India’s public healthcare is in a terminal crisis

The Unnao HIV horror shows the lacunae in health systems, especially in rural India

The tragic story of several people having been allegedly infected with HIV by a fake medical practitioner using one unsterilised syringe in Uttar Pradesh’s Unnao is plausible, even believable, and highlights the massive lacunae in the public healthcare system, especially in rural India. Data from the National Health Profile 2017 shows that India has a little over one million doctors to treat its population of 1.3 billion people. Of these, only around 10% work in the public health sector. To make matters worse, a 2016 World Health Organization (WHO) report on India’s healthcare workforce found that only one in five doctors in rural India is qualified to practise medicine; that 57.3% doctors did not have any medical qualification.

In such a scenario, it is hardly surprising that people who cannot afford private healthcare (if at all it is available), end up falling prey to either quacks or tricksters. The lack of doctors, coupled with a glaring lack of regulation, leaves millions with little or no option when it comes to healthcare. A new bill seeking to replace the Medical Council of India with a national medical commission contains a proposal to provide cross learning pathways between allopathy and traditional medicine and non-allopathic modes of healing. Perhaps this could ease the burden on allopathic doctors and provide better care to those in need.

Successive governments have promised to raise India’s public health expenditure to 2.5% of the GDP, yet the current spend hovers at 1.4%. No lessons appear to have been learned from the Gorakhpur tragedy of August 2017 in which several children died because a hospital had failed to pay its dues to a supplier. The public health crisis in India can only be solved by strong political will and far greater investment in healthcare. Until then, stories like the horror in Unnao will be the norm rather than the exception.