Governments after governments come and go, but not once did anyone feel the need to have a separate Ministry of Public Health which should be the sole ministry responsible to address India’s public health problems.
We talk about India’s entry into NSG, we are more worried about how China blocks our way to stardom. But in our own backyard we have problems which we have not been able to address since decades of Independence. We need to have effective public health policies which are meaningful to civilians on the ground. In the fast pace digital world, lifestyle has taken a severe beating. The leadership through this ministry needs to invest heavily to set up public parks, theme parks, fitness and sports centres to create environments that support changing lifestyle. With the creation of all these, the idea of quality and affordability should emerge as a basic human desire to scale for excellence.
I strongly believe that government needs to invest in healthcare heavily. Only education and health matters the most to individuals. This is the only thing that has held us back as a nation and has kept us with glaring contradictions for the world to watch. Most politicians see politics as a business, and they have no idea of what policy even means. It is about time, we send to the hustings those politicians who see politics as a calling. Whose commitment to the cause and purpose of humanity is non-negotiable. In the domain of health, we as a nation, require to achieve Universal Health Coverage, fulfil the health needs of all in a manner in which quality and care is met with ease. Resources need to be diverted to preventive medicine. History will record that the model of only addressing curative medicine in India has failed miserably.
Budget allocations for healthcare is a signal that the Ministry has no serious intention to change the trends. Sloganeering and rhetoric cannot be good governance, which as a concept is very deep and serious. Another joke as a country is that we have people with law background running health ministries. The competency of such individuals calls for serious questioning. These are internal challenges which we can easily correct, yet refuse too. The powerful Indian middle class and the ever vibrant civil society also sits quietly on issues that matter.
The generation that comes after us will question us on our face as to what kind of a world have we left behind for them. What face will we have to look at them in the eye and tell them that we created a nation state which leads the world in road traffic injuries, which is the diabetic capital of the world, which is the world’s most depressed nation, which meets with natural disasters year after year in forms of floods, earthquakes, cyclones and has not shown any path breaking sign to create resilient communities. If this is not enough, we will be in a brilliant position to leave behind an India which faces a triple burden of disease where we have not yet conquered the battle with infectious diseases like Tuberculosis, Malaria, Dengue; in all possibilities we are fighting a losing battle with Diabetes, Hypertension, Cancer and Kidney diseases and we are being pushed to the brink with Re-emerging diseases like Zika, H1N1 and other neglected diseases.
In the global imagery, India is an emerging economy which is among the top ten, but on the other hand, the gulf between the rich and the poor is widening with each passing day that we are near the rock bottom when it comes to Human Development Index. For more than 70% of the population, out of pocket spending is the norm. for others, they depend on the government to bail them out of their health problems. However, if one ever visits government hospitals, most of them are crumbling public infrastructures surrounded by fungus and leakages on the walls, with cockroach infested areas in other places and the toilets which go uncleaned for long hours giving way to hospital acquired infections and creating resistant strains to the bacterias.
40 million Indians are led into poverty because of excess spending on health from their pockets. Many a times, these poor patients are denied treatment or have to wait in line for treatment. How in-human would it be to make patients wait in line for their treatment that too, not for hours, but they have to actually wait for days or months together sometimes. A report by Save the Children estimated that there is a deficiency of 2.6 million health workers and meeting this deficit calls for radical surgery in the health systems which in the best of world’s should be led by the Ministry of Public Health.
While on one hand we look at spending on healthcare, on the other hand the case in point is the salary brackets that public health workers are paid. Most of the organizations pay public health professionals poorly and expect them to work in tough terrains. I firmly believe that this should change and change soon. Public health workers with an MPH should be paid minimum of Rs 85000 and those with MD/PhD degrees should have their salaries starting at Rs 1,50,000. The escalating costs of inflation, housing and urbanization has put increasing burden on individuals and families and without a good, secure quality of life, we cannot expect miracles to take place.
It is equally important to encourage work from home option once a week every month for those who wish to opt for this. Public health works needs people to move with their families to different places and organizations must be directed to enforce work from home options for those willing to opt for it.
The existing Ministry of health and family welfare can focus on the curative components of health care, but the nodal agency should be the Ministry of public health to oversee all operations.
Job opportunities for public health professionals, should originate through the ministry of public health and irrespective of ideological differences, the competent professionals should be recruited. Lack of planning, not so smart work environments and strategies have hampered India’s public health prospects till date. Other than the state of Kerala, majority of governments in other states have approached Health superficially to please the masses and the classes with no real change. We have not only disrespected the Indian Constitution, but also let down our own people who count on public health professionals to resurrect India into a new health order.
This is our moment to change, our time to do something and to leave behind a world, healthier, more energetic, more magnetic than ever before in the history of human race. While we mull over this idea, be sure this is an idea whose time has come. Shall we rise up together? May health win. Jai hind.
Credit:
TIMES OF INDIA
Dr. Edmond Fernandes is a community health physician leading efforts for CHD Group which is a global public health organization, headquartered in Mangalore, India. He is also a Non Resident Senior Fellow of the Atlantic Council and the US State Department Alumni. He is a Member – Health Task Force, DDMA, Government of Karnataka. Dr. Edmond has authored 2 books, got over 18 research publications and travels around the world for engagements related to global health, policy and humanitarian emergencies. He can be reached for feedback and discussions on office@edmond.in