TODAY -

Niti Aayog must stop plan to privatise public health

Dr Sandeep Pandey, Surabhi Agarwal, Bobby Ramakant *

  Niti Aayog must stop plan to privatise public health



In late November 2019 Khwahish Warsi, a daily wage earner who makes his living by making and selling 'dholaks', the Indian percussion instrument, who did not have one pelvic joint, met with a major accident and suffered major fracture in both his legs. He was taken to the trauma centre of the King George's Medical University (KGMU) in Lucknow, India. Because of major rush here he could not be admitted for two days and was ‘advised’ to seek treatment in private hospital. That is how he landed at a private hospital in the city.

Even after he had borrowed Rs. 1.1 Lakhs (around US$ 1500) from his village in Barabanki he could not muster half the amount the hospital was asking to go ahead and perform the surgery which included putting iron rods in his legs. Had it not been for some charitable individuals he would not have been able to make all hospital payments. But everyone may not be as lucky.

A senior citizen was not so lucky to get much-needed healthcare when government-run hospital declined him services. Health activist Rahul Dwivedi shares that in January 2020, a 72 years old patient was referred by government-run Bahraich District Hospital (in UP, India) to government-run tertiary-care hospital KGMU for urgent dialysis and specialized care.

Patient who was already struggling to meet expenses in Bahraich, came under even more pressure to raise money to meet expenses for the ambulance transfer to Lucknow-based KGMU. When he reached KGMU despite his deteriorating condition, after several long hours of waiting, he could eventually get the preliminary checkups done for admission in medicine department. But was later 'advised' by a senior faculty to rather go to a private hospital in Lucknow.

Duty doctors however referred him to outdoor patients' department (OPD) of another government-run Dr Ram Manohar Lohia Institute of Medical Sciences. But being a weekend, he had no money to stay in state capital Lucknow for additional two nights and try his luck on Monday morning (13 January 2020). He returned back to Bahraich without much-needed life-saving treatment and care.

When will we walk the talk on right to health?

The best judge if we are respecting right to health is: how the poorest of the poor, and most marginalized sections of the society, are accessing healthcare.

The Niti Aayog has unveiled a plan to hand over district government hospitals to private players. It claims that the guiding principles for the public-private participation scheme will be based on “international best practices”.

Firstly, worldwide in countries where health security for all citizens especially the most marginalized is guaranteed, it is through stronger public health systems, and not private. Secondly, public-private partnerships result in benefitting the private sector only, and thus is privatisation in garb of 'doing good'. That is why we condemn this Niti Aayog's plan to privatise India's public healthcare system (and other public services too).

It should be remembered that the Indian government's per capita expenditure on healthcare is among the lowest in the world (and in the South Asian region). The World Health Organisation (WHO) recommends that countries spend at least 4-5% of their GDP on health to achieve optimal healthcare outcomes. In the current central budget, the percentage of funds allocated for healthcare is 2.25%.

This comes to about 1.4% of the GDP, which is much less even than the 2.5% of GDP goal for 2025 which is set by the National Health Policy of 2017. In contrast, India spends about 10% of its budget on defence. Several African nations committed to spend 15% of their budget on health (Abuja Declaration of 2001). In 2019, the Delhi government allocated 14% of its budget to healthcare.

In the absence of the political will to provide adequate funding to something as basic and essential as healthcare, placing the blame of the system's dismal performance on public sector inefficiencies and presenting this as a justification for privatisation, is clearly disingenuous.

The problems of inadequate facilities, understaffed clinics and overworked and poorly performing personnel, which plague healthcare in India, are all linked to a lack of financial resources and bad governance, and cannot be solved without stronger government's commitment to public health, which includes significantly increasing healthcare expenditure. Privatisation can only lead to superficial short-term improvements, while inevitably reducing access for most-in-need by driving up costs, taking us even further from the goal of universal healthcare.

India has promised to deliver on the promise of universal health coverage (UHC) where "no one is left behind" in its National Health Policy of 2017 and UN Sustainable Development Goals. But privatisation of public health is pushing us backwards from these goals which are rooted in the human rights to health. The vision of universal healthcare coverage - which leaves no one behind - can only be achieved from robust and well-funded public health system which is not running on cost-to-cost or for-profit motives.

People belonging to marginalised communities such as Dalit and other lower castes, Adivasi/Tribal communities, women and other minority groups, face the greatest obstacles in accessing proper healthcare. This is due to a combination of the general low economic status of these groups, as well as deeply entrenched, systemic prejudices against them.

In such a scenario, it becomes even more important that instead of abdicating its responsibilities, the government exercise its powers to regulate the healthcare sector in a way which minimises bias and exclusion and ensures equal access to all. A private, profit-driven healthcare system on the other hand, will only deepen these faultlines by inevitably prioritising those who can afford to pay for its services over those who can't.

Some of the best, most efficient and inclusive healthcare systems in the world are government-run. The healthcare systems of countries like Canada, Iran and Sri Lanka are shining examples. Private cannot substitute the public. We must stop believing the illusion that privatized system of healthcare is better. There is a need to believe in the government system and to make it accountable to the people.

In India too, the current Delhi government has made remarkable strides in improving access to quality healthcare among the general public by making significant investments in close to 450 primary healthcare centres around Delhi, called Mohalla Clinics, and ensuring they are well-staffed and properly equipped. The Niti Aayog would do well to take note of these international and domestic best practices.

Public health is not an 'industry'

One cannot ignore the fact the private players are there only so long as profits are to be made. Will these private players continue to play their role in so-called 'public private partnerships' if cost-benefit ratio is not in their interest? Health is not an industry, rather right to health needs to take primacy over trade.

It is common sense that we cannot mop the floor when the tap is still running on it. Neglecting preventive healthcare and focussing on curative healthcare is another major problem which makes 'curative healthcare' an industry. For example, by opening the markets for air purifiers and private on-payment lounges for 'fresh air', will we solve the problem of air pollution (and linked deadly diseases such as lung cancer)? Focussing on preventive aspect does not mean shifting priorities and competing with curative component, but both go in tandem.

Also, some industries are knowingly pushing products and lifestyles that is programmed to kill (and cause disease). For example, tobacco, alcohol and Big Food companies. With raging epidemic of non-communicable diseases (NCDs) causing over 70% of deaths, we have no choice but to hold these corporations to account (legal and financial liability). Heart diseases, stroke, cancers, diabetes, chronic respiratory diseases are among the major NCDs, a significant number of which is preventable.

It is constitutionally possible to ban alcohol and tobacco. There are Indian states that have banned alcohol (north-east states, Bihar and Gujarat for example). Gutkha (a chewing tobacco form) was also banned by the government, within existing legal and policy framework, although several other forms of tobacco continue to be consumed in India.

So despite overwhelming scientific evidence linking alcohol and tobacco to deadly diseases and other ill-effects, what is preventing government to end alcohol and tobacco, and hold industries to account? Governments have aimed to reduce alcohol by 10% by 2025, but intend to end TB 100% by 2025 - but TB is linked to alcohol and tobacco use too!

We know TB is preventable and curable, but for almost 1.5 million people who died of TB in 2018 globally, it is not preventable and curable. TB is the world’s biggest killer-infectious disease, and India has the highest burden. We are failing to prevent transmission of TB, as last year almost 10 million people got newly infected with TB globally. If we are serious about health security “where no one is left behind” we have to strengthen public health systems.

Health is a fundamental human right and it is government's responsibility to ensure that every citizen "where no one is left behind", is able to fully realize her/his right to health.


* Dr Sandeep Pandey, Surabhi Agarwal, Bobby Ramakant (CNS (Citizen News Service)) wrote this article for e-pao.net
The writer can be contacted at ramakantbobby(AT)gmail(DOT)com
This article was webcasted on January 14, 2020.



* Comments posted by users in this discussion thread and other parts of this site are opinions of the individuals posting them (whose user ID is displayed alongside) and not the views of e-pao.net. We strongly recommend that users exercise responsibility, sensitivity and caution over language while writing your opinions which will be seen and read by other users. Please read a complete Guideline on using comments on this website.




LATEST IN E-PAO.NET
  • Violence in Manipur 2023-2025 : Timeline
  • Govt services reach Manipur's tribal villages
  • COVID-19: Update 05 July 2025 : Manipur
  • Konung Kang Chingba #1 : Gallery
  • Manipur Iskcon's 25th Ratha Yatra 2025
  • Native Threshing machine made for farmers
  • COVID-19: Update 04 July 2025 : Manipur
  • Riso Ejang: Youth-led Transformation
  • Include males too in addressing HPV
  • Whispers from the past :: Poem
  • LPU opens permanent outreach centre
  • Raj Bhavan moving on the right track
  • Speculations over PM Modi's visit to state
  • Colonial Knowledge Production in NE #7
  • Make Yourself Visible to Opportunity
  • Orange bowl: tradition with ecological wisdom
  • 10 ways to keep a kitchen garden disease free
  • Between PR, military mandates & AFSPA
  • Allocation fund for MLALAD Fund during PR
  • Denounces Killing of KNA Deputy C-in-C
  • COVID-19: Update 03 July 2025 : Manipur
  • Cases of fake Aadhaar cards
  • Sincere dealing must for stricter Aadhaar
  • Archaeology: Culture of Manipur : Booklet
  • Wanna be a singer? Get Botox
  • A Central institute in Manipur
  • Nagging in the name of love
  • COVID-19: Update 02 July 2025 : Manipur
  • 'Benefits' of Indira's Emergency
  • Social Stigma :: Poem
  • Inking a peace pact: Why, how: SoO quagmire
  • Van Mahotsav under shadow of declining forest
  • 11th Th Kishan Memorial Lecture : Gallery
  • Shinthoibi, Jangvei, Tamphaton : eMing
  • Manipur crisis & the Left media's blind spot
  • COVID-19: Update 01 July 2025 : Manipur
  • Bombom RK : Musclemania Universe NYC
  • The Grief :: Poem
  • Music Concert & Quiz (MCQ) 2.0
  • SoO agreement unlikely to be scrapped
  • Regulating use of plastic carry bags
  • Mera Houchongba @Kangla #4 : Gallery
  • International Day of Yoga @JNMDA : Gallery
  • BD Behring: The inimitable Gentleman I knew
  • Violence in the name of patriotism : Misguided
  • Daily oral vs long-acting injectable for HIV
  • COVID-19: Update 30 June 2025 : Manipur
  • Smile :: Poem
  • Why was President's Rule imposed ?
  • BJP under pressure to forge unity
  • Kang @Leikai in Imphal : Gallery
  • July Calendar for Year 2025 : Tools
  • COVID-19 : A recurring crisis in Manipur
  • DC Kaith and Forestry in Manipur : Book
  • COVID-19: Update 29 June 2025 : Manipur
  • Longing for Peace :: Poem
  • Black badge, slogan protest by peeved scribes
  • Present the true picture before Delhi
  • Pung-Cholom @ Polo Tournament : Gallery
  • Life: A Journey Through Thought & Being
  • Khongjai Hills & Kuki claim to indigeneity
  • Master Time by Managing Information
  • COVID-19: Update 28 June 2025 : Manipur
  • Pride & patriotism in CCpur's army families
  • The Power of Poppy - 87 :: Poem
  • World Decarbonisation Day: green environment
  • Welcome Home - Nganthoi #2 : Gallery
  • Loss of two precious lives from Manipur
  • Balancing civil liberties with public safety
  • COVID-19: Update 27 June 2025 : Manipur
  • Gender equality & human rights are indivisible
  • Stay hydrated this summer season
  • Silent Half of the Sun :: Poem
  • Connecting the dots in the wishlist
  • Assembly record tampering claims by ex-CM
  • The immortal legacy of Pukhramba Kajao
  • International Day against Drug Abuse 2025
  • COVID-19: Update 26 June 2025 : Manipur
  • Black pottery from Ukhrul - tribal heritage
  • Program on "Mission-Drug Free Campus"
  • Play makes a better world
  • Urgent Appeal to the Honourable MLAs
  • Tribal Empowerment Campaign at CCpur
  • Talk doing the round: PM to come
  • 'Emergency' relief for under-fire BJP
  • Golden Jubilee Art Fair @Imphal : Gallery
  • Declaration: Meetei People Convention, Delhi
  • A Flower Among the Rocks :: Review
  • Book Donation Campaign
  • Improved road connectivity boosts livelihoods
  • To Have Great Dreams :: Poem
  • COVID-19: Update 25 June 2025 : Manipur
  • Regret vs Sorry: Technical & moral insight
  • Cocktail of inept Govt, selfish people
  • State trailing others in cleanliness
  • Colonial Knowledge in NE India #6
  • UHI effect & rising temperatures in Manipur
  • Frequent road blockades cripple economy
  • COVID-19: Update 24 June 2025 : Manipur
  • Unite Health with Community health services
  • NSU, Imphal, tops IIRF Ranking 2025
  • Endless conflict :: Poem
  • Pak nobel pish prize for Trump
  • May 3, 2023 - June 24, 2025: Failure of Delhi
  • Hotter days, sudden rainfall no more a rarity
  • "The Great June Uprising" #2 : Gallery
  • How to Build a Career, Lead with Purpose
  • 2nd Foundation Day- Karnataka Meitei Assn
  • COVID-19: Update 23 June 2025 : Manipur
  • NSCN-IM Amnesty threatens to isolate it
  • Sunset :: Poem
  • Intl Yoga Day for a healthier environment
  • Of clogged drains and plastics
  • Poor roads testify Govt indifference
  • Welcome Home - Nganthoi #1 : Gallery
  • The Silent Erosion of Manipuri Language
  • Design health services around people
  • Serene Hills Host Inspiring Int'l Yoga Day
  • COVID-19: Update 22 June 2025 : Manipur
  • Chopper services between Senapati & Imphal
  • High Court Judges interacted with convicts
  • Redyeing the Fabric :: Poem
  • Differences yet to be resolved stand
  • Border fencing rage as solution eludes
  • Radio E-pao: 14 new songs updated
  • Climate Adaptive Agroforestry
  • Manipur overlooked demographic shifts
  • Young designers shine on Fashion Stage
  • COVID-19: Update 21 June 2025 : Manipur
  • International Day of Yoga at Lamphelpat
  • International Day of Yoga at JNMDA
  • The Power of Poppy - 86 :: Poem
  • Keishampat Lairembi Haraoba #1 : Gallery
  • Crisis in Manipur's Contemporary Education
  • Best 8 Performances in Manipuri Cinema
  • Identity: Caught between China & India ?
  • COVID-19: Update 20 June 2025 : Manipur
  • To The Father Who Listens :: Poem
  • How does net suspension affect youths ?
  • Targeting farmers to cripple state's economy
  • The virus is back and spreading
  • Who is afraid of Manipur ?
  • A threatened lily growing at Shirui Hills
  • World Environment Day in Manipur : Gallery
  • Ambubachi Mela at Maa Kamakhya
  • COVID-19: Update 19 June 2025 : Manipur
  • Dolls made from repurposed vegetable refuse
  • Condemns Attack on Farmer & Killing
  • Abhorrent politics of SoO
  • Police arrogance on harmless drivers
  • "The Great June Uprising" #1 : Gallery
  • Solution from Buddhist & Jain perspectives
  • AI sparks employment concerns in Manipur
  • Greatest Foe :: Poem
  • Chief Justice at Relief Camp, Kangpokpi
  • Call for Recognition of a 3rd Category of IDPs
  • Jun 18, 2001- May 3, 2023: Seed of violence
  • Contract scam in hill districts
  • Colonial Knowledge in NE India #5
  • Spaced Out - Panthung Di Kadaaida! : Rvw
  • Condemns the Killing of Abdul Qadir
  • COVID-19: Update 17 June 2025 : Manipur
  • Thoubal aspirant makes Manipur proud
  • Tamenglong hospital brings quality healthcare
  • Chief Justice at Relief Camp, Mayang Imphal
  • Kuki CM & Sixth Schedule
  • Selective protests, selective silence
  • Nailing the culprits need of the hour
  • UK Meetei diaspora run for Myanmar : Gallery
  • Erwin Khundrakpam : NEET-UG 2025 topper
  • Will we rise to #endAIDS challenge or stumble
  • COVID-19: Update 16 June 2025 : Manipur
  • Appeal to Prime Minister: Manipur Crisis
  • Urges Action on Misinformation
  • Condolences : 2 young cabin crew
  • Grateful To Be Alive :: Poem
  • Making bonfire on the roads
  • Aggression yet again, inspite of playing victim
  • Aftermath of flooding @ Khurai #2 : Gallery
  • Zomia, geopolitics, & the struggle for unity
  • COVID-19: Update 15 June 2025 : Manipur
  • Condolences : Demise of 2 Manipuri Girls
  • Manipur unites in grief after Air India tragedy
  • Hail arms recovery as step toward peace
  • Cleanliness Drive at JNIMS Campus
  • Global Wind Day for a clean environment
  • First came the rain, then the heat
  • Rise in Covid-19 cases
  • Thang-Ta Day @Khuman Lampak #3 : Gallery
  • Meetei diaspora in UK runs for Myanmar victim
  • Manipur empower children with disabilities
  • COVID-19: Update 14 June 2025 : Manipur
  • World Blood Donor Day 2025
  • The Power of Poppy - 85 :: Poem
  • A Northeast Gin Makes Its Mark
  • Mera Houchongba @Kangla #3 : Gallery
  • Saluting Nganthoi, Lamnunthem : Joining hand
  • Condolence : Nganthoi & Lamnunthem
  • 50 years of Pebet #2 : Gallery
  • Indo-Naga Talks (From 2012) :: Timeline
  • Colonial Knowledge in NE India #4
  • Namphake Monastery @ Dibrugarh : Gallery
  • Protest @Checkon -AT arrest [Jun 9] : Gallery
  • Protests - AT arrest [Jun 8 night] : Gallery
  • Aftermath of flooding @ Khurai #1 : Gallery
  • /li>
  • Flooding at JNIMS Hospital #2 : Gallery
  • North East NSS Festival @ MU : Gallery
  • 27th Meira Paibi Numit : Gallery
  • Trump's tariff legacy & its global echo
  • Flooding at JNIMS Hospital #1 : Gallery
  • Flooding Imphal East [31 May] #3 : Gallery
  • Flooding Imphal East [31 May] #2 : Gallery
  • Flooding Imphal East [31 May] #1 : Gallery
  • S Nirupama @Miss Universe : Gallery
  • Protesters to Raj Bhavan [May 25]: Gallery
  • Human Chain @Airport road [May 26]: Gallery
  • Miss Shirui Pageant Contestant: Gallery
  • 48 hrs Bandh: protest security forces: Gallery
  • Protest Rally: Journalist harassment: Gallery
  • HSLC 2025: Full Result (Check Roll No)
  • HSLC 2025: Important Info & Grading System
  • HSLC 2025 : Compartmental candidates
  • HSLC 2025 : Comparative Statement
  • HSLC 2025 : Statistical Abstract
  • HSLC 2025 : District Pass Percentage
  • HSLC 2025 : Govt School Pass %
  • HSLC 2025 : Aided School Pass %
  • HSLC 2025 : Private School Pass %
  • People's Convention on 3rd May #2 : Gallery
  • Featured Front Page Photo 2025 #2: Gallery
  • Riya Khwairakpam : HSE Science Topper
  • Keisham Hannah : HSE Arts Topper
  • Warepam Lidia : HSE Commerce Topper
  • HSE 2025 Result : Science Full Result
  • HSE 2025 Result : Arts Full Result
  • HSE 2025 Result : Commerce Full Result
  • HSE 2025 Information / Abbreviation
  • HSE 2025 Topper : Science
  • HSE 2025 Topper : Arts
  • HSE 2025 Topper : Commerce
  • HSE 2025 : Pass Percentage
  • HSE 2025 : Result Abstract
  • HSE 2025 : Candidates with Highest Marks
  • Ougri Lirol :: Part 1 : Ooba Video
  • President's Rule in Manipur : 1967 - 2025
  • Downloadable Manipuri Calendar :: 2025