Why in News?
Officials from the Union Ministry of Health and Family Welfare and other Government departments have started the process of finalising several provisions of the draft Bill for a new national public health law.
The suggested National Public Health Act has been in the works since 2017 and, once enacted, will replace the 125-year-old Epidemic Diseases Act, 1897.
What is the Background?
- In 2017, the draft of the Public Health (Prevention, Control and Management of Epidemics, Bio-terrorism and Disasters) Act, 2017 was published.
- In September, 2020, it was promulgated that the Government would formulate a national public health law (National Public Health Bill).
Expected Provisions of the Draft Bill-
- Four tier Health Administration Architecture-
- The draft Bill proposes a four-tier health administration architecture, with “multi-sectoral” national, state, district and block-level public health authorities who will be provided “well defined” powers and functions to deal with “public health emergencies”.
- It is proposed to be headed by the Union Health Ministry, and be chaired by health ministers of states.
- District Collectors will lead the next-tier and the block units will be headed by Block Medical Officers or Medical Superintendents.
- These authorities will have powers to take measures for the prevention of non-communicable diseases and emergent infectious diseases.
- Creation of Public Health Cadres- The proposed law provides the creation of public health cadres at national and state levels.
- Definition of Isolation, Quarantine and Lockdown- The draft Bill has defined several measures such as isolation, quarantine and lockdown, which have been extensively enforced by the Centre and states for Covid management.
- It defines a lockdown as “restriction with certain conditions or complete prohibition of running any form of transport” on roads or inland water.
- The definition of a lockdown covers “restrictions” on the movement/gathering of persons in any place whether public or private.
It also comprises “prohibiting or restricting” the working of factories, plants, mining or construction or offices or Educational institutions or market places. - Situation for Declaring Public Health Emergency-The draft lays down many situations in which “public health emergency” can be declared. They include,
- Bioterrorism,
- A natural disaster,
- A nuclear attack or accident,
- Appearance of a novel or previously controlled or eradicated infectious agent or biological toxin,
- A chemical attack or accidental release of chemicals,
Progress made by India-
- India has made significant progress in improving its health outcomes over the last two decades by eradicating polio, guinea worm disease, yaws and maternal and neonatal tetanus.
- According to the latest National Family Health Survey (NFHS)-5, social indicators like total fertility rate, sex ratio and health outcome indicators viz., infant mortality rate, under-five mortality rate, institutional birth rates have improved over year 2015-16.
- Increased Expenditure on Health- As per the recently published National Health Accounts (NHA) report for 2017-18, the government has raised the expenditure on health, reducing the Out-Of Pocket Expenditure (OOPE) to 48.8% in 2017-18 from 64.2% in 2013-14.
- It reveals that total public spending on health as a percentage of GDP has increased to a historic high of 1.35% of GDP breaking through the 1%-1.2% mark of GDP.
- Share of Primary Health Care- The share of primary healthcare in present Government health expenditure has increased from 51.1% in 2013-14 to 54.7% in 2017-18. Primary and secondary care accounts for more than 80% of the current Government health expenditure.
- Social Security Expenditure on Health- The share of social security expenditure on health, which comprises the social health insurance programme, Government financed health insurance schemes and medical reimbursements made to Government employees, has increased.
Challenges in Health Sector-
- Less expenditure on the health sector.
- Lack of awareness among the people.
- Lack of robust public health infrastructures such as hospitals, primary health centres.
- Shortage of number of Doctors and Specialists as per the population of the country.
- Lack of Private Sector Involvement.
- Expensive of Healthcare Insurance.
Way Forward-
- India’s health system requires more government funding for health. But, when it comes to Urban Local Bodies, this has to be a blend of incremental financial allocations supplemented by elected representatives showing health leadership.
- There is also need of multiple agencies coordinating with each other, increased citizen engagement in health, setting up of accountability mechanisms and guiding the process under a multidisciplinary group of technical and health experts.
- As the economic growth progresses, there is a need to supervise the population against the risk of spread of NCDs. Also, people must be made aware of the healthy life choices and benefits of active and fulfilling life.
- Incentivising R&D (Research and Development) by additional tax reduction to further support greater investments in new drug developments and reducing GST (Goods and Services Tax) on life saving and essential drugs.