India Uncut

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Friday, February 18, 2005

The health of India's healthcare

Amir Attaran and Roger Bate, in a piece in Tech Central Station titled "India's Deadly Lies", attack the Indian government's manoueverings against the WTO's patent rules for medicines. They make some interesting points.

One, they write that "most of the medicines that WHO terms 'essential' in developing countries are no longer patented -- fully 98% of them are off patent." In other words, they contend that, contrary to the rhetoric of anti-globalisation NGOs, patents "aren't an obstacle to essential medicines."

Two, they point out that India's "health systems are crumbling, making it patently obvious that its government cares not a jot for its people." They say that "by some estimates India may have more HIV positive people (over 5 million) than any other nation, including South Africa." (For my earlier post on Aids in India, click here.)

Three, they note that "India spends 4.5% of its GDP on health, of which only 0.9% is public expenditure. No government in South Asia spends less, making New Delhi dead last (tragic pun intended) in providing for its citizens' health."

Here's more:
[S]een from a slowly-propelled bicycle, the health of poor Indian villagers is shockingly worse than in much of Africa. Few medicines, whether patented or not, are available in public hospitals, principally because the government does not care to provide them. We are haunted by the sight of a man, crossing the road, dragging behind him a leg made lame and elephantine by lymphatic filariasis -- a disease for which Western pharmaceutical firms offer the medicines not just cheaply, but for free, if only the elites and Brahmins officiating in New Delhi cared to distribute them.

The international community should not forgive India's perfidy lightly. The next time Indians arrive at the WTO with a pressing demand, let it chill on the agenda. And the next time India seeks foreign aid for AIDS, malaria, tuberculosis, et cetera, donors such as USAID and the Global Fund should absolutely refuse. Any country having spent billions of dollars to acquire nuclear weapons, or on follies such as a lunar exploration probe (coming in 2008!) clearly has significant sums to spend on public health; frankly, India neglects its citizens' health out of choice rather than fiscal stringency. [Italics in original.]

Strongly worded stuff. No matter what you feel about the patents regime of the WTO, though, one thing is undeniable: the Indian government's delivery systems for public healthcare are abysmal, just like its delivery systems for anything. The solution for this lies not within the ambit of government, but outside it. The answer lies in free markets, and in globalisation, enabled in a manner designed to drastically reduce government interference and control.

(For more of my thoughts on this [sigh], read my earlier posts, "Fighting poverty" and "The myth about the rich and the poor".)
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