Public expenditure on health has increased from less than 1% of our GDP in 2006-07 to an estimated 1.4% of GDP by the end of the Eleventh Five year Plan. But we will need to work harder and do more if we have to reach our goal of increasing public expenditure on health to at least 2.5% of the GDP.

The National Council on India’s Nutrition Challenges is spearheading our efforts to address the challenge of malnutrition. The Total Sanitation Campaign aims to eradicate the practice of open defecation by 2017. We are moving towards the creation of Public Health Cadres to work for the prevention and the control of disease. It will be our effort to ensure that every village has access to safe drinking water. The Right to Education Act is in place and we have made considerable progress in universalisation of elementary education. However, going forward we have to give proper attention to issues such as bridging social and gender gaps in school enrolment, adult literacy particularly of women and the need to improve learning outcomes.

Reduction of infant and maternal mortality rates and population stabilization are among the core health goals of our national programme, National Rural Health Mission. Some states in the Union have already reached the United Nations’ Millennium Development Goals. This agenda however remains a challenge in many of the other states. We need to, in a mission mode, focus on these states and deploy more human, financial and managerial resources to improve their health status. This was what was done in the last three years under the polio campaign.

As the country enters a demographic and epidemiological transition, we need to focus more attention on non communicable diseases and a wider range of infectious diseases. The task of prevention of trauma through prompt and effective emergency care has also acquired great urgency. About 10% of our mortality is now due to trauma which is claiming many young lives.

The Rashtriya Swasthya Bima Yojana provides insurance cover today to over 2.67 crore poor families. However, two thirds of private healthcare expenditure is on out-patient and diagnostic care and for purchase of medicines. Insurance schemes generally tend to focus on in-patient cares. We therefore need to work towards hassle free and cashless outpatient care in our public hospitals.
Public expenditure on health has increased from less than 1% of our GDP in 2006-07 to an estimated 1.4% of GDP by the end of the Eleventh Five year Plan. But we will need to work harder and do more if we have to reach our goal of increasing public expenditure on health to at least 2.5% of the GDP. Education and health will be the key priorities of the Twelfth Five Year Plan.

Beyond investments, we, therefore need greater capacities for decentralized health care planning and management. This will require greater focus on human resource development as well as on technological innovation and information systems that can support such decentralization. These are the challenges for the future. Building capacities in our 600 odd districts and states of the union is one important area where the sustained support and partnership of all stakeholders will be vital in terms of health outcome.