NEW DELHI:
Describing the recently launched Pradhan Mantri Jan Arogya Yojana (PMJAY) as a “tremendous” first step towards universal health coverage, World Health Organisation deputy director-general Dr Soumya Swaminathan said on Wednesday that it is exactly the kind of commitment WHO wants from countries. However, she emphasised that a good governance mechanism is essential to ensure a fair system free of frauds.
“The government of India needs to be congratulated to have thought about it. This is exactly what we want countries to commit to and it is a tremendous first step. The challenges are enormous but this what we want countries to do. India has the Human Resource’s, the capacity and the wherewithal within the country to do this…there is no need for India to reinvent the wheel it can learn from other countries and other countries can learn from India. A good governance mechanism is essential to ensure that the system is fair and does not encourage fraudulent practices,” Dr Swaminathan said. She was speaking to the media on the sidelines of the fifth Global Symposium on Health Systems Research.
Earlier, during her keynote address in a plenary session, Dr Swaminathan had spoken about WHO’s triple billion targets – one billion more people benefiting from universal health coverage, one billion more people better protected from health emergencies and one billion more people enjoying better health and well-being. PMJAY launched by prime minister Narendra Modi on September 23, covers 500 million people – one half of the one billion UHC target set by WHO.
Dr Swaminathan said that the preventive arm of Ayushman Bharat – 1,53000 health and wellness centres – is “equally if not more important” in the context of UHC. “Prioritisation of tertiery care without investment into primary care could lead to costs being increased because you are not preventing but waiting for diseases to be more complex. The new primary care model of health and wellness centres is where India is moving away for the first time from mother and child care to tackle NCDs, mental health etc at the primary care level. This is also where the real learning will come from. They will have to be developed and implemented well and this is also where health systems research comes in – looking at things like the provider whether it is an Ayush physician or a nurse who delivers the care,” she said.
While technology cannot replace manpower in healthcare, she added, it could still provide new models of care delivery.
Replying to a question about recent WHO recommendations about using the antibiotic bedaquiline in TB patients, Dr Swaminathan who has been a TB researcher (and a secretary to the government of India on health research), said that WHO has access to all data from the company and is now convinced that the drug is better than kanamycin. “Kanamycin causes hearing loss that is why we have recommended replacing it with bedaquiline. India might consider using bedaquiline over shorter regimens. Patients will obviously have to be followed up and data collected,” she said.
