Nov 22, 2014

Implement the Promised free medicines scheme


Motivates people to send telegrams to remind the Prime Minister of his promise. 

Shocking, but true!  An average Indian spends about Rs. 1,336 every year on medicines. This translates to Rs. 3.66 per day. Taken cumulatively, people of this country spend Rs. 1,61,704 crores on medicines every year. Medicines account for 72 per cent of the total out-of-pocket expenses. According to the World Health Organisation (WHO), 50 to 65 per cent of Indians do not have regular access to even essential medicines.

Every year, the country spends about 4 per cent of its GDP on heath care (approximately Rs. 3,78,479 crores). Out of this, the government spends only 31 per cent and the rest of it is private spending (including insurance and out of pocket expenses). Of the 69 per cent private spending,  86 per cent of it is out-of-pocket expenses (what you pay from your own pocket for doctor's consultation fee, medicines etc. -- not covered by insurance or any government scheme).

  Rajasthan, one of the least developed states in the country has been successfully running a free medicines scheme. Preliminary investigations suggest that the scheme has led to increase in number of people accessing public health centres in the state. The Rajasthan experience shows that medicines procured in bulk by their generic names cost 40-4000% less.  This disparity is possible because most of the medicines are not under any price control. 

Against this backdrop, the Prime Minister Manmohan Singh, during his independence day speech last year (on 15th Aug, 2012), announced that the government is "formulating a scheme for distribution of free medicines through Government hospitals and health centres". As a follow up to this, in September 2012, the Health Minister announced to provide Rs. 1,300 crores to states for purchase of medicines and setting up of Central Procurement Agency for bulk procurement of drugs. However, the scheme hasn't taken on off yet. The States which do not have the financial resources have refused to implement the scheme unless the Central Government provides them the adequate funds for procuring medicines. The Planning Commission has refused to spare the money for this scheme citing fund constraints. 

Reminding the Prime Minister of his promise of providing free medicines to all that he had made on last year’s independence day, Oxfam India members across the country, some of them braving torrential rain, queued up at post offices on July  12 to focus attention on this urgent need by sending telegrams. They also encouraged urban poor collectives and other civil society organisations to send telegrams so as to highlight the fact that this scheme has still not been implemented.

Telegrams was chosen as an effective means to communicate the urgency behind saving millions of lives which are lost because of lack of proper, timely and free medicines. “Last 15th August you prescribed free medicines for all from the Red Fort. I am still waiting at the counter.” This simple and forceful message was what Oxfam India conveyed to the Prime Minister on 15 July, the date on which telegram services in India were bid farewell by millions of citizens.

Oxfam India’s campaign does not end with the telegrams. It is now putting together a follow up plan that will include post cards and other action across the country to build pressure on the PM and the government to implement the free medicines scheme immediately.

The campaign forms a part of Oxfam India’s vision of empowering the poor and the marginalised to demand their rights.

Oxfam has been working on access to medicines issues for over two decades now. In India, we have been working with our partners and People's Health Movement (Jan Swasthya Abhiyan), especially on demanding free medicines since 2009. It was CSOs continued advocacy and campaigning, and the Rajasthan success story that compelled the PM to make that announcement. Of course policy implementation takes time. But for how long can we wait? Especially when the roll out plan is in place and states are more than willing to implement this. The real problem is funding. The Planning Commission is refusing to give money citing fund constraints. Slowly this scheme is being put in cold storage. 

Our campaign is an effort to push the government to allocate adequate funds to kick start this scheme. Also, this is the last opportunity we have to make this a reality before general elections.

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