Draft Bill for a New National Public Health Law

In News 

• Officials from the Union Ministry of Health and Family Welfare and other Government departments started the process of finalising various provisions of the draft Bill for a new national public health law.
• It will be placed in the public domain for consultation before being sent to the Union Cabinet. 
  • With the third Covid wave ebbing across the country, the National Public Health Bill is expected to be introduced in the Monsoon Session of Parliament.

Major Highlights 

• The proposed National Public Health Act has been in the works since 2017 and, once enacted, will replace the 125-year-old Epidemic Diseases Act, of 1897.
  •  It will also cover public health emergencies caused by bioterrorism, natural disasters, chemical and nuclear attacks or accident
• Four-tier health administration architecture,
  • The draft Bill proposes a four-tier health administration architecture, with “multi-sectoral” national, state, district and block-level public health authorities who will have “well defined” powers and functions to deal with “public health emergencies”.
    • The national public health authority is proposed to be headed by the Union Health Ministry,  and be chaired by health ministers of states. 
    • District Collectors will lead the next tier, and block units will be headed by Block Medical Officers or Medical Superintendents. 
    • These authorities will have powers to take measures for the prevention of non-communicable diseases and emerging infectious diseases.
• The proposed law also provides for the creation of public health cadres at national and state levels
• The draft Bill has defined various measures such as isolation, quarantine and lockdown, which have been extensively invoked by the Centre and states for Covid management.
  • It defines a lockdown as a “restriction with certain conditions or complete prohibition of running any form of transport” on roads or inland water.
  • The definition of a lockdown covers “restrictions” on the movement or gathering of persons in any place whether public or private. 
  • It also includes “prohibiting or restricting” the working of factories, plants, mining or construction or offices or Educational institutions or market places.
• The draft lays down several situations in which a “public health emergency” can be declared. 
  • They include bioterrorism; the appearance of a novel or previously controlled or eradicated infectious agent or biological toxin; a natural disaster; a chemical attack or accidental release of chemicals; a nuclear attack or accident.

Other Steps taken by India for improving the health sector:

• Budget:

• Union Budget 2021-22, announced Ayushman Bharat Health Infrastructure Mission, a new Centrally Sponsored Scheme, with an outlay of about ` 64,180 crores in the next five years to develop capacities of primary, secondary, and tertiary care Health Systems, strengthen existing national institutions, and create new institutions to cater to detection and cure of new and emerging diseases. 
  • Besides, Union Budget 2021-22 provided an outlay of Rs 35,000 crore towards COVID-19 vaccination. 
• The National Health Policy, 2017 envisaged increasing the government’s health expenditure to 2.5 per cent of GDP by 2025. 
  • In keeping with this objective, Central and State Governments’ budgeted expenditure on the health sector reached 2.1 per cent of GDP in 2021-22, against 1.3 per cent in 2019-20.

• Ayushman Bharat Health and Wellness Centres (AB-HWCs): The vision of Ayushman Bharat is to achieve universal health coverage. It adopts a continuum of care approach, comprising of two interrelated components
• Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY): The second component of Ayushman Bharat is PM-JAY; it is being implemented by the National Health Authority (NHA) in partnership with state governments. The scheme provides a health cover of ` 5 lakhs per family per year for secondary and tertiary care hospitalisation to over 10.74 crores of poor and vulnerable families in the bottom 40 per cent of the Indian population.
• PM-Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) is a mission to develop the capacities of primary, secondary, and tertiary care health systems, strengthen existing national institutions, and create new institutions, to cater to the detection and cure of new and emerging diseases.
• Pradhan Mantri Swasthya Suraksha Yojana (PMSSY) is being implemented to correct regional imbalances in the availability of affordable reliable tertiary healthcare services and to augment facilities for quality medical education in the country.
• Ayushman Bharat Digital Mission (ABDM), erstwhile National Digital Health Mission (NDHM), was announced on 27th September 2021 with the aim to develop the backbone necessary to support the integrated digital health infrastructure of the country.
• e-Sanjeevani: In wake of the COVID-19 pandemic, the Ministry of Health and Family Welfare upgraded the eSanjeevani application to enable patient-to-doctor teleconsultation to ensure the continuum of care and facilitate health services to all citizens in the confinement of their homes free of cost. 
  • Telemedicine services have been rolled out in 36 States/UTs.

• National Health Mission– The mission was launched by the government of India in 2013 subsuming the National Rural Health Mission and the National Urban Health Mission. It was further extended in March 2018, to continue till 2020.

• National Nutrition Mission-It is the government’s flagship programme to improve nutritional outcomes for children, pregnant women and lactating mothers.
  • The Ministry of Women and Child Development (MWCD) is the nodal ministry for implementation.

• National Digital Health Mission (NDHM) –It aims to develop the necessary to support the integrated digital health infrastructure of the country. 
  • It will bridge the existing gap amongst different stakeholders of the Healthcare ecosystem through digital highways.

• Poshan Abhiyan –It is the flagship programme that aims at improving nutritional outcomes among pregnant women, lactating mothers and children by reducing the level of stunting, underweight, anaemia and low birth weight by 2022. 

Progress made by India 

• India has made significant progress in improving its health outcomes over the last two decades by eliminating polio, guinea worm disease, yaws and maternal and neonatal tetanus.
• As per the latest National Family Health Survey (NFHS)-5, social indicators such as total fertility rate, sex ratio and health outcome indicators viz., infant mortality rate, under-five mortality rate, institutional birth rates have improved over year 2015-16 (Table 11).

Image Courtesy: Economic Survey 

Challenges in Health Sector 

• Poor expenditure on the health sector
• India lacks affordable health care services for the marginalised sections.
• Lack of robust public health infrastructures like hospitals, primary health centres.
• Lack of number of Doctors and Specialists as per the population of the country.
• Lack of awareness among the people.

Way Forward:

• More emphasis should be on quick and hassle-free delivery of medical services to the marginal section. 
• There is a need for an increase in expenditure on health so that India can improve existing facilities as well as add more of them.
• Focus should be on healthcare infrastructure and healthcare R&D 
• As the economic growth progresses, there is a need to monitor the population against the risk of spread of NCDs. Also, people must be made aware of the healthier life choices and benefits of a more active and fulfilling life.
• Also, the government needs to increase spending in the healthcare sector, because a healthier workforce is one of the most important factors contributing to the economic growth and overall progress of the country.

Source: IE