India&Healthcare&Bulletin&&

An initiative towards better healthcare access in India (www.indiahealthprogress.in) ! A!Monthly! ! ! ! !

&

!!!!Volume!XXVII,!Issue!9.!Nov!2012!!

Content
Page%1% Edit!Speak!by! Aman!Gupta! ! Page%2% YK!Gupta:!It!is!time!to! take!a!quantum!leap!in! healthcare! Page%3% Dr!Arvind!Lal! emphasizes!on! quality!diagnosis! Page%3+4% Advocating!the! case!of!the! patient! Page%4% Utilising!the! potential!of!the! pharma!industry! Page%5% More!spending!essential! to!push!health!reforms! on!fast!track! ! Page%5+6% Forging!ahead!towards! ensuring!universal! access!to!healthcare! !

EDIT+SPEAK%

Health%Reforms:%Lets%Talk%Solutions%Rather%than%Hurdles%
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Health!care!in!India!faces!multifarious!challenges!not!only!in!the!form!of!inadequacy!of!infrastructure,!facilities!and!human!resource!but! also!access,!outreach!and!consistency.!As!we!move!closer!to!the!end!of!another!year,!lack!of!reforms!in!the!healthcare!sector!resonates!as! earlier.!Once!again,!we!are!left!with!more!problems!than!solutions!to!the!glaring!larger!issue!of!healthcare!access.! Paradigm!shifts!are! required!to!beget!a!transformation!in!the!approach!towards!health!care!in!the!country,!such!that!we!begin!taking!wellSthoughtSof!steps! towards!managing!the!issues!rather!than!just!identifying!them!and!finally!achieve!the!goal!of!universality!along!with!quality.!Sustainability! of!these!efforts!is!essential!and!therefore!we,!at!India!Health!Progress,!robustly!support!continuum!of!access!to!health!care!and!ensuring! availability! of! the! required! resources! and! infrastructure! to! each! individual.! This! requires! collaborative! action! from! every! stakeholder! attached!to!healthcare!delivery!!be!it!doctors;!diagnostic!centres;!patient!groups;!nursing!and!medical!staff;!various!healthcare!service! providers;!insurance!sector;!the!pharmaceutical!industry;!industry!bodies;!NGOs;!academia;!Government!!at!the!state!and!central!level;! and!the!media.! ! With! 18%! people! in! rural! areas! and! 10%! in! urban! receiving! no! health! care! at! all,! the! case! for! health! system! reform! and! defining! the! solutions!to!the!problems!as!well!as!the!role!of!each!stakeholder!couldnt!be!stronger.!Acting!as!a!catalyst!and!a!platform!for!each!part!of! rd the!Indian!healthcare!pie!to!discuss!the!course!of!conduct!in!their!area,!the!IHP!Roundtable!held!on!3 !November!2012!mooted!the!way! forward! in! formulating! a! roadmap! to! achieve! the! common! goal.! IHP! recognised! four! major! areas! ! Infrastructure,! Human! Resources,! Finance! and! Drug! Availability! SS! in! which! challenges! exist.! Outlining! the! ways! to! overcome! them,! brainstorming! was! done! in! several! aspects! of! these! areas,! including! role! of! diagnostic! centres! in! prevention! of! diseases! apart! from! detection;! patient! advocacy! for! strengthening!patient!voices;!technology!and!innovation!as!key!drivers;!the!issue!of!lack!of!medicines!as!well!as!ensuring!quality!of!drugs;! responsibility!of!the!media!in!educating!the!masses;!public!private!collaborations!for!more!outreach!and!fighting!the!problem!of!finances;! and!the!importance!of!the!global!pharmaceutical!industry!in!leveraging!sustainable!initiatives.!!!!!!!!!!!!!! ! The! Government! ! not! just! the! health! ministry,! but! also! others! such! as! environment,! urban! development! and! human! resource! departments!SS!has!to!take!up!prevention!of!illnesses!as!a!huge!cause!by!addressing!lack!of!basic!infrastructure,!including!potable!water,! sanitation! and! housing,! as! well! as! inadequate! delivery! systems! like! primary! healthcare! setups! and! diagnostic! centres.! Apart! from! extending!public!services,!encouraging!the!public!private!model!is!immensely!vital!for!successful!rollout!and!implementation!of!universal! health!care!in!the!country.!!! ! Augmenting!the!number!of!medical!personnel!and!empowering!them!by!way!of!better!training!and!skill!development!can!resolve!one!of! the! biggest! challenges! the! Indian! healthcare! industry! faces! ! that! of! human! resource! development.Increasing! public! expenditure,! enhancing! the! penetration! of! insurance! schemes,! extending! their! mandate! to! include! medicines,! and! moreover! effective! utilisation! of! available!funds!are!required!to!accelerate!easy!availability!of!finance.!Introduction!as!well!as!implementation!of!innovative!schemes!such! as!Rashtriya!Swasthya!Bima!Yojana!must!assist!in!this!regard.!!!!!!!!!!! ! Moreover,!the!pressing!issues!of!irregular!drug!supplies!and!poor!delivery!channels!for!outreach!require!improved!distribution!channels! so!that!branded!and!generic!drugs!are!easily!obtainable.!! ! Achieving!all!this!requires!a!collaborative!approach,!in!which!each!and!every!stakeholder!contributes!and!allies!with!others!in!the!field!to! make!access!to!health!care!a!reality.!Without!such!cooperation,!our!efforts!will!go!in!vain.!!! !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!"Aman"Gupta,"Principal"Advisor,"IHP!

Its%time%to%take%a%quantum%leap%in%healthcare%
Dr%Y%K.%Gupta,%All%India%Institute%of%Medical%Sciences%
! A!few!things!have!to!be!considered!about!access!to!health!care!in!the!Indian!perspective.!The!scenario!of!US!and!European!countries!is! very!unlike!India,!with!different!socio!economic!situation,!education,!myths!and!perceptions.!Moreover,!the!Indian!economy!is!at!a!good! stage!now!and!therefore!this!is!the!time!when!we!can!take!a!quantum!leap!in!the!healthcare!sector.!! ! For! a! country! like! India! with! health! issues! as! diverse! as! diabetes,! hypertension! and! reSemergent! illnesses! such! as! malaria,! kalaSazar,! dengue,! H1N1! and! even! simply! diarrhoea,! we! cannot! think! of! anything! else! unless!we!adopt!high!technology.!And!this!technology!will!only!provide!an!answer!to!reach!not!only!to!the! metro!cities!but!also!to!the!remotest!area!where!nothing!is!available.!The!preventive!aspect!of!health!care!is! very! important! but! not! enough! money! has! been! invested! on! prevention.! Across! the! country,! the! type! of! hygiene!that!we!have!accustomed!to!is!horrible.!That!requires!a!change!of!mindset!SS!not!only!at!institutions! but!also!at!the!grassroots.!! ! The! second! aspect! is! positive! health! promoting! SS! once! you! have! achieved! that! positive! health! it! is! very! important! to! maintain! that! health,! particularly! if! you! are! becoming! aged! or! you! are! exposed! to! environmental! pollution.! Therefore,! lifestyle!management!is!important.!That!is!why!the!philosophy!of!ayurveda,!yoga!and!meditation!is!considered!the!wealth!of!India!which! is!now!being!adopted!by!the!US!and!European!community.!I!think!that!has!to!be!scientifically!validated,!upgraded!and!taught,!and!a!huge! investment!in!the!right!method!should!be!done!into!that.!! ! The!third!aspect!is!the!diagnostics.!Once!you!have!suspected!disease,!the!most!important!thing!is!that!one!has!to!have!an!accurate!and! fast!diagnosis!so!that!you!can!start!the!treatment!in!the!right!direction!rather!than!being!at!an!empirical!stage.!What!you!need!today!is! quality! diagnosis.! Quality! means! that! you! need! to! have! a! standard! operative! system,! Quality! Assurance/Quality! Control! as! well! as! accreditation! of! laboratories.! The! main! thing! is! that! the! diagnosis! should! be! affordable.! We! have! to! develop! a! system! of! affordable! diagnostics!and!point!of!care!diagnostics.!! ! India!is!one!of!the!largest!manufacturers!and!exporters!of!vaccines!in!the!world.!But!today!the!question!is:!Can!we!develop!a!vaccine,! which!is!multivalent,!that!can!cover!large!number!of!infections!and!be!given!as!one!shot!so!that!the!compliance!becomes!much!easier?! The!Department!of!Biotechnology!has!a!huge!programme!for!the!development!of!vaccines!in!India!and!several!new!investigative!drugs! are!being!submitted!for!these!vaccines!like!rotavirus!vaccine,!malaria!vaccine!and!many!more.! ! The! drug! issue! or! the! medicine! issue! is! another! one.! Today,! we! are! not! only! selfSsufficient! in! medicine! but! also! a! major! exporter! of! medicine.!The!issue!is!the!quality!of!medicine!and!for!that!we!need!to!have!a!system!that!can!quickly!identify!what!is!the!good!quality.! The!reason!is!that!we!do!not!even!know!the!extent!of!substandard!medicine!in!India.!Another!important!thing!is!that!we!do!not!have!the! capacity!also!in!India!to!quickly!identify!the!standard!of!medicines.!! ! Lastly,!the!mindset!and!the!attitude!of!the!prescribing!doctor,!the!patient,!the!paramedics,!the!public!and!the!media!about!the!use!of! medicine!are!vital.!Its!the!general!belief!that!the!branded!is!a!pure!drug,!a!safer!drug,!whereas!with!the!generic!drugs!there!is!a!may!be! attached.!This!myth!does!not!develop!overnight,!it!develops!because!of!the!experience!of!the!people!which!gets!propagated!rightly!or! wrongly!and!not!negated!because!of!the!lack!of!evidence.!! ! We!did!a!project!with!Jan!Aushadhi!and!analysed!about!1,600!samples!of!Jan!Aushadhi!from!all!the!centres!of!pharmaceutical!project,! and!not!a!single!drug!was!sub!standard.!Now!this!is!what!needs!to!percolate!SS!that!a!drug!which!is!cheap!and!generic!not!necessarily! means! it! is! of! poor! quality.! And! this! needs! to! be! propagated! as! there! is! a! tremendous! pressure,! including! monetary,! media! and! advertising.!But!there!is!also!reason!to!believe!that!the!treating!physicians!have!experienced!a!few!samples!of!generic!medicines!become! ineffective,!and!then!the!confidence!shakes.!Therefore,!this!shift!has!to!take!place.!! ! Finally,! all! these! issues! SS! from! the! sensitisation! of! the! public,! awareness! of! all! these! sectors,! creating! technology! to! reach! masses,! implementation,! creating! rules! and! regulations! and! enforcing! them! at! different! places! staring! from! manufacturing! process! to! quality! control!to!prescribing!to!punishment!if!there!is!a!perilous!drug!SS!require!whats!known!as!a!shake!hand!approach.!! ! Shake! hand! approach! means! that! it! has! to! be! not! only! the! responsibility! of! the! government! alone.! So! regulator,! government,! media,! educated!and!uneducated!people,!leaders!in!the!villages!and!panchayats!need!to!come!together.!The!blame!game!must!stop.!The!shake! hand!approach!is!the!answer!and!technology!is!the!medium.!!!

Draw%a%Preventive%Model%with%Emphasis%on%Quality%Diagnosis%

(Hony)%Brig%Dr%Arvind%Lal,%Padma%Shri,%Chairman%&%Managing%Director,%Dr%Lal%PathLabs! ! Over!the!years,!the!healthcare!scenario!in!India!has!mostly!focused!on!combating!communicable!diseases!such!as!tuberculosis,!AIDS!and! other! infectious! illnesses! that! take! a! heavy! toll.! Only! recently,! the! importance! of! curbing! the! near! epidemic! situation! of! nonS communicable!diseases!(NCDs)!has!come!to!the!fore.!! ! The! incidence! of! NCDs! is! increasing! at! an! alarming! rate! in! the! country,! with! 61.3! million! people! living! with! diabetes,! nearly! 550,000! cancer!deaths!in!a!year,!and!65!million!Indians!likely!to!be!affected!with!heart!disease!by!2015.!! ! In! such! a! situation! also,! owing! to! a! highly! fragmented! diagnostic! industry,! diagnosis! as! a! tool! of! prevention! of! diseases! is! not! used! effectively!in!India.!When!70%!of!clinical!decisions!!causes!of!illnesses!starting!from!fever,!indications!for!surgery,!patient!admission!or! discharge!SS!are!based!on!lab!tests,!it!becomes!essential!to!have!faster!diagnosis!resulting!in!reduced!hospital!stay.!! ! The! scientific! management! of! a! disease! is! possible! only! after! correct! diagnosis! with! tests! and! this! also! leads! to! huge! cost! saving! in! healthcare!expenses!and!spending!on!drugs.!! ! The!suffering!caused!by!many!diseases!can!be!reduced!by!detecting!early!changes!in!the!body!with!the!help!of!diagnostic!tests.!A!host!of! diseases!can!be!prevented!and!their!complications!avoided!with!maintenance!of!various!parameters!in!the!body.!!!!!!!!!! ! In! diagnosis,! like! everything! else,! accessibility,! affordability! and! quality! are! the! three! main! challenges.! Labs! or! collection! centres! are! missing! from! scores! of! Indian! villages! with! almost! nil! infrastructural! support! in! the! form! of! roads,! electricity! and! water.! Moreover,! diagnostic! tests! are! quite! expensive! ! leading! to! lack! of! access! and! causing! more! disease.! Dearth! of! skilled! medical! professionals! and! weak!governmental!regulations!causes!unrestricted!proliferation!of!subSstandard!diagnosis!in!the!country.!!!!!! ! A! highStech! hub! and! spoke! model! with! large! test! menus! at! the! centres! as! well! as! stateSofStheSart! design! and! implementation! of! best! practices! are! the! solution! to! these! issues.! Good! quality! pathology! education! with! highSlevel! training! of! medical! or! paramedical! lab! personnel! can! also,! moreover,! assist! in! better! services.! With! reasonable! prices,! allSround! accreditation! and! tighter! government! regulation,!proper!basic!tools!of!disease!detection!can!be!made!available!to!all.! ! Public!Private!Partnerships!must!be!nurtured!both!in!operating!labs!and!training!personnel.!A!greater!adoption!of!technology!as!well!as! more!research!and!development!are!the!need!of!the!hour.!Ideally,!diagnosis!should!also!be!included!in!health!insurance.!! ! Such!measures!will!place!diagnosis!as!a!preventive!modality!in!health!care,!apart!from!being!a!basis!for!! medical!decisions!post!illness.!"% % ***%
!

Advocating%the%Case%of%the%Patient%%%%
Ratna%Devi,%Independent%Expert%on%Public%Health%
! The!endSuser!in!the!healthcare!scenario!is!the!patient!and!he!should!be!the!focus!of!any!discussion,!recommendation!or!policy!regarding! access!to!medical!facilities.!Support!to!the!cause!of!patients!to!receive!correct!diagnosis!and!timely!as!well!as!costSeffective!treatment!for! any!disease!on!the!face!of!the!earth!is!the!need!of!the!hour.!!! ! A! very! important! aspect! that! is! often! not! included! in! continuum! of! care! is! psychoSsocial! support! required! by! a! patient! of! a! lifeSlong! illness.! Patients! with! paralysis,! cardiac! event! or! those! who! have! got! amputated! after! diabetes! would! need! such! kind! of! support.! This! includes!rehabilitation!and!livelihood!opportunities!for!medication!continuation!and!to!sustain!regular!life.!!! ! The!preventive!and!accountability!aspects!have!to!involve!each!individual,!community,!care!providers!and!Government!at!all!levels.!! ! There! is! also! a! need! for! more! patient! voices! in! getting! access! to! health.! Patient! welfare! groups! are! present! but! fewer! patients! are! involved!in!these.!Patient!involvement!is!a!must!for!disease!prevention!and!early!treatment.!Moreover,!prevention!is!still!not!understood! as!an!important!aspect!by!the!people.!There!is!an!intervention!only!when!there!is!a!major!health!incident.!This!disappointing!reality!has! to!be!changed.! !

One!of!the!most!successful!patient!advocacy!groups!in!terms!of!awareness!generation!has!been!for!AIDS.!For!other!diseases,!including! rare!illnesses,!such!groups!are!started!with!a!small!group!of!patients,!their!relatives!and!physicians!but!they!need!to!be!lent!more!support! and!expanded!by!registering!them!under!a!national!registry.!! ! In!the!case!of!diseases!such!as!diabetes!and!renal!illnesses,!women!self!help!groups!have!been!able!to!spread!word!at!the!community! level.!Village!health!committees!have!also!come!forward!in!this!regard.!But!surely;!more!activities!can!be!done!at!the!school,!village!and! community!levels!for!wider!dissemination!of!knowledge.!!!! ! What! works! is! a! belief! in! the! cause.! Advocacy! for! the! cause! by! famous! personalities,! political! affiliation! and! commitment! from! the! physician!community!also!help.!! ! Though! challenges! such! as! difficulty! to! mobilise! people! into! groups;! lack! of! funding! and! resources! for! group! activities;! lack! of! commitment!from!government!and!other!agencies;!and!the!perennial!problem!of!Indias!size!in!area!and!population!do!exist,!a!focused! approach!as!well!as!concerted!effort!can!assist!patient!groups!trying!to!create!awareness!and!gather!support.!! ! ***! %

Utilize%the%potential%of%the%pharma%industry%
Mr%Ranga%Iyer,%Advisor,%India%Health%Progress%and%Ms%Amiee%Adasczik,%Assistant%Vice%President,%PhRMA!
! It!is!increasingly!being!recognised!now!that!just!as!joint!efforts!are!required!in!every!area!of!development,! the! health! sector! too! needs! to! benefit! from! the! public! private! partnership! model.! In! this! context,! the! pharmaceutical!industry!!both!local!and!global!!can!act!as!a!strong!supporter.!Not!much!is!known!about! the!work!actually!being!done!by!the!pharmaceutical!companies!and!their!contribution!to!the!healthcare! sector.!While!they!do!try!and!meet!the!unmet!medical!needs!of!a!lot!of!people,!by!not!only!promoting! medicines,!but!by!innovating!and!introducing!newer!drugs,!there!is!a!huge!vacuum!that!still!needs!to!be! filled!!a!space!which!can!be!occupied!and!filled!by!the!sector.!! ! The!pharmaceutical!sector!plays!a!very!different!role!in!its!own!capacity!in!very!specific!areas.!For!example,!Arogya!Parivar!supported!by! Novartis!has!a!social!programme!to!reach!out!to!the!rural!masses!by!way!of!drugs!and!vaccines!for!various!illnesses.!Patient!education! and!local!capacity!building!are!a!part!of!the!initiative!to!make!it!a!sustainable!effort.!Similarly,!global!companies!like!Sanofi,!Pfizer!as!also! their!Indian!counterparts!have!their!own!such!initiatives.!There!are!several!individual,!expansive!and!clear!access!programmes!being!run! by!companies;!though,!they!may!not!be!collaborated,!coordinated!or!well!organised!for!people!to!know.! Despite!this,!there!is!a!huge! access!gap.!! ! The!need!of!the!hour!is!PPP!!a!clearly!defined!model!which!states!the!role!each!one!would!play.!Similarly,!examples!of!the!BOT!(BuildS OperateSTransfer)!model!used!elsewhere!can!also!be!identified!and!replicated!here.!That!said,!the!government!must!also!capitalize!on! the!efficiencies!of!the!private!sector!with!the!latter!making!an!effective!use!of!the!expansive!network!support!that!the!government!can! offer.!Such!joint!efforts!could!go!a!long!way!in!paving!the!way!for!better!healthcare!accessibility!in!the!country.!! ! The! global! pharmaceutical! industry! can! also! help! in! enhancing! disease! awareness! both! at! the! patient! and! physician! levels! with! the! immense!knowledge!it!possesses!in!the!areas!of!screening,!awareness,!diagnostics!and!treatment!protocols.!Parallely,!the!industry!could! bring!forth!best!practices!that!could!be!further!customized!to!meet!specific!needs!in!the!Indian!context.!! ! Another!area!where!the!pharmaceutical!industrys!capacity!can!be!utilised!is!technology!!technology!to!reach!the!masses,!the!patients! and!doctors!!introduce!seamless!communication!for!ensuring!greater!awareness.!In!addition,!newer!ways!can!be!developed!to!provide! greater! thrust! to! the! aspect! of! awareness! creation.! For! example,! pharmaceutical! companies! can! partner! with! pharmacy! colleges! to! devise!ways!for!countering!issues!related!to!spurious!drugs!other!than!developing!antiScounterfeit!technologies.!! ! It!is!essential!to!explore!opportunities!and!options!and!derive!on!the!strengths!of!all!stakeholders!to!make!way!for!a!seamless!healthcare! system!in!India.!! ! ***!

% More%spending%essential%to%push%health%reforms%on%the%fast%track%

Edited"excerpts" Vishal%Gandhi,%Managing%Partner%&%CEO,%BioRX%Venture%Advisors%Pvt.%Ltd% Pervez%Ahmed,%Founder%Chairman%&%Managing%Director,%Apka%Urgicare%Pvt%Ltd.%

! There! is! no! escaping! the! fact! that! more! investment! is! needed! to! make! universalisation! of! health! care! a! reality.! It! is! important! for! the! government!to!formulate!the!right!policies!that!are!really!conducive!to!further!investment.!In!the!case!of!public!private!partnerships!also,! there!is!a!need!to!find!why!they!havent!worked!yet,!as!PublicSPrivate!is!the!future!as!far!as!the!health!industry!is!concerned!!be!it!in!the! area!of!medicines,!vaccines,!diagnostics!or!other!allied!areas.!A!structure!that!is!favorable!for!a!more!operational!role!for!private!players! is!required.!NonSaffordability!of!diagnostics,!drugs!and!treatment!costs!is!one!of!the!major!hurdles!in!reaching!out!to!the!masses.!While! the!government!has!a!social!responsibility,!the!corporate!sector!has!to!survive.!And!while!for!the!latter,!sustainability!means!profitability,! it!should!not!be!allowed!to!affect!the!affordability.!! ! Similarly,!insurance!options!are!limited!with!lack!of!general!awareness!of!governmental!schemes.!The!number!of!people!under!health! insurance! cover! has! to! be! drastically! increased.! Apart! from! more! public! expenditure! on! health! care,! the! question! is! also! of! allocating! funds! to! various! areas! that! are! lacking! in! reform.! NonScommunicable! diseases! and! their! prevention! is! one! such! area.! Moreover,! sustainability!of!good!quality!medical!services!can!only!be!achieved!when!they!are!also!economically!viable.!Transparency!in!investment! and!utilisation!of!funds!is!also!an!important!factor.!! ! Economic!viability!is!an!important!component,!basis!which!any!policy!or!partnership!should!be!based!so!that!these!are!a!success!in!the! long!term.!!! ! ***% %

Forging%ahead%towards%universal%access%to%healthcare%
Recommendations%of%the%panel%at%the%roundtable%hosted%by%India%Health%Progress% ! Finally,!we!reach!a!point!where!we!understand!various!insightful!ways!to!promote!healthcare!access!in!the!country!with!concerted!and! cooperative!efforts!of!all!stakeholders!involved.!Large!awareness!generation!campaigns!and!programmes!can!not!only!benefit!the!poor! and!mobilise!communities!in!the!fight!against!diseases;!it!will!also!help!increase!the!levels!of!health!literacy!in!the!country!for!prevention! as! well! as! proper! treatment.! So! while! we! talk! about! preventive! measures,! the! need! is! to! ensure!early! education! ! right! from! primary! schooling!system!S!that!inculcates!practices!of!good!hygiene!and!cleanliness.!Furthermore,!a!preventive!model!must!answer!the!question! of!how!to!spend!money!assigned!to!various!areas!such!as!nonScommunicable!diseases.!! ! One!major!factor!that!needs!to!be!emphasized!on!is!human!resource!development!in!the!field!of!medical!services!across!multiple!layers! ! be! it! nurses,! paramedics,! chemists,! counselors! or! others.! There! is! an! urgent! need! of! having! more! medical! professionals! who! are! competent! and! capable! of! handling! various! situations.! They! must! also! be! empowered! both! in! terms! of! training! and! skills! as! well! as! decisionSmaking.!Moreover,!without!technology,!a!country!where!accessibility!of!most!things!is!an!issue!cannot!be!successful!in!any!area.!!! ! It! has! been! understood! that! any! kind! of! delivery! of! services! has! to! be! sustainable! and! it! will! be! possible! by! involvement! of! private! players.!The!clout!of!the!private!sector!must!be!used!to!strengthen!the!economic!viability!of!services.!! ! Pricing! and! quality! of! drugs,! diagnostics! and! treatments! have! to! be! considered! simultaneously! so! that! more! and! more! people! feel! confident! to! take! advantage! of! the! health! facilities.! There! is! also! a! need! for! the! media! to! play! a! much! larger! role! in! highlighting! and! creating!awareness!about!prevention!of!diseases,!especially!those!related!to!lifestyle!and!communicable!diseases.!! ! The!government!has!to!be!the!harbinger!of!right!policies!!policies!that!provide!an!environment!where!each!stakeholder!can!do!their!bit! in!the!larger!interest!of!the!healthcare!needs!of!the!country.!Rightly!said,!the!need!is!to!ensure!collaborative!or!a!shakeShand!approach!to! ensure!a!healthy!future!for!the!country.!! ***! ! ! !
81/2,!Second!Floor,!Opposite!STC!Housing!Colony,!Shri!Aurobindo!Marg,!Adhchini,!New!Delhi!!110017! Tel:!+91S11S46668640!|!Fax:!+91S11S!4666865!|!Web:!www.indiahealthprogress.in! ! Follow!us!! !

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