The Minister of Finance, Government of India, unveiled the Union Budget for April 1, 2023-March 31, 2024 on February 1, 2023. The Amrit Kaal Budget (as it is commonly known) may be the first step towards India’s global agenda of Vasudeva Kutumbakam. And what better way than to start with healthcare for all through Government-run initiatives and close cooperation with the public sector.
The National Health Mission (NHM) envisages the achievement of universal access to affordable, equitable, and quality healthcare, which is responsive to the populace’s needs. To strengthen India’s public health system, including the various medical and nursing professionals that compose such a system, the Economic Survey for 2023-24 highlights the rising importance of public healthcare.
The Budget seeks to set up 157 nursing colleges with the already proposed medical colleges, increasing the number of medical and nursing professionals to cater to the ever-demanding nature of an efficient public health system while attempting to eliminate health setbacks such as sickle cell anemia by 2047.
The Department of Health and Family Welfare (DOHFW) will be allotted Rs 86,185 crores. However, records have registered a failure to fulfill its earlier targeted estimate of Rs 83,000 crores for the previous Budget for the DOHFW, which resulted in a drastic reduction to a more realistic assessment of approximately Rs 76,000 crores.
The Economic Survey mentions the rise in health sub-centers, primary and community health centers. However, it fails to consider the Rural Health Statistics 2021-22, which establishes that the number of nurses or medical professionals was considerably low to almost non-existent, rendering the healthcare service in rural areas negligible. If this were to continue due to a shortfall in the allocation of the estimated Budget, the proposal to establish nursing colleges would remain merely a number, requiring not only a revision in the Budget estimate but probably also a revision in the number of nursing colleges proposed to be established.
The NHM was allocated rs 29,085 crores, which is considerably lower than the Rs 37,000 crores allocated in 2022-23, thereby raising doubts on the success of the Mission’s agenda of quality healthcare for all.
In the pharmaceutical sector, facilities in select Indian Council of Medical Research (ICMR) Labs will be made available by public and private medical college faculty and private sector research and development (R&D) teams to encourage collaborative research and innovation. A new program to promote pharmaceutical research and innovation will be launched through centers of excellence. The pharma industry would be encouraged to invest in R&D in specific priority areas. The Budget has allocated INR 2980 crores for this select purpose. This may further result in curtailing imports of active pharmaceutical ingredients, which remain higher than their exports despite PLI (Production Linked Incentive) schemes for their manufacture.
Yet another important priority of every pharmaceutical set-up is a robust regulatory mechanism. With the negative press, following incidents in The Gambia and Uzbekistan, the Government has allocated Rs 651.97 crore to strengthen the drug regulatory system, set up new testing laboratories, and upgradation of existing laboratories, amongst other positive steps to make India the pharmacy of the world.
This move is likely to improve the manufacturing and testing processes, but it can only do so if coupled with more current legislation, considering the concepts of good manufacturing practices, stringent regulation of clinical trials, and a clear distinction between drugs, cosmetics, and medical devices (including software as a medical device).
Winston Churchill once remarked, “The discoveries of healing science must be the inheritance of all, and disease must be attacked.”
Overall, while the Amrit Kaal Budget does prioritise improved health systems in its blueprint for a prosperous, just, and self-reliant India, the need of the hour is ensuring an increased number of nursing professionals, the elimination of sickle cell anaemia, as well as a public-private model towards healthcare, without compromising the Budget estimate. Else, the Amrit Kaal Budget, insofar as health care is concerned, may not prove to be Amrit!
Sidharrth Shankar is an M&A Partner, and Arjun Krishnamoorthy is a Principal Associate at JSA, Advocates & Solicitors. Views are personal.