SONGSOPTOK: Do you consider primary healthcare to be a fundamental right? Is it deemed as such in the society you live in? Please explain your answer with a few examples if possible.

SOUMYA:  Primary healthcare should be considered as a fundamental right. Having said that, I feel that in a country like India even fundamental rights are flagrantly violated, and primary healthcare has every chance of being neglected even if it comes to be treated as a fundamental right. As of now, healthcare is not a fundamental right in India, and primary healthcare more so. 

SONGSOPTOK: What is the system of healthcare in the country and the society you live in? Is it a just and equitable system in the sense that all citizens enjoy the same benefits across economic and social classes?

SOUMYA: Healthcare in India and the immediate society I live in is not at all equitable, where the poor suffer poor health and the very poor suffer appallingly.  In addition the gap in access to healthcare between the rich and poor remains very wide. There is also a dominant urban-rural gap in the availability of medical services. The facilities available with the government institutions are inadequate and suffer from dearth of funds, poor management, political and bureaucratic interference, lack of leadership in medical community, etc. India ranks very low in any objective international ranking of countries by health status. Despite the advances made in the tertiary sector in the development of several large multi-speciality commercial hospitals, and also in the provision of a decent level of primary healthcare in a few States such as Kerala and Tamil Nadu, health deprivation on a mass scale stands out as one of the country’s intractable challenges.

SONGSOPTOK: Do you think that free healthcare cannot be a right, but it can be a privilege and a shared burden of sacrifice for the sake of the social contract?

SOUMYA: I feel ideally healthcare for the masses, particularly for the economically underprivileged, should be the responsibility of the government. The sense of ‘a shared burden of sacrifice’, in my opinion is not a tenet that would either be understandable in this country or appreciated across the body polity.  For India the system that is best likely to work is a directed mandatory contribution to the healthcare corpus in exchange of certain articulated benefits, in which system the contribution would vary according to the individual earnings.

SONGSOPTOK: What, in your opinion, should be the role of the government for ensuring equal healthcare to all citizens? What role is played by the government of the country you live in?

SOUMYA: In India, where healthcare remains the most potent domain for securing business, equal healthcare to all citizens is something which is beyond the scope of the government – a choice willingly accepted by the government. What the government can and should do is to ensure affordable healthcare to the economically underprivileged sections of the society and to assume a role of leadership in reducing the impact of endemic diseases across the country since only the government has the proper mechanism to administer and lead such efforts.

SONGSOPTOK: According to the data published by World Health Organization (WHO), nearly 16 000 children under the age of 5 die every day in the world (5.9 million in 2015) from infectious, neonatal or nutritional conditions. Is this a reality in the country you live in? If so, what would your suggestions of improvement be?

SOUMYA: Since independence there has been considerable improvement in provision of neonatal care in the country, though the effort is woefully inadequate as of now. I feel that a large component of government intervention should be directed to child and geriatric care. Nutrition is yet another source of worry for India, as the larger section of the underprivileged population still do not have access to two square meals a day.

SONGSOPTOK: “Free access to healthcare is a fundamental human right. Access to free healthcare is not” – do you agree with this statement? Please explain your choice.

SOUMYA: I agree to the statement

SONGSOPTOK: How important is the role of the private sector for providing healthcare and related facilities in your country? What it is your opinion about it?

SOUMYA: The private sector is already relevant in India in so far as healthcare for the affluent is concerned. However, private healthcare providers view healthcare as a business opportunity rather than from an altruistic point of view and in my opinion these service providers would have little or no interest in mass healthcare interventions.

SONGSOPTOK: Are charitable and Non-Governmental Organizations (NGO) active in the domain of public health? If yes, then in what spheres? Do you think that the civil society, either independently or through these organizations, should become the prime actor for ensuring healthcare for all?

SOUMYA: Many charitable and NGOs are active in the provision of healthcare to the masses, but there is a lot of overlap in the individual efforts. A parallel model can definitely be conceived whereby the willing organizations working in close collaboration with civil society can take care of certain identified and niche healthcare areas.

SONGSOPTOK: Do you think that multinational pharmaceutical and healthcare companies are responsible, to a certain extent, for the widely variable quality of healthcare in different countries? Can you please illustrate your reply with some examples?

SOUMYA: Pharmaceutical companies, in my opinion, are the biggest culprits for the poor state of healthcare that exists in many developed and developing countries. These companies have immense clout and almost a throttlehold on individual government in so far drug pricing practices are concerned. In addition, these companies in my opinion reduce the population in poorer countries to human guinea pigs and conduct clinical trials which they can do in their own countries at a hefty price. Many of the sufferings in the poorer countries are results of the drug dumping practices followed by the pharmaceutical companies. The nexus between pharmaceutical companies – government –private healthcare providers are also quite visible.

SONGSOPTOK: Do you think that adopting the Social Security model implemented in a lot of countries in Europe which ensures primary health coverage to all citizens and is financed by the totality of the working population can be relevant and efficient in all countries?

SOUMYA: This system in my opinion is an elegant model where the working population in its totality finances healthcare for all in a specific country. But whether this model can be relevant in India is doubtful, given the huge population of the country and the wide gap that exists between individual earnings.

SOUMYA SEN SHARMA: Senior Principal Scientist, CSIR-CMERI, Durgapur, India. Electical Engineer from Jadavpur University, Soumya is specialized in Electrical Motors and Renewable  Energy Systems. Group Head at CMERI, he has worked for several projects linking renewable energy and sustainable development. He is involved in various societal projects both in professional and personal capacity

We sincerely thank you for your time and hope we shall have your continued support.
Aparajita Sen

(Editor: Songsoptok)


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