Heal the nation before healing the rest of the world

Context

The Health Ministry recently released a set of implementation guidelines for a long over­due Indian public health cadre. A more recent announcement, however, raises concerns over the coherence of India’s vision with respect to health human resources.

WHO forecast for India

• Scarcity of human resources- A World Health Organization (WHO) 2020 report projected a requirement of nearly two million more doctors and nursing professionals for India in order to attain the minimum threshold ratio of health­care professionals to the population.
• Skill­mix of healthcare professionals -As per a study by WHO and the Public Health Foundation of India, over and above a veritable shortage of health­care personnel and their skewed skill­mix across a number of States, their current pace of growth is unlikely to result in any significant improvement in the density or skill­mix of healthcare professionals by 2030.
• Healthcare professionals outside the labour force - Such inadequacies are further compounded by the legions of healthcare professionals who remain inactive and outside the labour force.

Soft power projection

• Projection of soft power- Health care particularly in the post­COVID­19 era has been a fertile ground for countries to project soft power at times even at the expense of the nation’s own health interests.
• Healthcare exports- There is a distinction between exporting products such as vaccines and that of health­care professionals. While the first is characterised by a much simpler transactional math, training health­care manpower entails large subsidies (even a fraction of which is hardly recovered through remittances and skill transfers), thus entailing a net drain of resources from the native country
• Medical Tourism- A similar draw on scarce national health­care resources is laid through medical tourism which is almost always to the detriment of health equity, particularly in developing settings such as India.