India pledged along with other WHO member Nations, 'Health for All by the Year 2000' at Alma-Ata in 1978; and in the same year signed the International Covenant for Economic, Social and Cultural Rights Article 12, in which the State is obliged to achieve the highest attainable standard of health. However the health scenario in India is abysmal.
In India, annually 22 lakh infants and children die from preventable illnesses; 1 lakh mothers die during child birth, 5 lakh people die of Tuberculosis. Diarrhoea and Malaria continue to be killers while 5 million people are suffering from HIV/AIDS.
In context of poverty, access to public health systems is critical. However, since 1990s, the public health system has been collapsing and the private health sector has flourished at the cost of the public health sector.
Health policy in India has shifted its focus from being a comprehensive universal healthcare system as defined by the Bhore Committee (1946) to a selective and targeted programme based healthcare policy with the public domain being confined to family planning, immunization, selected disease surveillance and medical education and research.
The larger outpatient care is almost a private health sector monopoly and the hospital sector is increasingly being surrendered to the market. The decline of public investments and expenditures in the health sector since 1992 has further weakened the public health sector thus adversely affecting the poor and other vulnerable sections of society. Introduction of user fees for public health services in many states has further reduced their access to health services.
The time has come to reclaim public health and make a paradigm shift from a policy-based entitlement for healthcare to a rights based entitlement. For this healthcare has to become a political agenda.
The above and related issues have been discussed at great length, with solid evidence and within a historical context in an edited volume published by CEHAT titled Review of Healthcare in India. The book includes six sections across 400 pages including critical topics like health policy making in India, public health services in India, communicable diseases, community health programs, population policies, mental health, children's health, reproductive health, Indian systems of medicine, healthcare financing, the private health sector, inequities in healthcare access, availability of drugs, right to healthcare and legal issues and an elaborate statistical appendix covering health status, health infrastructure and personnel and health expenditures. The authors include Ritu Priya, Mohan Rao, Ravi Duggal, T. Sundararaman, S. Srinivasan, Anant Phadke, Rama Baru, TR Dilip, Leena Gangolli, SV Joga Rao, Leena Abraham, Abhay Shukla, Vandana Prasad, Padma Deosthali, Poornima Maghnani, Rakhal Gaitonde, Aparna Joshi and the SAMA team. The Preface has been written by B. Ekbal, the National Convenor of Jan Swasthya Abhiyan and the volume has been edited by Leena Gangolli, Ravi Duggal and Abhay Shukla.