Where is health in the stimulus package?-THE HINDU-18-05-2020

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Our bowlers have done well to limit the COVID-19 score and flatten the curve. Putting aside threats to personal safety, family interests, and stigma, selfless government health workers across the country are the ones who are leading the charge. Unemployment has been growing since January 2020 when the first cases of coronavirus emerged. According to the Centre for Monitoring Indian Economy, India’s unemployment rate at the end of May 16, 2020 was staggeringly high at around 24%.

The second reason why the pitch isn’t in India’s favour is because our healthcare delivery system in most States is extremely fragile. One wonders, for instance, whether Bihar can handle the consequences if the virus begins to spread with the return of millions of migrant workers back to the State. Many other States also face a similar plight given the poor state of primary healthcare facilities.

Restoring livelihoods:

The package of Rs20-lakh crore, equivalent to about 10% of India’s GDP, announced by the Prime Minister on May 12, is expected to restore the livelihoods of millions of migrants and other workers who have lost their jobs and also enable entrepreneurs and businesses to get re-started. Economic desperation might leave poor workers with no choice but to return to work. This could well be a reason why, according to recent reports, in the midst of the long-term structural shift from China, companies prefer to relocate manufacturing to countries in the Association of Southeast Asian Nations region, and not India. In all this, the silence around health is disturbing.

While economic stimulus packages are essential, the match cannot be won without urgently and immediately stepping up investments in health.

Strengthening public health:

Dealing with the COVID-19 pandemic has brought out the critical importance of the public sector in health provisioning. However, stuck at around 1.15% of GDP for well over a decade, the low level of public spending on health is both a cause and an exacerbating factor accounting for the poor quality, limited reach and insufficient public provisioning of healthcare. Despite this, the public health system has risen to the challenge so far. Not addressing weaknesses in the public health delivery system can thwart all efforts at reviving the economy.

This is the time then to seize the opportunity and invest in universal health coverage by reversing the financial neglect of public healthcare. Nearly every country in the world that has achieved anything like UHC has done it through the public assurance of primary healthcare. Announcing a new ‘health investment plan’ is the urgent need of the hour. At least 1% of GDP out of the stimulus package should be earmarked for improving the country’s health infrastructure and strengthening public health service delivery.

And up to 70% of the additional expenditures should be ring-fenced for primary healthcare and further strengthening health and wellness centres, primary health centres and community health centres. Investing in health, apart from improving people’s well-being, is also essential for accelerating and sustaining India’s economic growth. If cricket is a game of chance, so is the match against COVID-19. What the immediate future holds for India in terms of the spread of the virus is not known.