 "Interim Budget 2024-25: Health gets an approval but awaits a boost")
An Interim Union Budget, presented on the eve of a general election to the Parliament, is limited in scope. The full Budget will only be unveiled in the new parliament. Will the old adage of the child being the father of the man, apply to the Interim Budget predicting the policy priorities of the regular budget to follow? Besides being shaped by the election results, the regular budget will present a larger bouquet of policy initiatives. It is hoped that health will feature more prominently in that budget which comes forth in June.
The vision of Viksit Bharat by 2047 must incorporate commitment to protection and promotion of all Indians across a long, healthy and disability free life course. That effort must commence from safe child birth and supportive early child development. Bringing together maternal and child health schemes under one comprehensive programme for synergy, through Poshan-2 and Saksham Anganwadi programmes will help to promote the physical and cognitive growth of children, while protecting them from health threats. India’s growing strength in digital health is sought to be utilised for advancing the universal immunisation programme through the U-Win platform.
Worldwide practice of Human Papilloma Virus vaccination programme, for prevention of cervical cancer, found India to be a late adopter because of controversies surrounding an earlier field trial involving the administration of a foreign manufactured vaccine to adolescent tribal girls in Telangana. With the wider availability of an India manufactured vaccine, at more affordable cost, the government proposes to encourage vaccination for girls in the age group of 9-14 years. This overdue initiative is welcome.
For delivering needed, easily accessible, affordable and quality assured health services universally across the country, shortages in the health workforce need to be addressed. These gaps exist in numbers, skills and distribution of doctors being produced. Limited opportunities for medical education have led to aspirants going abroad for questionable quality training abroad or being severely stressed by NEET examination preparation and results. The proposal to utilise existing hospital infrastructure to set up more medical colleges, announced by the Finance Minister, will help to meet health system needs while meeting the aspirations of more students. It is hoped that the thrust of this initiative will be on upgrading more district hospitals rather than leaning on tertiary care centred urban private hospitals.
Since ASHAs and Anganwadi workers are valuable promoters, facilitators and providers of health, nutrition and child development services at the frontlines of primary care, the proposal to include them and their helpers as beneficiaries of the Pradhan Mantri Jan Arogya Yojana (PMJAY) is laudable. While it is possible that many of them may have already qualified under the provisions of PMJAY or state health insurance schemes, providing assured health cost coverage to these women is appropriate recognition of their value to the communities they serve.
As the Finance Minister has often stressed, budgetary allocations for non-health sector programmes too impact health. The physical environment, as an important determinant of human health, is receiving increasing attention in this era of accelerated climate change. Reiteration of commitment to Net Zero has been accompanied by support for rooftop solarisation, adoption of e-buses for public transport, strengthening of the e-vehicle ecosystem and a new scheme for bio-manufacturing and bio-foundry. The actual allocation to health, in this interim budget, is less than needed. It is 1.16 percentage more than allocated last year and 12.5 per cent more than the revised estimate of money actually spent. The gap between these budgetary and revised estimates must be reduced by improving the utilisation capacity of a strengthened health system and removing the bureaucratic hurdles of red tape and administrative inertia. Can we hope that the vibrant vision of election manifestos and vigour of campaigning will be transmitted to a regular budget that gives health its due.
The writer is a cardiologist, epidemiologist and Distinguished Professor of Public Health, PHFI