India’s Healthcare: Building on Gains, Facing Challenges

Health is pivotal to a nation’s future. India, a country with a predominantly young population, will not find it easy to leverage its demographic dividend without improving its healthcare system. Even as India has made remarkable economic progress in the last two decades, its healthcare system continues to trail behind those of other emerging
economic powers. For example, the vast majority of Indians continue to pay for most of their medical needs out of their own pockets. Underlying the nation’s healthcare problems are key structural issues that perpetuate inequities; they must be addressed urgently. Consider this: urban India has four times more doctors and three times more nurses than rural India. Affordability and accessibility are two key challenges facing India’s healthcare system as it seeks to cope with the double burden of infectious
and non-communicable diseases.
One of the big talking points in India in the run-up to the 12th Five Year Plan has been universal health coverage (UHC). In 2012, India proposed an ambitious plan to substantially increase spending on providing free drugs for the country’s population of over 1.2 billion. In the coming months, there are important policies which are likely to be rolled out and should contribute towards the goal of UHC. The idea is inspiring but the road ahead is fraught with challenges. Seeing those challenges as opportunities is vital—how India deals with these issues will have implications within and beyond this country.
As India embarks on the next wave of healthcare reforms, several important questions are coming to the fore. What should be the role of the state in delivering accessible and affordable healthcare? What should the role of the private sector be? What are the costs and benefits of globalisation from a public health perspective? An international conference on “Basic Healthcare and the State” organised by the Observer Research Foundation (ORF) and the Berlin-based Rosa Luxemburg Stiftung (RLS) in Delhi in November 2012 brought together
eminent scholars from various countries to examine some of the thorniest issues and critical challenges facing governments planning healthcare policy changes. This publication seeks to make a case for accessible and affordable healthcare by contributing to the discourse on the state of public health, the socio-economic determinants of health, affordable health insurance, healthcare reforms and governance in healthcare delivery, highlighted at the global meet and which resonates within the wider public health community.