75 Years Of Health, Nutrition & Hygiene In India: What Have We Learned & The Road Ahead

New Delhi: NDTV-Dettol have been working towards a clean and healthy India since 2014. This year, the campaign moves forward into the eighth year. To kick-start the season, on October 3, the 12-hour of Swasth Bharat, Sampann Bharat telethon as a part of Banega Swasth India campaign was organised. The telethon saw many eminent personalities coming together to put the focus on Health, Hygiene and Nutrition that lays a foundation for a Swasth and Healthy India. This year, the agenda of the telethon was also on – One Planet, One Planet, One Health and One Future – Leaving No One Behind as human health is dependent on the environment they live and together clean and healthy environment is the foundation for a good health.

The first session saw a discussion on ’75 Years of Health, Nutrition & Hygiene in India’.

Campaign Ambassador Amitabh Bachchan who initiated the session said, “If the health of the country is not good, even the GDP of the nation falls. Despite the fact if you are a rich country or a popular country, if you are not healthy, you will not grow. The universality of the problem has become one ”

The experts who joined the discussions added:

The Vice President of India, M. Venkaiah Naidu talked about the importance of the campaign and how the theme ‘leaving no one behind’ can make a difference. He said:

COVID-19 pandemic has taught us many important lessons. It has also generated awareness; every one of us, have now become aware, from individuals to governments, that we have to focus greater attention on health.

India has made significant gains in health indices since the Independence, the centre and state must work in a team to further improve the health indices of the country. Be it be infrastructure, availability of doctors, nurses and modern health care facilities. One is increasing public spending on health. There is also the need to augment the health infrastructure at various levels, through public provide partnership. The stark disparities in health infrastructure between urban and rural areas need to be bridged.

Nitin Gadkari, Minister for Road Transport & Highways spoke about strengthening our infrastructures and healthcare systems, he said:

The aim for One Health, One Planet and One Future is correct and it is government’s priority as well, but we need citizen’s support. We need to assess our strength and weaknesses. The challenge current with us is of managing our waste and air pollution. Due to stubble burning, Delhi faces pollution, every year.  This time we got 4 air pollution manning units installed, imagine if we have 100 such units. So, we need to strengthen both our infrastructures and healthcare system in coming few years, so we all are better prepared.

Dr NK Arora, Head, National Technical Advisory Group on Immunisation talked about the importance of focussing on vaccines and COVID-19 vaccination programme, he said:

We have vaccinated over 90 crore people against COVID-19 and we will continue to increase this number with each passing day. As far as availability of vaccines is concerned, it is sorted. All vaccines manufacturers have started stock piling the vaccines and we will soon have 6 crore vaccines, so there will be no shortage as such. In 6 months time, we have seen that we can administer 1-2 crore vaccine doses a day. Lastly, if we can ensure that the excitement among people for vaccines continues then we will be able to achieve our goal.

Dr Srinath Reddy, President Public Health Foundation of India, Padma Bhushan Awardee spoke about COVID-19 and the road ahead, he said:

We have to live with the fact that virus is going to stay with us, I don’t think it will ever get extinguished. All we can hope is to build immunity of people so that they don’t get terribly sick. How do we do that? It can only be done by taking series of public health measures like masking and vaccination. If we do all this, the virus will become less virulent. Many viruses have altered their behaviour to adopt to human community and co-exist. It is our behaviour that determines the virus behaviour. We should not become careless nor expect that the virus will go away permanently. Vaccines should be taken as that will help give a boost to our immunity. Everyone should get these two doses, the variants can develop and creep back anytime.

Junaid Ahmad, Country Director, India, World Bank spoke about the learnings from COVID-19 and said:

Three factors that we must learn and implement from the COVID-19 pandemic, I think the world and India have discovered that we must give it back into public health. We now discovered that unless we go into preventive measures, into public health, nations won’t be able to improve public health. How do you rediscover and reimagine public health, for example, India has world’s largest healthcare workers – ASHA and Anganwadi. They are future of India. POSHAN Abhiyaan – world’s largest nutrition programme, it can only work if there is interface between communities. What to eat, when to eat. For me, the story that came out of COVID is that India needs to strengthen public health at tier 3 – panchayat level.

Soumya Swaminathan, Chief Scientist, World Health Organisation talked about the biggest achievements in Health sector in the last 75 years and said:

One of the first achievements I would like to highlight is the elimination of polio and a few other vaccine preventable diseases, and this is thanks to the wonderful expansion of immunization coverage. I still remember when I was a young doctor, I used to see many cases of newborn babies with this tetanus, a horrible disease. Maternal and neo-natal tetanus was eliminated thanks to immunization. So was small pox and polio. So, I would really count that as one of the top achievements. The second one would be in the area of maternal and child health, and this is thanks to improvements in antenatal care, immunization of pregnant women, institutional deliveries, and the care of the newborn after birth.

Along with that, we have expanded the coverage of family planning. And we had seen significant and sustained reductions in the total fertility rate, that is the number of children that each couple is having. And that obviously helps to control the overall population growth. The third area, I think, is really the vision, right from the beginning, for universal health coverage. And having a system of healthcare in India which goes from primary healthcare to secondary and then tertiary healthcare and provide that to people without them having to incur a lot of financial expenditure. This is something that we’re still on the path. We’re not yet where we want to be, but I think that can be achieved in coming years if we bring together programs like the Jal Jeevan Abhiyan, the Swachh Bharat Abhiyan, as well as Ayushman Bharat. We all know that to have good health – focussing on water, sanitation, hygiene are also extremely important. So bringing all of these as national programs and focusing on providing it as a part of universal health coverage, is a journey that India is on, but i’d say it’s the right path to be. And finally, I would say one of the biggest achievements perhaps has been that India has become the pharmacy of the world, when you look at diseases like TB or HIV, over 80% of the drugs used today that are affordable and of best qualities, come from India.

Also Read: Opinion: The Sustainable Development Goal Of Zero Hunger VS Where India Stands

JVR Prasada Rao, Former Union Health Secretary on the other hand spoke about areas where India is lagging after the 75 years of healthcare system, he said:

If you look at the present situation and what we have learned in last 75 years, the biggest challenge that we face even now is having a political dialogue and discourse around health.
Health is only 40 per cent with the government, 6 per cent with states. How many elections have been fought on healthcare basis? In 60s we had ‘roti kapda makaan’, did we ever have slogans like swasth, shiksha? You may say that there are 29 states, how to bring all of them together? We have seen everyone coming together in GST because there is political will.

Major challenges is also nutrition, 40 million children in our country is stunted, 25 million are wasted. Nutrition is a big failure in 75 years, now it is being given prominence. When we look at health, we only look at health ministry but there are social determinants like nutrition, education. These are contributing factors for a good health, as a policy coherence and program coherence, we are not able to bring them all together.

Also Read: Opinion: Public Health Nutrition Priorities- Disrupted But Not Defeated By COVID-19

Dr Indira Chakravarty, Former Director & Dean, All India Institute of Hygiene & Public Health, Ministry Of Health and Family Welfare & Padma Shri Awardee spoke on the importance of focussing on our nutritional goals, she said:

One of the important areas where we need to focus on an urgent basis is nutrition, which is key to safe health. Compared to many underworld countries, we are far away from our nutritional goals – Wasting is 21 per cent, 1/3rd of the wasted children globally are in our country. So, there is definitely a need to focus on this area. If India is progressing, then why do we have undernutrition at such a high rate? Anaemia is another thing. As per, National Family and Health Survey 4 of 2015-16 and 5 of 2019-20, the data shows anameia among women and children has significantly gone up, and all this we are talking before the pandemic stage.

Also Read: COVID-19 Has Made Children More Vulnerable To Malnutrition, Here’s How

Neeraj Jain, Country Director India, PATH talked about immunisation and while today, India is a leading producer and exporter of vaccines, it is still home to one-third of the world’s un-immunised children, he said:

Immunisation is clearly one of the most cost-effective interventions when it comes  to return on investment from economic perspective. I think we have achieved a lot over the last many years – reduced Under-5 mortality rate, maternal mortality, but still a lot needs to be done. We have introduced a lot new vaccines in regular immunisation like rotavirus, pneumococcal, we have been the pharmacy to the world, but in terms of reach of our own immunisation, we are still at 70-75% per cent. We have seen immunisation take a huge hit during pandemic, for future generations, absolutely important for routine immunisation programmes to work continuously.

Susan Ferguson, UN Women Representative for India highlighted the importance of gender equality, she said:

Women make up 50 per cent of the population globally. Currently, many women are at the bottom of the pyramid. There are so many women and girls who are left behind in different categories. Women need to be part of everything so that whole country reach its full development. It is important to look at gender equality as part of leaving no one behind.

Martha Chen, Development Practitioner & Scholar, Padma Shri Awardee highlighted the need on focussing on the informal workforce in India, she said:

Informal workforce of India is a link between health and prosperity. 90 per cent of all workers, that is 415 million are in informal sector. They provide healthcare, transport, waste management services and more. Their main effort is their physical labour. If they fall ill, their earnings stop immediately. If they are hospitalised, they draw their savings and go deeper into debts. Informal workers survive on their daily earning and do not have health insurance or paid sick leaves. We have to ensure they are not left behind going forward. We have to recover the economy from COVID in a way that informal workers are included. Informal workers are handicapped going forward because they have lost assets, savings, the recovery needs to build from below and provide not only health but also economic stimulus, India will prosper, if they prosper.

Watch The Full Discussion

NDTV – Dettol have been working towards a clean and healthy India since 2014 via Banega Swachh India initiative, which is helmed by Campaign Ambassador Amitabh Bachchan. The campaign aims to highlight the inter-dependency of humans and the environment, and of humans on one another with the focus on One Health, One Planet, One Future – Leaving No One Behind. It stresses on the need to take care of, and consider, everyone’s health in India – especially vulnerable communities – the LGBTQ population, indigenous people, India’s different tribes, ethnic and linguistic minorities, people with disabilities, migrants, geographically remote populations, gender and sexual minorities. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign will continue to raise awareness on the same along with focussing on the importance of nutrition and healthcare for women and children, fight malnutrition, mental wellbeing, self care, science and health, adolescent health & gender awareness. Along with the health of people, the campaign has realised the need to also take care of the health of the eco-system. Our environment is fragile due to human activity,  that is not only over-exploiting available resources, but also generating immense pollution as a result of using and extracting those resources. The imbalance has also led to immense biodiversity loss that has caused one of the biggest threats to human survival – climate change. It has now been described as a “code red for humanity.” The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene. Banega Swasth India will also be taking forward the dream of Swasth Bharat, the campaign feels that only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and the country can become a Swasth or healthy India.