Médecins Sans Frontières (MSF), an international humanitarian organization called upon Big Pharma to pool their HIV patents to enable quick transfer of know-how to manufacture and increase access to cheaper and more effective medicines for the deadly disease that affects millions around the world. This is a much needed step towards collaboration that can lead to progressive percolation of health services and essential medicines to the poor and needy than ever before.
The Indian healthcare scenario has a paradox. On one hand by 2015, India is expected to rank among the top 10 global pharmaceutical markets. According to research, the industry is growing at around twice the country’s GDP growth. Yet, according to Save the Children, despite a decade of rapid economic growth, India’s record on something as basic as child mortality at 72 per 1,000 live births is worse than that of neighboring Bangladesh, one of the poorest countries in the world. However, what is shocking is that despite having more neonatologists and neo-natal intensive care beds per person than Australia, Canada and the United Kingdom, the United States has the second worst newborn mortality rate in the developed world, according to the report. While it is obvious that the economic boom being experienced by India has been unable to control a shocking rate of infant deaths among the country’s poorest, US statistics lead us to believe that it is not necessarily the country’s economic progress that is key to basic healthcare but effort made to ensure its distribution to the needy in the best manner possible.
A 2007 CII-McKinsey report estimated that outpatient care currently accounts for 61 per cent of private healthcare spending, of which maximum is on acute infections like fever, diarrhoea and gastrointestinal disease. This for a country that is expected to emerge as the third biggest economy in the world in the next two decades! The healthcare sector contribution to GDP and employment is significant and it is one of the largest service sectors of the economy. The report suggests that to meet the rising demand, India will need to invest in infrastructure and create cost-effective facilities. Approximately 80 per cent of the required investment should come from the private sector. The government’s spending on healthcare is around 0.9 per cent of the total GDP, which limits the extent and effectiveness of the coverage it can provide. The US government spends 16% of its GDP on healthcare which is still very inefficient and called for recent reforms that are still under debate.
A study on the health system in India showed that a mother’s education/awareness had a high significance in all the three factors of maternal health care services. Another very important finding was that mother’s religions have significance (99 percent level of significance) with assistance during delivery and postnatal care services. The report highlights three areas that have the most influence on child well-being: female education, presence of a trained attendant at birth and use of family planning services. This again reinforces the need for the 4 As:
1. Awareness – people know about the facilities available
2. Access – people can afford those services
3. Availability – people get the services when they need them most
4. Applicability – people know how to reach the facilities/services and are not confused about which to use when.
When economic progress does not facilitate percolation of basic benefits to its needy, it’s the system and not the progress that needs to be re-looked at. It is the country’s economic progress that got it included into the elite Group of 20.Can this inclusion be an opportunity to change things? Can Prime Minister Singh redo his magic of the Indo-US nuclear deal? Can the governments of India and the United States come together to let information flow from the knowledge based research centers in the US, to the low cost research facilities in India so that medicines and services that are essential for the common good of at least two nations, if not many more, are addressed in a coming together of elite science and quality mass production? Economists have proven that loans from IMF/World Bank to countries is not necessarily linked to economic progress. Hence, a better option is to fund projects [private or state-run] that have accountability rather than provide blanket loans that are often diverted for political benefit than anything else [as in the case of Pakistan using US military aid]. Can world leaders encourage big lenders such as IMF and the World Bank to provide capital to private players to develop products and services through pooling technology and manufacturing capability in true humanitarian spirit? Royalties and revenue sharing models can be worked out to ensure that the model becomes sustainable. In this context, does the MSF call to Big Pharma teach us something?