2.5% GDP a far cry, India slashes funding for flagship health mission

Despite assurances on the contrary since NDA was voted to power three years ago,  the Indian government has slashed funding for its flagship health programme the National Health Mission.

Expenditure Finance Committee a crucial decision making body on government expenses has approved Rs 85,217 crore for NHM  for a period of three years. This is a little over 25% less than the NHM allocation for the 12th five year plan which was s 1.94 lakh crore for the 2012-17 plan period. Along with the 40% contribution of the state, the actual spend on NHM over the next three years will come to about Rs 1.33 lakh crore.

The Union health ministry had sought Rs  1.59 lakh crore when it moved in March this year for the extension of the flagship health programme. The fund cut is significant because the National Health Policy adopted earlier this year commits to increase health spend to 2.5% GDP.  Interestingly though health minister J P Nadda has told in multiple fora, that there is no dearth of funds for health, only states are not in a position to absorb a 2.5% health spend, his own ministry clearly thought otherwise, when it sought a more than 75% increase in NHM budget. Health being a state subject NHM is actually implemented by the states through programme implementation plans approved by the Centre.

The final NHM allocation was conveyed to the ministry of health by the finance ministry through a letter dated October 17. During the preceding consultation Niti Ayog came down heavily on the health ministry for lack of convergence, the vertical diseases approach and the Rs 500 crore administrative cost of the mission. A mission cannot be continuing forever, the Ayog told the ministry in a tersely worded communication.

Started in 2005 as the National Rural Health Mission and expanded into an additional urban component in 2013, the National Health Mission has for years been the most important programme run by the ministry of health. Niti Ayog comments on the EFC note for the continuation of NHM from April 1, 2017 to 31.3.2020 read:  “Time limit for the Mission needs to be clearly defined (i.e. end of the EFC period) and a Mission should not be continuing forever, more so when there is huge unrest across the country among health workers about the (wage) disparities”.