Health is not valued till sickness comes. And Covid-19 has shown us that for India to be truly a world class economy, its healthcare system has to be robust
STHANA BALA – is a Sanskrit phrase, which translates poorly to “positional strength” and relates to the influence a place has on a person. There has never been a time when the Sthana Bala of being an Indian in India has been stronger. A country has to get many things right to make its citizens feel this. Powered by GDP growth of 7.3%, India has one of the youngest populations. The demographic dividend that India has been enjoying since 2018 will last us 40 years. No other country of relevance can talk of this window of opportunity. However, historian Thomas Fuller talked about this in the 1600s and Covid-19 has Shown us that “health is not valued till sickness comes”. Healthcare in India today is characterised by significant developments but vet there are substantial challenges that need rapid addressal. As the world looks at India, we need to redefine our healthcare to truly enjoy economic growth.
India’s healthcare sector has grown at a compound annual rate of 22% for nearly 10 years. This growth is driven by factors such as investment in healthcare infrastructure, growth in insurance and diagnostics. But we need to now solve for an ageing population, rapid urbanisation, financial constraints, and historically low levels of public spending.
The US spends 17% of its GDP on healthcare, while India spends about 4%. In addition to the inadequate spend, the demographic shift in India is significant. The UN Population Fund estimates the size of the elderly population in India to nearly double to 192 million by 2030. Rapid urbanisation has seen multi-morbidity becoming a significant health concern. This phenomenon makes low-income groups more vulnerable to multiple health issues. This morbidity is linked to adverse outcomes such as disability, heightened utilisation of medical resources, and increased health expenditure. Financial constraints and historically low public healthcare funding have led to substantial out-of-pocket expenditure, pushing households, especially those in the lowest income groups, further below the poverty line.
There are five Key healthcare transformations needed.
Address healthcare holistically
We need to ensure that every aspect of healthcare- diagnosis, treatment and adherence- is addressed. Our hospitals, doctors, and even pharmaceutical companies are overburdened. We need more doctors, more hospital beds, and more healthcare providers.
India targets eradicating one of its most persistent healthcare issues, tuberculosis, by 2025, leveraging initiatives such as drug sensitivity testing, improved diagnostics, strengthened healthcare infrastructure, financing and community involvement. While the target is ambitious, the intent is right. Success in addressing challenging targets such as this relies on establishing public-private partnerships, deep government initiatives and supportive policies. We need multiple big, ambitious goals like this to improve healthcare holistically in India.
Ensure the quality of medicines
We take pride in being the pharmacy for the world. The Indian pharma industry is renowned for its contribution to the global supply of medicines. That said, a few incidents have shown the sector in a poor light- whether it is 70 children dying in Gambia due to contaminated Indian cough syrup, oncology drugs that did not work or eye drops with contamination. It would be a folly to colour the sector with one paintbrush, but they highlight concerns about drug safety. We need to address similar issues in India, where the incidence of spurious and substandard medicines remains a concern. The quality of drugs should never be in question. We need to go beyond setting rules to a regulatory system that ensures that we penalise the bad and reward the good.
Ensure healthcare is delivered across India
There are many Indias. In the healthcare context, India has multiple layers of economic disparity and social structures. How much of India’s prosperity reaches its hinterland? The recent increase in public expenditure on healthcare, 2.1% Of GDP in FY23 as against 1.6% two years ago (Economic Survey 2022-23), instils optimism fora more inclusive healthcare system. Still, there is a very long way to go. While there is a brick-and-mortar part of what we need to fix to deliver healthcare to every part of India, we must use technology to supplement this delivery-India needs more telemedicine, digital health, remote delivery. Technology is key to ensuring we deliver to our many Indias.
Ensuring we deliver the continuum of healthcare
Covid-19 showed us how fragile our healthcare system is. Diagnosis and treatment are not enough; we need to ensure adherence. Initiatives such as the Digital Health Mission are expected to foster the adoption of electronic medical records, ensuring improved patient care and diagnostics. We need to ensure widespread adoption so that people are not just treated in hospitals, but the treatment leads to a cure.
Deliver on innovation
The Indian pharma industry has been a responsible citizen with good ancestors such as Dr Anji Reddy and my father, Desh Bandhu Gupta. While we have always brought the latest medicines to India, ensuring cost and quality, the drug world is changing from a cost-based approach to a value and innovation-based one, with recent developments in gene and cell therapy, for example. Delivering these treatments relies heavily on reinforcing the country’s R&D infrastructure, both public and private. Creating a network of academic institutes doing research and incentivising true innovation will be pivotal in ensuring that Indians continue to have access to the latest life-saving medicines.
India’s GDP is expected to grow by 7.3% this year, positioning us as one of the fastest-growing major global economies. This is particularly noteworthy given the global economic slowdown. As India charts its course towards economic excellence, building a healthy India is a must. BT
The author is Managing Director of Lupin. Views are personal
This authored article has been published in the Business Today magazine February 2024 edition