India warming up to vast potential of crowd-funding for healthcare

In five days of its launch, the Ni-kshay 2.0 scheme has found donors for 190,000 tuberculosis patients, hinting at the Centre tasting success with crowdfunding for a public cause at a time India — especially its private sector — is warming to the practice.

The central government scheme, launched as part of the Pradhan Mantri TB Mukt Bharat Abhiyaan on September 9, aims to involve the community in the drive to eradicate TB by 2025, and also ensure sufficient nutrition for patients.

Food is often called a “vaccine” for TB, as the bacteria causing the disease is more harmful for malnourished persons and those with low immunity, says Raghuram Rao, additional deputy director general, central TB division, Ministry of Health and Family Welfare. It is therefore important to ensure that along with the medicines, which the Centre provides for free, the patient also gets adequate and nutritious food.

This is not the first time the government has resorted to crowdfunding for a public cause. But, unlike Ni-kshay 2.0, the other campaigns have not found many takers. In August 2021, the Centre began a crowdfunding programme for the treatment of rare diseases. Corporates and individuals could donate money to people, mainly children, suffering from rare diseases. Eight hospitals, termed as centres of excellence, were allowed to accept the donations, too. However, a year later, the scheme is yet to gain much support.

Till now, 360 patients have registered under the rare disease portal and received a paltry sum of Rs 179,097 as donations. “Compared to private sector companies, the government’s crowdfunding projects across segments have few takers due to the lack of marketing and not enough social media outreach programmes. Based on estimates, the collective money raised as crowdfunding in the country through online platforms is around Rs 10,000 crore,” said Hetal Jhaveri, a professor at Ahmedabad University.

Private sector campaigns in rare diseases have fared better. Crowdfunding platform ImpactGuru raised Rs 125 crore through 1,200 rare disease campaigns between January 2021 and this February. Around 1.2 million donors had participated. “About 50,000 to 60,000 people benefit from healthcare crowdfunding per year. But we expect this figure to increase to benefit more than a million every year in the coming decade. The quantum of the healthcare financing gap in the country is upwards of $18 billion per year and experts believe that about $4 billion could be the targeted addressable market over the next decade,” said Piyush Jain, co-founder and CEO, ImpactGuru.com.

There are several recent examples of government fundraising initiatives failing. An effort by the government of Kerala to raise around Rs 700 crore from the public to offer free laptops to 345,000 students managed to net merely Rs 2.99 crore till May.

Kerala is also working on ideas of crowdfunded infrastructure development by seeking investments from non-resident Keralites. In Tamil Nadu, too, a similar platform for developing infrastructure at 17,844 schools through crowdfunding was affected by a change of guard. The project was started by the previous All India Anna Dravida Munnetra Kazhagam government in 2019.

Crowdfunding initiatives have gathered steam in the private sector. According to estimates shared by crowdfunding platform Milaap.org, the top five — including Milaap besides Ketto, ImpactGuru and LivIndia — in the sector have raised close to Rs 8,000 crore in the last 10 years.

“Till 2025, we are expecting the industry to grow at a rate of 25-30 per cent. Public participation should also happen in areas with good synergies, such as sharing of unique health ID details with consent and joining hands for projects. Through this, the government will be able to make use of the aggressive marketing strategies of private players,” said Anoj Viswanathan, co-founder and president, Milaap.

In case of contributors, donations are tax deductible only if they are made to a non-profit organisation registered under Section 80G. So, if a person wants to get tax benefits for donations to crowdfunding platforms, the latter — private or government-run — has to be registered under Section 80G and issue a receipt of donation stating the donor’s PAN.

Experts say that crowdfunding is not a great model for public healthcare interventions.

According to Anish T S, associate professor of community medicine at Government Medical College, Manjeri, Kerala, the best healthcare interventions for the community involves spending taxpayer money efficiently. “Only if there is no other option should one start a crowdfunding initiative,” he said, adding that there could be platforms to channel CSR funds for the public good through government initiatives.

He also cited lacunae in private sector healthcare crowdfunding. “Hundreds of children die in India every day, but those cases are invisible. Let’s say a crowdfunding drive manages to raise Rs 1 crore for treating a child/patient with a rare disease. The chances of success of the treatment may be only 10 per cent. Usually, people donate on humanitarian grounds,” he said, adding: “Imagine how many children, who die due to malnourishment, could get proper nutrition with that kind of money.”

The public policy expert felt crowdfunding in healthcare should be for community well-being, and not only for individual cases. In the TB project, the government is attempting to do that. Of the 1.3 million active patients in India, around 890,000 have given consent to be up for adoption. Already industry bodies like FICCI have stepped forward and adopted 100,000 TB patients, sponsoring a Rs 1,000 food box per month per patient for six months (treatment duration).

Health researcher Anant Bhan noted that while involving the community is a great idea, one has to be sensitive towards maintaining the patient’s dignity. “In most cases, donation or adoption by a corporate or a political heavyweight may become photo ops,” he quipped.

If Ni-kshay grabs more eyeballs, it can set the tone for public-sector crowdfunding initiatives in India.

Helping hand

1. Under Ni-kshay 2.0, 190,000 TB patients have found donors since its launch on September 9
2. The central scheme aims to involve the community to eradicate TB by 2025 and ensure sufficient nutrition for patients
3. A central crowdfunding plan started in August 2021 for the treatment of rare diseases is yet to gain support; only 360 patients have registered on a portal and received Rs 179,097 as donations
4. The collective money raised via crowdfunding in India through online platforms is around Rs 10,000 cr, said Hetal Jhaveri, professor, Ahmedabad University
5. Private sector campaigns have fared better; ImpactGuru raised Rs 125 cr through 1,200 campaigns between Jan 2021 and Feb 2022
6. In the private sector, the top five platforms have raised close to Rs 8,000 cr in 10 years, according to Milaap.org