In search of an effective health system

Ranjana Smetacek, Director General, Organisation of Pharmaceutical Producers of India speaks about the need for innovation in order to improve healthcare access in India

India is the fifth fastest growing economy in the world and poised to become the third largest by 2040. A growing educated middle-class, rising income levels and increase in life expectancy are all indicators of a developing country. Unfortunately, rising affluence has also led to an increase in chronic and lifestyle-related diseases. The emergence of non-communicable diseases now poses a big challenge to the healthcare system. A news report in India has cited Richard Horton, Editor-in-chief of The Lancet to say, “Failing to combat non communicable diseases like diabetes and heart disease and reduce maternal and child health will cost India’s health system and social care ‘enormously making India collapse.’” Horton also said “the (Indian) government cannot protect the sovereignty of its nation, cannot ensure sustainability unless it has a healthy population.”

For India to realise her dream of health for all, we need an effective healthcare system. Access to healthcare extends beyond the cost of medicine, to the proximity, quality and functionality of the infrastructure that supports that access. More than affordability, the barrier to access is the inability to pay out-of-pocket and the lack of insurance cover. According to Horton, “The main issue is the lack of investment in the public health system and the growth of an unregulated private sector. And this imbalance between the unregulated private sector and the quality of care in many cases is appalling compared with the public system that is struggling to meet the demands of the rising population.”

We must accord priority status to healthcare and this will be best demonstrated by increasing budget allocation. Noted economist and Nobel Laureate, Amartya Sen pointed out that India spends 1.2 per cent of GDP on public healthcare which has now been reduced to one per cent, while China spends three per cent. India is wanting high growth rates like China but overlooking that China has improved public services dramatically. It has pretty much guaranteed healthcare for all. At one per cent of GDP, public spending on healthcare in India is among the lowest in the world. Our draft National Health Policy has proposed an increase in public spending on healthcare, from the current one per cent to at least 2.5 per cent. A new study on Healthcare Financing, released at OPPI’s fourth Healthcare Access Summit, elaborates on the need for a well-designed composite and hybrid model of Universal Health Assurance that is efficient and affordable. Here, public insurance programmes can be supplemented by a private insurance system, to establish an affordable, quality healthcare system. This would also encourage international investment in Indian healthcare.

Healthy India, innovative India

The creation of a healthy India requires balancing the need for innovation with the necessity for more affordable medicines, within a robust environment. Pro-innovation policies must go hand-in-hand for the benefit of our patients. We will need to make, develop and innovate in India if we are to truly become a ‘Pharmacy of the World.’ The plan for a new IPR Policy presents a positive step toward building the architecture of an IP regime that has the potential to support a number of economic and socio-cultural benefits. A robust IPR framework provides the country an excellent opportunity to further stimulate the biopharmaceutical industry creating thousands of new high value jobs, while paving the way for newer avenues of foreign direct investment.

India has signalled its intention to become a significant player in the innovative medicines sector and develop the necessary environment to support biomedical investment, technology transfer, and growth.

Cashing on ‘Make in India’

The ‘Make in India’ campaign lays emphasis on life sciences as a strategic sector. Such aspirations are also aligned with Prime Minister Modi’s goals of bringing growth to India through research, innovation, and manufacturing. “Intellectual Property (IP) not only attracts innovative medicines to a market, but it can also impact whether that nation’s scientists and physicians will play a role in global drug development, and if drugs will be developed for locally endemic conditions,” according to Scientific American Worldview: A Global Biotechnology Perspective.

During the past year, the government has taken some laudable steps, such as liberalising FDI in brownfield and greenfield pharmaceutical projects, developing a National Health Policy draft and stating their intention to encourage R&D and implement IPR regulations in letter and in spirit. In the recently released Ease of Doing Business ranking by the World Bank, India still lags at 130 among the 189 countries covered. We must continue to strive for an ecosystem of transparency and predictability in our business environment. India has all the knowledge, technologies and interventions required for providing quality healthcare to her people, for both disease prevention and treatment. The research-based pharma industry continues to bring the fruits of years of research, for the benefit of Indian patients. We look forward to a tomorrow that will see a ‘Healthy India and an Innovative India’.