Citizen’s Manifesto for Indian Elections 2009

Our key requests to the Indian Finance Minister to ensure that budget to be presented next month (July 2009) would contribute to the health and well-being of the Indian citizens.

Health care financing

• Increase health care budget from current 1% of GDP to 3% within 5 years and to 5% in 10 years. This would increase the share of public funds in health-care expenditure from the current 20% to 60% in 5 years and to 100% in 10 years. Ensure increase at both the Center and State levels.
• Ensure increased allocation and effective expenditure of funds for the NRHM. The NRHM had envisaged expenditure of Rupees 55000 crores per year by 2012 but for past 2-3 years it has stagnated at about Rupees 10000- 12000 crores per year.
• Increase allocation for drugs per capita to least Rs. 50. Presently it is as low as Rs. 2 in some states. Set up systems and ensure their effective functioning for transparent procurement of drugs, equipment, etc.
• Universal Healthcare Coverage Scheme to include all sections of the people given the fact that any scheme targeted to the poor is implemented poorly. State’s share of contribution should be 100% for resource-poor families. Rest of the population would contribute to begin with; this contribution will be progressively more as we go up the socio-economic ladder. But within 10 years, all Health Care expenses for all people to be financed by the State.
• As a key first step towards this Universal coverage, implement a Universal Social Health Insurance scheme as part of Social security for all unorganized and organised sector workers, which is mandatory and offers comprehensive health care coverage, covering all members, and their families with a schedule covering all health conditions.
• Abolish user fees with immediate effect.

Food, water and sanitation

• Universalize Public Distribution System (PDS) and all other schemes related to food security with urgency, to fight food insecurity and malnutrition.
• Ensure 100% availability of safe water without discrimination, in each village and habitation and 100% access to safe hygienic toilets in homes, institutions and public places, along with adequate water supply and proper waste disposal system for sanitary waste.

Health and Medicine

• Enact the National Health Act to guarantee the right to comprehensive, quality health care at public expense in relevant health institutions to all, where every one is entitled to the full range of guaranteed, free health services.
• Expedite setting up and implementation of the National Urban Health Mission (NUHM) with civil society consultation and participation.
• Reduce prices of all essential medicines and keep them under strict price control. Withdraw excise duty from all essential medicines.
• Revive all public sector medicine and vaccine producing companies with no transfer of vaccine production to the private sector.

Women and children

• Assure women of gender-specific health entitlements (maternity leave, abortion leave, sterilization leave, creches, toilets) in public and private employment. A national scheme for maternity entitlements in the informal sector, on the lines of the “Dr. Muthulakshmi Reddy Maternity Benefit Scheme” in Tamil Nadu (including cash support of Rs 1,000 per month for six months for care during pregnancy and after delivery), should be introduced.
• Infant and young child feeding counseling and support should be recognized as one of the core “services” both in ICDS and NRHM, with a clear budget head. Special sub-scheme to give appropriate supplementary nutrition to children in the age group 6 months to 3 years.

(For more details, please read the People’s Health Manifesto 2009, www.phm-india.org)