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Universal Health Coverage remains an over-ambitious English word

“For years, New Delhi has not delivered a health system that honours health as a human right and has failed to address policy reforms that could safeguard the health of every single Indian, the young and old, the new born or the mother, those who require health systems every-time, or those who visit health systems during required times. The choices we ought to make is not about which health policy is good or bad and who made it and who did not. What is necessary is the learning’s from the past, to protect the future and deliver a health system that recognizes patient as the heart of the very health system.” – Dr. Edmond Fernandes, CEO, Center for Health and Development, (CHD Group), Mangaluru.

India’s prosperity has risen from the grass-roots. The nation has survived and thrived essentially because of the power middle class who continues to discover and craft its own future. The same very middle class has yearned for better health systems which we have not been able to deliver.

In the year 2010, the Planning Commission of India formed a High Level Expert Group (HLEG) to create an ambitious framework for changing health destinies of millions in India by making healthcare accessible and affordable.

But over time, do we begin to recognise it has been an over ambitious English word and a theoretically rich document with practical implementation nearly impossible to achieve without radical surgery in India’s health system delivery.

Universal Health Coverage (UHC) is a document very rich in quality whose arrival was deeply appreciated, but it is also the same entity whose absence is becoming a reality to live with and accept. In so far, it is like India’s health system. Anything I tell you about it, the opposite of the story also exist.

The people of India have for too long depended on out of pocket expenditure and the vulnerable have depended on dusty, crumbling infrastructure of government machineries because they have nowhere else to go. To those stolen generations who have lost their lives because we have not delivered, we must be sorry. UHC is a sustainable idea which in the present scenario must be up for debate. In a world where India is poised to make its economic mark and be Asia’s super-power, healthcare delivery is a dismal apathy which struggles to survive. If you wish to understand more about this, take a walk around AIIMS, New Delhi and see how patients and their families wait for their turn on the roads and corridors of the campuses and sometimes even outside, look at how blood banks function in high priority areas and see how primary health centres work in many regions of the country. More than half our population does not even know that healthcare is a human right, although I do not have statistics to prove the same.

Health systems are further compounded by the self-serving attitudes of health workers, lack of proper regulations, grossly inadequate human resource to change mortality indicators and inability of enlightened leaders to engage and identify talent in the new markets.

The day we wake up and feel secure that we have healthcare at our door-step, the day we are certain that a sick child in a crowded neighbourhood shall not die from preventable under-5 death, the day we bring maternal mortality to zero after boosting human resource in health and knowing that health care is reality, a right and not a dream, that is the day when UHC will begin to take shape, that is the day when I believe that as a country, we can build a more prosperous nation. That is the day we can believe, we have arrived.



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