Q. What are the updates for 2019 regarding Indo-Danish relationship in Healthcare?

The relationship between India and Denmark is becoming better each day. In December 2018, the Foreign Ministers of both the countries met in New Delhi and relaunched the Indo-Danish Joint Commission, which provides the framework for all strategic sectors’ cooperation including healthcare. This breakthrough paved the way for the Danish Prime Minister’s visit to India in January this year. Among other things, he participated in Vibrant Gujarat spearheading a Danish business delegation, where he also met with Prime Minister Modi. The purpose of these visits was to strengthen political and economic ties between India and Denmark because both countries will benefit tremendously from increased interaction and business collaboration. In this regard, healthcare is a key focus area for 2019. This decision is based on the success of two large projects in 2018; one is focused on non-communicable diseases and the other on attaining the SDGs within healthcare. We were able to develop concrete grounds for working in a focused manner in this field and assist Danish companies looking to gain a footing in India. Several Danish companies are already established in the Indian market including Novo Nordisk, Widex, Coloplast, Fertin, Falck and many more are expressing their interest.

Q. The Danish Health System is incorporating changes for good in recent past with new hospitals and other delivery mechanisms, can you share your viewpoint on the relevance of them to India?

The Danish health system is a publicly funded scheme, which covers all Danish citizens. There is a lot Denmark can contribute to India in terms of know-how and sharing of best practices. Areas where Denmark can assist India to include:

• Digitalization of some solutions to address the challenges that exist in the current healthcare system. Denmark is a leader when it comes to digital workflows and working with electronic health records. Like in India, there are multiple stakeholders within the healthcare system (doctors, patients, nurses, local and state authorities, pharmacies, etc.) that are bound to work together but at the same time operate as individual entities as well. Denmark managed to achieve a high level of efficiency by digitalizing processes and thus, improve efficiency.

• Digitalization has helped Denmark save both time and money. These learnings can be adopted in India to bring down costs in public as well as private set-ups.

• Empowered its patients allowing them to access all relevant information about their health and well-being. I believe that the Indian government’s launch of Ayushman Bharat Scheme is also a move in a similar direction and with the similar intent of providing better healthcare access to all. Therefore, I see a great scope of collaboration and partnership between the two countries.

• Other areas where Denmark has done exceptionally well is the use of Telemedicine for connecting patients in remote locations and reduce time at the hospitals.

• The Danish hospital system is undergoing unprecedented expansion and restructuring. Denmark has spent years of research and gathered experts from all over the world to develop 5 new national super hospitals and renovating 11 existing hospitals. India can leverage this knowledge while it is at a stage where there are still new hospitals getting on.

Q. What can India offer to Denmark, your opinion?

One of the common areas of work between Denmark and India is dealing with NCDs. It is a global challenge. Denmark is currently investing a lot in developing solutions to address this global multifaceted issue. Our research environments, universities, and companies are trying to create products that could be suitable not only for Denmark but across the globe. One of the very specific things Denmark could explore is:

• India has a lot of data available and Denmark could collaborate with India to develop solutions and therapies.

India is a bigger country with a much bigger amount of data; this can be utilized to further make the Danish healthcare sector more effective.

Furthermore, private players dominate the Indian healthcare sector, which has created different incentives and quicker implementation time. Both learnings from private players and data from India can be beneficial to the Danish healthcare sector.

Q. Any message for the readers of InnoHEALTH Magazine that you want to share?

Healthcare is a global challenge, and we need global solutions to attain the Sustainable Development Goals. Having in mind that 17 percent of the world population lives in India, it is safe to say that if India fails, the world will not succeed. Therefore, the strategic sector cooperation between Denmark and India is very important.

World Health Day

April 7th marks the birth anniversary of the World Health Organisation (WHO) and along with drives worldwide attention by spreading the message of the importance of global health each year.

Ranging from imperative issues such as food safety, diabetes, depressions, etc., this year the World Health Day embarks the mission of people-centered care irrespective of their financial hardships. The 2019 theme envisions the Universal Health Coverage (UHC), i.e., health for all. There are millions of people who have no access at all to healthcare. Majority of the populations are forced to choose between healthcare and other daily needs such as food, clothing, and shelter. In India, a lot of efforts need to be put in to ensure adequate medicines, affordable health policies, and financing strategies to enable everyone to get access to equal healthcare. “Universal” in UHC means “for all”, without discrimination, leaving no one behind, i.e. providing healthcare facilities which are

• Accessible
• Affordable
• Available
• Appropriate
• Adequate

Addressing the Financial Crisis

“Universal health coverage is also about ensuring access to essential quality care and financial protection,” says Dr. Mahjour. It aids in enhancing people’s health at large and increasing their life expectancy. Under this, many countries are protected from epidemics and the risk of hunger. This paves a way for new jobs, enhanced economic growth, and gender equality.

To make the phenomenon of Universal health coverage achievable globally, there should be concrete roadmaps which highlight the gaps and obstacles patients face in accessing proper healthcare. This can be done only when there are identified challenges, key actions and sustainable goals to be taken care of.

• There must be a holistic range of health and related services
• Quality care is a must
• There must be an end to discrimination and stigma
• The healthcare products and services should be affordable
• Sustainable investment in health is another prerequisite

Where India Stands – The New “Health-Y” Politics

The much-awaited general election will be held in India in April 2019 when the Indian voters will go to the polls. It is anticipated that whichever government comes into play will surely set a course for newer and better health policy.

Recent researches reveal an alarmingly rapid epidemiological transition. The occurrence of diseases such as cardiovascular diseases, diabetes, and cancer are rapidly on a rise. For instance, since 1990, the number of Indians with diabetes has increased from 26 million to approximately 65 million to date. The incidence of all cancers has increased by 28% between 1990 and 2016, with new cases of cancer emerging each year. India not only seems terribly engulfed in the swirling epidemic of non-communicable diseases, but it is also in the grip of a mental health emergency. The rate of global suicide deaths is speculated to be 1.1 times higher among women and 1.4 times higher among men than global averages in 2016.

It would be unfair if we highlight only the negative side of the picture. After many years of neglect, the Government of India has finally recognized and considered the perils of public discontent relating to health. Prime Minister Narendra Modi has initiated a new programme called Ayushman Bharat, which along with focusing on preventive health, emphasizes affordable health.

Ayushman Bharat majorly comprises two new flagship programmes. First, the creation of 1.5 lakh health and wellness centers across the whole country. These centers will primarily be responsible for providing primary healthcare facilities to provide health coverage for all. The second includes the National Health Protection Mission (NHPM)—a system of health insurance that intends to cover 500 million people. It covers secondary and tertiary care for the poorest and most vulnerable strata of society. These twin programmes together must help India improve access to quality health services and reduce out-of-pocket health expenditures.

Modi is the first Indian Prime Minister who has grasped the importance of health for Indian citizens and has prioritized universal health coverage as part of his political platform. “Modicare” as it is sometimes addressed to, can become a decisive issue in the upcoming general elections.

Way Forward for a Healthy Nation
Does Universal health Coverage still seem a distant goal in India!

The scant funding from the Central and state governments seems the root cause and the major hindrance in achieving UHC. The Central Government has recently announced a massive expansion of healthcare facilities.

Through its ambitious National Health Protection Scheme (NHPS), the Government of India provides a framework for universal health coverage in which it prioritizes healthcare delivery and its easy access. By reducing out-of-pocket payments, expanding service coverage, improving quality of services, and ultimately advancing UHC, countries and in particular, India with schemes like NHPS in place can transform the health of their people and bring drastic changes in society. As stated by WHO Director-General: “No one should have to choose between death and financial hardship. No one should have to choose between buying medicine and buying food.” UHC indeed is a way to go ahead.

About the author

Dr. Jasmeet Kaur is a Doctorate in Immunology and whenever she gets free time from the full-time job she loves to read and write about imperative issues in healthcare.

Prof. Paul Lillrank (moderator) presented his keynote by giving insights of his ideas and implementations in the organization for which he is the chairman (Aalto Health Platform). Explained how the world famous, ARAVIND EYE CARE model was chosen and implemented by his student in Finland who studied ARVIND EYE CARE in Tamil Nadu. Stressed on technology circulation instead of technology transfer, as the later is only one directional flow. He felt India is the most innovative place in the world with the land full of opportunities.

Molshree Pandey, currently working on communicable diseases and finding ways to collaborate stakeholders in a much more efficient way. Conducts and concentrate on boot camps, road shows in Denmark, presentations to many companies; connecting and opening pathway to better delivery of care in India as well as Denmark. Insisted on modification of products according to the country.

Ankit Bahl compared the way of delivering care and implementing in 2 countries Estonia of 1.2 million populations with India of 1.2 billion populations. Estonian healthcare developments:

-Have S.E.Z for Pharmaceuticals, diagnostic companies in Estonia
-Worlds first biobank which Is commercialized too!
-97% of their patient prescriptions are made online for better access for both patients as well as stakeholder handling it.

Only three things can’t be made online in Estonia 1.marriage 2. Divorce 3. Trade property. Haha!! Introduced E ambulance in Estonia! They call E-Estonia and are also working towards to achieve it!

Iris Ohrn, A kind of matchmaker and identifies companies, investors which would benefit mutually. She observed similar challenges in India as well as Sweden in terms of the cost of healthcare.

K Gopalan, Works for the betterment of healthcare ecosystem of underprivileged. India is a big corridor for the scope of solutions. The focus needs to be on Primary health care, an example is vatsalya which is trying to provide subsidized private care. Promoted SANKALP, which is a form of the network of healthcare stakeholders.

Identification of right partners and right market recognition is required. IPR (very important) during technology transfer is at-most concerned.

As GDPR in EU, likewise, we need in India too. Shared her views on DISHA Act
DISHA:
– Setting up central and state organizations
– Ensuring trust in the system
– Recognition of ‘RIGHT TO RECTIFY’ by the patients is becoming important
Differences in DISHA and GDPR should be studied,
Example: right to forget/Erase isn’t there in DISHA