‘Need to spend a lot more on public health’

Former Union Health Secretary JVR Prasada Rao o ers his views on this critical sector, and the work that remains to be done. Edited excerpts:

How have health and pharmaceuticals fared in 10 years? And how would you rate them, on a one-to-five scale?

Despite challenges, the health sector has done quite well.

The National Health Policy (2017) set the agenda. The comprehensive policy document addresses several aspects, including social determinants of health (contributing factors to good or bad health).

Ayushman Bharat includes health and wellness centres, and insurance coverage. The Jan Aushadhi stores, selling a ordable medicine, help bring down out-of-pocket expenditure. On infant mortality and maternal mortality we have made very impressive gains.

The government health expenditure, as a percentage of GDP, has gone up.

In pharmaceuticals, the total turnover is about $43 billion (including $25 billion exports, to developed countries as well).

I would rate pharma at 4- 4.5; and health at 4.

What are the key initiatives that took centre stage?

There have been important legislative initiatives — the Mental Health Act; the Poshan Abhiyaan (targeting nutrition) and the Maternity Benefits Act 2016. The Ayushman Bharat Health Infrastructure mission is also a good initiative.

What are the challenges?

Health expenditure is a major challenge; we need to spend a lot more on public health. Health expenditure has to be 2.5 per cent of GDP. It should be spent on primary health infrastructure. Also, there should be coordination between Ayushman Bharat coverage, the wellness centres and Jan Aushadhi stores.

Pharmaceuticals need to be careful about quality control; and we need to strengthen the drug control organisation.