!

Content 

India&Healthcare&Bulletin&&

 An initiative towards better healthcare access in India

(www.indiahealthprogress.in) &

A!Monthly! ! ! ! ! !!!!Volume!XXVII,!Issue!9.!Nov!2012!!

Page%1%

Edit!Speak!by!

Aman!Gupta!

Page%2%

YK!Gupta:!It!is!time!to!

take!a!quantum!leap!in!

healthcare!

Page%3%

Dr!Arvind!Lal!

emphasizes!on!

quality!diagnosis!

Page%4%

Utilising!the!

potential!of!the!

pharma!industry!

Page%5%

More!spending!essential!

to!push!health!reforms!

on!fast!track!

!

 

Page%3+4%

Advocating!the!

case!of!the!

patient!

Page%5+6%

Forging!ahead!towards!

ensuring!universal!

access!to!healthcare!

!

EDIT+SPEAK%

Health%Reforms:%Let’s%Talk%Solutions%Rather%than%Hurdles%!

Health!care!in!India!faces!multifarious!challenges!not!only!in!the!form!of!inadequacy!of!infrastructure,!facilities!and!human!resource!but!

also!access,!outreach!and!consistency.!As!we!move!closer!to!the!end!of!another!year,!lack!of!reforms!in!the!healthcare!sector!resonates!as!

earlier.!Once!again,!we!are!left!with!more!problems!than!solutions!to!the!glaring!larger!issue!of!healthcare!access.! Paradigm!shifts!are!

required!to!beget!a!transformation!in!the!approach!towards!health!care!in!the!country,!such!that!we!begin!taking!wellthoughtof!steps!

towards!managing!the!issues!rather!than!just!identifying!them!and!finally!achieve!the!goal!of!universality!along!with!quality.!Sustainability!

of!these!efforts!is!essential!and!therefore!we,!at!India!Health!Progress,!robustly!support!continuum!of!access!to!health!care!and!ensuring!

availability! of! the! required!resources! and! infrastructure! to! each! individual.!This! requires! collaborative! action! from!every! stakeholder!

attached!to!healthcare!delivery!–!be!it!doctors;!diagnostic!centres;!patient!groups;!nursing!and!medical!staff;!various!healthcare!service!

providers;!insurance!sector;!the!pharmaceutical!industry;!industry!bodies;!NGOs;!academia;!Government!–!at!the!state!and!central!level;!

and!the!media.!

!

With! 18%!people! in!rural!areas!and!10%!in! urban! receiving!no! health!care!at! all,! the!case!for! health!system!reform!and!defining!the!

solutions!to!the!problems!as!well!as!the!role!of!each!stakeholder!couldn’t!be!stronger.!Acting!as!a!catalyst!and!a!platform!for!each!part!of!

the!Indian!healthcare!pie!to!discuss!the!course!of!conduct!in!their!area,!the!IHP!Roundtable!held!on!3rd!November!2012!mooted!the!way!

forward!in! formulating! a! roadmap!to! achieve!the! common!goal.! IHP!recognised!four!major! areas! –! Infrastructure,!Human!Resources,!

Finance!and!Drug! Availability! ! in!which! challenges! exist.!Outlining! the!ways! to! overcome!them,! brainstorming!was!done! in! several!

aspects! of! these! areas,! including! role! of! diagnostic! centres! in! prevention! of! diseases! apart! from! detection;! patient! advocacy! for!

strengthening!patient!voices;!technology!and!innovation!as!key!drivers;!the!issue!of!lack!of!medicines!as!well!as!ensuring!quality!of!drugs;!

responsibility!of!the!media!in!educating!the!masses;!public!private!collaborations!for!more!outreach!and!fighting!the!problem!of!finances;!

and!the!importance!of!the!global!pharmaceutical!industry!in!leveraging!sustainable!initiatives.!!!!!!!!!!!!!!

!

The! Government! –! not! just! the! health! ministry,! but! also! others! such! as environment,! urban! development! and! human! resource!

departments!!has!to!take!up!prevention!of!illnesses!as!a!huge!cause!by!addressing!lack!of!basic!infrastructure,!including!potable!water,!

sanitation! and! housing,! as! well! as! inadequate! delivery! systems! like! primary! healthcare! setups! and! diagnostic! centres.! Apart! from!

extending!public!services,!encouraging!the!public!private!model!is!immensely!vital!for!successful!rollout!and!implementation!of!universal!

health!care!in!the!country.!!!

!

Augmenting!the!number!of!medical!personnel!and!empowering!them!by!way!of!better!training!and!skill!development!can!resolve!one!of!

the! biggest! challenges! the! Indian! healthcare! industry! faces! –! that! of! human! resource! development.Increasing! public! expenditure,!

enhancing! the!penetration!of!insurance!schemes,!extending! their!mandate!to! include!medicines,! and!moreover!effective!utilisation!of!

available!funds!are!required!to!accelerate!easy!availability!of!finance.!Introduction!as!well!as!implementation!of!innovative!schemes!such!

as!Rashtriya!Swasthya!Bima!Yojana!must!assist!in!this!regard.!!!!!!!!!!!

!

Moreover,!the!pressing!issues!of!irregular!drug!supplies!and!poor!delivery!channels!for!outreach!require!improved!distribution!channels!

so!that!branded!and!generic!drugs!are!easily!obtainable.!!

!

Achieving!all!this!requires!a!collaborative!approach,!in!which!each!and!every!stakeholder!contributes!and!allies!with!others!in!the!field!to!

make!access!to!health!care!a!reality.!Without!such!cooperation,!our!efforts!will!go!in!vain.!!!

!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!"Aman"Gupta,"Principal"Advisor,"IHP !

 

It’s%time%to%take%a%quantum%leap%in%healthcare%

Dr%Y%K.%Gupta,%All%India%Institute%of%Medical%Sciences%

!

A!few!things!have!to!be!considered!about!access!to!health!care!in!the!Indian!perspective.!The!scenario!of!US!and!European!countries!is!

very!unlike!India,!with!different!socio!economic!situation,!education,!myths!and!perceptions.!Moreover,!the!Indian!economy!is!at!a!good!

stage!now!and!therefore!this!is!the!time!when!we!can!take!a!quantum!leap!in!the!healthcare!sector.!!

!

For!a! country!like!India!with!health! issues!as! diverse!as!diabetes,! hypertension!and! reemergent!illnesses!

such! as!malaria,! kalaazar,! dengue,! H1N1! and! even! simply! diarrhoea,!we! cannot! think! of! anything! else!

unless!we!adopt!high!technology.!And!this!technology!will!only!provide!an!answer!to!reach!not!only!to!the!

metro!cities!but!also!to!the!remotest!area!where!nothing!is!available.!The!preventive!aspect!of!health!care!is!

very!important!but!not!enough!money!has!been!invested!on!prevention.!Across!the!country,!the!type!of!

hygiene!that!we!have!accustomed!to!is!horrible.!That!requires!a!change!of!mindset!!not!only!at!institutions!

but!also!at!the!grassroots.!!

!

The!second!aspect! is!positive! health!promoting! !once!you! have! achieved! that!positive! health! it! is! very!

important! to!maintain! that! health,!particularly! if! you!are! becoming! aged! or! you!are! exposed! to!environmental! pollution.!Therefore,!

lifestyle!management!is!important.!That!is!why!the!philosophy!of!ayurveda,!yoga!and!meditation!is!considered!the!wealth!of!India!which!

is!now!being!adopted!by!the!US!and!European!community.!I!think!that!has!to!be!scientifically!validated,!upgraded!and!taught,!and!a!huge!

investment!in!the!right!method!should!be!done!into!that.!!

!

The!third!aspect!is!the!diagnostics.!Once!you!have!suspected!disease,!the!most!important!thing!is!that!one!has!to!have!an!accurate!and!

fast!diagnosis!so!that!you!can!start!the!treatment!in!the!right!direction!rather!than!being!at!an!empirical!stage.!What!you!need!today!is!

quality! diagnosis.! Quality!means! that! you! need! to! have! a! standard!operative! system,! Quality!Assurance/Quality! Control! as!well! as!

accreditation! of! laboratories.! The!main! thing! is! that! the!diagnosis! should!be! affordable.!We! have! to!develop!a! system!of! affordable!

diagnostics!and!point!of!care!diagnostics.!!

!

India!is!one!of! the!largest!manufacturers!and!exporters!of!vaccines!in!the!world.!But!today!the!question!is:!Can!we!develop!a!vaccine,!

which!is!multivalent,!that!can!cover!large!number!of!infections!and!be!given!as!one!shot!so!that!the!compliance!becomes!much!easier?!

The!Department!of!Biotechnology!has!a!huge!programme!for!the!development!of!vaccines!in!India!and!several!new!investigative!drugs!

are!being!submitted!for!these!vaccines!like!rotavirus!vaccine,!malaria!vaccine!and!many!more.!

!

The!drug! issue!or!the!medicine!issue!is! another!one.!Today,!we!are!not! only! selfsufficient!in!medicine!but!also!a!major! exporter!of!

medicine.!The!issue!is!the!quality!of!medicine!and!for!that!we!need!to!have!a!system!that!can!quickly!identify!what!is!the!good!quality.!

The!reason!is!that!we!do!not!even!know!the!extent!of!substandard!medicine!in!India.!Another!important!thing!is!that!we!do!not!have!the!

capacity!also!in!India!to!quickly!identify!the!standard!of!medicines.!!

!

Lastly,!the!mindset!and!the!attitude!of!the!prescribing!doctor,!the!patient,!the!paramedics,!the!public!and!the!media!about!the!use!of!

medicine!are!vital.!It’s!the!general!belief!that!the!branded!is!a!pure!drug,!a!safer!drug,!whereas!with!the!generic!drugs!there!is!a!may!be!

attached.!This!myth!does!not!develop!overnight,!it!develops!because!of!the!experience!of!the!people!which!gets!propagated!rightly!or!

wrongly!and!not!negated!because!of!the!lack!of!evidence.!!

!

We!did!a!project!with!Jan!Aushadhi!and!analysed!about!1,600!samples!of!Jan!Aushadhi!from!all!the!centres!of!pharmaceutical!project,!

and!not!a!single!drug!was!sub!standard.!Now!this!is!what!needs!to!percolate!!that!a!drug!which!is!cheap!and!generic!not!necessarily!

means! it! is! of! poor! quality.! And! this! needs! to! be! propagated! as! there! is! a! tremendous! pressure,! including! monetary,! media! and!

advertising.!But!there!is!also!reason!to!believe!that!the!treating!physicians!have!experienced!a!few!samples!of!generic!medicines!become!

ineffective,!and!then!the!confidence!shakes.!Therefore,!this!shift!has!to!take!place.!!

!

Finally,! all!these! issues! ! from!the! sensitisation! of! the!public,! awareness! of! all! these! sectors,!creating! technology! to! reach!masses,!

implementation,! creating! rules! and!regulations!and!enforcing! them!at! different! places!staring!from!manufacturing! process!to! quality!

control!to!prescribing!to!punishment!if!there!is!a!perilous!drug!!require!what’s!known!as!a!shake!hand!approach.!!

!

Shake!hand!approach!means!that!it! has!to!be!not!only! the!responsibility! of!the!government! alone.!So! regulator,! government,!media,!

educated!and!uneducated!people,!leaders!in!the!villages!and!panchayats!need!to!come!together.!The!blame!game!must!stop.!The!shake!

hand!approach!is!the!answer!and!technology!is!the!medium.!!!

Draw%a%Preventive%Model%with%Emphasis%on%Quality%Diagnosis%

 

(Hony)%Brig%Dr%Arvind%Lal,%Padma%Shri,%Chairman%&%Managing%Director,%Dr%Lal%PathLabs !

!

Over!the!years,!the!healthcare!scenario!in!India!has!mostly!focused!on!combating!communicable!diseases!such!as!tuberculosis,!AIDS!and!

other! infectious! illnesses! that! take! a! heavy! toll.! Only! recently,! the! importance! of! curbing! the! near! epidemic! situation! of! non

communicable!diseases!(NCDs)!has!come!to!the!fore.!!

!

The!incidence!of! NCDs!is! increasing!at!an! alarming!rate!in! the!country,!with! 61.3!million!people!living!with! diabetes,! nearly! 550,000!

cancer!deaths!in!a!year,!and!65!million!Indians!likely!to!be!affected!with!heart!disease!by!2015.!!

!

In! such!a! situation! also,! owing! to! a! highly! fragmented! diagnostic! industry,! diagnosis! as! a! tool! of! prevention!of! diseases!is! not!used!

effectively!in!India.!When!70%!of!clinical!decisions!–!causes!of!illnesses!starting!from!fever,!indications!for!surgery,!patient!admission!or!

discharge!!are!based!on!lab!tests,!it!becomes!essential!to!have!faster!diagnosis!resulting!in!reduced!hospital!stay.!!

!

The! scientific!management!of! a! disease! is!possible!only! after! correct!diagnosis! with! tests! and! this! also! leads! to!huge!cost! saving! in!

healthcare!expenses!and!spending!on!drugs.!!

!

The!suffering!caused!by!many!diseases!can!be!reduced!by!detecting!early!changes!in!the!body!with!the!help!of!diagnostic!tests.!A!host!of!

diseases!can!be!prevented!and!their!complications!avoided!with!maintenance!of!various!parameters!in!the!body.!!!!!!!!!!

!

In! diagnosis,! like! everything!else,! accessibility,!affordability! and!quality! are!the! three!main! challenges.!Labs! or! collection! centres!are!

missing! from!scores! of! Indian! villages! with! almost! nil! infrastructural! support! in! the! form!of! roads,! electricity!and! water.!Moreover,!

diagnostic!tests!are!quite!expensive!–! leading!to! lack!of! access!and!causing!more!disease.!Dearth!of!skilled!medical! professionals!and!

weak!governmental!regulations!causes!unrestricted!proliferation!of!substandard!diagnosis!in!the!country.!!!!!!

!

A!hightech!hub!and!spoke!model!with!large! test!menus!at!the! centres!as!well! as!stateoftheart!design!and! implementation!of! best!

practices! are! the! solution! to! these! issues.! Good!quality!pathology! education! with! highlevel! training! of!medical! or! paramedical! lab!

personnel! can! also,! moreover,! assist! in! better! services.! With! reasonable! prices,! allround! accreditation! and! tighter! government!

regulation,!proper!basic!tools!of!disease!detection!can!be!made!available!to!all.!

!

Public!Private!Partnerships!must!be!nurtured!both!in!operating!labs!and!training!personnel.!A!greater!adoption!of!technology!as!well!as!

more!research!and!development!are!the!need!of!the!hour.!Ideally,!diagnosis!should!also!be!included!in!health!insurance.!!

!

Such!measures!will!place!diagnosis!as!a!preventive!modality!in!health!care,!apart!from!being!a!basis!for!!

medical!decisions!post!illness.!"%

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Advocating%the%Case%of%the%Patient%%%%Ratna%Devi,%Independent%Expert%on%Public%Health%

!

The!enduser!in!the!healthcare!scenario!is!the!patient!and!he!should!be!the!focus!of!any!discussion,!recommendation!or!policy!regarding!

access!to!medical!facilities.!Support!to!the!cause!of!patients!to!receive!correct!diagnosis!and!timely!as!well!as!costeffective!treatment!for!

any!disease!on!the!face!of!the!earth!is!the!need!of!the!hour.!!!

!

A! very! important! aspect!that! is!often!not!included! in!continuum!of! care! is!psychosocial! support!required! by!a!patient!of! a! lifelong!

illness.! Patients!with!paralysis,!cardiac!event!or! those!who!have!got! amputated!after!diabetes!would!need!such!kind!of! support.!This!

includes!rehabilitation!and!livelihood!opportunities!for!medication!continuation!and!to!sustain!regular!life.!!!

!

The!preventive!and!accountability!aspects!have!to!involve!each!individual,!community,!care!providers!and!Government!at!all!levels.!!

!

There! is! also! a! need!for! more!patient!voices!in! getting!access! to! health.!Patient!welfare!groups! are!present! but! fewer! patients!are!

involved!in!these.!Patient!involvement!is!a!must!for!disease!prevention!and!early!treatment.!Moreover,!prevention!is!still!not!understood!

as!an!important!aspect!by!the!people.!There!is!an!intervention!only!when!there!is!a!major!health!incident.!This!disappointing!reality!has!

to!be!changed.!

!

 

One!of!the!most!successful!patient!advocacy!groups!in!terms!of!awareness!generation!has!been!for!AIDS.!For!other!diseases,!including!

rare!illnesses,!such!groups!are!started!with!a!small!group!of!patients,!their!relatives!and!physicians!but!they!need!to!be!lent!more!support!

and!expanded!by!registering!them!under!a!national!registry.!!

!

In!the!case!of!diseases!such!as!diabetes!and!renal!illnesses,!women!self!help!groups!have!been!able!to!spread!word!at!the!community!

level.!Village!health!committees!have!also!come!forward!in!this!regard.!But!surely;!more!activities!can!be!done!at!the!school,!village!and!

community!levels!for!wider!dissemination!of!knowledge.!!!!

!

What!works! is! a! belief! in! the!cause.! Advocacy! for! the!cause! by! famous! personalities,! political! affiliation! and!commitment! from!the!

physician!community!also!help.!!

!

Though! challenges! such! as! difficulty! to! mobilise! people! into! groups;! lack! of! funding! and! resources! for! group! activities;! lack! of!

commitment!from!government!and!other!agencies;!and!the!perennial!problem!of!India’s!size!in!area!and!population!do!exist,!a!focused!

approach!as!well!as!concerted!effort!can!assist!patient!groups!trying!to!create!awareness!and!gather!support.!!

!

***!

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Utilize%the%potential%of%the%pharma%industry%Mr%Ranga%Iyer,%Advisor,%India%Health%Progress% and%Ms%Amiee%Adasczik,%Assistant%Vice%President,%PhRMA !

!

It!is!increasingly!being!recognised!now!that!just!as!joint!efforts!are!required!in!every!area!of!development,!

the!health! sector! too!needs! to!benefit! from!the! public!private!partnership!model.! In! this! context,! the!

pharmaceutical!industry!–!both!local!and!global!–!can!act!as!a!strong!supporter.!Not!much!is!known!about!

the!work!actually!being!done!by!the!pharmaceutical!companies!and!their!contribution!to!the!healthcare!

sector.!While!they!do!try!and!meet!the!unmet!medical!needs!of!a!lot!of!people,!by!not!only!promoting!

medicines,!but!by!innovating!and!introducing!newer!drugs,!there!is!a!huge!vacuum!that!still!needs!to!be!

filled!–!a!space!which!can!be!occupied!and!filled!by!the!sector.!!

!

The!pharmaceutical!sector!plays!a!very!different!role!in!its!own!capacity!in!very!specific!areas.!For!example,!Arogya!Parivar!supported!by!

Novartis!has!a!social!programme!to!reach!out!to!the!rural!masses!by!way!of!drugs!and!vaccines!for!various!illnesses.!Patient!education!

and!local!capacity!building!are!a!part!of!the!initiative!to!make!it!a!sustainable!effort.!Similarly,!global!companies!like!Sanofi,!Pfizer!as!also!

their!Indian!counterparts!have!their!own!such!initiatives.!There!are!several!individual,!expansive!and!clear!access!programmes!being!run!

by!companies;!though,!they!may!not!be!collaborated,!coordinated!or!well!organised!for!people!to! know.!Despite!this,!there! is!a!huge!

access!gap.!!

!

The!need!of!the!hour!is!PPP!–!a!clearly!defined!model!which!states!the!role!each!one!would!play.!Similarly,!examples!of!the!BOT!(Build

OperateTransfer)!model!used!elsewhere!can!also!be!identified!and!replicated!here.!That!said,!the!government!must!also!capitalize!on!

the!efficiencies!of!the!private!sector!with!the!latter!making!an!effective!use!of!the!expansive!network!support!that!the!government!can!

offer.!Such!joint!efforts!could!go!a!long!way!in!paving!the!way!for!better!healthcare!accessibility!in!the!country.!!

!

The! global! pharmaceutical! industry!can! also! help! in! enhancing! disease!awareness! both!at! the!patient!and!physician! levels!with! the!

immense!knowledge!it!possesses!in!the!areas!of!screening,!awareness,!diagnostics!and!treatment!protocols.!Parallely,!the!industry!could!

bring!forth!best!practices!that!could!be!further!customized!to!meet!specific!needs!in!the!Indian!context.!!

!

Another!area!where!the!pharmaceutical!industry’s!capacity!can!be!utilised!is!technology!–!technology!to!reach!the!masses,!the!patients!

and!doctors!–!introduce!seamless!communication!for!ensuring!greater!awareness.!In!addition,!newer!ways!can!be!developed!to!provide!

greater! thrust! to! the! aspect!of! awareness! creation.! For! example,! pharmaceutical! companies! can!partner!with! pharmacy!colleges! to!

devise!ways!for!countering!issues!related!to!spurious!drugs!other!than!developing!anticounterfeit!technologies.!!

!

It!is!essential!to!explore!opportunities!and!options!and!derive!on!the!strengths!of!all!stakeholders!to!make!way!for!a!seamless!healthcare!

system!in!India.!!

!

***!

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More%spending%essential%to%push%health%reforms%on%the%fast%track%

 

Edited"excerpts"

Vishal%Gandhi,%Managing%Partner%&%CEO,%BioRX%Venture%Advisors%Pvt.%Ltd%

Pervez%Ahmed,%Founder%Chairman%&%Managing%Director,%Apka%Urgicare%Pvt%Ltd.%

!

There! is!no!escaping!the!fact!that!more!investment!is!needed!to!make!universalisation!of! health!care!a! reality.!It! is!important!for!the!

government!to!formulate!the!right!policies!that!are!really!conducive!to!further!investment.!In!the!case!of!public!private!partnerships!also,!

there!is!a!need!to!find!why!they!haven’t!worked!yet,!as!PublicPrivate!is!the!future!as!far!as!the!health!industry!is!concerned!–!be!it!in!the!

area!of!medicines,!vaccines,!diagnostics!or!other!allied!areas.!A!structure!that!is!favorable!for!a!more!operational!role!for!private!players!

is!required.!Nonaffordability!of!diagnostics,!drugs!and!treatment!costs!is!one!of!the!major!hurdles!in!reaching!out!to!the!masses.!While!

the!government!has!a!social!responsibility,!the!corporate!sector!has!to!survive.!And!while!for!the!latter,!sustainability!means!profitability,!

it!should!not!be!allowed!to!affect!the!affordability.!!

!

Similarly,!insurance!options!are!limited!with!lack!of!general!awareness!of!governmental!schemes.!The!number!of!people!under!health!

insurance! cover!has! to!be! drastically!increased.!Apart! from!more!public!expenditure!on! health!care,!the!question! is!also!of! allocating!

funds! to! various! areas! that! are! lacking! in! reform.! Noncommunicable! diseases! and! their! prevention! is! one! such! area.!Moreover,!

sustainability!of!good!quality!medical!services!can!only!be!achieved!when!they!are!also!economically!viable.!Transparency!in!investment!

and!utilisation!of!funds!is!also!an!important!factor.!!

!

Economic!viability!is!an!important!component,!basis!which!any!policy!or!partnership!should!be!based!so!that!these!are!a!success!in!the!

long!term.!!!

!

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Forging%ahead%towards%universal%access%to%healthcare%Recommendations%of%the%panel%at%the%roundtable%hosted%by%India%Health%Progress%

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Finally,!we!reach!a!point!where!we!understand!various!insightful!ways!to!promote!healthcare!access!in!the!country!with!concerted!and!

cooperative!efforts!of!all!stakeholders!involved.!Large!awareness!generation!campaigns!and!programmes!can!not!only!benefit!the!poor!

and!mobilise!communities!in!the!fight!against!diseases;!it!will!also!help!increase!the!levels!of!health!literacy!in!the!country!for!prevention!

as!well!as!proper!treatment.!So!while!we!talk!about!preventive!measures,! the!need!is!to! ensure!early!education!–! right!from!primary!

schooling!system!!that!inculcates!practices!of!good!hygiene!and!cleanliness.!Furthermore,!a!preventive!model!must!answer!the!question!

of!how!to!spend!money!assigned!to!various!areas!such!as!noncommunicable!diseases.!!

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One!major!factor!that!needs!to!be!emphasized!on!is!human!resource!development!in!the!field!of!medical!services!across!multiple!layers!

 –! be! it! nurses,! paramedics,! chemists,! counselors! or! others.! There! is! an! urgent! need! of! having! more! medical! professionals! who! are!

competent! and!capable! of!handling! various! situations.!They!must!also!be!empowered!both! in! terms! of! training! and!skills!as!well! as!

decisionmaking.!Moreover,!without!technology,!a!country!where!accessibility!of!most!things!is!an!issue!cannot!be!successful!in!any!area.!!!

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It! has!been understood! that! any!kind! of! delivery! of! services!has! to!be! sustainable!and! it!will! be!possible!by! involvement!of!private!

players.!The!clout!of!the!private!sector!must!be!used!to!strengthen!the!economic!viability!of!services.!!

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Pricing! and!quality!of! drugs,! diagnostics! and! treatments! have! to! be! considered! simultaneously! so! that! more!and!more!people! feel!

confident!to!take!advantage!of!the!health!facilities.!There!is!also!a!need!for!the!media!to!play!a!much!larger!role!in!highlighting!and!

creating!awareness!about!prevention!of!diseases,!especially!those!related!to!lifestyle!and!communicable!diseases.!!

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The!government!has!to!be!the!harbinger!of!right!policies!–!policies!that!provide!an!environment!where!each!stakeholder!can!do!their!bit!

in!the!larger!interest!of!the!healthcare!needs!of!the!country.!Rightly!said,!the!need!is!to!ensure!collaborative!or!a!shakehand!approach!to!

ensure!a!healthy!future!for!the!country.!!

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81/2,!Second!Floor,!Opposite!STC!Housing!Colony,!Shri!Aurobindo!Marg,!Adhchini,!New!Delhi!–!110017!

Tel:!+911146668640!|!Fax:!+9111!4666865!|!Web:! www.indiahealthprogress.in !

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