India’s National Health Policy 2017 and 2030 Agenda for Sustainable Development

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  • Shantesh Kumar Singh

    The Indian government recently adopted the National Health Policy in March 2017 (NHP-2017) to strengthen the health sector. The UN supports India in achieving the goal of the recently adopted National Health Policy 2017 (in line with SDG-3) to “attain the highest possible level of health and well-being for all at all ages through a preventive and promotive health care orientation in all developmental policies, and universal access to good quality health care services without anyone having to face financial hardship as a consequence”.

    With the objective of “leaving no one behind”, the UN General Assembly adopted the universal, integrated and transformative 2030 Agenda for Sustainable Development together with a set of 17 Sustainable Development Goals (SDGs) in 2015. At the 2015 United Nations summit, India’s Prime Minister Narendra Modi said that the “Sustainable development of one-sixth of humanity will be of great consequence to the world and our beautiful planet,”. Health is a core dimension of the SDGs; goal 3 aims to “ensure healthy lives and promote wellbeing for all at all ages”. Health-related indicators- directly pertaining to health services, health outcomes, and environmental, occupational, behavioral, or metabolic risks with well-established causal connections to health- are present in 10 of the other 16 goals.

    It is commendable that NHP-2017 recognizes the SDG’s to be of “pivotal importance”, identifying seven priority areas outside the health sector which can have an impact on preventing and promoting health. In the improvement of urban health, the NHP calls for “achieving convergence among the wider determinants of health.” The seven priority areas highlighted in the NHP are: “air pollution, better solid waste management, water quality, occupational safety, road safety, housing, vector control, and reduction of violence and urban stress.”

    With regard to the improvement of maternal and child health, the policy “seeks to address the social determinants through developmental action in all sectors.” It states that “research on social determinants of health” will be promoted, combining this with “neglected health issues such as disability and transgender health”; while giving importance on Panchayati raj institutions “to play an enhanced role at different levels for health governance, including the social determinants of health.” In highlighting the need for “an empowered public health cadre,” the NHP explains the need to “to address social determinants of health effectively, by enforcing regulatory provisions.” The insertion of gender based violence in national programs, and the call for increased sensitization of health systems to provide care “free and with dignity in the public and private sector,” are innovative contributions to better health care. NHP is patient centric and quality driven policy that addresses health security and Make-In-India for drugs and devices. The policy proposes raising public health expenditure to 2.5% of the GDP in a time bound manner. It advocates extensive deployment of digital tools for improving the efficiency and outcome of the healthcare system. It looks at problems and solutions holistically with private sector as strategic partners. It seeks to promote quality of care focusing on emerging diseases and investment in promotive and preventive healthcare. It envisages private sector collaboration for strategic purchasing, capacity building, skill development programmes, awareness generation, development of sustainable networks for community to strengthen mental health services, and disaster management. The policy also advocates financial and non-incentives for encouraging private sector participation.

    Accessing the steps taken by the Indian government in the last three years, it is evident that the government has accorded priority to the health sector. The target is to achieve “Health for All”, which has been the basic objective of NHP 2017. The government proposes opening a new medical college for every three to four parliamentary constituencies. It has increased 6,000 seats in Post Graduate (PG) medical courses in the past year. The prices of stents for heart patients were around ₹1.5 lakh to ₹2 lakh have been reduced. Making such stents available at just 40% of its original price. The government has also set up a chain of stores to sell generic medicines at subsidized rates to bring down the price of medicines.

    Underscoring the importance of Ayurveda, Prime Minister Modi stated that the time has come for a “health revolution” under the aegis of the traditional medicine system in order to enhance affordable and accessible healthcare. Government proposes to set up an Ayurveda hospital in each district with the assistance of the Ayush ministry (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy-AYUSH). Ministries of Ayush and Agriculture can guide farmers to grow medicinal plants in their fields, which can also boost their income. Anchored on NHP 2017, these steps will improve the health sector in India towards achieving SDG targets.

    The primary aim of the NHP 2017 is to inform, clarify, strengthen and prioritize the role of the Government in shaping health systems in all its dimensions- investment in health, organization and financing of healthcare services, prevention of diseases and promotion of good health through cross sectoral action, access to technologies, developing human resources, encouraging medical pluralism, building the knowledge base required for better health, financial protection strategies and regulation and progressive assurance for health. With NHP 2017 and related regulatory frameworks there is a sense of optimism that India will make Sustainable progress towards attaining “Health for All” and the SDG targets.