— Photo: M. Vedhan

MORE LAURELS: Prof. M.S. Swaminathan, president, Voluntary Health Services (VHS), confers the K.S. Sanjivi Endowment Lecture Gold Medal on Prof. Amartya Sen, Nobel Laureate, in Chennai on Saturday. N.S. Murali, honorary secretary, VHS, is beside him.

CHENNAI: Health is influenced not just by health care and the use of medicine, but also by general economic prosperity and social cohesion, and economic and social inequalities, Nobel Laureate Amartya Sen said here, on Saturday. Though economic prosperity helped in the achievement of good health, it alone may not be able to guarantee it in a society.

Delivering the 14th K.S. Sanjivi Endowment Lecture on `Health and Society' at the Voluntary Health Services in Taramani, Prof. Sen called for "fuller recognition" of health as a human right.

"Dislodge barriers"

This would provide a huge political incentive to fulfil that claim. "Those barriers that can be removed, including institutional and economic ones, need to be dislodged as widely and as rapidly as possible," he said.

Drawing parallels between India and China to highlight his point on the role of economic prosperity in facilitating good health, the Nobel Laureate said China had managed to achieve astounding progress in general health and longevity during a period of moderate economic growth.

Life expectancy

These achievements in the pre-reform (pre-1979) era in China were not matched by progress in the post-reform period. After the economic reforms, which ushered in a period of sustained growth and super-rapid expansion, progress in life expectancy slowed down dramatically, he said.

This slow-down could be expected as China already had a high life expectancy at birth (around 68 years) and a high absolute level of longevity made further expansion difficult.

However, China's life expectancy was still moderate compared to other societies in which the progress of longevity expansion had continued to occur at a very high rate.

Analysing the reasons for the slow-down, Prof. Sen said the abolition of universal public insurance of health care had a big role to play. To see health as a human right would make a strong case for reestablishment of universal health coverage.

Longevity

Those parts of India that had high life expectancy by 1979, partly because of following the Chinese model of social commitment, — particularly Kerala — have continued to have high rates of longevity expansion and mortality reduction. Though Indian longevity had grown, on an average, three times as fast as that in China since 1979, it had a lot of catching up to do with China.

The issue to be considered is not the elimination of private health care, but the expansion of public health care, the Nobel Laureate said. "In thinking about health as a human right, we must, therefore, seek an adequately capacious view of private and public actions for better health." Ensuring health coverage for all as a part of the human right to basic health need not await the distant possibility of the disappearance of inequalities in income and wealth, he argued.

Prof. Sen said K.S. Sanjivi was a pioneer in building VHS, a major landmark in India and the world, in order to put health care within the reach of all. A wide range of policies and actions have strong influence on human health and they have to be taken into account comprehensively in order to advance good health — reduce avoidable morbidity and escapable mortality — across the globe.

"Dr. Sanjivi was right to think that we can make the world a very different place," Dr. Sen concluded.

M.S. Swaminathan, president, VHS, spoke about the vision and commitment of Dr. Sanjivi, whose centenary was celebrated in 2003-2004. VHS was conceived of, and stood for the purpose of advancing health equity, he added. N.S. Murali, honorary secretary, VHS, also spoke.

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