Health Care for the Vulnerable Population
As mentioned earlier, approximately one-third of the people of our country, particularly living in the tribal, hilly and arid as well as feudal areas have a critical health status. Their health problems are very much associated with the issues of food security and underdevelopment. The health of this population is directly linked to their economic, social and political status. It is quite clear from the findings of all social development ministries that there is a need to think of a Sub-Plan for the vulnerable and deprived regions. Major thrust should be to help them reverse the situation through a well-planned, adequately financed community-oriented Integrated Health and Development Programmes with substantial participations from voluntary organisations. There has been several efforts in the Planning Commission in identifying these vulnerable areas.
| In some of the more critical areas of these vulnerable regions, the situation is not expected to improve permanently within the foreseeable future. |
Therefore, it is proposed that in these pockets, subsidised supply of basic staple food be introduced. Given the fact that our country has additional food grain lying in stock as well as the fact that similar approach has given extremely good dividends in Andhra Pradesh and Tamil Nadu, this should not be a difficult proposition. This will ensure food security and health security for the most vulnerable population of the country.
Health Impact of Developmental Projects
Many of the emerging health problems of rural areas are related to the development processes. It is essential to look at the health impact of these projects during planning. Incidence of pesticide poisoning, pollution and gradual degradation of ground water and emergence of malaria in desert areas are examples of some of the problems which are directly linked with developmental projects. We should ensure that health hazards of development projects are properly looked at before implementing them.
Similarly, serious efforts should be made to educate and diagnosis sexually transmitted diseases including AIDS in the rural areas. With the very large migration of workers from rural to urban areas, health problems from these diseases are gradually taking alarming proportions.
Success Stories
In the past thirty years, there has been a great improvement in tackling the problem of Leprosy. The lessons of this success should be utilised to mount similar attacks on other National Health Programmes. There should be sufficient financial allocations to ensure that the problem of malaria and TB are tackled substantially if not fully, within the next few years.
Drug Policy
The changes in the Industrial Policy 1991 and the advent of the New Liberalized Economic Policy resulted in the New Drug Policy of 1994, further spiralling drug prices and increase in drug imports, while the formulation of the Essential Drug List, withdrawal of irrational and hazardous drugs, provision of consumer caution, e.g. for drugs which have teratogenic effect and unbiased drug information are still to take place. Areas needing urgent attention are:-
- Formation of the National Drug Authority
- Application of the concept of Essential Drugs in public and private sectors.
- Formulation of Graded Essential Drug List for different levels.
- Provision of clear therapeutic guidelines to health professionals in public and private sectors on National Health Programmes e.g. TB, Malaria, STDs, rationalisation of drug purchase, drug distribution to primary health centres and subcentres through fair price drug outlets etc.
- Setting up of Adverse Drug Reaction Centres and the reporting of their findings.
- Conducting post-marketing surveys and studies on drug prescriptions and drug consumption patters related to specific health problems like TB and STDs.
- Monitoring and reporting of court cases related to sub-standard, hazardous and banned drugs.
