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Indian Journal of Community Medicine

Health for all in India: Nightmare, Dream or Reality?

Author(s): Rajan Madhok

Vol. 32, No. 1 (2007-01 - 2007-03)

Letter to the Editor

Despite tremendous economic successes, entrenched health inequalities, lack of access to basic amenities like clean water and sanitation and, escalating costs of health care make the goal of health for all in India seems like a nightmare. The acknowledgement by the Government: ”...ample evidence of a dysfunctional, non-performing public health system. …The situation varies across the country and in some parts of the country it functions very well. I think on an average, it does not function well and there are some parts where it is really functioning incredibly badly” (Mr Montek Singh Ahluwalia at the Indian Confederation for Health Care Accreditation meeting in Delhi, 2005) and little demonstrable and concerted action by the policymakers to tackle this system failure does not engender much confidence.

Equally, if India can be the global force economically then surely it can rise to the challenge of improving this state of affairs also. There is clearly no shortage of intellectual capacity, commitment and leadership in India, and amongst Indians overseas. In addition, the launch of the Rural Health Mission and new initiatives like The Public Health Foundation potentially allow one to start dreaming that the nightmare can be overcome. There is, however, still a long way to go before the dream can become reality.

Given the audience of this conference, and having lived away from India for over 25 years, I will not be telling you what to do. You live and breathe the challenges every day and I know that many of you are providing excellent leadership to overcome some of the most fundamental barriers that contribute to the poor health experience of a significant proportion of the Indian population.

However, although on the one hand, having ‘deserted’, I do not have the right anymore, I feel a strong responsibility to ‘do something’. In the global village we are all connected now – the distinction between East and West is blurred. Both worlds are experiencing similar and increasing problems with widening health inequalities and difficulties in ensuring affordable good quality health care. Both worlds need to learn from, and work with, each other to provide the necessary leadership in the face of relentless political, economic, societal and technological (PEST) forces which rather than bringing people together are further pulling them apart.

To develop partnerships and collaborations we have planned this special session at National IAPSM conference at New Delhi. I hope that between your commitment and deep understanding of the issues and my reflections and suggestions we would be able to develop a robust programme of collaboration for what we both passionately believe in: to improve the health status of the people in India by building capacity through teaching and research and by informing policy and provision of services.

This session would be the beginning of our efforts to identify suitable partners for Indo-UK collaborations in future. We encourage participation of faculty members and students who have interest and want to take the lead in the field of Public Health Intelligence and Surveillance Systems, and Health Systems Research.

Rajan Madhok
University of Manchester, UK
Email: [email protected]
Received: 02.01.07

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