Post COVID-19 crisis, most of the countries and economies are facing dual challenges. While on one hand there is a challenge to improve the existing healthcare systems, they also need to eliminate the risk of illicit trade as well as figuring out ways to identify increasing public finance, which has been under considerable strain.
In the Indian scenario, our health budget is the fourth lowest in the world and we ranked 155th (out of 158 countries considered in the survey) on the health spending index, however, the situations have changed significantly in the last few years. In the last months, we have made tremendous progress in becoming self-reliant on the production of PPE kits and other products. According to sources, with this fiscal year, the Government of India is likely to unveil a four-year health budget plan to move India’s healthcare spend to four per cent of GDP. We should continue this momentum not only for medicine production but also for ensuring their safety and authenticity. Developing a strong authentication eco-system can benefit India in many ways.
1. Strengthening current procurement and supply chain systems: The Government of India has announced a Rs 69,000 crore outlay for the health sector that is inclusive of Rs 6400 crore for Prime Minister Jan Arogya Yojana (PMJAY) in Union Budget 2020-21. In the Health Sector, there is an instant need to secure and strengthen the current supply chain to reduce the circulation of counterfeit and substandard medicines and medical equipment. Currently, there are more than 3,600 Jan Aushadhi stores across the country. It is vital that any plans to scale up the number of stores also ensure security and streamlining of the entire supply chain. It will not only ensure the delivery of quality medicines to the patients but will also help build confidence in the patients’ minds regarding the Pradhan Mantri Bhartiya Jan Aushadhi Pariyojana Kendra (PMBJP). There is no way to track products beyond the Bureau of Pharma PSUs of India (BPPI) warehouse up to the Jan Aushadhi Kendras (JAKs), which makes the system vulnerable to spurious and substandard medicines sneaking in. There is a need to link good health with good economics and it cannot be achieved without investing in strong authentication and traceability measures at all important stakeholders’ points. One of the important aspects of good healthcare systems is providing safe, quality, and affordable medicines to the people of India.
2. Minimising risk of illicit business: According to WHO an estimated 1 in 10 medical products circulating in low and middle-income countries is either substandard or falsified. COVID represents a once-in-a-generation opportunity for counterfeiters as people will be willing to pay exorbitant amounts to get vaccinated. So even if just one crore people pay an average of Rs. 3000 each for two doses of the vaccine through illicit channels, that is Rs 6,000 crores worth of illicit business and tremendous risk to people’s lives. Any chances of falsification in medicines could result in the waste of exchequer money. We need to protect the health and safety of patients as well as the supply chains. Many vaccines are on the cusp of being approved and distributed. Those who are low on the priority list will have to wait for someone, what the temptation will be to get access to the vaccine early. So, there is a high probability of these criminal elements selling COVID-19 vaccines. Some cases that have already surfaced prove this. Counterfeiting is a problem that has been recognised globally and it is a problem that needs to be addressed systematically so that lives are not put at stake with fake vaccines.
3. Improving public finance: According to estimates, the government might face a revenue shortfall of Rs 7 lakh crore in 2020-21 as tax collection and proceeds from disinvestment has been lower than Budget estimates. At the same time smuggling, counterfeiting and illicit activities are resulting in more than Rs 1 trillion loss of sale to industries and economy every year adding to the difficulty for businesses. The counterfeiting activities are not limited to pharma products. Considering these circumstances, plugging counterfeiting can help the Government increase tax revenues, safeguard businesses and prevent social security frauds. Till now a few steps have been taken towards anti-counterfeiting, but no government has adopted it as a strategy for the economic wellbeing of the country. The magnitude of the counterfeiting problem in the country cannot be undermined. Policies ensuring the implementation of active anti-counterfeiting measures across sectors can bring a huge turnaround for the economy by contributing to the revenues of both the government and businesses. This considerable amount of added government revenue can be invested towards schemes for citizen well beings such as education and health.
The upcoming budget should include measures and regulations to plug in the holes and make the system stronger. Including provisions in these directions in the upcoming budget can be a huge reform for the economy and a big step towards ensuring public welfare.