Healthcare A Poli-Trickal Issue
World’s largest democracy, India, is now in the midst of election fever. Political parties are going all out and decorating their manifestos with all kinds of promises. However, despite being a crucial sector, political parties haven’t given due priority to healthcare in their agenda. Yet, the industry has pinned a lot of hopes on the next Prime Minister as he is always at the helm of affairs.
India has more than a billion population, with different kinds of healthcare needs. Moreover, a major portion of this population is constituted by sections of the society that cannot afford expensive healthcare. Yet, statistics reveal that Indian population consumes medicines worth a few billions rupees every year, most of it comprising out-of-pocket spending. So, politicians sidelining healthcare needs is likely to have a negative impact on the industry’s growth.
 “Unlike in the developed world, health and education topics are the least debated. Parties have namesake manifestos on these subjects.”Dr K Anand Kumar Dy. Mng. Director, Indian Immunologicals Ltd. (IIL) |
“Unlike in the developed world, health and education topics are the least debated. Parties have namesake manifestos on these subjects. Affordability and accessibility of medicare should be debated. Citizens should be well informed about the initiatives and improvements that each party will undertake. The exclusion of health from debate will have no impact on the industry as it has been customary for politicians to not consider health as an important topic,” says Dr K Anand Kumar, Deputy Managing Director, Indian Immunologicals Limited (IIL).
 “What the pharma industry needs is the clarity on policies rather than additional policies to the existing one.”Jayant Singh Asso. Director, Healthcare Practice, Frost & Sullivan |
Jayant Singh, Associate Director, Healthcare Practice, Frost & Sullivan, opines otherwise. He says, “Correlation between the health sector as a priority area in election and impact on pharma industry is a too far-fetched conclusion. Any intervention on health policy will have a lag time of around few years before its impact starts becoming visible on the pharma industry. What the pharma industry needs is clarity on policies rather than additional policies to the existing ones. Ambiguity or lack of decisiveness on issues like pricing, M&As, threat of cheap imports from China in bulk drugs, non-trade barriers hurting our exports are some of the issues for which we don’t require new policies. Clarity on current policies along with some amendments in current policies should be able to take care of the immediate problems plaguing the pharma sector.”
Singh adds, “Long-term policy interventions like universal coverage, free medicine scheme, opening of new colleges should ideally have been a part of the election agenda, however, these schemes don’t provide instant gratification to voters and hence political parties also tend to just touch these issues in a very superficial manner in their agenda. This will though have an impact on the healthcare sector in terms of lesser funding and attention; however, I believe that a big section of the industry is in autopilot mode and will continue to grow provided some policy clarity and rectification is done in time.”
Separate budget for healthcare?
Singh has pointed out that political parties giving a cold shoulder to the healthcare industry may affect the inflow of funding and necessary attention for the industry. Over the last few years, America’s ‘Obama Care’ made headlines across all the leading global news papers. Besides being the second most populated country in the world, India is also a developing nation. The country has its own share of healthcare problems, which are perhaps even more severe than any developed nation. So, why are we lagging behind in devising schemes like ‘Obama Care’ with modifications made to suit India’s needs? More than $1.50 trillion has been pumped into ‘Obama Care’. Has the time come to arrange for separate budget sessions to address healthcare needs in India? Government can have agreements with the pharma industry as well to reduce healthcare costs.
 “For the growth of the healthcare industry political will is needed, which the government does not have.”Dr SGA Rao CMD, International Stem Cell Services |
Dr SGA Rao, CMD, International Stem Cell Services, doubts whether separate budget sessions to address healthcare needs would really make the government more dedicated towards the healthcare needs of the country. “Will it help focus government’s attention?,” questions Rao.
According to Anand, should the expenditure exceed several times the current budget, a separate session may be necessary.
Clinical trial industry, a victim of political unwillingness?
Another victim of lack of political will or government’s apathy has been the clinical trials sector. It is perhaps the most prominent example of what political neglect can do to an industry. To take the advantage of India’s cost- friendly environment, many clinical trial operators used to flock India. Once on the verge of becoming the clinical trial hub of the world, now clinical trial operators are giving a wide berth to India due to regulatory and bureaucratic issues. It is important to revive and regulate the clinical trials sector, since it is one of the most important sections of the Indian healthcare setup. This industry has the potential to bring in a lot of research activities, revenue and most importantly advanced healthcare solutions to India, which would be of great benefit to its populace.
“For the growth of this industry, political will is needed, which the government does not have. I am not confident whether the next PM would show some guts,” stresses Rao. A section of the industry is of the opinion that PM should intervene to address the grievances of clinical trials industry. “PM’s intervention is expected. India will end up in the dark ages if intervention is not immediate,” says Anand.
Singh says, “We believe that the government has sorted out this issue in an appropriate manner, though some provisions of the law may seem very stringent. However, the government has done a delicate balancing act of safeguarding the interest of the industry as well the common population, a chunk of whom are not even able to read the piece of paper which they sign upon, leave alone comprehending the agreement.”
Accessibility, an issue?
Young Pharmacists Association in Pakistan had recently requested their PM to formulate laws in such a way that pharmacists in that country would be able to set up their own plants. Pakistan’s PM has promised to think over the request. Is the Indian PM easily accessible for the pharma industry and pharma associations in the same manner? If not what should be done to reduce or remove this communication gap?
Anand opines, “PM is hardly a name connected to the pharma industry. Yes, any measure to narrow the gap would be welcome.”
Rao criticises, “Babus are the main hurdles for any intervention by the PM. They create problems. They should be disciplined first.”
Policy makeover
Central government invests thousands of crores in different healthcare schemes. Its decisions regarding healthcare policies directly affect the entire population or to be more specific, a population that is largely dependent on government to fulfil its healthcare needs. No policy at the central government level can be framed or approved without the PM’s consent. Hence, the new PM would have a huge challenge to face in this area.
However, according to Singh, it would be unrealistic to expect a policy makeover from the next PM as healthcare is a concurrent list subject and visible cooperation from state governments is required to implement these policies in a more effective manner.
Singh also suggests some policy changes in the drug industry which is also one of the key drivers of the Indian healthcare system. He says, “There should not be flip flops on foreign investment in the pharma sector. Clear and long-term policy related to pricing, the science behind the pricing should be progressive and safeguarding the interests of both the consumer and manufacturer is required. The government should look at strengthening the inspection mechanism for drug manufacturers and making sure that the cost of violation is prohibitively expensive, this will ensure that our credibility as world generics supplier remains intact. It is also necessary to take a tough stand at bilateral forums in order to ensure that our manufacturers don’t face the heat of non-trade barriers.”
He adds, “Compulsory licensing related issues should be sorted out and it should be confirmed that a MNC is sure about the treatment its drug is going to face in India. Universal coverage scheme on a test pilot basis should be launched, say in 50 districts of India. Creating an ombudsman like authority for healthcare will also help.”
Anand stresses that there should be zero customs duty for import of materials used in vaccines. He says, “Complete overhaul of regulatory procedures to ensure early licensure of products is necessary. Adequate capital spend to modernise primary health centres is required. Government should try to make available adequate surveillance centres and ensure that data for various infectious diseases is reliable. Strict vigilance measures to ensure that prescription drugs (e.g. antibiotics) are not sold over the counter is also very important.”
Conclusion
A nation deprived of basic healthcare facilities would find it very difficult to become developed. Hence, following Martin Luther King’s maxim, ‘Time is always right to do what is right’, politicians should start realigning their agendas to include healthcare as a key factor and deliver on their promises.
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