater surveillance, must become routine practices for early detection and tracking of microbial threats.
• The “One Health” approach is essential for integrating surveillance data across human, animal, and environmental domains.
• Climate change’s role in exacerbating water-borne and vector-borne diseases necessitates vigilant and interconnected monitoring systems, underpinned by big data analytics.

Digital Transformation for Integrated Healthcare

• Integrated digital health systems are key to improving patient care and addressing the gaps in India’s mixed public-private healthcare landscape.
• Seamless transfer and integration of diagnostic and treatment-related data are critical for efficient and equitable healthcare delivery.
• The current disconnect between public and private healthcare data systems hinders the development of rational treatment strategies and undermines patient rights.
• Bridging this gap through digital technologies, such as artificial intelligence and shared data banks, can enhance referral systems and ensure contextually relevant healthcare delivery.

Conclusion:

• India’s digital strengths must be harnessed to bridge gaps between primary care and health insurance programs while fostering community participation in surveillance and healthcare delivery.
• By enabling technology-driven integration of public and private healthcare systems, India can lay the groundwork for a transformative health system in 2025.
• Such reforms are pivotal to achieving the nation’s aspiration of a healthy, productive population and a developed economy by 2047.

What are the Major Challenges Related to India’s Healthcare System?

Inadequate Public Health Expenditure: Despite being the world’s fifth-largest economy, India’s healthcare expenditure remains one of the lowest globally at 2.1 % of GDP in FY23 Also, while India supplies 20% of the world’s generic drugs, its own citizens face a 47.1% out-of-pocket expenditure, signaling a critical gap in public health provisioning. Urban-Rural Healthcare Divide: India’s healthcare infrastructure disproportionately favors urban areas, creating a ‘two-tier’ system. Despite 65% of Indians living rurally, these areas have only 25-30% of hospitals within reach. This is not just a resource issue, it is a fundamental challenge to India’s constitutional promise of equality. Silent Epidemic of Non-Communicable Diseases (NCDs): While India battles infectious diseases, NCDs silently claim 64% of the disease burden in India (WHO, 2021). India’s diabetes burden (77 million in 2019, projected 134 million by 2045) exemplifies this crisis. As India’s economy grows, so does its NCD burden, a byproduct of lifestyle changes. Yet, public health strategies remain disproportionately focused on communicable diseases, creating a growing, unaddressed health burden. Mental Health Blind Spot: India’s mental health crisis is a glaring oversight. With just 0.75 psychiatrists per 100,000 people and only 0.05% of the health budget for mental health, India grapples with 36.6% of global suicides. Digital Divide in Telemedicine: Telemedicine, hailed as a panacea during Covid-19, exposed India’s digital divide. In India, despite having the second-largest number of internet users in the world, rural penetration lags behind the urban. This gap turns telemedicine from a solution into another layer of inequity, disproportionately benefiting the urban while leaving rural areas behind. Climate Change– The Overlooked Health Determinant: Climate change is more than an environmental issue, it is a health crisis. Governance Conundrum: India’s health challenges are exacerbated by governance disparities. Many states have over 50 approvals under various regulations, creating a bureaucratic nightmare for facilities. Also, some states often prioritize large corporate hospitals, neglecting the needs of smaller clinics and nursing homes. Pharmaceutical Paradox: India, the “pharmacy of the world,” faces a credibility crisis. The 2022 cough syrup tragedy in Gambia highlights that the industry’s global reputation and its domestic healthcare efficacy are at stake. Neglect of Preventive and Primary Care: India’s health system is tilted towards curative, hospital-based care, neglecting the foundation of public health – prevention and primary care.

PYQ: “Besides being a moral imperative of a Welfare State, primary health structure is a necessary precondition for sustainable development.” Analyse. (150 words/10m) (UPSC CSE (M) GS-2 2021)

Practice Question:  Discuss the importance of building a robust, equitable, and digitally integrated healthcare system for India’s aspiration to become a developed nation by 2047. Highlight the challenges and suggest measures to achieve this vision. (250 Words /15 marks)

For more such UPSC related Current Affairs, Check Out: 18 January 2025 : Indian Express Editorial Analysis