Spend more on health: Sachs

By Our Special Correspondent

NEW DELHI, SEPT. 8. The well-known economist, Prof. Jeffrey Sachs, has urged policy-makers in this country to raise the spending on health services because of its impact on economic growth. He noted that India was spending only 0.9 per cent of the GDP on the health sector as against an average of 2.2 per cent for other developing countries.

Conceding that it would be difficult for India to allocate substantial amounts in view of its huge debt burden, he felt the proportion of funding should at least equal that of much poorer countries. He suggested that funds raised through the disinvestment process could be earmarked for improving health services and described the urgency in this regard as a ``matter of national conscience''.

Delivering a lecture on ``Investing in Health for Economic Development'' organised by the Indian Council for Research in International Economic Relations (ICRIER) here today, he highlighted the need for the developed world to make a significant contribution to support better health infrastructure in the South. The World Health Organisation's Commission on Macroeconomics and Health, which he is now heading, will shortly recommend that developed countries contribute around $25 billions annually, is five times the existing level.

Prof. Sachs, who is the Director of Harvard's Centre for International Development, pointed out that improved health of the general populace leads to higher productivity and better educational performance and results in lower fertility levels. Equally important is the fact that prevalence of disease can affect inflow of investments such as in Africa where the spread of AIDS has scared away investors.

He recalled that the construction of the Panama Canal was delayed by 40 years because the prevalence of yellow fever and malaria in the region which led to the death of workers on the project. He said the consequences of ill-health on economic well-being is huge and the benefits of addressing it are equally high.

In the case of India, the conditions that account for the avoidable mortality include hepatitis B, respiratory infections, diarrhoea-related illnesses, lack of micro-nutrients in the diet and maternal and peri-natal mortality. Besides, 50 per cent of deaths are accounted for by communicable diseases, which is high. This is despite the existence of relatively inexpensive interventions available such as for tuberculosis.

On the available solutions, Prof. Sachs said the cost needed for essential health interventions is estimated at $30 to 40 per person per year for India as against $4400 in the U.S. India is spending about $3 in the public sector and $20 in the private sector, he said, describing the gap in public spending as ``quite shocking''.

He conceded there was no way the country could bear the burden of better healthcare through domestic resources. He felt there had to be better cooperation between low income countries and the developed world on this issue. The WHO's Commission was therefore planning to recommend that rich countries should contribute 0.1 per cent of the GNP for the health sector in developing countries. An ``international partnership'' was essential in this sector, he said.

He underlined the need for cooperation at the policy level between the Finance and Health Ministries to recognise the importance of such investments. Secondly, cooperation was needed between the Centre and States since health is primarily a State responsibility. He also urged cooperation between the Government and civil society as private sector has an important role to play.

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