Written By: Nirmalya Dutta | Updated : September 12, 2013 10:22 AM IST
Recently, President Pranab Mukherjee expressed concern at the low expenditure on healthcare in South-East Asia and advocated universal healthcare as the only plausible solution. At a meeting a session of WHO Regional Committee for South-East Asia at Rashtrapati Bhavan, he noted that 46% people in South-East Asia lived below the poverty line and asked governments to build an environment that provides quality healthcare.
'It is also a matter of concern that South-East Asia Region registers the lowest total expenditure on health as a percentage of Gross Domestic Product (3.8 pc) and per capita total expenditure on health as per World Health Statistics 2009,' he said. According to WHO, India's told spending was 3.9% in 2011 but almost half of this private out-of-pocket spends.
The President also said that the region needed to boost its primary healthcare approach while focussing on public health based on domestic resources. The president was addressing the inaugural function of the 66th session of the World Health Organisation's (WHO) regional committee meeting. Mukherjee said strategic investments in medical education and training would be needed to enhance the availability of scientifically credible professionals for all communities.
'Existing inefficiencies in the supply chain and logistics management of drugs and vaccines should also be addressed on a priority basis,' he said. The WHO regional meet, being attended by health ministers of 11 South-East Asian countries, would discuss, among other things, high blood pressure and health issues related to ageing.
Mukherjee said: 'This international platform is crucial for this region since it houses 1.79 billion people, 26.4 percent of the global population. As many as 46 percent of this region's population is living below the poverty line.'
'A significant portion of the disease burden in this region, more than 28 percent, arises from communicable diseases, maternal and perinatal conditions and nutritional deficiencies which are closely knitted with poverty,' he said.
The president said the health situation is not uniform in all countries of the region. 'Some countries are still lagging far behind and would require much more efforts as well as resources to achieve the health-related millennium development goals'.
Exactly how low is our spending?
We've mentioned the issue of low spends before. Currently, India spends about 2% of the nation's GDP on healthcare. This has led to very high out-of-pocket (OOP) expenditure for the general public. This means that 78% of all spends on healthcare are paid by the people and 72% of this is on drugs alone. Estimates suggest that 39 million people are forced into poverty because of medical expenditure. Here's a breakdown of total % of GDP spent on healthcare, percentage spent by individuals and per capita spent by the governments of various developed, developing and under-developed countries.
Country | Total % of GDP spent on healthcare | Private Expenditure % | Per capita spent on healthcare (US $) | Per capita government spends on healthcare (US$) |
India | 4.1 | 70.8 | 132 | 39 |
USA | 17.9 | 46.9 | 8362 | 4437 |
UK | 9.6 | 16.1 | 3480 | 2919 |
South Africa | 8.9 | 55.9 | 935 | 412 |
China | 5.1 | 46.4 | 379 | 203 |
Brazil | 9 | 53 | 1028 | 483 |
Pakistan | 2.2 | 61.5 | 59 | 23 |
Nigeria | 5.1 | 62.1 | 121 | 46 |
Russia | 5.1 | 37.9 | 998 | 620 |
Source: WHO
As we can see we're nowhere near the top bracket US or UK. We don't even spend anything close to what our BRICS (Brazil, Russian, India, China and South Africa) counterparts spend. In fact, our spends are even lower than a country like Nigeria's.
Because of the centre's negligent attitude, most of the resources lie with the private sector. It currently has 80% of all doctors, 26% of nurses, 49% of beds and 78% of ambulatory services and 60% of in-patient care. It seems audacious not to exploit those resources. To this effect, the Planning Commission had suggested that the public sector tie-up with the private sector to improve the country's healthcare scenario. However, the proposal was vehemently opposed by health activists who felt that it would 'corporatize' healthcare.
Source: Planning Commission Health Division report for the 12th Five Year Plan
With inputs from IANS
