Cabinet clears National Health Policy

Union Health Minister JP Nadda issues statement on NHP 2017

The Union Cabinet has approved the National Health Policy. Health Minister J P Nadda made a suo motu statement in the Parliament to make details of the new policy public. The policy makes health an entitlement but not a fundamental right as the draft policy had envisaged. It stops short of a legislative backing for right to health. A Right to Health legislation in the nature of right to education would need a constitutional amendment to bring health in the concurrent list from where it currently is on the state list.

In the current policy, health services are merely “assured”. It, however, talks of imposing a health cess much like the education cess that was imposed after RTE was legislated. It talks of increasing public expenditure on health to 2.5 per cent of GDP — as demanded by experts for a long time.

The draft also addressed the issues of universal health coverage, reducing maternal and infant mortality rate, as well as making drugs and diagnostics available free at least in the public healthcare system of the country. It suggests that the Centre must amend laws to align them with the current healthcare scenario.

Nadda said, “The policy informs and prioritises the role of the government in shaping health systems in all its dimensions — investment in health, organisation 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. The policy is aimed at reaching healthcare in an assured manner to all, particularly the underserved and underprivileged.

Nadda further added, “The policy aims for attainment of the highest possible level of health and well-being for all at all ages, through a preventive and promotive healthcare orientation in all developmental policies, and universal access to good quality healthcare services without anyone having to face financial hardship as a consequence. This would be achieved through increasing access, improving quality and lowering the cost of healthcare delivery. The broad principles of the policy are centred on professionalism, integrity and ethics, equity, affordability, universality, patient centred and quality of care, accountability and pluralism. The policy seeks to move away from sick care to wellness, with thrust on prevention and health promotion. While the policy seeks to reorient and strengthen the public health systems, it also looks afresh at strategic purchasing from the private sector and leveraging their strengths to achieve national health goals. The policy looks at stronger partnership with the private sector.”

The policy has also assigned specific quantitative targets aimed at reduction of disease prevalence/incidence under three broad components viz. (a)health status and programme impact, (b) health system performance and (c) health systems strengthening, aligned to the policy objectives.

According to Nadda, some key targets that the policy seeks to achieve are:

1. Life expectancy and healthy life

  • Increase life expectancy at birth from 67.5 to 70 by 2025.
  • Establish regular tracking of Disability Adjusted Life Years (DALY) Index as a measure of burden of disease and its trends by major categories by 2022.
  • Reduction of TFR to 2.1 at national and sub-national level by 2025

2. Mortality by age and/ or cause

  • Reduce Under Five Mortality to 23 by 2025 and MMR from current levels to 100 by 2020.
  • Reduce infant mortality rate to 28 by 2019.
  • Reduce neo-natal mortality to 16 and still birth rate to “single digit” by 2025

3. Reduction of disease prevalence/ incidence

  • Achieve global target of 2020 which is also termed as target of 90:90:90, for HIV/AIDS i.e,- 90 per cent of all people living with HIV know their HIV status, – 90 per cent of all people diagnosed with HIV infection receive sustained antiretroviral therapy and 90 per cent of all people receiving antiretroviral therapy will have viral suppression.
  • Achieve and maintain elimination status of Leprosy by 2018, Kala-Azar by 2017 and Lymphatic Filariasis in endemic pockets by 2017.
  • To achieve and maintain a cure rate of >85 per cent in new sputum positive patients for TB and reduce incidence of new cases, to reach elimination status by 2025.
  • To reduce the prevalence of blindness to 0.25/ 1000 by 2025 and disease burden by one third from current levels.
  • To reduce premature mortality from cardiovascular diseases, cancer, diabetes or chronic respiratory diseases by 25% by 2025.

The policy focusses on tackling the emerging challenge of non-communicable diseases. It also envisages a three dimensional integration of AYUSH systems encompassing cross referrals, co-location and integrative practices across systems of medicines.

The policy advocates development of cadre of mid-level service providers, nurse practitioners, public health cadre to improve availability of appropriate health human resource. It also seeks to address health security and make in India for drugs and devices. It also seeks to align other policies for medical devices and equipment with public health goals.