ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

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The Budget: Wrong Priorities in Health

Because vocal, visible metropolitan India is relatively well-served, there is a general sense that the country is over the hump – communicable diseases are a thing of the past. This has brought about a transformation in the way they are treated. For instance, cases of malaria are no longer a public health concern, but a matter for the neighbourhood doctor and pathology laboratories. Leprosy impinges on people’s consciousness only as what happens to the less fortunate. And TB is too personal to even talk about, but is entirely curable. 

Undoubtedly, investment in health care has risen sharply in the last decade. Corporate health institutions, fee for care, charitable hospitals and others dot the map with predictable distribution of both quality and quantity: dense in metropolitan areas, sparse in poorly developed regions. Surprisingly, state health services are also absent in the areas which do not have private health institutions. But because vocal, visible metropolitan India is relatively well-served, there is a general sense that the country is over the hump – communicable diseases are a thing of the past. In newspapers and the television, in parliament and elsewhere, there is little discussion of these diseases. This has brought about a transformation in the way they are treated. For instance, cases of malaria are no longer a public health concern, but a matter for the neighbourhood doctor and pathology laboratories. Leprosy impinges on people's consciousness only as what happens to the less fortunate. And TB is too personal to even talk about, but is entirely curable. What formed the major focus of the health ministry, the communicable diseases control programme, is today perhaps the most neglected part of the ministry's activities. It is not then surprising that sudden occurrences, like the Siliguri fever, find the public health department and the research wings completely unprepared.

It is this neglect that is reflected in the allocations in the central budget year after year. In 2001-2002 public health, which includes four vertical programmes and AIDS control, accounts for 34 per cent of the total for health and 12 per cent of the ministry's entire allocation. While this has been a trend over the years, the latest budget offers figures which are particularly depressing. Meagre as the allocation under the head was in 2000-2001, the various programmes returned unspent Rs 67 crore of the Rs 847 crore budgeted. Most of the unspent amount is from the malaria control programme. The allocation under this head, which accounted for 29.5 per cent of the total for public health, has registered a sharp decrease in 2001-2002 from Rs 250 crore to Rs 173 crore which is 21 per cent of the total provision for public health. Does this mean that malaria is under control? Reports and available statistics indicate that there has been a resurgence of the disease, especially of the more virulent forms. The incidence in urban areas, which have never had an effective control programme, is on the increase. And given the changing symptomatology, its control may require a more intensive multi-pronged approach, with close interaction with other public departments. But none of this concern is reflected in the health ministry's budget.

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