April 16, 2004 ☼ Public Policy
When silence is not golden: One subject not being discussed in India’s current election campaign is AIDS. Yet, on the most conservative of estimates, 600,000 Indians already have the disease and 4.58m are infected with HIV, the virus that causes it. That means India ranks second only to South Africa in terms of its number of infections—and that with only about 0.9% of the adult population HIV-positive, compared with over 20% in South Africa. If India’s rate were to rise by just a few percentage points, not only would millions more Indians be condemned to live with—or, more likely, die of—AIDS, but so would millions of their neighbours. India’s population alone is much bigger than the whole of Africa’s. Throw in that of Bangladesh, Nepal and Pakistan, and you have the makings of a regional pandemic affecting nearly a quarter of the world. [The Economist]
More generally, it is time that there is a deep rethink on India’s healthcare system. What passes off as a healthcare system today is a number of ill-equipped apathetic underfunded government hospitals which are hotbeds of corruption and squalour. Being essentially free of charge, the government hospitals are unable to attract good doctors or invest in modern facilities, while attracting large numbers of poor patients. Black markets and corruption are the inevitable result.
Its time to move away from “free” medical care to a co-payment model. The health insurance system is totally isolated from hospitals and pharmacies. These have to be brought together into a coherent healthcare system - not an easy task for any country, but nevertheless one of the top social priorities for India. The involvement of the private sector into the public healthcare system will be a necessary first step.
AIDS is shocking because of sheer numbers - but there are a number of deadly diseases that diminish lives in India. Along with specific campaigns to tackle ‘branded’ diseases it is equally important to put in place a healthcare system that can take care of a billion Indians; a large number of whom earn less than one dollar a day.
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