A fair and effective health system requires freedom from political influence

 A fair and effective health system requires freedom from political influence

स्वास्थ्य क्षेत्र  में क्या क्या काम 

१ political leaders across the spectrum have leaned towards initiatives that promise immediate results, such as 

• new hospitals, 
• subsidised treatments in private hospitals, 
• emergency response (over preventive response), 
• and populist health policies. 

२ Many of these measures do not have much of an impact 

because of a lack of action beyond public announcements, which is almost always due to budgetary constraints.

३  But even before being implemented, these schemes and the focus of our leaders on them divert attention from critical areas such as 

• sanitation, 
• disease surveillance, 
• and public health education, 
• which are important to maintain population health and prevent disease outbreaks.

The case of dengue

dengue का इलाज इस प्रकार से hota है 

१ Consider the story of dengue, a disease that has only symptomatic treatments, and no definitive cure. 

२ When cases surge, political leaders often 

mobilise the State machinery to set up immediate relief camps at the expense of long-term strategies 

such as understanding vector bionomics or developing effective vaccines. 

३ We need both, yet, dengue stands out as a classic example of prioritising immediate response over sustainable prevention.

४ The focus on providing emergency relief also sidelines the availability of public attention for the 

• root causes of dengue and its long-term prevention, 
• and the research required in vector control, 
• vaccine development, 
• and improvement in public health infrastructure. 
• As a result, the current approach fails to prevent future outbreaks and strains the health-care system.

Research and development in these areas are crucial for dengue

१ dengue vaccine underscores the need for more research. 

२ Climate change is also affecting mosquito breeding and movement patterns, and public health strategies need to adapt to these changes.

स्वास्थ्य Kshetra में स्वतंत्रता 

१ health care will benefit from being separated from political processes. 

२ Public health decisions should be based on scientific evidence and long-term goals rather than short-term political interests.

३  This separation will ensure public health policies are driven by data and expertise, not electoral cycles.

४ निवारक स्वास्थ्य उपायों की उपेक्षा की आर्थिक और मानवीय लागत पर सिविल सेवक जोसेफ भोरे की 1946 की अंतर्दृष्टि अभी भी सच है। पोषण कार्यक्रमों में निवेश, हालांकि तुरंत दिखाई नहीं देता है, स्वास्थ्य और उत्पादकता पर दूरगामी प्रभाव पड़ता है।

सरकार के कुछ प्रयास और कुछ हेल्थ के डेटा 

१ समसामयिक प्रधान मंत्री की सर्वांगीण पोषण योजना (पोषण) अभियान योजना 

में हर साल स्टंटिंग को 2%, अल्पपोषण को 2%, एनीमिया को 3% और जन्म के समय कम वजन को 2% कम करने की योजना है। 

२ लेकिन पांचवें राष्ट्रीय परिवार स्वास्थ्य सर्वेक्षण में पाया गया कि 2019-21 में पांच साल से कम उम्र के 35.5% बच्चे अविकसित थे और 32.1% कम वजन वाले थे। 

6-59 महीने की उम्र के बच्चों में एनीमिया की व्यापकता 58.6% से बढ़कर 67.1% हो गई, 

और 15-19 साल की महिलाओं में 54.1% से 59.1% हो गई। 

३ व्यापकता और नीतिगत लक्ष्यों के बीच यह असमानता सार्वजनिक स्वास्थ्य प्रयासों में एक महत्वपूर्ण अंतर को उजागर करती है।

The influence of the pharmaceutical industry in public health is undeniable.

और टीबी की बीमारी का उदाहरण  

१ While instrumental in advancing curative medicine, its profit-driven nature often sidelines areas such as public health. 

२ For instance, despite having the same medicines to fight tuberculosis (TB),

🥬 India reported 21.4 lakh TB cases in 2021, 

🥬an 18% increase from 2020, 

🥬translating to an incidence of 210 cases per 1,00,000 population. 

३ दुनिया में टीबी की बीमारी 

In contrast, the United States reported only 8,331 TB cases in 2022, about 2.5 cases per 1,00,000 persons. 

४ This disparity is not merely a matter of the availability of medical treatment but is deeply linked to 

• socio-economic factors such as poverty, 
• sanitation, 
• and overcrowding (as a result of poorly organised urban housing) prevalent in India.

Some gaps

और कहाँ कहाँ कमियाँ हैं 

१ Behavioural change 

is key to managing public health challenges. Yet, it can be challenging in political environments influenced by populist tendencies. 

२ The absence of specialised courses such as public health engineering in India’s educational institutions points to a gap in the multidisciplinary approach required in public health management.

३ Public health is not just about treating diseases. It is about 

• preventing them, 
• requiring expertise from various fields such as environmental science, sociology, urban planning, and economics. 

४ The current physician-centric focus of India’s public health system often fails to capture this comprehensive nature.

A degree of autonomy is needed

१ Effective public health management should encompass 

• preventive measures, 
• policy formulation, 
• community health, 
• and environmental health, among others.

२ In public health, adopting a separation of powers approach is essential.

३  A fair and effective health system requires freedom from political influence, focusing on policymaking and  implementation driven by scientific evidence and long-term objectives. 

४ While prioritising health decisions based on scientific evidence and overarching public health goals are crucial, there is a risk of disconnecting from the immediate health concerns of the general populace.

To address this

an ideal solution would be to place Health Ministries directly under the leadership of elected officials, such as the Chief Minister or the Prime Minister, 

similar to the management of the space and the atomic energy departments. 

This structure would not only provide a degree of autonomy 

but also ensure that health policies are aligned with the people’s immediate and practical needs, striking a balance between expert-driven decisions and public aspirations.

In summary

 democracy is not inherently harmful to public health but the way public health is managed within democratic systems often leads to significant shortcomings.

 Infectious diseases, non-communicable diseases, health-care access, mental health, and misinformation pose challenges that demand a more holistic, long-term approach in public health policy. 

A separation of health-care decision-making from short-term political goals is crucial to develop sustainable health strategies that address both the immediate and future health needs of the population.

The views expressed are personal

Source the hindu