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Budget 2024: Healthcare Sector Urges Government to Boost Public Health Spending

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The healthcare sector in India is advocating for increased public health spending in the upcoming Budget 2024, urging the government to raise public health expenditure above 2.5 percent of the GDP. The industry is also calling for an Ayushman Bharat-like scheme specifically for the middle class to address healthcare needs more comprehensively. Key Recommendations: Increase Public Health Expenditure: The Healthcare Federation of India (NATHEALTH) has emphasized the need for the government to boost healthcare spending to over 2.5 percent of GDP. This increase is seen as crucial for enhancing infrastructure, addressing demand and supply challenges, and improving overall social insurance. Expand Healthcare Facilities: Abhay Soi, president of NATHEALTH and chairman of Max Healthcare Institute, highlighted the necessity for two billion square feet of advanced healthcare facilities. Expanding healthcare infrastructure in smaller cities and advancing digital healthcare services are also top priorities. Comparison with Other Countries: According to the Economic Survey 2022-23, healthcare expenditure by the Centre and state governments reached 2.1 percent of GDP in FY23. In comparison, OECD data shows that the US had the highest health expenditure to GDP ratio at 16.6 percent in 2022, while India’s was at 2.9 percent. Middle-Class Healthcare Scheme: Industry leaders, including PD Hinduja Hospital CEO Gautam Khanna, suggested implementing a healthcare scheme similar to PM-JAY for the middle class. This would require allocating 2.5-3.5 percent of GDP to healthcare to ensure broader coverage and affordability. Policy Reforms and Innovations: Suneeta Reddy, Managing Director of Apollo Hospitals, emphasized the need for the government to prioritize the healthcare sector to spur growth and productivity. The industry is also advocating for easing compliance burdens, promoting medtech innovation, rationalizing the goods and services tax (GST), and reviewing the health cess on medtech products. As the first Budget of Modi 3.0 approaches, the healthcare sector’s recommendations highlight the critical need for increased investment and policy support to enhance India’s healthcare infrastructure, improve access to quality healthcare, and ensure affordability for all citizens. Boosting public health spending is seen as a vital

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Joe Biden’s Latest Health Concern: Reports of Parkinson’s Disease Specialist Visiting White House Surface

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Health concerns surrounding 81-year-old Joe Biden have always been at the center stage during the ongoing US Presidential Elections campaign, and a new concern has hit the Biden camp as reports of a top neurologist from Walter Reed National Military Medical Center visiting Biden’s physician earlier this year surface. According to Fox News, Dr. Kevin Cannard, who visited the White House, is a renowned Parkinson’s disease expert. This news has created a frenzy among US voters, who are concerned about Biden’s fitness in case he is re-elected to office for a second term. New Wave of Controversy Hits Biden Camp The Biden camp is already dealing with fallout from President Biden’s performance at the US Presidential Debate 2024, where he appeared underprepared against former President Donald Trump. Following the debate, rumors surfaced that Biden was considering dropping out of the race, though he later confirmed his intention to continue his re-election campaign. Was the Doctors’ Meeting Related to Biden’s Health? White House Spokesperson Indicates Otherwise White House visitor logs show that Dr. John E. Atwood, a renowned cardiologist at Walter Reed, also attended the meeting with Dr. Kevin Cannard. A White House spokesperson commented that doctors from Walter Reed routinely visit the White House to treat military staff stationed there, according to Fox News. It remains unclear whether the doctors’ visit was related to Biden’s health, as the White House has not explicitly confirmed this. White House Press Secretary Karine Jean-Pierre stated that Biden had not undergone any recent medical exams up until the US Presidential Debate. However, voter concerns about Biden’s fitness for office persist.

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States Asked to Keep Vigil After 8 Zika Cases in Maharashtra

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On Wednesday, the Centre ordered states to maintain vigilance due to Zika virus spread in Maharashtra, with eight cases reported by July 2: six in Pune, one each in Kolhapur and Sangamner. Spread by Aedes aegypti mosquitoes, Zika usually causes mild symptoms but poses risks for pregnant women, potentially causing microcephaly in the fetus. Atul Goel, Director General of Health Services, issued an advisory for constant monitoring. The Health Ministry urged screening pregnant women and tracking fetal growth as per guidelines, given the infection’s neurological consequences. Affected areas must prioritize vigilance, screening, and monitoring efforts. The Centre on Wednesday asked states to maintain a state of constant vigil over the Zika virus situation in the country amid reports of the spread of the mosquito-borne infection in various districts of Maharashtra. As of July 2, Maharashtra has reported eight cases of Zika virus infection: six from Pune and one each from Kolhapur and Sangamner. Zika virus is transmitted by Aedes aegypti mosquitoes, similar to dengue and chikungunya. It spreads when a mosquito carrying the virus infects a person. Experts say the infection doesn’t cause severe symptoms in most cases and subsides in a few days. However, in the case of pregnant women, the infection is known to affect the fetus and cause microcephaly (reduced head size), making it a major concern. According to the health ministry, Director General of Health Services Atul Goel has issued an advisory to states highlighting the need for maintaining constant vigilance. As Zika is associated with microcephaly and neurological consequences in the fetus of the affected pregnant woman, the health ministry said on Wednesday, states have been advised to alert clinicians for close monitoring. “States are urged to instruct the health facilities to screen pregnant women, monitor the growth of the fetus of expecting mothers who have tested positive for Zika and act as per central guidelines,” it said.

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80% of Public Health Facilities in India Are Substandard, Reveals Government Survey

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A recent government survey under the National Health Mission (NHM) has revealed that nearly 80% of public health facilities in India fail to meet the minimum standards for infrastructure, manpower, and equipment. This self-assessment exercise involved over 200,000 facilities, out of which only 8,089 scored 80% or higher for compliance. The government aims to make 70,000 facilities compliant within 100 days and will conduct surprise inspections to ensure standards are met. Public health facilities from states and Union Territories were asked to provide details on the number of doctors, nurses, and basic medical equipment available. The data shared on the Indian Public Health Standards (IPHS) dashboard showed that 40,451 facilities submitted key statistics through the Open Data Kit, a digital tool developed by the health ministry. The results were alarming, with only 20% of facilities qualifying as IPHS compliant, meaning they had the necessary infrastructure, human resources, drugs, diagnostics, and equipment to provide essential services. Approximately 42% of the facilities scored less than 50%, while the remaining scored between 50% and 80%. A senior health ministry official emphasized that the self-assessment and real-time monitoring are crucial to ensure health facilities maintain required standards, leading to better health outcomes and a more equitable society. The Centre is pushing states and UTs to address the identified gaps with full support to improve service quality. In addition to the IPHS, the National Quality Assurance Standards (NQAS) will continue to physically evaluate district hospitals, sub-district hospitals, community health centres, and primary health centres on best practices such as availability of essential medicines, equipment, waste management, infection control, support services, and patient rights. A new provision of virtual assessment has been introduced for Ayushman Arogya Mandir, the most numerous public health facilities under NHM. The NHM covers 60% of the costs for public health facilities, with the remaining expenses borne by the states.  

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Health Ministry Suspends Mandatory Linking of CGHS and ABHA IDs

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The Ministry of Health and Family Welfare has announced the suspension of the compulsory linking of Central Government Health Services (CGHS) beneficiary IDs with Ayushman Bharat Health Account (ABHA) IDs until further notice. This decision, stated in an office memorandum signed by Satheesh YH, director of CGHS, follows a review of previous orders that had made the linkage mandatory. The mandatory linkage, originally set to be enforced from April 1 and later extended to June 30, aimed to integrate various government health schemes under the Ayushman Bharat Digital Mission (ABDM). However, practical issues, including data privacy concerns and the current state of technology infrastructure, appear to have influenced the decision to make the linkage optional for the time being. The CGHS provides comprehensive healthcare services to central government employees, pensioners, and their dependent family members, covering over 4.5 million people across 75 cities. In contrast, the ABHA ID is a unique 14-digit number identifying beneficiaries within India’s digital healthcare ecosystem. Despite the previous mandate, only 231,134 CGHS IDs had been linked with ABHA IDs by June 26, according to the CGHS dashboard. Experts have pointed out several issues with the mandatory linking of CGHS and ABHA IDs. Sunil Rao, COO of Sahyadri Group of Hospitals, highlighted data privacy concerns and the inadequacies in current technology infrastructure as potential reasons for the decision. An anonymous expert further noted that the government had not clearly outlined how digital records would be protected, despite assurances that records under ABHA ID would be encrypted and safeguarded under the Digital Protection of Data and Privacy Act. Rao welcomed the move, describing it as a balanced approach that allows time to address data security and system integration issues. He emphasized that making the linkage voluntary would enable the government to ensure infrastructural readiness and gain public acceptance before full implementation. The Health Ministry’s decision reflects a cautious approach, ensuring that when the policy is ultimately enforced, it will be with comprehensive preparedness and widespread support.

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Pune Reports Two Cases of Zika Virus Infection

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Pune has reported its first two cases of Zika virus infection this year, involving a doctor and his teenage daughter, both residents of Erandwane. This marks the city’s initial encounter with the virus in 2024, officials confirmed on Monday. The first case involves a 46-year-old doctor associated with two major hospitals in Pune. He exhibited symptoms such as fever and rash and was treated at Mai Mangeshkar Hospital. His blood samples, sent to the National Institute of Virology (NIV) on June 18, confirmed Zika infection on June 20. The second case is the doctor’s 15-year-old daughter, who showed mild symptoms, including fever. Her blood samples, sent to the NIV on June 21, also tested positive for the Zika virus. She is currently receiving outpatient treatment at home. Zika virus is transmitted through the bite of an infected Aedes Aegypti mosquito, which also spreads dengue and chikungunya. Most Zika infections are asymptomatic (up to 80%) or present with mild symptoms such as fever, rash, conjunctivitis, body ache, and joint pain. In pregnant women, Zika can cause microcephaly in the fetus. Following these detections, Pune Municipal Corporation (PMC) health officials and communicable disease experts visited the area. The public health team also inspected Erandwane on Monday. The infected man’s family, including his parents, wife, and daughter, are currently asymptomatic. A senior PMC doctor, speaking anonymously, stated, “Surveillance activities are being conducted in the entire Erandwane area and will continue for the next 14 days. Mosquito breeding was found in a few societies, leading to show-cause notices being issued to six housing societies. Door-to-door surveillance, insecticide spraying, and fogging are underway in the affected area. No suspected cases have been found during the surveillance so far.” Dr. Rajesh Dighe, assistant health officer of the PMC, urged citizens with fever to visit the nearest PMC hospitals for Zika virus testing. He emphasized, “The vector for Zika, dengue, and chikungunya is the same mosquito, Aedes Aegypti. In-house breeding of Aedes mosquitoes is highly possible. Citizens should keep their houses and surroundings clean, and clear stagnant water to prevent an outbreak of vector-borne diseases.”  

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Finance Says No to Health Request for $10-Million Fund to Meet G20 Pledge

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The Global Initiative on Digital Health (GIDH), launched during India’s G20 Presidency, remains unfunded by India despite a $10-million pledge. This initiative, a key deliverable from the Health Ministers’ meeting in Gujarat on August 19 last year, was part of the New Delhi declaration. The GIDH, formally initiated on February 20, 2024, by then Health Minister Mansukh Mandaviya, is still awaiting India’s promised contribution. The delay stems from the Department of Economic Affairs (DEA) under the Ministry of Finance, which has not approved the contribution despite India’s commitment. The GIDH, managed by the World Health Organization (WHO), aims to support national digital health transformations within a framework that respects data protection regulations. A source from the Health Ministry indicated the proposal is “under consideration,” but the DEA had previously rejected the request in July 2023 without specifying reasons. The DEA suggested that India should offer technical support instead of financial contributions to avoid creating “committed liabilities.” Despite this setback, the Permanent Mission of India (PMI) to the UN recommended making a “substantial financial commitment” to the GIDH in November 2023. Highlighting India’s role as a leader in digital health, the Health Ministry, with approval from the Health Minister, reconsidered the contribution. In comparison, Indonesia contributed $50 million to establish the Presidency Prevention, Preparedness Response (PPR) Financial Intermediary Fund (FIF) during its G20 Presidency. As Brazil currently heads the G20 Presidency, the GIDH remains a priority within the health sector.

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Maharashtra Govt Allocates ₹9.4 Crore for Healthcare Facilities During Ashadhi Ekadashi Wari

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The Maharashtra government has allocated over ₹9.4 crore to provide healthcare facilities for pilgrims during the Ashadhi Ekadashi Wari. Of this, ₹2.40 crore is earmarked for medicines and ₹3 crore for food and snacks for the healthcare staff and pilgrims. The State Public Health Department issued a general resolution regarding this on June 13. Dr. Abhijit More, a health activist, raised concerns about the higher budget for food compared to medicines and medical equipment. He questioned the logic behind such allocation and called for an investigation into the matter. A senior Health Ministry official, speaking anonymously, explained that the costs shown for medicines and food are just allocations. Funds can be redirected as necessary. The official noted that the food budget appears higher due to the large number of doctors and healthcare staff deployed from various parts of the state and beyond. These staff members are provided with meals and water during and after the Wari, considering the increased cost of food due to inflation. The health department will set up four health camps for pilgrims and provide OPD, IPD, and ICU facilities at 258 medical units. Additionally, 707 ambulances will be available for the Palkhi procession. This year, approximately 3,362 healthcare staff, including doctors, 1,500 volunteers, and 500 department staff, will be deployed to ensure the health and safety of the pilgrims.

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Health Workers Protest at Azad Maidan for Minimum Wage Increase and Benefits

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Nearly 1,000 health workers protested at Azad Maidan on Tuesday, demanding a mandated minimum wage of ₹18,000, up from the current ₹12,000. The protesters also called for maternity laws for health workers, the implementation of minimum wages, the provision of provident fund, pension benefits as per court orders, and fair compensation for overtime work. “We’re here in Azad Maidan, waiting for our fair pay. Even though we’ve been working here for so long, we’re not treated as BMC employees. We just want the same security and benefits,” said Kalpana Kajrekar, a community health volunteer from Tilak Nagar. “Time after time, the BMC keeps assuring us that we will receive our deserved salaries, but they quickly forget that when they ask us to take on additional tasks like polio campaigns and dengue/malaria vaccinations,” said Pooja Karne. “But this time, we won’t budge. We’ll stay here until we get what we deserve.” The ongoing protest is expected to disrupt several health activities in the community, including the ongoing BCG survey. The health workers, who visit an average of 60 houses daily, emphasized their commitment despite the risks. “After we visit someone’s house, we often discover they have dengue, or worse, Covid, but that doesn’t stop us,” said Pooja Kurne from Reay Road Aarogya Health Post.

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WHO and FIND Join Forces to Accelerate Diagnostic Innovation and Access

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FIND and the World Health Organization (WHO) have signed a new Memorandum of Understanding (MoU) that lays the foundation for accelerating innovation and achieving equitable access to quality diagnostics for people globally. One year on from the historic resolution to strengthen diagnostics, and with FIND as co-lead of the Access to COVID-19 Tools (ACT) Accelerator diagnostics pillar, this new agreement marks a step change in a strengthened partnership between WHO and FIND to speed up both innovation and access to diagnostics, supporting countries to implement the World Health Assembly (WHA) Resolution on diagnostics. “We are proud to be signing this MoU with WHO, as quality and accessible diagnostic testing is the backbone of health systems, primary healthcare and health security,” said Dr. Ayoade Alakija, Board Chair of FIND. “At a time when there have been three cases of H5N1 avian flu spillover events from cows to humans in the last month and an outbreak of mpox in the Democratic Republic of the Congo, the importance of diagnostic testing to identify outbreaks and quash them before they become major epidemics or even pandemics has never been more critical.” This new agreement establishes FIND as the key strategic partner for diagnostics, working with WHO and others to address a number of priority areas including antimicrobial resistance, infectious diseases like HIV, malaria and tuberculosis, and noncommunicable diseases like hypertension, heart disease, cervical cancer and diabetes. Signed on 1 June 2024 at a ceremony attended by Dr. Tedros Adhanom Ghebreyesus, Dr. Yukiko Nakatani (Assistant Director-General), and Dr. Ayoade Alakija (Board Chair of FIND), the MoU will also see the two organizations building new avenues to share knowledge and scale up critical activities to accelerate access to life-saving diagnostics. The signing of this MoU formalizes a long-standing partnership between WHO and FIND and marks a major milestone in the journey towards better health and well-being across the world. By leveraging the strengths and expertise of both WHO and FIND, this partnership promises to drive innovation on diagnostic tests and also improve access to the tests to reduce health inequalities, ultimately leading to a healthier future for people everywhere.  

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