Hitting the right notes with the health budget

Introduction

• This article discusses the various allocations under the Union Budget 2021–22 towards the health sector.

Context of packages

• Aatmanirbhar Bharat Abhiyaan packages announce several short-term and longer-term measures to strengthen the health sector.
• Production-Linked Incentive schemes have been announced to boost the domestic manufacture of pharmaceuticals and medical devices.
• Mission COVID Suraksha has also been launched to promote the development and testing of indigenous vaccine candidates.
  • At least 92 countries have approached India for a COVID-19 vaccine, thus bolstering the country’s credentials as the vaccine hub of the world.
• Pradhan Mantri Garib Kalyan Package: Further, to ensure food and nutrition security for the poor and the vulnerable during the COVID-19 crisis, the Government of India launched the Pradhan Mantri Garib Kalyan Package for providing free foodgrains to 800 million beneficiaries.
• ‘One Nation One Ration Card’ scheme: To facilitate access to subsidised grains across the country, the ‘One Nation One Ration Card’ scheme has been enabled in 32 States/Union Territories covering 690 million beneficiaries.

Importance of water, sanitation and clear air to healthcare

• The National Health Policy (NHP), 2017, highlights the close links between health, water and sanitation.
• This Economic Survey-2020 too recognises that improvements in access to bare necessities such as water, sanitation and housing are strongly correlated with progress in health indicators.

Good water, vaccine coverage

• The substantive allocation for the newly launched Jal Jeevan Mission (Urban) is especially commendable as access to adequate, good-quality water supply has major positive externalities for the health sector.
  • A report released by the Johns Hopkins Bloomberg School of Public Health in 2019 suggested that nearly one out of every 100 Indian children does not live to celebrate their fifth birthday on account of either diarrhoea or pneumonia.
  • Suboptimal access to clean water and sanitation is directly linked to diseases such as diarrhoea, polio and malaria.
  • Moreover, water contaminated with heavy metals such as arsenic increases the risk of developing heart ailments and cancer.
• Expand the coverage of pneumococcal vaccine: Another important public health-related announcement in Budget 2021 was the government’s decision to expand the coverage of the pneumococcal vaccine across the country.
  • Pneumococcal pneumonia is a major killer of children under the age of five years.
  • Once universalised, this indigenously developed vaccine could save up to 50,000 lives annually.
• The Finance Minister has also made a special allocation of? 35,000 crore for the COVID-19 vaccine in 2021–22, which could be increased if required.
• India has already delivered over eight million doses of the vaccine to healthcare and frontline workers thus far — the fastest vaccination drive in the world.

Pradhan Mantri – Atmanirbhar Swasth Bharat Yojana (PMANSBY)

• PLANS BY lays emphasis on the health system being strengthened at all levels, including establishing integrated public health laboratories and institutes of virology.
• This is crucial as experts have repeatedly highlighted the need for enhancing disease surveillance and diagnostic capabilities to be better prepared for disease outbreaks.
• Additionally, the emphasis on the expansion of health and wellness centres under PMANSBY, together with a ? 13,192 crore Finance Commission grant for strengthening the primary health system through local government bodies, is also noteworthy.

Pradhan Mantri Jan Arogya Yojana

• Another point of discussion in relation to the health Budget is the stagnant allocation for the Pradhan Mantri Jan Arogya Yojana (PM-JAY), a flagship scheme launched by the government in late 2018 as part of the Ayushman Bharat initiative.
• Despite being a relatively new scheme, the Economic Survey estimates a 20% decline in the infant mortality rate between 2015–16 and 2019–20 in States that adopted PM-JAY, compared to a 12% decline in States that did not.
• It is important, therefore, to persist with this highly ambitious scheme and accelerate its roll-out as the absorptive and governance capacity of States improve.

Promoting Ayurveda

• This budget has nearly hiked 40% for the Ministry of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy (AYUSH).
• The pandemic has catalysed a behavioural shift in favour of preventive care, holistic health and wellness.
• There is considerable potential for promoting Ayurveda and yoga as well as integrative health-care approaches in the post-COVID-19 scenario, especially for stress reduction and the management of chronic diseases.

States must act too

• The National Health Accounts 2017, 66% of spending on health care in India is done by States.
• It is imperative, therefore, that States increase expenditure on health to at least 8% of their budget by 2022 as recommended by the National Health Policy (NHP), 2017 and the Fifteenth Finance Commission.

Conclusion

• The health sector has found a prominent place in the government’s agenda over the last few years, with the implementation of a series of well-thought-out and carefully sequenced reforms and achieving Universal Health Coverage by 2030 as part of the Sustainable Development Goals agenda.