Wealth is not health

Health and nutrition may be prime concerns for an individual, but they have not been an area of notable success for the government. Otherwise, the state of health cover would not have been so deplorable as to make the government shy of releasing the findings of the National Family Health Survey-III, conducted in 2005-06. The limited survey data pertaining to 22 states that have been placed in the public domain bear testimony to the total lack of progress in the health arena in the seven years since such a survey was last conducted. In fact, matters have deteriorated in some respects. The percentage of children suffering from anaemia has risen from 73 in 1998-99 to 77 in 2005-06. What is worse, the number of extremely undernourished (classified as wasted) children has swollen to 17 per cent now, from 15 per cent earlier. No wonder then that some 37 per cent of children suffer from stunted growth. Equally disquieting is the revelation that over half of all children are not fully immunised. That explains why scourges like polio defy eradication, and why many communicable and dreaded diseases, including tuberculosis, which had been tamed to an extent earlier, have staged a comeback.

It would seem counter-intuitive that the country's health and nutrition status should get worse as people become better off. If it is indeed true, as the National Sample Survey has reported on the basis of its surveys, that the percentage of people living below the poverty line has been diminishing steadily, the absence of change on the nutrition front defies logic. The answer to the puzzle may lie in how the public health infrastructure has become less effective over time, if not reduced to a shambles. Most public hospitals, dispensaries and primary health centres are ill-equipped, under-staffed and poorly managed. Public health investment as a percentage of the gross domestic product (GDP) has tended to slide, despite the emergence of new challenges like the dreaded HIV/AIDS""dropping from 1.3 per cent of GDP in 1990 to a mere 0.9 per cent in 1999. International data comparisons show the inevitable result: up to 80 per cent of health expenditure in India is done privately, not through the government. The biggest losers will be the vulnerable sections of the population, the poor""and this might explain the poor numbers reported in the latest survey. It is ironic to recall that the government had set the year 2000 as the target date for achieving "health for all", with 2 per cent of GDP being spent on public health. Indeed, similar numbers are a part of the national common minimum programme of the ruling United Progressive Alliance (UPA). But matters have not improved.