The Jan Swasthya Abhiyan (JSA), a national platform of a group of organisations that coordinates action and activities on health and healthcare, on Thursday condemned the inadequacies in the Union Budget and its allocation for the health sector.
“While the central government claims that ‘India has emerged a shining star, showing signs of robust viability’, we find that the Union Budget allocations for the health sector have declined further, making it the second year in a row to have witnessed sharp budgetary cuts in crucial health schemes,” activists with the JSA said in a statement issued on Thursday.
While last year’s budget had seen a decline of about 7% in real terms, this year’s budget has also declined. Allocations for health and related programmes reduced in real terms in the 2023-24 budget by 2% compared to the budget estimate of 2022-23, Dr Abhay Shukla, national co-convenor of JSA, said.
According to Dr Anant Phadke, co-convenor of the Jan Arogya Abhiyan in Maharashtra, people had faced a very difficult period during the Covid-19 pandemic with inadequate health facilities and an under-resourced public health system. “We have been demanding that concrete measures be taken to improve the dilapidated health system and that allocations for crucial schemes be increased significantly. However, all demands have fallen on deaf ears,” Dr Phadke said.
The budget “falls flat” because it has “completely overlooked the lessons of the Covid-19 epidemic”, the JSA statement said. “It fails to allocate much-needed increases in allocations for public health system strengthening, the major National Health Mission programme, services for women and children, mental health programme, essential health research…,” the statement adds.
“If we look at the Union Health Ministry’s total budget (including Ministry of AYUSH), the allocations have been increased from Rs 89,251 crore (2022-23 Budget Estimate) to Rs 92,803 crore (2022-23 BE), that is an increase of Rs 3,552 crore only. If we adjust for the effect of inflation, this means a decline of 2% in real terms,” Dr Shukla further pointed out.
As a share of GDP, the Union government allocation to health has declined from 0.37% to 0.31% between 2021-22 actual expenditure and 2023-24 budget estimate, the JSA said. This also means that the Centre has reduced its priority towards the health sector as the share of health in the total budget has declined from 2.26% to 2.06% compared to the previous year, activists said. Since 2019-20, National Health Mission (NHM) allocations have also declined in real terms, they added.
“It was important that the government undertake special efforts to ensure safe motherhood, universal vaccination and expand various disease control programs to catch up with the loss during the pandemic, but this major need has been ignored,” the statement said.
The Pradhan Mantri Jan Arogya Yojana has failed in providing access to healthcare services to the poor and deprived, the JSA said. “This scheme should be scrapped and instead resources should be used to strengthen the public health system,” Dr Shukla added.
While a cut in NHM allocations directly impacts the programmes on reproductive and child health care, there are other critical elements related to women’s health that got neglected under the current budget, activists said.
In 2020-21, the actual expenditure on health research was 3.8% of the budget, which declined to 3.1% in the current budget. Furthermore, the Indian Council of Medical Research (ICMR), which has led several research initiatives during the pandemic, including vaccines, has received a cut. On mental health too, the National Mental Health Programme has received a measly allocation of Rs 40 crore, which continues to be the same since 2019-20, the activists said, adding that this amounts to spending just 30 paise per person per year, for the NMHP.