The current budget allocation (Budget Estimate or BE) in the current year 2022-23 is Rs 86,200.65 crore which is a 16.59 per cent increase compared to the BE of Rs 73,931.77 crore in 2021-22. However, if the revised estimate (RE) budget for the year 2021-22 which was Rs 86,000.65 is compared, the allocation to the health ministry is barely 0.23 per cent.
Several other major components of the healthcare sector have received minimal hikes. Public health experts have said that the healthcare budget this year failed to impress and may fall short in handling the ongoing pandemic. Sitharaman in her Budget 2022 speech said that with the accelerated improvement of health infrastructure in the past two years, India is in a strong position to withstand challenges. The finance minister further said that the strengthening of health infrastructure, speedy implementation of the vaccination programme, and the nation-wide resilient response to the current wave of the pandemic are evident for all.
As per World Health Organisation (WHO) data, as on the second week of January 2022, 66.3 per cent and 48.3 per cent of the total population in India is vaccinated with first and second doses respectively. With a significant chunk of the Indian populated remaining unvaccinated the Budget has no special announcement for vaccines.
"The Budget did not provide the prominent focus, a long-term strategy and a much higher allocation for healthcare as was expected. It appears that the intent in this year’s Budget was not to make new major announcements but to consolidate and successfully implement some of the initiatives announced during the past 18 months of the pandemic,” said Charu Sehgal, Partner, Life Sciences & Health Care Leader, Deloitte India. "However, setting up of integrated public health labs and establishing critical care hospital blocks will ensure that the crisis of the kind we experienced during the COVID 19 waves will be avoided,” she said.
The National Health Mission (NHM) has been the government of India’s flagship health programme since 2005 and has played a crucial role in improving health outcomes in the country. The NHM budget has increased marginally by 1 per cent over the previous year from Rs 36,575.5 crore in 2021-22 to Rs 37,000.23 crore in 2022-23. “A stagnant budget allocation to health sector amidst the raging pandemic sends a wrong signal. States may have to take a larger role to financing and delivering health care soon, in the backdrop of a fall in Centre’s allocation to states,” said Sakthivel Selvaraj, Director and Professor, Health Economics Financing and Policy Unit, Public Health Foundation of India (PHFI), Public Private Partnership (PPP) initiative for healthcare.
In fact, the centrally sponsored schemes’ health allocation is lower at Rs 47,634 crore (BE for 2022-23) from Rs 50,591 crore last year. “This is exacerbated by a stagnant allocation to the centres’ flagship program, the National Health Mission. What is even more worrisome is the allocation for PMABHIM – scheme to strengthen health infrastructure at all levels – it was barely Rs 900 crore which is expected to go up to Rs 5,156 crore in the next fiscal against an estimated Rs 10,000 crore that is expected to be incurred under the 15th Finance Commission grants to states,” said Selvaraj.
Amid the pandemic, NHM allocations would mean that non-Covid programs may take a hit which have already been severely impacted for the last two years. “Low allocation to NHM would put the burden of financing the programme on the states. While the relatively developed states have greater resources to invest in the health needs of the population, the lack of support from the Centre will put the less developed states at a significant disadvantage. In terms of healthcare budget, India ranks 179 out of 189 countries in prioritisation accorded to health in its government budgets,” said Poonam Muttreja is Executive Director of Population Foundation of India, a national civil society and healthcare organisation.
“Last year’s budget signalled the importance of health and well-being by terming it as the first of six pillars. It also focussed on strengthening three key areas, namely preventive, curative, and overall well-being. However, a similar prioritisation of health is missing in this year’s budget, especially as we are during a third wave of the pandemic,” she said.
Experts have said that public health does not seem to be a priority in the 2022-23 budget. Even the allocations for the National Programme of Mid-Day Meal in schools, now renamed as Pradhan Mantri Poshan Shakti Nirman, declined by 11 per cent from Rs 11,500 crore in 2021-22 to Rs 10,233.75 crore in 2022-23. “The Finance Minister also did not mention any announcements around how the ongoing nutrition crisis will be tackled, despite the rising levels of anaemia in the country as indicated by the recently released fifth round of the National Family Health Survey,” said Muttreja.
The National Health Policy 2017 envisages increasing the public health expenditure to 2.5 per cent of the GDP by 2025. India also doesn’t seem to be reaching that target with the pace of the increments in the health budget.
“India is among the top 10 countries in the world incurring a very high magnitude of out-of-pocket expenditure. On the other hand, India also faces the challenge of housing a very high proportion of households with low incomes. In such situations India should be spending at least 2.5 per cent of GDP on health sector, as suggested by the National Health Policy of India way back in 2017. However, it was only 1.8 per cent last year,” said Arup Mitra, professor of Economics, Delhi University. Mitra strongly felt that given the disease environment in India, the productivity levels are low and poor health outcomes can affect economic growth adversely.
Also read: Budget 2022: Hospitality industry disappointed with Sitharaman’s announcements