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Mainstream, VOL LVIII No 49, New Delhi, November 21, 2020

Health Budgets of Developing Countries in COVID Times | Bharat Dogra

Saturday 21 November 2020, by Bharat Dogra

Many developing countries including India had highly inadequate health budgets even before the COVID-19 phase. Now there are very critical questions of maintaining all essential health services and meeting all essential expenses in the middle of new difficulties brought by the pandemic.

In this situation a statement made by Adar Poonawalla, CEO of the world’s largest vaccine producer Serum Institute on September 26 attracted a lot of attention. ( This manufacturer has tie-ups with global manufacturers for potential COVID 19 vaccines). He stated— Quick question; will the government of India have Rs. 80,000 crore, over the next one year ? Because that is what Ministry of Health and Family Welfare of India needs to buy and distribute the (Covid) vaccine in India.

In a seperate but related statement, Poonawalla told the Times of India , “ The government has assured that there will be plenty of funds available for vaccines. We have now been assured by the highest levels in the government that enough funds will be available for vaccine procurement, supply and logistics.” ( The Times of India September 27)

To place the figure of Rs. 80,000 crore mentioned by the CEO in perspective, however, it needs to be added that the total budget of the Union Ministry of Health and Family Welfare and the Ministry of AYUSH ( the two figures together make up the total health budget of the Union Government) was Rs. 66,466 crore in 2019-20 ( Revised Estimate). During the last seven years this total health budget of the Union Government has ranged between Rs. 35,189 crore ( actual expenditure in 2015-16) to Rs. 69,234 crore ( Original Budget Estimate for 2020-21 given at the time of the presentation of the budget).

On September 30 the Times of India quoted the health secretary of the government of India as stating, “ We do not agree by the calculation of Rs. 80,000 crore.” He also stated that the government has enough funds to meet actual needs related to the Covid vaccine.

On October 4 the Hindustan Times reported quoting government officials who are familiar with the matter, “ The officials, who had asked not to be named, added that much of India’s vaccine plan will be funded by the state and cost around Rs. 50,000 crore.”

Hence estimates ranging from Rs. 50,000 crore to Rs. 80,000 crore for only COVID vaccine related expenses of the government are being talked about in a country where the total Union government health budget has been of around Rs. 67,000 crore till the last year.

Now as is well-known very serious lack of funds for meeting urgent health needs of people have been discussed in recent years. To give just one example, according to the government’s own data for 2018, 82 per cent of the posts for specialized doctors in Community Health Centers in India ( 94 per cent in U.P.) , crucial for meeting health needs of villages and small towns, have been vacant. This is just one example. There are so many glaring unmet health needs of people crying out to be met and it is only to be expected that demands for raising the health budget have been accompanied during recent years by demands for correct prioritization and increasing allocations for the most urgent but unmet needs of health care.

Now suddenly in the COVID phase it appears that demand for raising health budget will be fulfilled but the increase will be only or mainly for Covid related expenses, concentrated mostly on Covid vaccine, while other urgent needs emphasized for several years may remain unmet or may even face budget cuts. In this hurry some hard facts should not be ignored. Senior scientists have raised serious issue regarding efficacy of Covid vaccine which may not provide more than 50 per cent protection. Safety of a vaccine developed in great hurry , one year in place of the normal ten years, has been questioned by several senior scientists, in terms of ADE ( Antibody Dependent Enhancement ) and for other reasons.

Completely independent health experts , entirely free from conflict of interest, should therefore come forward to suggest how best developing countries like India should proceed in terms of making the best possible use of their health budgets in difficult times. Unless adequate caution is exercised, very massive misallocation of resources can take place in the coming days which can further badly aggravate the health crisis of several developing countries.

(The writer is a freelance journalist who has written extensively on health and budget related issues.)

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