Context

• Health is an integral part of a prosperous society. India aims to become a US$ 5 trillion economy; therefore, it needs to take care of the health of every citizen. 
• Therefore, it is logical to reflect on the priorities of the health sector for India at 100 in 2047.  

Priorities of the Health Sector

• First, effective, timely and science-based communication is integral to health services. The Covid-19 pandemic has reminded us that misinformation is a major challenge for the health sector. 
  • Vaccine hesitancy and refusal and resulting lower vaccine coverage in some sections of the population has been some of the outcomes of misinformation. Mechanisms must be established to dispel any health misinformation in real time. 
• Second, Covid-19 has reminded us that vaccination is not just for children but also for  adolescents and adults. Apart from Covid, a few other vaccines such as hepatitis-B, meningococcal and pneumococcal vaccines can reduce diseases in adults. 
  • India now has an indigenously developed and low cost HPV (Human Papilloma Virus) vaccine which can protect adolescent age groups from cervical cancer and other conditions. 
• Third, Covid-19 has emphasised the importance of stronger health services and well-functioning primary health care services (PHC). The PHC services should be built around the people, where it is not just the treatment of disease but attention is on preventive and promotive services as well.
• Fourth, India has 11 diseases that are considered ‘neglected tropical diseases’, such as filariasis, kala-azar, snake bites, etc. which need higher policy and programmatic attention. It is time, sufficient investment is made in programmatic interventions, vaccines and medicine research and focus on public health interventions to tackle these diseases.
• Fifth, improve the health data quality and availability. Such data is useful for health decision making and for dispelling the myths and rumors. 
• Sixth, India has assumed the Presidency of the G20 for the year 2023. The country needs to play leadership in bringing and sustaining attention to the challenge of Antimicrobial Resistance, the coordinated global response to epidemics and pandemics, neglected tropical diseases and focus on ‘one health’ (health of humans, animals and the environment is related to each other). 
• Seventh, it is time to move towards stronger health systems, building upon the Ayushman Bharat Programme, and health and wellness centers initiatives. 
• Eighth, it is the time for a re-examination of the role of federalism in health policy. Health is a State subject in India, but there are many central policies and schemes that deal with various aspects of public health. It is time to deliberate in what ways cooperative federalism can be strengthened in the matter of public health. 
• Ninth, in the post-pandemic period health workforce availability and equitable distribution has to be the priority. 90% of the doctors are in the private sector and only one in ten doctors in the government sector. These have implications on the capacity of the government sector to deliver health services. 
• Tenth, the disease surveillance systems and public health measures need to be sustained. 
• Eleventh, malnutrition and anemia in women and children continue to be challenges. The National Family Health Survey-5 (NFHS-5) shows that despite decades of implementation of a range of schemes for women and children, malnutrition and anemia rates remain high, and the rate of improvement is very low. 
• Twelfth, the Mental Health and post and long Covid are two urgent post-pandemic health issues to be catered to. The National Mental Health Survey 2015-16 reported that one in every eight persons in India needed one or other form of mental health services. 
  • However, the issue was not recognized because of the stigma associated. Health services also need attention from the government for the post and long-covid especially through primary healthcare systems.  
• Thirteenth, India being a pharmacy to the world needs to assume responsibility and the government has to step-up investment in research and development on vaccines and therapeutics. 
  • This has become especially important for emerging and re-emerging diseases and many neglected tropical diseases, which affect low- and middle-income countries and are not a research priority for high income countries.