While releasing India’s progress report on the Millennium Development Goals (MDGs) on July 7, Niti Aayog member Bibek Debroy remarked that the country had lagged behind on health goals like maternal and infant mortality as well as basic sanitation, despite having achieved substantial success in poverty reduction. India’s economic progress has clearly not been matched by improvements in health.
Tellingly, India lags behind Sri Lanka, Bangladesh and Nepal in indicators like infant mortality rate, child immunisation rate and even total life expectancy. Even as private urban tertiary care centres vie for global medical tourism, the stark failure of basic public health services profiles the paradox of India’s health system. While India has become the global pharmacy for inexpensive generic drugs, the draft National Health Policy put out in January tells us that over 63 million Indians face the threat of poverty each year due to unaffordable health care expenditure. Huge inter-state disparities in health indicators testify to the widely varying quality of health services across India.
The 2015 deadline for meeting the MDG targets turned the spotlight on our poorly performing health system. The Sustainable Development Goals (SDGs) will replace the MDGs this September at the United Nations (UN). Can we resolutely revamp our health system to make it capable of delivering the targets set by the new health goal? As Toni Morrison writes in the Song of Solomon, ‘if we do not create the future, the present extends itself’.
The lone but lofty health SDG calls on all countries to “ensure healthy lives and promote wellbeing for all at all ages”. Tagged on are specific targets to be achieved by 2030: reduce maternal mortality to less than 70 per 100,000 live births (we are at 178 now); end preventable deaths of newborns and under-five children; end the epidemics of HIV, TB, malaria and neglected tropical diseases; reduce by one-third premature mortality from non-communicable diseases (deaths before 70 years from cardiovascular and chronic respiratory diseases, cancers and diabetes); halve deaths and injuries from road traffic accidents; provide universal health coverage, including financial risk protection, and access to essential medicines and vaccines to all; universal access to sexual and reproductive health services; substantially reduce harm from hazardous chemicals and pollution of air, water and soil.
This ambitious but essential agenda recognises health as pivotal to development. Even as our aspirational draft national health policy document of 2015 awaits an uncertain fate, with health remaining at the fringe of budgetary priorities, the SDG for health provides a road map of what a caring society must aim to achieve for its people.