Draft of National Public Health Law

Context:

Officials from the Union Ministry of Health and Family Welfare and other Government departments have started the process of finalising various provisions of the draft Bill for a new national public health law.

Key features of the new National Public Health Draft

• The proposed National Public Health Law has been in the works since 2017 and, once enacted, will replace the 125-year-old Epidemic Diseases Act, 1897.
• It will also cover public health emergencies caused by bioterrorism, natural disasters, chemical and nuclear attacks or accidents.
• It proposes a four-tier health administration architecture; National, State, District and Block-level public health authorities who will have “well defined” powers and functions to deal with “public health emergencies”.
  • The National Public health authority is proposed to be headed by the Union Health Ministry.
  • The State Health minister will head the State Public Health Authority.
  • District Collectors will lead at district level, and block units will be headed by Block Medical Officers or Medical Superintendents.
• These authorities will have powers to take measures for the prevention of non-communicable diseases and emerging infectious diseases.
• The proposed law also provides for creation of public health cadres at national and state levels.
• The draft Bill has defined various measures such as isolation, quarantine and lockdown, which have been extensively invoked by the Center and states for Covid management.
• It defines a lockdown as “restriction with certain conditions or complete prohibition of running any form of transport” on roads or inland water, it is learnt.
• The definition of a lockdown covers “restrictions” on the movement or gathering of persons in any place whether public or private. It also includes “prohibiting or restricting” the working of factories, plants, mining or construction or offices or Educational institutions or market places.
• The draft lays down several situations in which “public health emergency” can be declared. They include bioterrorism; appearance of a novel or previously controlled or eradicated infectious agent or biological toxin; a natural disaster; a chemical attack or accidental release of chemicals; a nuclear attack or accident.

What is the State of India’s Healthcare System?

• Increased Expenditure on Health:
  • According to the recently released National Health Accounts (NHA) report for 2017-18, the government has increased the expenditure on health, making the decline of Out-Of Pocket Expenditure (OOPE) to 48.8% in 2017-18 from 64.2% in 2013-14.
    • It shows that total public spending on health as a percentage of GDP has increased to a historic high of 1.35% of GDP breaking through the 1%-1.2% mark of GDP.
• Share of Primary Health Care: The share of primary healthcare in current Government health expenditure has increased from 51.1% in 2013-14 to 54.7% in 2017-18.
  • Primary and secondary care accounts for more than 80% of the current Government health expenditure.
• Social Security Expenditure on Health: The share of social security expenditure on health, which includes the social health insurance programme, Government financed health insurance schemes, and medical reimbursements made to Government employees, has increased.

What are the issues with Healthcare Infrastructure in India?

• Issues of Healthcare Insurance: In a recently released report by NITI Aayog, at least 30% of the population, or 40 crore individuals (referred as the missing middle in this report) are devoid of any financial protection for health.
  • Additionally, the high 18% GST on insurance premiums further discourages people from opting for health insurance.
• Lack of Private Sector Involvement: The primary healthcare sector is not one that will result in profits but provides more of basic level healthcare which is why the burden across the world for primary health care largely lies on the governments; it is more in the public domain rather than in the private domain.
• Lack of Original Molecular Development: India is the pharmacy to the world because the drug manufacturing in India is quite robust. However, due to lack of financing, there is no or very little original molecular development which is required as inputs into drug manufacturing.
  • This area requires impetus from the government so that India’s production can be updated along frontier medicines too rather than only on generic medicines.

Challenges in Health Sector 

• Poor expenditure on the health sector
• India lacks affordable health care services for the marginalised sections.
• Lack of robust public health infrastructures like hospitals, primary health centres.
• Lack of number of Doctors and Specialists as per the population of the country.
• Lack of awareness among the people.

Steps taken by Government:

• Promotion of Institutional deliveries through Cash incentive under Janani Suraksha Yojana.
• Janani Shishu Suraksha Karyakram: Free ante-natal Check-ups, Post-natal Care and treatment of Sick infants till one year of age.
• Providing Reproductive, Maternal, Newborn, Child and Adolescent Health Services, establishment of Special Newborn Care Units.
• Mission Indradhnaush: Expanding full immunization Coverage, introduction of new vaccines.
• PM Swasthya Suraksha Yojana for strengthening tertiary health Sector.
• POSHAN Abhiyaan to address Malnutrition.
• Iron and folic acid Supplementation for Prevention of Anaemia, home visits by ASHAs to promote breast feeding and Promote use of ORS and Zinc for management of diarrhoea in Children.
• Capacity building of health Care Providers: Trainings are being conducted under National Health Mission to build and upgrade the Skills of health Care Providers.
• Medical Devices Rules, 2017: Transparent regulatory System, Ensure Safety and quality of medical devices, Allowed 100% FDI in medical devices Sector to Promote Make in India.
• National Health Resource Repository: Create a reliable, unified registry of Country’s healthcare resources showing the distribution Pattern of health facilities and Services between Cities and rural areas. ISRO is technology Partner for Providing data Security.
• Allowed 100% FDI in Medical devices Sector to promote Make in India.
• Kayakalp initiative to Promote Cleanliness, hygiene and infection Control practices in public health facilities

Way Forward:

• More emphasis should be on quick and hassle-free delivery of medical services to the marginal section. 
• There is a need for an increase in expenditure on health so that India can improve existing facilities as well as add more of them.
• Focus should be on healthcare infrastructure and healthcare R&D 
• As the economic growth progresses, there is a need to monitor the population against the risk of spread of NCDs. Also, people must be made aware of the healthier life choices and benefits of a more active and fulfilling life.
• Also, the government needs to increase spending in the healthcare sector, because a healthier workforce is one of the most important factors contributing to the economic growth and overall progress of the country.

Source: Indian Express

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