By Dhurjati Mukherjee
India’s large population—about 30–35% of whom live at or near the poverty line—needs strong healthcare prioritisation. However, governments have long neglected this sector, leaving many rural and underprivileged health centers without sufficient staff or basic equipment like operational X-ray machines. A thorough examination of the recent Budget is necessary to determine if the government adequately addresses the essential needs of the population.
Prior to the Budget, the Jan Swasthya Abhiyan (JSA) stated the Centre’s health spending had stagnated at 0.29% of the GDP. It noted the central health outlay must rise at least 1% of the GDP for the country’s total public health spending, including that of states, to reach 2.5%. This requires the health allocation to increase to about 350,000 crore from roughly 100,000 crore in 2025-26. “We’re asking for at least a doubling of the Centre’s outlay for health to something like `200,000 crore for 2026-27”, said Indranil Mukhopadhyay, a health economist and JSA co-convenor.
At the same time, note that economist and social activist John Drèze has pointed out that India’s public expenditure on health stood at just 1.3% of the GDP, lower than 1.9% of sub-Saharan Africa, 2% in West Asia and North Africa, 2.8% in East Asia, 4.1% in Latin America and 8% in the European Union.
A dedicated `10,000 crore five-year programme has been allotted in the Budget to the bio-pharma sector to develop the country as a global manufacturing hub through Biopharma SHAKTI, which is welcome. Additionally, there’s a proposal to set up NIMHANS-II at Ranchi designed specifically for mental health and trauma care. But why just one? The government is placing particular emphasis on Ayurveda, planning to establish three All India Institutes and upgrade Ayurveda pharmacies. This initiative, it’s hoped, shall benefit the public.
While the reduction in prices for 17 cancer drugs and import cuts on treatments for rare diseases, alongside the promotion of medical tourism, may represent progress, these measures do not sufficiently address the needs of the general population, particularly those in lower-income segments who continue to face barriers to adequate healthcare and must often travel significant distances for specialized services. In a populous country such as India, there is a clear need to focus on rural and underdeveloped districts. Expectations existed that plans would be announced to establish 50 to 100 specialty hospitals within the next three to five years; however, no such initiatives were mentioned by Sitharaman. Furthermore, it is notable that the Health Mission’s allocation of `39,390 crore for strengthening primary healthcare, maternal and child health services, and disease control programmes appears insufficient to meet the actual demand in a nation of this size.
However, the `1.06 lakh crore allocation in the Budget, reflecting a 6% increase over the revised estimates of the current fiscal, may sound optimistic, but such an increase doesn’t have any meaning when considered with inflationary conditions. Health economists have calculated that the increase is in fact a decline in the government’s share of health expenditure from a stagnant 0.28% of India’s GDP over the past five years to an estimated 0.27%.
Is this adequate keeping in view the needs of the impoverished and marginalised sections, deprived of affordable healthcare?
It is indeed tragic that India’s low spending on public health has, over the past two decades or so, been acknowledged by successive governments, but very little has been done by way of increasing allocation.
It was expected that the Budget would substantially increase allocation and help in setting up at least one centrally funded hospital in each district, to start with the backward ones. But no such measures have been announced so far. Amends do need to be made.