Health care, the foremost agendum of Finance Minister Nirmala Sitharaman’s Budget speech, saw an allocation of Rs 223,846 crore —an increase of around 118 per cent over the Revised Estimate — to cover “health and wellbeing” with a large chunk, Rs 35,000 crore, going towards Covid-19 vaccination, a move widely cheered by the industry.
“The investment in health infrastructure in this Budget has increased substantially. Progressively, as institutions absorb more, we shall commit more,” the finance minister said.
Adar Poonawalla of Serum Institute of India, the maker of Covishield vaccine, said the allocation would not be able to cover the entire population. “However, it can cover vulnerable sections of the population at least.”
The increase in allocation pegged at 137 per cent by the finance minister was calculated over the Budget Estimate of 2020-21. Much of the increase in this year’s allocation for health and wellbeing is largely attributed to expenditure set aside for Covid vaccination and the finance commission grants for water, sanitation and health, and overall allocation to drinking water and sanitation.
Pankaj Patel, chairman, Zydus Cadila, which is one of the front-runners in the vaccine race, said the allocation for vaccines has given an environment of certainty.
If the cost per dose of vaccine is estimated to be around Rs 250, the government cannot cover more than 200 million people, another vaccine maker said. “This has probably been done keeping in mind the low turnout for the national vaccination programme.”
For the health ministry itself, which spearheaded the pandemic response of India, the allocation has gone down by almost 11 per cent. The expenditure budget for the departments of health & family welfare and research has dropped. However, the Revised Estimate itself was about 24 per cent more than the budgetary allocation for 2020-21. The announcement of the launch of a new centrally sponsored scheme, PM Atmanirbhar Swasth Bharat Yojana, with an outlay of about Rs 64,180 crore over six years is likely to boost health care infrastructure at the grassroots. “This will 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,” Sitharaman said.
The scheme also seems to have drawn lessons from the pandemic as it plans to set up 15 health emergency operation centres and two mobile hospitals and expand the integrated health information portal to all states and Union Territories to connect public health laboratories. The government will also set up a national institution for One Health, a regional research platform for WHO Southeast Asia Region, nine bio-safety level III laboratories and four regional National Institutes for Virology as part of the yojana.
Sitharaman, laying out the broad contours of the scheme, said that it will support 17,788 rural and 11,024 urban health and wellness centres. Building critical care hospital blocks in 602 districts and 12 central institutions is also part of the plan, along with operationalising 17 new public health units and strengthening 33 existing ones at various points of entry, including 32 airports, 11 seaports, and seven land crossings.
Though the allocation to the department of research under the health ministry reduced by over 34 per cent from Rs 4,062 crore in 2020-21 to Rs 2,663 crore in the Budget 2021-22, Sitharaman announced an outlay of Rs 50,000 crore for the National Research Foundation over five years to “ensure that the overall research ecosystem of the country is strengthened with focus on identified national-priority thrust areas".
“A similar amount should also be made available to the private sector... If it was not for the private sector, we would not have developed the vaccines, therapies, diagnostics for Covid-19 like we did during the pandemic,” said Kiran Majumdar Shaw, chairperson, Biocon.
The government also proposed to merge the supplementary nutrition programme and the Poshan Abhiyaan to launch the Mission Poshan 2.0 to improve nutritional outcomes across 112 aspirational districts. The Centre will take steps to strengthen the five regional branches and 20 metropolitan health surveillance units of the National Centre for Disease Control, which has played an important role in conducting the sero surveys in the country to understand the spread of coronavirus in the population. The finance minister also announced pneumococcal pneumococcal vaccine, also known as pneumonia vaccine, will be rolled out across the country from just five states at present. The vaccine is expected to avert more than 50,000 child deaths annually.