Jan hai to Jahaan Hai – an adage since ages, would have been just that – one for the ages, had it not been for the proactive and in many ways disruptive approach that PM Modi-led government has taken towards providing accessible, affordable, quality healthcare, for all citizens of India.
While both planned and unexpected medical expenditure was an additional burden for all under the previous administrations, it was the low-income households that suffered the major brunt. Thanks to programmes such as the flagship AB PM-JAY scheme that ensures universal health coverage to crores of poor families and the Ayushman Bharat Digital Mission that is revolutionising healthcare in India through digitisation of health records via Ayushman Bharat Health Accounts (ABHAs), medical needs are met, and unfathomable fears around expenses, mitigated.
The Government’s far-sighted approach towards healthcare is not an isolated strategy. Think back to COVID-19; India began implementing grave measures for the containment of the pandemic much earlier than the expected trajectory. Be it “do gaj doori” or mask mandates, or lockdowns, we were so well prepared that in April 2020, India had already set up a vaccine task force. Eventually, by administering over 220 crore vaccine doses, as well as exporting them to the world – Vaccine Maitri – We emerged as an exemplary roadmap for many other countries.
Not just during the pandemic, future-proofing India’s healthcare ecosystem, be it through the government’s bold decision of replacing the Medical Council of India with the National Medical Commission thus eliminating corruption, or the setting up of integrated public health labs across districts, or giving an impetus to education in medicine (such as the first ever AIIMS in the Northeast in Assam), over the last nine years, this government has followed an extremely comprehensive and visionary approach.
Of course, this extends to healthcare being made available digitally. Ayushman Bharat Digital Health Mission (ABDHM) which includes CoWIN and Aarogya Setu is a shining example of the power of tech in healthcare, or healthtech, becoming a viable tool for quality. ABDM facilitates evidence-based decision making for effective health interventions.
Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) that makes quality generic medicines available at affordable prices through Pradhan Mantri Bhartiya Janaushadhi Kendras (PMBJKs) is another great example of how the ‘complete coverage’ approach informs every health policy. Today, around 9200 Jan Aushadhi Kendras are providing quality generic medicines at affordable prices to citizens. At the Jan Aushadhi Kendras OTC products can be purchased without a prescription and they sell close to 1800 drugs and 280 surgical instruments. The most significant draw though is that the prices of medicines are 50-90 per cent cheaper than similar branded medicines sold elsewhere in the market. The AMRIT pharmacies, similarly, sell more than over 5000 drugs, stents, implants, surgical disposables and other consumables at up to 60 per cent discounts. This covers major diseases such as oncology and cariology.
In alternative and holistic therapy, too PM Modi-led government has made tremendous strides. AYUSH centres that cater to overall Wellness Ayurveda, Yoga, Naturopathy, Unani, Siddha and Homeopathy are seeing a much-awaited resurgence and adoption, both in India and globally. The market size of Ayush industry has increased exponentially over the last few years. This has led to another viable and healthy offshoot, the ‘Ayurveda Aahara’ category aimed at wellness that begins with right intake.
As with everything else in nature, nurture begins with the mother. It is therefore, with utmost empathy that PM Modi-led government has approached healthcare as it relates to a mother, and child: Surakshit Matritva Aashwasan (SUMAN), for instance provides assured, quality healthcare at zero-cost and zero-tolerance for denial of services to those visiting a public health facility. Mission Indradhanush (MI) extends immunisation coverage to all children across the country; by fully vaccinating children up to 5 years and pregnant women, this is the government’s effort to reduce child mortality. Similarly, PM POSHAN scheme covers school children studying in classes first through eighth in government and government-aided schools.
Perhaps the best analogy is also the simplest: the Jan Aushadhi Kendras sell sanitary napkins at just Rs. 1 to accord safety, hygiene and dignity to women. The same can be said of the government’s overall approach to healthcare for all – it is safe, it is hygienic and most importantly, by way of direct as well as indirect indicators, it accords dignity all. Without exception.
Comparative Analysis: Then and Now
Budget allocation for Department of Health & Family Welfare has increased by 159%!
● 2013-14 (BE): Rs. 33,278 crore
● 2023-24 (BE): Rs. 86,175 crore
The per capita Government Health expenditure has been increased 82%!
● 2014-15: Rs. 1108
● 2018-19: Rs. 2014
Healthcare: 2.6 times increase in expenditure in last 9 years!
● 2015-16: Rs. 34.13 thousand crore
● 2023-24 (BE): Rs. 88.95 thousand crore
Number of AIIMS: 3X Increase!
● 2014: 7
● 2023: 23
Number of Medical Colleges: Increase of 71%!
● 2014: 387
● 2013: 660
Number of MBBS seats: Increase of 97%!
● 2014: 51,348
● 2023: 1,01,043
Number of PG seats: Increase of 110%!
● 2014: 31,185
● 2023: 65,335
Households with any member covered by health insurance
● NFHS-4 (2015-16): 28.7%
● NFHS-5 (2019-21): 41%
Neonatal Mortality Rate (NMR) reduced 23%!
● 2014: 26
● 2020: 20
Maternal Mortality Ratio (MMR) reduced 25%!
● 2014-16: 130 per lakh live births
● 2018-20: 97 per lakh live births
Under-5 Mortality Rate (U5MR) reduced 28%!
● 2014: 45 per 1000 live births
● 2020: 32 per 1000 live births
A family which used to spend nearly 62% of health expenditure on its own is now spending only 41%!
o Share of Out-of-Pocket expenditure in Total Health Expenditure:
● 2014-15: 62.6%
● 2019-20: 47.1%
Share of Government Health Expenditure in Total Health Expenditure increased
● 2014-15: 29%
● 2019-20: 41.4%
Market size of AYUSH industry increased 535%!
● 2014-15: Rs. 23,532 crore
● 2020: Rs. 1.49 lakh crore
9 year of achievements: Holistic Development of Healthcare Infrastructure
1. Rs. 64,100 crore+ outlay for PM-Ayushman Bharat Health Infrastructure Mission
2. 110 crore+ registered users on the Made in India Co-WIN portal
3. 39 Crore+ Ayushman Bharat Health Accounts (ABHA) created
4. 1.59 lakh+ Ayushman Bharat Health and Wellness Centres operational
5. 9,200+ Janaushadhi Kendras and 230+ AMRIT Pharmacies for Affordable medicines
6. 5,000+ Rapid Molecular Diagnostic Machines for Tuberculosis now operational; up from just 40 in 2014
7. 660 Medical Colleges now operational, an increase of over 70 per cent since 2014
8. 730 Integrated Public Health Labs being established in all districts
9. 600+ Critical Care Hospital Blocks in all districts with population of 5 lakh
On the Global Stage
One Earth – One Health: Paving the Way for Healthier Tomorrow
220 Crore+ , vaccinations against COVID-19 is world’s largest voluntary vaccination drive
4.81 crore, admissions covered with Ayushman Bharat, World’s largest government-funded health insurance scheme
29 crore+, doses Shared Under Vaccine Maitri, India exported Made in India vaccines with over 100 countries.
2nd Highest FDA approved manufacturing plants,Indian is known as the ‘Pharmacy of the World’,
1st Low-cost pharmaceuticals. India is the largest supplier of low-cost Generics & Vaccines
Rs. 2 lakh crore+ Pharmaceutical Exports. India exported pharmaceuticals worth over USD 25 billion in 2022
2nd largest Ayurvedic and Herbal Medicine Exports, with a market size of USD 18 billion+, India is the 2nd largest exporter of Alternative Medicines
147 crore+ Cumulative Footfalls at AB-HWCs. Footfalls at AB-HWCs are over 3 times the population of the EU
Flagship Schemes -Transforming Healthcare Infrastructure
PM Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) launched to fill critical gaps in public health infrastructure
Support for 17,788 rural Health and Wellness Centres in 10 High Focus States
Establishing 11,024 urban Health and Wellness Centres in all the States
3382 Block Public Health Units in 11 High Focus states
Setting up of 730 Integrated Public Health Labs in all districts
Establishing 602 Critical Care Hospital Blocks
5 New National Centre for Disease Control (NCDC) and 20 metropolitan health surveillance units
Operationalisation of 17 new Public Health Units and strengthening of 33 existing Public Health Units at Points of Entry, that is at 32 Airports, 11 Seaports and 7 land crossings
Setting up of 15 Health Emergency Operation Centres and 2 container based mobile hospitals
Setting up of a national institution for One Health, 4 New National Institutes for Virology, a Regional Research Platform for WHO South East Asia Region and 9 Bio-Safety Level III laboratories
708 District NCD Clinics, 194 District Cardiac Care Units, 301 Day Care Centres and 5,671 Community Health Centre NCD Clinics have been set up across country under National Health Mission (NHM).
19 State Cancer Institutes (SCIs) and 20 Tertiary Care Cancer Centres (TCCCs) have been approved under NHM. 15 Institutes are functional so far.
Making Healthcare Affordable for the Most Vulnerable
● AB-PMJAY is the world’s largest health protection scheme
● Health coverage of Rs. 5 lakh per beneficiary family per annum to over 60 crore beneficiaries
23.3 crore Ayushman cards issued (as on March 20, 2023)
4.95 crore hospital admissions authorised (as on May 17, 2023)
28,090 hospitals empanelled (as on May 17, 2023)
About 40,000 hospital admissions are authorized under the scheme every day
Increased opportunity in Healthcare Education
● 157 medical colleges sanctioned; 97 Medical colleges are functional till now
● 22 new AIIMS approved, undergraduate courses have started in 19 of these.
● 75 government medical college up-gradation projects approved, out of which 60 projects are complete
Ayushman Bharat Digital Mission (ABDM) launched to develop the backbone necessary to support the integrated digital health infrastructure of the country
39 Crore+ Ayushman Bharat Health Accounts (ABHA) created
27 crore+ health records linked
2.06 lakh verified facilities
1.83 lakh verified healthcare professionals
● National telemedicine service of India – eSanjeevani ensuring quick and easy access to doctors even in remote regions
More than 11.83 Crore Teleconsultation provided till date
Over 57 per cent beneficiaries are women
Around 12 per cent beneficiaries are senior citizens
● Tele-MANAS providing free tele-mental health services all over the country
36 Tele MANAS Cells operationalised
63,800+ calls handled
Pradhan Mantri Jeevan Jyoti Bima Yojana (PMJJBY) gives life insurance coverage of Rs 2 Lakh to anyone aged upto 55 years and having a bank account
Cumulative enrolments under the scheme have been more than 16.19 crore (as on Apr 26, 2023)
Amount of Rs. 13,290 crore has been paid for 6.64 lakh claims paid under PMJJBY (as on Apr 26, 2023)
Pradhan Mantri Suraksha Bima Yojana (PMSBY) provides accidental death cum disability cover of Rs. 2 lakh for death or disability due to an accident against a premium of just ₹ 20 per annum
Cumulative enrolments under the scheme have been more than 34.18 crore (as on Apr 26, 2023)
Amount of Rs. 2,302 crore has been paid for 1.15 lakh claims
Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) – providing quality antenatal care to all pregnant women
Over 3.94 Crore pregnant women examined under PMSMA
19,215 facilities providing PMSMA services
Pradhan Mantri Matru Vandana Yojana (PMMVY): providing direct cash benefits to meet enhanced nutritional needs of pregnant women
More than 3.32 crore beneficiaries enrolled under PMMVY
More than 3.05 crore beneficiaries have been paid more than Rs 13,766 crores as maternity benefit under PMMVY
POSHAN Abhiyaan improving nutritional status of Children, Adolescent Girls, Pregnant Women and Lactating Mothers
Mission POSHAN 2.0 rolled out across all the country
Only fortified rice being allocated under POSHAN 2.0
Millets to be mandatorily supplied at least once a week under POSHAN 2.0
10.18 crore beneficiaries registered under POSHAN 2.0
Covers around 730 Districts including 112 Aspirational Districts
Around 60+ crore Jan Andolan-based activities have been held
Labour Room Quality Improvement Initiative (LaQshya): to improve the quality of care in labour rooms and maternity operation theatres
2660 Labour Rooms and 1989 Maternity Operation Theatres LaQshya National certified (up till 24 March 2023)
283 obstetric high dependency unit/Intensive care unit approved
● Percentage of institutional deliveries out of the total deliveries has increased from 86.9 per cent in 2014-15 to 94.8 per cent in 2020-21
Mission Indradhanush ensuring full immunization coverage to children & women
4.45 crore children and 1.2 crore pregnant women vaccinated
Beti Bachao Beti Padhao scheme to foster a change in the minds of people to ensure the survival, protection & education of girl child
Improvement in Sex ratio of the total population
Improvement of Sex ratio at Birth by 19 points from 918 (2014-15) to 937 (2020-21)
Percentage of 1st Trimester ANC Registration has shown improvement from 61 per cent in 2014-15 to 73.9 per cent in 2020-21
Other initiatives in Health Care for all- Providing Affordable and Quality Healthcare for All
● More than 1.59 lakh Ayushman Bharat – Health and Wellness Centres (AB-HWCs) operationalized across the country, in which essential drugs and healthcare services are provided free of cost to all citizens
● Around 9,200 Pradhan Mantri Bhartiya Janaushadhi Kendras (PMBJKs) have been opened across the country to provide quality generic medicines at affordable prices
● The prices of medicines sold through the Kendras are at least 50 per cent cheaper than that of branded medicines available in the open market
● The product basket of PMBJP presently comprises of 1,759 medicines and 280 surgical devices
● An estimated 10-12 lakh people buy medicines from PMBJKs on a daily basis
● Savings of more than Rs. 20,000 crores made by citizens since 2014 by purchasing medicines from Janaushadhi Kendras
● Affordable Medicines and Reliable Implants for Treatment (AMRIT) stores have been set up in hospitals, where essential life-saving medicines are provided at a substantial discount
● 238 AMRIT Pharmacies are operating in 28 States/UTs (as of 9th Dec 2022)
● National Pharmaceutical Pricing Authority (NPPA) has fixed ceiling prices of 890 scheduled formulations across various therapeutic categories under NLEM 2015
● NPPA has fixed ceiling prices of 344 scheduled formulations under NLEM 2022
● Maximum Retail Price (MRP) of 526 brands of anti-cancer medicines have been reduced by upto 90 per cent
Moving Towards a ‘TB Mukt Bharat’
● TB Patient Registrations: Up from 15.5 lakh (2014) to 24.22 lakh (2022); 56 per cent increase
● 18 per cent decline in incidence of TB in India in 2021 compared to 2015, from 256/lakh population in 2015 to 210/lakh population in 2021
● Rapid Molecular Diagnostic Machines scaled up from 40 in 2014 to 5,090 in 2022
Making India a Global Hub for Drugs, Pharmaceuticals and Medical Devices
● PLI Scheme for Bulk Drugs
o Total financial outlay of Rs. 6,940 crores
o 41 products identified for financial incentive
o 51 applications selected under the scheme
o 22 projects already commissioned with the installed capacity of 34,255 MT
● PLI Scheme for Promoting Domestic Manufacturing of Medical Devices
o Total financial outlay of Rs. 3,420 crore
o 26 applications approved
o 14 projects already commissioned
o Domestic manufacturing of high-end medical devices like MRI Scan, CT-Scan, Mammogram and X-ray tubes started
● PLI Scheme for Pharmaceuticals
o Financial outlay Rs. 15,000 crores
o 55 applicants selected for financial incentive
AYUSH – Reviving Knowledge of Traditional Medicines
● Indian medicine systems now being increasingly utilised by nations across the world
● 12,500 AYUSH HWCs approved
● 5,800+ AYUSH HWCs made functional
● 780 AYUSH colleges established with over 62,700 students
● WHO-Global Center for Traditional Medicine – 1st such center established in India
Paving the Way for Healthier Tomorrow
● 220 Crore+ Vaccinations against COVID-19 – India’s vaccination drive is the world’s largest voluntary vaccination initiative
● 4.95 crore Admissions Covered with Ayushman Bharat – AB-PMJAY is the world’s largest government-funded health insurance scheme
● 29 crore+ Doses Shared Under Vaccine Maitri – India shared critically important Made in India vaccines with over 100 countries
● 2nd Highest FDA approved manufacturing plants – Another reason why India is also known as the ‘Pharmacy of the World’
● 1st Low-cost pharmaceuticals – India is the largest supplier of low-cost Generics & Vaccines
● Rs. 2 lakh crore+ Pharmaceutical Exports – India exported pharmaceuticals worth over USD 25 billion in 2022
● 2nd largest Ayurvedic and Herbal Medicine Exports – With a market size of USD 18 billion+, India is the 2nd largest exporter of Alternative Medicines
● 147 crore+ Cumulative Footfalls at AB-HWCs – Footfalls at AB-HWCs are over 3 times the population of the EU