Photo: Mint
Photo: Mint

Opinion | The private sector has a role in the success of Ayushman Bharat

A call for concerted action by various players in the sector to meet India’s healthcare challenges

The late monsoon, drought, flooding and increased vector-borne diseases and other infections—this has been a tough year for India’s public health system, which already faces numerous challenges. Nearly two-thirds of hospitals, three-quarters of dispensaries and four-fifths of doctors are located in urban areas, servicing less than a third of the country’s population. Vast rural areas have little or no access to healthcare. How can we bridge the gap?

The government’s answer is Ayushman Bharat. This aims for large-scale reform of the health sector, making it possibly the world’s biggest effort in expanding access to healthcare.

The key aims of Ayushman Bharat are to reach 107.4 million Indians, establish 150,000 health and wellness centres by 2022, provide affordable medicines, and promote digital health innovations.

Every part of Indian society, including the private sector, can support and strengthen these efforts and ensure that the government’s ambitions will produce results—even in times of emergency—for the betterment of the population, especially those belonging to marginalized communities or residing in remote areas. We need to be aware that these people are consumers, as articulated in the vision of business guru C.K. Prahalad: he noted that “businesses, governments and donor agencies should stop thinking of the poor as victims and instead be responsive to their needs, recognising them as creative, resilient and value-demanding consumers".

Through our health camps and health education sessions, which are part of our Arogya Parivar programme in India, we continue to see evidence of that. However, those with the lowest incomes will, given awareness and the availability of low-cost treatments and diagnostics, be willing to invest in their health. Tapping the potential at the bottom of the pyramid is one of the best investments the government and the private sector alike can make. There is strong evidence that investment in health, particularly for the poorest, boosts worker productivity and contributes to higher levels of prosperity and child survival. Good-quality health services fuel economic growth.

Consider the story of Maurya. He tours rural India and gathers villagers in chaupals (community spaces) to deliver talks on health. As an arogya shikshak, he shows them visual storyboards and tells them stories, pointing them in the direction of a doctor who offers free diagnostics. He recently visited Dhaurahra, a village over 100 km away from Uttar Pradesh’s capital, Lucknow. This village is at the heart of India’s carpet-making region, where illnesses from respiratory disease to parasitical infections are common. But in such a rural region, access to timely diagnosis and treatment, though imperative, was hard to come by.

Nearby was Dr. Sonali, a volunteer providing tests and treatment to villagers. She and Dr. Ajit, her husband, tour the region to perform this work, helping empower those who may never have seen a doctor before in their life. Villagers are able to take charge of their health, understand the signs and symptoms of disease, and get the right medical attention. This is truly an affirmation of C.K. Prahalad’s vision.

The story of Maurya, of Dr. Sonali and Dr. Ajit and of the villagers they meet, is the story of everyone at Arogya Parivar as we have grown exponentially over the last twelve years. We have gone from 2 states to 13, from 18 workers to over 600, from 10 cells nationwide to 300. The next stage is moving from reliance on conventional outreach to new and innovative solutions in digital health, with which we expect to reach 15 million people across India.

Their stories are the stories of the over 50 million we have reached with health education, including 7 million in 2018 alone, and the over 2.5 million people who have availed direct health benefits as the scheme has expanded. Thanks to this collaboration of different actors in public health and health reform, public and private sector, these millions no longer have to rely on quack doctors or untested, potentially dangerous remedies.

Recognition of how these models encapsulate the wider potential of public-private partnerships is especially pressing at a time when the Government plans to raise spending on health to 2.5% of GDP and is encouraging state governments to spend 8% of their budgets or more on health by 2020.

Now is the time for scaling up such public-private collaboration to maximize the efficient use of resources. The challenges will not be resolved overnight but meaningful strides can and will be made if the government and private sector recognize that they themselves—and, indeed, patients—have much more to gain if they collaborate on practical solutions. Companies that undertake such missions can fulfil both its goals of commercial growth and social service, proving that profit and humanitarianism are not mutually exclusive but intertwined.

Ayushman Bharat has very ambitious aims. Amplifying success and outreach should involve maximizing the pool of expertise and resources available, both within the public and private sector. All companies in the healthcare sector should be keen to be a part of this—using our talents to complement government efforts to make access to health a reality for all Indians.

Lokesh Kumar is country head, Novartis Social Business, India, at Novartis