2010 Business Agenda : Access to Medicines
Achieving access to essential medicine at every level
There are various reasons for unfavorable healthcare environment system in India. Dr K C Jindal, President R&D Formulations, FDC Ltd stresses on easy availability of drugs in a competitive manner
Indian hospitals are attracting patients from developed as well as developing countries because of the low cost-high quality advantage while Indian pharma industry is produces high quality generic drug products at affordable price for not just the domestic market but also advanced markets. But the majority of Indian patients are still not able to access drug products and other healthcare delivery facilities. Various reasons for this unfavorable healthcare environment include poor public spending, lack of medical insurance mechanism, poor geographical access, and poor affordability and so on.
The geographical divide
Another reason, for poor healthcare access is geographical discrimination. Globalization has resulted in urbanization and rising urban population. Urbanization has promoted higher incidence of metabolic diseases like diabetes, hypertension, hyperlipidemia and CNS disorders, resulting in higher consumption of medicines and burden on healthcare facilities. Hence majority of hospitals/healthcare industries are based in urban areas to tap huge profits. In contrast, poor socio-economic status of rural people is unattractive for healthcare industry. Even with well-established hospitals, high cost of the healthcare expenditure has hindered access to facilities for poor people in urban areas. Doctors are not willing to serve poor people due to lack of financial benefits.
There is a vicious circle, where poverty compels unhygienic behavior, which in turn promotes ill health due to infectious diseases leading to higher expenses, lower income and indebtedness. Rising population is another factor, which hinders healthcare access, resulting in loss of work and further poverty. Healthcare needs far exceed the healthcare facilities often resulting in failure of various government programs. India’s vote bank politics has never allowed focusing on effective healthcare schemes.
New coherent initiatives required
In order to end such an unfavorable and hazardous healthcare scenario, government agencies, healthcare providers, government of India along with state governments and teaching hospitals should come up with new coherent ideas, which should be effectively implemented in near future. It is an urgent need for government of India to reform its healthcare system, which should provide adequate healthcare delivery for both rural and urban population, especially for poor people. Few initiatives such as public health insurance, increasing public spending, streamlining private sectors and controlling profitability of the healthcare providers are really effective, when implemented, to improve the healthcare scenario in India.
Health insurance is needed for poor sections at affordable and nominal charges. This will improve value and awareness of health insurance at rural level. For those who can’t pay premium in lump sum, micro-finance facility should be made available. To overcome poor transport availability in rural areas health insurance premium could be collected by post offices, banks or selected government offices. For non-affordable section, health is the main reason of poverty and indebtedness. This section needs protection by health insurance to the maximum extent. Government spending on healthcare as percent of GDP is very low and needs enhancement.
Budgetary support should be enhanced for primary health centers (PHCs) in rural areas for adequate supply of medicines. Incentives should be provided to pharmacists for opening drug stores in rural areas. Companies promoting like tobacco, alcohol and pesticides should be levied with additional taxes for contributing to rural healthcare ills and increasing the disease burden..
Government funded pharma companies should be asked to produce only essential drugs at minimum profit basis for supply to dispensaries, PHC’s and drug stores in rural areas. These medicines should be exempted from tax and excise duties.