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Access to Healthcare: Scaling up best practices

Access to Healthcare: Scaling up best practices

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Access to Healthcare: Scaling up best practices

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  1. Access to Healthcare: Scaling up best practices Shri Bhasker Iyer Chairman, ASSOCHAM National Council on Drugs and Pharmaceuticals

  2. Look ahead on the day’s agenda Today’s focus • Address by dignitaries • Plenary sessions focused on twoareas – • State of Indian Healthcare System • Innovative Models in Healthcare Delivery

  3. India’s Health Record – Key achievements in the last decade Improvements in health outcomes Systemic thrust in healthcare initiatives • Focus through 11th 5-year plan and NRHM • Shift from disease focused approach to integrated health-systems approach • Increased private participation - healthcare facilities, insurance coverage • Maternity Mortality Rate (MMR) decreased by ~50% • Infant Mortality Rate (IMR) decreased by ~25% • Certified Polio-free by WHO • Tuberculosis and Leprosy – Significant improvement in detection and cure rates Source: McKinsey-CII document on India healthcare, Dec-2012, Press search

  4. However, major challenges persist • Public spending on health is extremely low • Physical access remains a challenge with substantial infrastructure gap co-existing with under utilization • Health work-force remains inadequate and under-utilized • Affordability challenge – Out of Pocket spend continues to be high • Public private partnerships haven’t reached scale

  5. Defining access “The ability to reach, obtain or afford entrance to services” 1Parker 1974 1. Physical accessibility/ location IMS study2 (June-2013) – “Understanding Healthcare access in India” 2. Availability/ Capacity 3. Quality/ Functionality 4. Affordability 1Quoted from ‘Access to Healthcare’ report -2011 of ASSOCHAM (Frost & Sullivan) 2 IMS access study-2013, sponsored by OPPI

  6. Healthcare access in India’s context Definition of Universal Health Coverage “Ensuring equitable access for all Indian citizens, resident in any part of the country, regardless of income level, social status, gender, caste or religion, to affordable, accountable, appropriate health services of assured quality (promotive, preventive, curative and rehabilitative) as well as public health services addressing the wider determinants of health delivered to individuals and populations, with the government being the guarantor and enabler, although not necessarily the only provider, of health and related services.” High Level Expert Group on Universal Health Coverage constituted by planning commission in 2010

  7. Government commitment towards Universal Healthcare Access • Finance minister reference to Universal Health Care (UHC) in Interim Budget speech on 17th Feb 2014 • Prime Minister’s speech on 11th Feb 2014 – emphasis on strengthening public health systems. • NAC meeting on 29th Nov 2013 (chaired by UPA President Sonia Gandhi) – Progress on NAC recommendations on UHC briefed by then health secy.

  8. Role of key players in driving UHC Universal Health Care (UHC) Role of Government Role of Industry • Partnering with government on ‘priority health issues’ • Building relevant and tailored product portfolio • Innovative ways of supporting access and awareness enhancement • Increased spending on healthcare is key to improving access • Effectiveness in the procurement and utilization of essential drugs • Choice between playing ‘primary payor’ v/s ‘primary provider’ • Better utilization of the existing work-force

  9. A few examples of Industry initiatives towards improving access • Abbott’s Puducherry project • Novartis India – ArogyaParivar • MSD Wellness trust Hilleman Laboratories • Pfizer’s Patient Assistance program • Sanofi – Prayas • Bristol Myers Squibb - Delivering Hope

  10. Lessons on Universal Health Access journeys of other countries - Brazil Improvements in key indicators Brazil’s journey (1975 – till date) • 1920s – 1970s : Low physician density, coverage restricted • 1970s-1990s : Improved financial access by increasing coverage through SUS, their Unified Health System; Funding decentralized • 2000s onwards : Focus on reducing inequity and improving quality of care • Nearly 100% insurance coverage • Doctor density of 1.7 per 1000 in 2008 (up from 0.4 in 1960s) • Public expenditure as share of GPD of 4.2% in 2010 (up from 2.8% in 1995) • MMR of 56 per 100,000 live births in 2010 (~1/4th of India) • IMR of 15 per 1000 live births in 2010 (~1/3rd of India)) Source: McKinsey document for CII “India Healthcare – Inspiring possibilities, challenging journey (Dec-2012)”

  11. In conclusion • Willingness exists in both government and private sector to broaden healthcare access • Sustainable policy solutions needed to meet healthcare financing, infrastructure, and human resource challenges

  12. Thank you