Special report: Focus on India
Public health
In the past 10 years, Prime Minister Narendra Modi has worked to improve well-being in India, but much more progress is needed to look after 1.4 billion people, says Grace Wade
AS THE most populous country on the planet, India’s healthcare policy shapes the well-being of more than 1.4 billion people.
During Narendra Modi’s decadelong tenure as prime minister, the nation has started various initiatives to boost public health, and yet its medical system still falls short of meeting needs.
Preventable illnesses like tuberculosis and diarrhoeal diseases remain leading causes of death, and chronic conditions such as heart disease and cancer are on the rise. Can this be turned around?
Low healthcare spending is partly to blame for poor outcomes. In 2020, this was equivalent to less than 3 per cent of the country’s GDP. Other lowerincome economies such as China and Mexico spent roughly the equivalent to 6 per cent of GDP on healthcare whereas the US and UK were at almost 19 per cent and 12 per cent, respectively.
“Part of it is health has never been a political topic in India,” says Manoj Mohanan at Duke University in North Carolina. For example, less than 1 per cent of voters cited healthcare as their top concern in the 2019 election.
Instead, development and anticorruption are popular concerns, leading Modi’s government to focus on reforms such as reducing poverty, improving education and expanding infrastructure.
All these indirectly affect health, even if they aren’t captured by healthcare spending statistics. “If you think of health broadly, it has a lot to do with social determinants of health,” says Anuska Kalita at Harvard University.
One such project is Modi’s sanitation initiative, called the Swachh Bharat Mission. Between 2014 and 2019, the proportion of rural households with access to a toilet increased from 39 per cent to more than 95 per cent. This has cut India’s rates of open defecation, which is associated with the spread of diarrhoeal disease, although it remains common.
1.4 billion The size of the population of India
<3% Proportion of the country’s GDP that is spent on healthcare
39% Share of rural households with access to a toilet in 2014, when Narendra Modi was first elected. In 2019, the figure was 95 per cent
The government has also added 50,000 kilometres of highway over the past nine years, which has improved accessibility to clinics and hospitals. “If you look at the drop in maternal mortality, India has done phenomenally well over the last few years, and a lot of it [p
