NEW DELHI: Pointing out that the union government’s spending on health has continued to decline in the post-Covid period, as a percentage of GDP and in terms of its share in total expenditure, a network of 350 organisations and individuals have demanded that the health budget be at least doubled this year. A statement issued by this network on Wednesday pointed out that though the National Health Policy had promised public spending of 2.5% of GDP on health, it has remained alarmingly low at 1.15%.“Government’s own commitment in the national health policy of 2017 was that 40% of public expenditure should be the Union government’s responsibility. This translates to 1% of GDP or Rs. 350,000 crore at today’s prices. That’s what we expect the Union budget to commit,” said Ravi Duggal, Sociologist, health researcher and activist.Development economist and social activist Jean Dreze said that India is one of the world champions of public under-spending in healthcare. “For decades, public expenditure on healthcare has hovered around 1% of GDP, compared with an average of 3% in developing countries today. The result of this accumulated under-investment is a huge deficit in public health facilities. Universal health care cannot be achieved without a serious effort to address this deficit and transform healthcare standards in the public sector,” said Dreze. He added that even if India were to achieve the target of 2.5% for public spending on health, it would be among low-income countries that spend the least.Public health expenditure, 2022
| Region | As % of GDP | As % of health exp |
| India | 1.3 | 39 |
| Sub-Saharan Africa | 2 | 41 |
| East Asia & Pacific | 2.8 | 55 |
| Middle East & North Africa | 2 | 42 |
| Latin America & Caribbean | 4 | 52 |
| Europe & Central Asia | 2.9 | 60 |
| European Union | 8 | 77 |
“Public spending on health in India continues to be abysmally low compared to many countries. For instance, Bhutan’s per capita spending on health was 2.5 times more than India’s, while Sri Lanka’s was three times in 2021. All the other BRICS nations spent per person 14-15 times more on health than India does. Thailand, Malaysia spend at least ten times more per capita on health than India,” said a statement issued by Jan Swasthya Abhiyan, a network of organizations and individuals working on health.“Union government spending on health has continuously declined in real terms, making it impossible for the NHP 2017 goal to be realised by 2025. At least two-thirds of the Union Health Budget should be transferred to states, given that the states bear two-thirds of the total burden of public health expenditure. There should be greater proportion of untied or flexible funding for states to enable them to plan and execute their priorities on health,” said Indranil, Co-convener, JSA National Secretariat.Public expenditure on health as a percentage of GDP
| Region | 2010* | 2022 |
| India | 1.2 | 1.3 |
| Sub-Saharan Africa | 2.9 | 1.9 |
| East Asia & Pacific | 2.5 | 2.8 |
| Middle East & North Africa | 2.9 | 2 |
| Latin America & Caribbean | 3.8 | 4.1 |
| Europe & Central Asia | 3.8 | 4.2 |
| European Union | 8.1 | 8 |
*Developing countries only (except last row)“The harshest cuts are hitting programmes that strengthen the public system— National Health Mission (NHM), Pradhan Mantri Swasthya Suraksha Yojana (PMSSY), nutrition, and research—despite their value in hard times. NHM funds have declined in real terms by 5.5% on average. Even within limited allocations, the thrust continues towards private partnerships and insurance-basedmodels such as PMJAY,” said Richa Chintan, also Co-convener, JSA National Secretariat.
