Human Rights Archives - InnoHEALTH magazine

National Ageing Center Coming in New Delhi

InnoHEALTH Magazine — Wed, 19 Dec 2018 06:20:46 +0000

Ahead of an international day of old people on October 1, a foundation stone of the National Ageing Center has been laid recently at AIIMS in the national capital. The National Ageing Center will provide state of the art clinical care to the elderly population and shall play a key role in guiding research in the field of geriatric medicine and related specialties. The Centre will also be a key training facility for undergraduate and postgraduate courses. The Centre will provide multi-specialty healthcare and will have 200 general ward beds, which will include 20 medical ICU beds. The center will be developed at a cost of Rs 330 crores and shall be completed by February 2020.

On the occasion, Prime Minister Narendra Modi also dedicated the underground connecting tunnel between AIIMS and JNPA Trauma Centre, and Power Grid Vishram Sadan at AIIMS along with the 500 bedded New Emergency Block and 807 bedded Super Specialty Block at the Safdarjung Hospital to the nation.

Informatively, on the 70th anniversary of the Universal Declaration of Human Rights (UDHR), the United Nations International Day for Older Persons (UNIDOP) celebrates the importance of this Declaration and reaffirms the commitment to promoting the full and equal enjoyment of all human rights and fundamental freedoms by older persons.

Growing older does not diminish a person’s inherent dignity and fundamental rights.

On 14 December 1990, the United Nations General Assembly designated October 1 as the International Day for Older Persons. This was preceded by initiatives such as the Vienna International Plan of Action on Ageing – which was adopted by the 1982 World Assembly on Ageing – and endorsed later that year by the UN General Assembly.

In 1991, the General Assembly adopted the United Nations Principles for Older Persons. In 2002, the Second World Assembly on Ageing adopted the Madrid International Plan of Action on Ageing, to respond to the opportunities and challenges of population ageing in the 21st century and to promote the development of a society for all ages.

Almost 700 million people are now over the age of 60. By 2050, 2 billion people, over 20 percent of the world’s population, will be 60 or older. The increase in the number of older people will be the greatest and the most rapid in the developing world, with Asia as the region with the largest number of older persons, and Africa facing the largest proportionate growth.

The interdependence between older persons’ social integration and the full enjoyment of their human rights cannot be ignored, as the degree to which older persons are socially integrated will directly affect their dignity and quality of life.

Older human rights champions today were born around the time of the adoption of the UDHR in 1948. They are as diverse as the society in which they live: from older people advocating for human rights at the grass root and community level to high profile figures on the international stage. Each and everyone demands equal respect and acknowledgment for their dedication and commitment to contributing to a world free from fear and free from want.

The 2018 theme aims to:

Promote the rights enshrined in the Declaration and what it means in the daily lives of older persons;
Raise the visibility of older people as participating members of society committed to improving the enjoyment of human rights in many areas of life and not just those that affect them immediately;
Reflect on progress and challenges in ensuring full and equal enjoyment of human rights and fundamental freedoms by older persons; and
Engage broad audiences across the world and mobilize people for human rights at all stages.

On the day of laying of foundation stone for ageing persons, Mr. JP Nadda, Union Minister of Health and Family Welfare, Mr. Ashwini Kumar Choubey and Smt. Anupriya Patel, Ministers of State for Health and Family Welfare were also present at the event.

Addressing the participants, PM Modi said that our government has been successful in taking healthcare out of the ambit of the Health Ministry and today we have Rural Development Ministry, Water and Sanitation Ministry, and Child Development Ministry and AYUSH Ministry with our vision of healthcare.

He further added that our vision is not limited to hospitals, diseases, medicines, and super specialty care but also with the idea that affordable and equitable healthcare should be ensured for every citizen. PM Modi said that the government is equipping existing hospitals with all the modern facilities and at the same time it is also making sure that the healthcare facilities reach the remotest areas of the countries. He added that 58 district hospitals are being upgraded to medical colleges and the government has also sanctioned budgets for 24 new medical colleges.

PM Modi added that the global target for eliminating TB is 2030, but we have set 2025 as our target for India to eliminate TB, five years before the global target. He further stated that the government is providing Rs. 500 to the TB patients towards nutritional support.

The Prime Minister also mentioned the Ayushman Bharat programme. He said that under the National Health Protection Mission, 10 crore poor and vulnerable families (approximately 50 crore beneficiaries) will be provided a coverage up to 5 lakh rupees per family per year for secondary and tertiary care hospitalization. This will be the world’s largest government-funded healthcare programme, he stated.

Mr. Nadda said that there has been a visible change in the tertiary healthcare in the country and assured that the government is committed to ensuring that the new AIIMS will meet the same standards of service as AIIMS, New Delhi. No effort will be spared to make them the very best, he added. He said that that the new AIIMS will have the same work culture and the government is taking all the steps to ensure that. He further stated that the Ministry in the past 4 years has not left any stone unturned – from monitoring the clean and effective implementation of national programmes to establishing 13 new AIIMS like institutes across the country. Reiterating the commitment of the government, he said under Ayushman Bharat, 150,000 sub-centers will be converted into Health and Wellness Centres (HWCs) that will deliver comprehensive primary healthcare.

“The HWC would provide preventive, promotive, and curative care for non-communicable diseases, dental, mental, geriatric care, palliative care, etc. He further stated that the government has initiated universal screening of common NCDs such as diabetes, hypertension and common cancers along with Tuberculosis and Leprosy and everybody above the age of 30 years will be screened for these diseases and as such this will eventually help in reducing the disease burden of the country. “We will implement the vision of the Prime Minister in letter and spirit,” he added.

The underground tunnel is providing connecting facility between AIIMS and JPNA Trauma Centre and will reduce the commute time between the two centers. The completed length connectivity between two centers is approximately 1 km and has been completed at a cost of Rs. 44 crores.

The Powergrid Vishram Sadan has a 300 bedded night shelter facility meant for the patients and their relatives visiting AIIMS main hospital and JPNA Trauma center at AIIMS. The 11-floor facility has been constructed at a cost of Rs. 32.67 crores and funded by the Power Grid Corporation.

New emergency block at Safdarjung Hospital will house 64 triage beds, red zone for children & adults and 90 ICU beds for victims of road traffic accidents, acute trauma suffered by individuals at home or work, acute poisoning and severe medical and surgical emergencies. The block has been developed at a cost of Rs. 346 crores.

Super Specialty Block at Safdarjung Hospital holds tertiary care facilities in the areas of cardiovascular sciences, neurosciences, pulmonary medicine, nephrology, and endocrinology and shall be offering the facility of a Heart Command Centre, respiratory care facility, sleep labs, 24×7 dialysis unit, MRI guided Braine Suite, etc. It also has a 228-bedded private ward. The super specialty block has been developed at a cost of Rs. 920 crores.

Also present at the event were Smt. Preeti Sudan, Secretary (Health); Prof. Randeep Guleria, Director, AIIMS New Delhi; Dr. Rajendra Sharma, Medical Superintendent, VMMC & Safdarjung Hospital, New Delhi and Mr. IS Jha, CMD, Powergrid Corporation along with the senior officers from the Health Ministry and faculty of AIIMS.

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UNIVERSAL HEALTHCARE: INNOVATIONS NEEDED IN REGULATIONS

InnoHEALTH Magazine — Mon, 10 Apr 2017 06:58:46 +0000

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Universal Healthcare: Innovations Needed in Regulations
Dr. Sanju Ganju is the founder chairman of Atrimed Pharmaceuticals, a company modernizing Ayurveda. He is the founder of ‘Save a Mother’, a healthcare NGO, which works in over 1200 villages. During his career, he has participated in over a hundred non-profit projects.In the past, he was the CEO of Reliance Health and Technology, executive director of America India Foundation, chairman of Action for India and adviser to Rajiv Gandhi Charitable Trust. He also served in the Indian army. He graduated from the All India Institute of Medical Sciences, Delhi and specializes in gastroenterology and hepatology.

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In most other countries, the constitution requires the government to provide some form of healthcare. The implementation, however, suffers from deficit of policy, government or resources even in the countries that consider healthcare as a part of social justice. The Author talks about how India can lead with innovations in legislation, policy, governance and finance to provide health for all.

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Adequate healthcare is both, a prerequisite and a consequence, of the growth of a country. A health system can deliver public health and medical services, if its solid foundation includes skilled workforce, information systems, medical products, technology, adequate financing and governance. While technology can provide innovative tools to improve health, it is the regulatory framework whichcan provide the enabling ecosystem. It is important that Innovations not be limited to drugs and devices but also include regulations.Ultimately,it is laws that determine financing and structure of healthcare.

The nations of the world have included healthcare in their legal framework in some form.Almost all countries are signatories to one or more international human rights or health rights declarations.

One third of the countries include healthcare as a constitutional right for individual citizens. Russiaand former countries of the Soviet bloc Italy, Spain, Brazil, Philippines and South Africa have maintained health as human right in their constitution. On the other end of the spectrum are countries like the USA, which have no individual constitutional right to healthcare.

In most other countries, the constitution requires the government to provide some form of healthcare. The implementation,however, suffers from deficit of policy, governance or resources even in the countries that consider healthcare as a part of social justice.

India extrapolates health rights from other parts of the constitution.The right to health in India is outlined the Directive Principles of State Policy- Articles 42 and 47 and the fundamental right to life as stated in article 21.

Article 42 states that the State shall make provision for securing just and humane conditions of work and for maternity relief.

Article 47 states that the State shall regard the raising of level of nutrition and the standard of living of its people and the improvement of public health as among its primary duties and, in particular, the State shall endeavor to bring about prohibition of the consumption, except for medicinal purposes, of intoxicating drinks and of drugs which are injurious to health.

Article 21,“The Fundamental Right to Life” guaranties individual life.

The Indian judiciary has interpreted the “Right to Life’ in many ways. It has held that humane working conditions, health services and medical care are an essential part of Article 21. Public interest litigation, as well as litigation arising out of claims made by individuals,has generated substantial case law showingright to health is an integral part of the Right to Life.

For technological innovations to flourish in its current stage of development, India needs more proactive regulations to progress towards universal healthcare.

Currently the Indian government spends about 1 percent of GDP on healthcare. Compare that to 3 percent in China and 8.3 percent in the USA. Private expenditure on healthcare is in addition to public expenditure; approximately 70% of health expenditure in India is from private sources.

A study done by PGI Chandigarh, suggests that universal health care services for entire 1.2 billion population, the annual cost of providing preventive and curative services will be INR 2415 billion (USD 54 billion). This would amount to increasing the allocation to health sector from current nearly 1% to 3.8% of GDP.

Indian business association, FICCI and consultants EY, estimated in 2012 that universal health cover would require government health spending to increase to 3.7-4.5 percent of GDP.

The current government, under the National Health Assurance Mission, would provide all citizens free drugs and diagnostic treatment and insurance cover to treat serious ailments. It would cost an estimated $11.4 billion annually.

In 2010, a High Level Expert Group on Universal Health Coverage recommended increasing public financing from 1% of the gross domestic product to at least 2.5% to provide essential health care package through tax funding and employer-provided insurance.

The Lancet published an India focused issue on health in Jan 2011. The lead authors (K SrinathReddy, Vikram Patel, Prabhat Jha, Vinod K Paul, A K Shiva Kumar, Lalit Dandona),summarized the recommendations of various working groups as ‘call to action’ as follows. They propose the following targets to be achieved by 2020 through the creation of the Integrated National Health System with three overarching goals: ensure the reach and quality of health services to all in India; reduce the ﬁnancial burden of health care on individuals; and empower people to take care of their health and hold the health-care system accountable.

Service delivery

• The entire population should be covered by an entitlement package of health care with

ﬁnancing from a combination of public, employer, and private sources. Full range of relevant diseases need to be included in the entitlement package of health services with cost-eﬀective interventions that include health promotion and disease prevention.

• All health practitioners and facilities in the public and private sectors have to be registered with the Integrated National Health System.

Health Financing

• Public spending on health should be increased from 1% to 6% of the gross domestic product, and 15% of tax revenues—including new taxes on tobacco products, alcohol, and food with little nutritional value—should be earmarked for this purpose.

• Reduce the proportion of out-of-pocket spending from 80% to 20% of the total health expenditure.

• Increase spending on health research to 8% of the health budget.

Human resources for health

• Establish the Indian Health Service with guidelines developed through an autonomous National Council for Human Resources in Health.

• An updated training curriculum should be fully in place for medical and allied professions that is relevant to the situation in India.

• Establish suitable incentive structures to retain health providers in underserved areas.

Health information system

• Have in place comprehensive health information and surveillance system that covers all major diseases, health-system issues, and key social determinants, which also facilitates assessment of public health interventions.

• Establish adequate research capacity in India to investigate and report key issues that aﬀect the health system and policy for further improvements.

• Have in place a fully functional autonomous council that compiles and synthesizes relevant information to develop guidelines for evidence-based health care and its assessment.

Drugs and technology

• Implement a national network of pharmacies for generic low-cost drugs for the entire population.

• Establish mechanisms for bulk purchase of patented drugs at low cost.

• Have in place mechanisms to check and control the use of perverse incentives by pharmaceutical and biotechnology companies for health-care providers.

Governance

• Have in place mechanisms to make functional the components of the National Health Bill.

• Have a system in place that requires all middle and senior functionaries in public health to have relevant training in public health.

• Ensure devolution of responsibility for health care to district management systems along with accountability mechanisms and explicit community participation (The Lancet, Jan 2011).

India, at current stage of development needs more healthcare in every form and not less. Multiple studies have confirmed the fiscal feasibility and for technological innovations to flourish we needs a progressive enabling ecosystem.

Opposition to right to health emphasizes that it could increase the fiscal deficit;it could create shortage and increase the wait time for medical services, which would lead to rationing and lower the quality. It could also cause people to overuse health care resources. While appreciating valid opposing view, human development is not possible without guaranteed healthcare. Financial burden of a single episode of disease pushes millions of Indians into poverty, which stifles the market for technological progress.

Health and longevity have improved as never before in human history. And with explosive growth in the knowledge of human biology and genetics, it is likely that the life span will increase exponentially. It may even change the very definition of health to include happiness, intelligence and aesthetics as components of a new paradigm. It is imperative that innovations in legislation, policy, governance and finance will have to stay ahead of the burgeoning technologic innovations and not fall behind to irrelevance. It is important to have innovative strategic thinkers in the leadership positions that understand biology, healthcare, governance and finance.

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