New Delhi: Union finance minister Nirmala Sitharaman Thursday announced the government’s intent to launch vaccination against cervical cancer for all girls aged 9-14 years in the interim budget for 2024-25.
This comes more than a year after the National Technical Advisory Group on Immunisation (NTAGI), the central government’s top advisory body on immunisation, recommended the introduction of the vaccine through the Universal Immunization Programme (UIP).
“Our government will encourage vaccination for girls in (the) age group of 9 to 14 years for the prevention of cervical cancer,” said Sitharaman in her budget speech.
According to the World Health Organization-International Agency for Research on Cancer (WHO-IARC), every year, nearly 1,23,907 women in India are diagnosed with cervical cancer, which is caused by Human Papillomavirus (HPV), and 77,348 die from the disease.
Overall, Rs 90,657 crore has been allocated to the health ministry for FY 2024-25 — marking an increase of 1.6 percent over the full Budget presented last year, and an increase of 12.5 percent over the revised 2023-24 estimate of Rs 80,516 crore.
Of the proposed Rs 90,657 crore, Rs 3,001 crore has been allocated to the department of health research, and the remaining is to the department of health and family welfare.
In her budget speech, Sitharaman also announced that the government’s flagship health scheme, Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) will be extended to Asha (Accredited Social Health Activist) and anganwadi workers and helpers across India.
Under the scheme, secondary- and tertiary-care hospitalisation coverage of up to Rs 5 lakh is offered to nearly 10 crore of India’s poorest families.
There are nearly 10 lakh Asha workers in the country who work at the community level, functioning as healthcare facilitators, service providers and generating awareness on health issues, according to government estimates.
The number of anganwadi workers, who work as volunteers under the Centre’s Integrated Child Development Services to raise the nutrition-related parameters among preschoolers and pregnant women, stands at about 13 lakh. There are about 11.6 lakh anganwadi helpers across states, show government estimates.
The interim budget also saw an announcement by the finance minister on opening more medical colleges in the country by utilising the existing hospital infrastructure. For this, a committee will be set up, she said.
Among other initiatives, Sitharaman announced the nationwide launch of the U-WIN portal — similar to the Covid-19 vaccine management system Co-WIN — aimed at documenting all vaccination and immunisation programmes in the country, including registration, follow-ups, and vaccination certificates. A pilot related to the initiative was started in January last year.
According to public health expert Dr K. Srinath Reddy, who is a former president of the Public Health Foundation of India, there were “no big-bang announcements for the sector, likely because it was a low-key budget.”
“There was a mention of, but no clear indication on, when exactly will the HPV vaccination be rolled out in India even though it has been long overdue,” Reddy said.
“Also, the umbrella of AB-PMJAY has been extended slightly to include Asha and anganwadi workers, but I think the majority of them will already be covered by it given their socio-economic backgrounds,” he added.
On the announcement related to medical colleges, he said it would be beneficial only if district hospitals were upgraded as medical colleges, rather than the private sector joining the initiative.
Meanwhile, Ameera Shah, promoter and managing director, Metropolis Healthcare — an Indian multinational chain of diagnostic labs — acknowledged the initiatives, but said she had hoped for deeper investment and resource allocation in the healthcare sector.
“India should prioritise and invest more in healthcare, exploring public-private partnerships to enhance services without significantly increasing budgets,” she said.
There is a need for regular and inclusive screening, along with more skilling courses for healthcare professionals to attract and upskill talent in the healthcare space, she added.
The government elected after the upcoming Lok Sabha election will present a full Budget for the financial year.
Overall, since 2014, when the Modi government came to power, the Budget allocation for the health sector has not seen much year-on-year hike.
In 2018, however, the announcement of the AB-PMJAY was dubbed a mega initiative for the sector.
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Health continues to be on backburner
In the 2023-24 fiscal, the health ministry was allocated Rs 89, 155 crore — marking a rise of 12.6 percent compared with the revised Budget estimates for FY23. The overall increase, when compared to the 2022 budget, was 16 percent. This meant that the hike was barely enough to cover the effects of inflation.
In her Budget speech, Sitharaman had announced that research and development in the pharmaceutical sector would receive a government push, while also declaring that 157 new nursing colleges would be set up.
Also, according to the announcements, some Indian Council of Medical Research (ICMR) labs were to become accessible for private researchers, and a project to eliminate sickle cell anaemia — a blood disorder common among tribal people — by 2047 was launched.
Among the centrally-sponsored schemes, the two that received a considerable hike were the Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PMABHIM) aimed at aiding infrastructure at district hospitals, and the National Digital Health Mission — a project to support the integrated digital health infrastructure of the country.
But a status quo was maintained for most other schemes and there were no big-ticket announcements or major hikes for the sector.
The Union Budget for FY23 had been even more disappointing for the sector. It earmarked an allocation of Rs 86,200 crore for the sector — just 0.2 percent higher than the revised estimates for 2021-22, when the allocation was Rs 85,915 crore.
Also, the government’s proposed expenditure on medical and public health in the fiscal had seen a drastic drop of more than 45 percent from the revised estimates for 2021-22.
In 2021-2022, the government had provisioned Rs 35,000 crore for Covid-19 vaccination. But in the next year, despite the pandemic having exposed major chinks in the country’s healthcare system, no noteworthy initiatives were introduced for the sector.
(Edited by Richa Mishra)
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