India's poor to get free medicine


THE INDIAN government plans to give free medicine to more than half of its 1.2 billion citizens as part of an initiative to improve regular access to drugs in a country where two out of three people are estimated to lack it.

The scheme will expand the number and type of generic drugs that can be prescribed freely in rural areas and will ban doctors from issuing branded drugs.

The policy, thought to be a priority of prime minister Manmohan Singh, could be set up by the end of this year if the planning commission approves the full programme.

It is budgeted at 266.7 billion rupees (€3.93 billion) for the period 2012-17, by which time the ministry of health and family welfare estimates that 52 per cent of Indians will be covered by the programme.

Charan Wadhwa, an economist at Delhi’s Centre for Policy Research, says the scheme could prove popular with voters when the Congress Party-led government faces national elections in 2014.

But it raises questions for an economy facing an estimated 5.9 per cent fiscal deficit.

“It’s an important step and it can win them votes also,” Prof Wadhwa says. “The issue is whether they can sustain the fiscal deficit it may create – one should first have the resources, then talk of allocation.”

More than 800 million Indians live on less than $2 a day. But India has plenty of initiatives targeted at its many poor. The problem, says Dr George Mathew, chairman of Delhi’s Institute of Social Sciences, is in the implementation.

“Very often what happens is that there are excellent programmes with great intentions . . . but the target group are deprived of the benefit,” he says. “These billions of rupees worth of medicine can [easily] be diverted to the black market, or diverted through middle men to some other sources.”

As an example of a troubled health programme, Dr Mathew cited the National Rural Health Mission, which has been plagued by corruption allegations.

Still, Rana Vikas, manager of two rural hospitals in the western state of Jharkhand for the Krishi Gram Vikas Kendra, a development charity, says rural doctors are optimistic about the latest scheme. It will expand the drugs government clinics can provide for free, from simple antibiotics to a potential list of 348 products, including antiretrovirals and cardiovascular drugs.

The programme will require doctors at government hospitals and clinics to prescribe generic rather than branded drugs, but analysts say it is unlikely to affect pharmaceutical companies: their target customers are rich and urban, not poor and rural.

The central government will pay three-quarters of the costs, with states making up the rest, according to the health ministry. – Copyright The Financial Times Limited 2012