The statistics tell a grim story. India carries 20% of the world’s disease burden, according to data from the World Health Organization (WHO). About 75% of deaths globally are caused by communicable diseases, of which India accounts for 17%. A report published in May by British charity Oxfam says India records the highest number of maternal deaths in the world. Yet, India also is the third largest manufacturer of pharmaceuticals and according to PricewaterhouseCoopers (PwC) India’s monthly internal report for June, has the largest number of medical schools globally (381) and produces the most medical graduates each year (50,000).The reason for the dichotomy is simple: India lacks the financial resources required to reinforce its deficient healthcare infrastructure and improve its health indicators. Healthcare programmes are funded by government budgets, international aid and charitable organizations, but the money isn’t quite enough for a country of 1.25 billion people, two-thirds of whom live in the countryside, where the supply of medical care and the ability to pay for services is limited.“India spends only 5% of its gross domestic product (GDP) on health, of which government’s share is only 1.4%,” said Charu Sehgal, senior director at consulting firm Deloitte Touche Tohmatsu India Pvt. Ltd. “It is among the lowest in the world. And this low percentile automatically translates into inadequate infrastructure, limited medical technology as well as inadequate human resources in the healthcare continuum.” With government finances under pressure, requiring a tight rein on spending, and organizations such as the Bill and Melinda Gates Foundation increasingly channelling aid in the form of technical support rather than cash, can companies step in with corporate social responsibility (CSR) funds to fill the breach?No, according to Dhananjay Bakhle, executive vice-president of medical research at Mumbai-based drug maker Lupin Ltd.“The main challenge in this country’s healthcare machinery is the lack of infrastructure, which cannot be resolved with the use of CSR funds alone,” Bakhle said.Government budgets have not kept pace with population growth, and along with galloping demand for healthcare “has led to skewed access to healthcare in the country—leaving many diseases unattended”, Bakhle said.Logistically, only the government can reach the last mile in healthcare delivery, said Rani Desai, head of Biocon Foundation, the CSR arm of Biocon Ltd, the country’s largest bio-pharmaceutical company. “CSR funds will not bridge the existing gap of demand and supply in the healthcare sector,” Desai said.However, CSR funds can and are being used to encourage innovation in healthcare processes and medical devices to deliver healthcare in a portable, convenient and cost-effective way, she said.To be sure, many companies have undertaken healthcare-related CSR initiatives, from eye check-up camps organized by Coal India Ltd to health centres and camps held by ITC Ltd.Most such activities are restricted to their area of operations. Apollo Hospitals Enterprise Ltd, for instance, runs several charitable initiatives such as SACHI (Save a Child’s Heart Initiative), which aims to provide paediatric cardiac care and financial support to children from underprivileged families suffering from heart disease in its hospitals in Delhi, Chennai and other locations. But the group’s reach in rural areas is limited. This year, Apollo has adopted Thavanampalle mandal in Chittoor district of Andhra Pradesh to provide healthcare to 60,000 people. This CSR project, starting with a door-to-door survey, delivers mobile healthcare facilities to mitigate the effects of “non-communicable diseases and other health disorders”, said Deepa Reddy, vice-president, CSR, Apollo.Mumbai-based pharma company Abbott India Ltd says timely detection and awareness can help reduce a large number of deaths and that is the focus of its health-related CSR initiative.The company, in collaboration with the Indian Thyroid Society (ITS), is working on a “Making India Thyroid-Aware” campaign, which will explain thyroid disorders and related conditions, work on early detection and increase access to diagnosis. The initiative was launched in 2014.On the same lines, Lupin announced a tuberculosis detection programme as part of its CSR programme and tied up with the Mumbai Rotary club; it will hold 150 detection camps across Mumbai in 2015-16. “Based on the success of this, we will then take this initiative to other cities,” said Bakhle.While these are well-intentioned initiatives, those working in the healthcare sector are doubtful if CSR funds can help make a dent in India’s massive disease burden. They also doubt how serious firms are in their commitment to spend money for the spread of healthcare“In the past one year, we have approached at least a dozen companies every month but only two responded and are keen to fund our projects,” said Sandeep Ahuja, chief executive, Operation ASHA, a Mumbai-based non-profit that works in healthcare. Operation ASHA started in September 2006 with one tuberculosis treatment centre in a Mumbai slum and now has expanded to over 2,000 slums in India. It also has a presence in countries such as Cambodia that have a high incidence of tuberculosis.Public-private partnerships may be the way to go. CSR funds can help bridge the gap between healthcare supply and demand if “it is planned well, companies take on accountability as a priority so that technical expertise could be provided to government, support public-private partnerships”, said Padma Bhate-Deosthali, who works with the Mumbai-based Centre for Enquiry into Health and Allied Themes (CEHAT), which is involved in research, training, service and advocacy on health.And for these projects to have maximum impact, Bakhle of Lupin said, “the government needs to set up a sort of think tank which can put together a consortium with different stake-holders from the health sector in order to identify the key problems and adopt a strategic approach to resolving them”.Bakhle points out that the current CSR approach is scattered and too localized. Bhasker Iyer, vice-president of Abbott India, says CSR funds can be mobilized to support the healthcare system in two ways.“Strategic partnerships can strengthen diagnosis, treatment and care for patients; and community programmes can help to keep people healthier, which prevents visits to the doctor and hospital,” he said.Rana Mehta, leader of the healthcare practice at PwC India, envisages a strategic partnership among non-profits, the government and companies using CSR funds, but cautions that CSR funds aren’t a silver-bullet solution to India’s daunting healthcare challenges.“CSR is not a panacea to all ills—it can only act as a catalyst or complement government efforts,” Mehta said.