Health policy and enforcement in India is an area of abject neglect and increasingly a source drama because Health is not something that is considered important in the Federal Ministry. But health of India is becoming more important as the visibility into major diseases such as HIV/AIDS, Diabetes, Cancer, and Leprosy are being highlighted by many international organizations and media reports. While international, media, and Non-Government Organization (NGO) attention is forcing the Government into action into these areas, other areas requiring proactive intervention such as respiratory illness from pollution or quality of food and drink does not receive any attention. Even a serious incident such as a bird flu epidemic outbreak saw action from the Food and Agriculture Departments with muted, if not limited, action from the Health Ministry.

Instead, there was a lot of press and media attention on several wrong reasons such as incidents involving the unconstitutional termination of a preeminent cardiologist director in the nation’s premier medical facility. Another incident was a brouhaha created over a communist party leader casting aspersion on a popular Yoga master who also sells Ayurvedic drugs and the Health Minister Anbumani Ramdoss jumped in to order a scrutiny of Ayurvedic drugs. Of course, like most issues in India where media attention span is limited to advertising value, no one questions results of these investigations or actions.

But there are also several success stories in India which have origins to programs that were initiated long ago. For example, the fight against Leprosy has been very successful that it may be declared out of India in the near future. Another initiative triggered by Ramdoss which bans smoking on screen is also commendable. Even with these success stories, what is lacking is follow through, communication, learning process, and carry over best practices from one program to another.

While Health is one of the 7 so-called thrust areas of the Common Minimum Program of the United Progressive Alliance (UPA) Government, there have been few initiatives to address principal problems in improving the health of Indians. According to Government sources, only 20% of the population is served by the 145,000 sub-centers and 23,000 Public Health Centers (PHCs) and 3222 Community Health Centers (CHCs).  Displaying frailty of thinking and complete lack of vision, Ramdoss announces a Rs. 10,000 (USD 217) grant per sub-center to “meet the unmet needs” of the Village Health Plan!

What India needs are a set of goals that can address issues of public health. The Government has demonstrated that it is incompetent to handle public health issues and is unable to scale. Instead of trying to spend limited budget on a massive problem, the Government will be better of encouraging large hospitals to assume responsibility for Government hospitals under condition that they will run it for marginal profit and have a pay as you use service. Government-run hospitals are decrepit, host awful facilities, deliver sub-standard healthcare, and is a burden on the exchequer.

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