We're empowering govt machinery like never before

Q&A: Anbumani Ramadoss

A revolution in the country's health system is firmly under way, Union Health Minister Anbumani Ramadoss tells Sreelatha Menon.

The National Family Health Survey-III has exposed the poor access to health that women have. Both maternal and infant mortality rates remain high.

The data are at least two years old. After we launched the National Rural Health Mission (NRHM), there have been lots of changes. Besides, health is not purely a matter of facilities. It is a social issue. The truth is that in the last 30 years, health has not been given importance by the governments. After we took over, my total budget of Rs 6,700 crore has gone up to Rs 15,800 crore in three years. This shows the intention of the government. Each year has seen a 30 per cent increase (in the budget allocation).

But the NRHM has not done anything new. It has merely clubbed whatever was already there.

The intention was to increase the rural health coverage, which is now transforming the scene. Of course, we can't promise to do overnight what has not been done in 30 years.

But there is criticism that it has nothing, except deploying some more semi-trained health workers. There has been no new strategy to deal with inefficient and indifferent health clinics.

You should remember that you are talking of a country with one-sixth of the world's population. The population of Uttar Pradesh and Bihar combined is more than the population of the US. People have to understand.

But what about the condition of health care?

It is a seven-year programme which we started two years ago. It took me one-and-a-half years to put district health societies under the NRHM. In Rajasthan, the rogi kalyan samitis (patient welfare councils) are a part of the NRHM. Tamil Nadu has the best health care system in the government set-up.

Why is it not being replicated?

That system was put in place much before the NRHM, almost ten years ago. We are taking models from various states for the NRHM. By next year I will be able to show you tremendous results. All 6.2 lakh villages have an ASHA (Accredited Social Heath Activist) scheme. ASHA workers live in villages, take kids for immunisation, and women to sub-centres for deliveries. There will be an extra auxillary nursing midwife in each sub-centre. I am giving Rs 10,000 annually to each sub-centre to buy medicines. Each ASHA centre has a medicine kit. Besides, there is a sanitation and health committee in every village, comprising an anganwadi worker, an ASHA worker, and panchayat members. Already, 80,000 committees are in place. Rs 10,000 will be given to each committee every year.

Will that be enough to make up for the fact that there are no doctors in villages, no medical facilities?

We are upgrading all the sub-centres. Each primary health centre will get three nurses on contract. A total of 6,500 out of 24,000 primary health centres are already working 24x7. In two years, 70 per cent of them will be working round the clock. Give me two years. As for doctors, all MBBS students will get a rural posting, during which they will spend four months in district headquarters, four months in Community Health Centre (CHC) and four months in a primary health centre. So we will have doctors round the year. All district hospitals are being upgraded with Rs 10 crore each. Each primary health centre will have a patient welfare council with a budget of 75,000. Every CHC will get 2 lakh and every samiti Rs 5 lakh. They can spend the money on the betterment of the centre. We are empowering the government machinery like never before.

But why do we see outbreaks of strange new diseases like chikungunya. Aren't surveys of mosquito density being done?

Of course they are done. The Indian Council of Medical Research and Institute of Vector Borne Diseases are doing this. In Kerala, chikungunya struck because larvae grew in rubber and pineapple plantations. Despite literacy, people were careless. The NRHM sanitation committee in Alappuzha, which reported the highest numbers last year, was given Rs10,000 this year for cleaning up. It reported very few cases this year.

The NFHS shows that 80 per cent of women are anaemic. Child birth is killing them.

There are three categories of anaemia. Mild and moderate forms are being clubbed with severe forms. Only 5.5 per cent women have severe anaemia. And 72 per cent of children have moderate to mild anaemia. We are joining hands with the women and child development ministry to combine the micronutrient supply with the macronutrients that are supplied through the ICDS (the pre-school nutrition scheme for kids).

One of the biggest manufacturers of ultrasound machines, Aloka, has opened a unit in Tamil Nadu. Does it bode well for the sex ratio scene in the country?

People say this because of the declining sex ratio. It is all junk. Ultrasound scanning is a life-saver. Scanning saves millions of lives every year. There are more uses than abuses. There are only a few black sheep who misuse it. They should be exposed. There are 30,000 registered machines. Even replaced machines have to be returned. What is the harm in new companies selling these machines?

Are you planning a regulation on medical devices?

Yes, the national drug authority will now be a central licensing authority for all devices. Research, ayurveda""all will come under this. We want it to be like the USFDA (US Food and Drug Administration). We are also bringing in a Clinical Establishment Regulation and Registration Act, under which all hospitals and diagnostic clinics will be registered.

Can you explain your recent stand on vibrating condoms?

Yes, one has to put one's foot down. I remain firm on the issue of promoting condoms as a means of birth control. I speak my mind and I am not swayed by fear. I am a professional trying to be a politician and not the other way round.