The government must immediately initiate efforts towards universal health coverage with a legislation on ‘Right to Health and Healthcare’. Health and Healthcare are basic human rights which must be treated as political priority by all governments, whether at central or state level, especially in the current situation.

Download the Country Position Paper on Universal Health Coverage, India (2023) here.

 India’s health system is characterised by lack of care, particularly for the vast majority of people who need it the most. It is organised to ensure hegemony of the powerful and privileged and the scream of deprived voices remain systematically unheard. Thus, people die avoidable deaths, delay their health needs, lack access to appropriate and good quality care, and submerge into deeper pauperisation or indebtedness in their desperate attempts to save lives of their near and dear ones. The COVID-19 pandemic exposed the fault lines of India’s healthcare system.

If one looks at the Union Budget allocations on health for the post-COVID years, it looks like things are unlikely to change. While the union government claims that “India has emerged a shining star”, “showing signs of robust viability”, we find that the union budget allocations for the health sector have declined further, making it the second year in a row to have witnessed sharp budgetary cuts in crucial health schemes. As we are being made to believe that Amrut Kaal has arrived, one wonders if we can achieve eternal glory without health security for the majority of its people. Can we become a vishwaguru without a more caring health system? In health what matters is care, care as a right; care when lives are at stake, taking care that lives are not at stake, not at least, prematurely.

Demands for health sector:

The Union government must immediately initiate efforts towards universal health coverage (UHC) with a legislation on “Right to Health and Healthcare”. Health and Healthcare are basic human rights which must be treated as topmost political priority by all governments, whether at Central or State level, especially in the current situation.

These must be done in larger context of major expansion and strengthening of Public health services, including regular recruitment of staff, filling all vacant posts, upgrading honorarium, urgently paying the pending honorarium and working conditions of ASHAs and other frontline health workers, democratic and participatory governance etc. supported by massively expanded public health budget.

The government must undertake special efforts to ensure safe motherhood, universal vaccination and expand various disease control programs, ensure appropriate nutrition to catch up with the loss during the pandemic. NHM budget cuts should be revised immediately and more resources should be devolved towards Non-communicable diseases.

The government should immediately scrap PMJAY and instead use these resources to strengthen the public health system.

Even after many years of its inception of NMHP there remain huge gaps in human resources. Trying to fill those major gaps in services just by relying on a tele-medicine program will invariably mean that a large section of the society would continue to be deprived of quality mental healthcare.

The government must step up domestic manufacturing production of all essential medicines, diagnostics, vaccines and adopt a policy of compulsory licensing and ensure that price control mechanisms comprehensively cover all essential medicines.

The central government must unequivocally reject all policy proposals for privatisation of Healthcare, including the entire set of recommendations provided by NITI Aayog in its recent document, along with reversing all decisions regarding privatisation and handing over of public health facilities like district hospitals to private providers, at either central or state government levels.

Government must urgently regulate the irrational prescriptions and rates by both private and public hospitals for all medicines, curb black marketing and take punitive actions for violations.

These should go hand in hand with implementation of Patients’ Rights Charter as advised by the NHRC; ensure full operationalisation of Clinical Establishments Act (CEA) and ensure implementation of similar legislations in the context of states which have not adopted Central CEA.

Lastly, what is also needed is a strengthening of the death reporting system; ensuring rights of records and certificates; and, ensuring public dissemination of gender, caste disaggregated data on morbidity, mortality and utilisation.