A Budget that places Health on the Margins

The Union Budget for the fiscal year 2024-25 has shifted focus towards economic growth through infrastructure and employment, while also addressing critical issues in health and agriculture amidst the ongoing COVID-19 pandemic and climate challenges.

Health Sector Budget Allocation:

• Comparison Metrics: The Budget compares budgetary estimates (BE) of the current year with those of the previous year rather than revised estimates (RE). This has led to an apparent 12% increase in health budget allocations, though the actual increase is much lower when comparing BEs of 2023-24 and 2024-25.
• Modest Increases: The overall Health Ministry budget saw a marginal increase of 1.98%, with only 1.16% for the National Health Mission (NHM) and 1.4% for the Pradhan Mantri Jan ArogyaYojana (PMJAY). This falls short of the need to expand healthcare coverage, especially for immunization, tuberculosis, and non-communicable diseases.
• Challenges for NHM: NHM, responsible for primary care and district hospitals, needs substantial resources to achieve universal child immunization and combat diseases like tuberculosis and non-communicable diseases effectively.

Universal Health Coverage and PMJAY:

• Coverage Concerns:Despite aspirations to achieve universal health coverage by 2030, PMJAY's budget increase is insufficient to include all elderly individuals, raising doubts about its inclusivity.
• Missed Opportunities: While new medical colleges were mentioned, the Budget overlooked the need for a larger healthcare workforce. The health sector presents significant employment and skill-building opportunities, particularly for the youth.
• Drug Pricing and Procurement: Customs duty waivers on anti-cancer drugs were noted, but broader price controls and pooled procurement mechanisms for other essential drugs were missed opportunities in the Budget.

Climate-Resilient Agriculture:

• Budgetary Commitment: The Budget prioritizes investment in climate-resilient agriculture amid concerns over global warming's impact on staple crops' quantity and quality.
• Benefits of Diversification: Promoting climate-resilient crops not only enhances nutrition security but also reduces water, pesticide use, energy consumption, and greenhouse gas emissions, aligning with sustainable agricultural practices.
• Smart Agriculture Initiatives: The focus on climate-smart agriculture marks a strategic approach towards ensuring food security and sustainability in the face of environmental challenges.

Mains Question:

Q. Critically analyze the budgetary allocations and policy priorities for the health sector in Union Budget 2024. How far do they align with India's goals of achieving universal health coverage and addressing emerging health challenges? What additional measures are necessary to strengthen healthcare infrastructure and services in the country?