India Likely to Miss Health-Related SDGs
India is behind on reaching the health-related SDGs and is likely to miss them by 2030. Insufficient health spending is one of the main reasons according to the government’s auditor.
While the health ministry proposed to increase India’s public health expenditure to 2.5% of its gross domestic product (GDP) by 2025, it has remained within a narrow band of 1.02-1.28% of GDP,” read the report, as per India Spend.
FNITI Aayog, the health ministry, the ministry of statistics and programme implementation, and 14 other ministries for preparedness to achieve SDGs were audited. To analyse the states’ performance, seven states – Assam, Chhatitsgarh, Haryana, Kerala, Maharashtra, Uttar Pradesh (UP) and West Bengal – were chosen based on their ranking on various health indices for 2015-16.
Public health expenditure falls short
The NITI Aayog’s three-year action agenda (2017-2020) expected an increase in the Centre’s health budget to Rs 1 lakh crore ($14.5 billion) by 2019-20. But, India allocated only Rs 65,038 crore ($9.4 billion) in 2019-20.
India’s National Health Policy 2017, framed in line with the SDGs, prescribes increasing the health expenditure of states to more than 8% of their annual budgets by the year 2020, but the seven states evaluated spent between 3.29% and 5.32% for the period of 2012-2017
The National Health Mission is the primary tool to reach the following health targets:
- maternal mortality ratio (MMR) of less than 70 deaths per 100,000 live births,
- neonatal mortality rate (NMR) of 12 deaths per 1,000 live births and
- under-five mortality rate (U5MR) of 25 deaths per 1,000 live births.
In 2017, India’s MMR was 130 deaths per 100,000 live births, according to Census data. NMR was 24 deaths per 1,000 live births. U5MR was 39 deaths per 1,000 live births.
Yet, allocations to the National Health Mission fell short by 13.6% in 2018-19 compared to the budget projections.
Pervasive alcohol burden in India
According to a report by the Ministry of Social Justice and Empowerment (MoSJE), Government of India, outlining the magnitude of alcohol and other drug problems,
- Alcohol is the most common psychoactive substance used by Indians.
- Alcohol use has been reported in all the age groups, including among children aged 10-17 years.
- About 14.6% of the population, between 10 and 75 years of age, uses alcohol. This translates to 160 million people.
- Use of alcohol is considerably higher among men (27.3%) as compared to women (1.6%). For every one woman who consumes alcohol, there are 17 alcohol using men.
A study, recently published in the International Journal of Drug Policy, found that after adjusting for tax receipts from the alcohol sale, the economic loss from adverse effects of alcohol consumption is about 1.45% of the gross domestic product (GDP). For comparison, the government’s annual expenditure on health is about 1.1% of the GDP.
A case for investment
Investing to prevent and reduce alcohol harm in India can be an effective mechanism to increase the GDP of the country. This can in turn be used for public health funding.
Alcohol taxation is a WHO recommended evidence based policy measure in decreasing alcohol harm and boosting the economy. For example the Philippines already has a plan to fund healthcare through alcohol taxation.
It’s an option which India should consider in order to meet the health related SDGs by 2030.