India is all set to vote in the seven-phase national election starting April 14. With 970 million eligible voters, or over 10% of the global population, participating in the 2024 Lok Sabha elections, the world will be watching closely. Current projections indicate that Prime Minister Narendra Modi’s Bharatiya Janata Party (BJP), will win a third consecutive term.
Under PM Modi’s leadership, healthcare has fared poorly, as described in this week’s World Report.
The Lancet in its recent report said that the government expenditure on healthcare has dwindled to a dismal 1.2% of the gross domestic product, while out-of-pocket healthcare costs remain exorbitantly high. Despite ambitious initiatives aimed at bolstering primary healthcare and achieving universal health coverage, the delivery of essential services to the most vulnerable segments of society has faltered.
Widespread disparities in both access to and the quality of healthcare worsen existing inequalities, it said. Compounding these challenges is a significant obstacle that often escapes public attention: the dearth of transparent health data in India.
Accurate and timely data serve as the backbone for informed health policy formulation, strategic planning, and effective management. However, India has encountered substantial setbacks and hurdles in the collection and dissemination of such crucial information.
The delay in conducting the 2021 census due to the COVID-19 pandemic marks the first instance in 150 years where a decade has passed without comprehensive official data on India and its populace. Despite assurances, the transition to an electronic survey for the 2024 census remains unfulfilled, further complicating national and state-level health surveys, which rely on census data.
Critical surveys, such as morbidity and out-of-pocket expenditure assessments by the National Sample Survey Organization, are overdue, with no plans for imminent execution. Similarly, the delay in releasing the Sample Registration System survey report for 2021—the nation’s most reliable source of data on births and deaths—remains unexplained. The unavailability of completed poverty surveys to the public adds to the opacity surrounding health data.
Of grave concern is the forced resignation of K S James, the Director of the Institution for Population Sciences, who oversaw the National Family Health Survey, following allegations of irregularities in recruitment. However, reports have linked his dismissal to the survey finding results that were unfavourable to the government, The Lancet piece added.
Another contentious issue revolves around the credibility of India’s assertion that only 0.48 million deaths resulted from the COVID-19 pandemic, a stark contrast to estimates by the WHO and other sources, which suggest figures six to eight times higher. The unpublished 2021 Civil Registration report holds the potential to corroborate or challenge the government’s stance, offering insights into mortality trends during the pandemic.
The delayed release of crucial studies, including the Sample Registration System survey and the Million Death Study, until after the elections, if at all, raises suspicions about the government’s reluctance to confront the true state of health affairs. This begs the question: Why the hesitancy to embrace transparency in health data? And more importantly, how does the government plan to gauge progress in the absence of reliable data?
A dearth of recent and credible data undermines the essence of democracy, depriving citizens of informed decision-making. As the Modi government sets its sights on Viksit Bharat 2047—a vision to propel India into the ranks of developed nations by its centennial year of independence—prioritising investments in healthcare and education is paramount. However, this necessitates a commitment to transparency and accessibility of data.