Lokesh Sharma, Head, Public Health – Africa, Middle East, South Asia, QuintilesIMS, speaks on the steps needed to reform public health in India and shares the learnings from some of the projects implemented by his organisation in this sphere, in an interview with Viveka Roychowdhury
As Head of Government Solutions in India for QuintilesIMS and Director, QuintilesIMS Institute India, describe some of the public health projects that the Institute manages for the public health segment in India.
We have worked across the spectrum in the public health domain from providing policy support to improving the service delivery, infrastructure and skill development, and capacity building in the public health space. We have been closely working with NITI Aayog on the accessibility issue and have given recommendations on enhancing the role of private sector in setting up medical colleges, upgrading the infrastructure for managing non-communicable diseases.
We are also working on the ways of engaging the private sector for improving the service delivery and patient adherence in TB supported by the Bill & Melinda Gates Foundation in multiple states of India. On infrastructure development, we have worked with the Government of Nagaland and working with development agencies like World Bank. We are also undertaking supply chain assessment and programme monitoring and evaluation with agencies like UNDP and WHO as well as working closely with organisations like DGHS and Pharmexcil.
You have worked with various state governments in India. What are the solutions to bridge the gap between the developed and developing states, in terms of health indicators and health outcomes?
In the e-vaccination initiative of the Government of India, which is supported by UNDP, we supported the preparatory assessment of supply chain of vaccines across 12 states. We assessed their readiness for deployment of technology solutions to manage the logistics and supply chain of the vaccines. As this is being implemented, the situation of availability and distribution of vaccines at the public health will improve drastically. We worked with the Government of Karnataka on a pilot programme for providing prevention and management services for non – communicable diseases at the primary facility level. There were some key learnings which can be incorporated in the National Programme for Prevention and Control of Diabetes, Cardiovascular Disease and Stroke (NPCDCS) to make it more effective.
On the policy formulation and advocacy front, what are the most viable models for India, with proven success which balance patient access with affordability?
It is important for the government to focus on disease burden assessment, robust delivery framework, and resource planning for policy formulation, to ensure there are enough resources including manpower, infrastructure and finance to bring in efficiency into implementation of the policy on ground. Also, the transition of the policy making should be from responsive to being proactive. There are many examples to prove that proper resource planning and effective allocation can play a major role in improving implementation.
In Tamil Nadu, which has successfully set up medicine procurement management system, effective implementation has made all the difference and not the policy. While many states have visited Tami Nadu models, none of the states have been able to replicate it yet. Similarly, the medicine procurement management systems developed for Rajasthan by C-DAC’s e-Aushadhi has been appreciated for its ability, not only in procurement but also monitoring prescription practices, including antibiotics and rational use of medicine.
Reference The Lancet report on how countries fare on the GBD data, India lags on the health-related SDGs. What are the policy decisions that government, industry leaders need to take to make sizeable gains and avert a public health crisis in India?
India witnessed unprecedented progress in terms of economic development, mortality and diseases profile. Policy formulation by the government is working towards the right direction. However, the government along with the industry needs to aggressively focus on the operational and the implementation aspect of the policies. We need to be more realistic and look at capacity building of the resources at hand during policy formulation to make the desired progress. To achieve sizeable gains it is important for the government and industry to develop partnerships with a focus on improving the coverage and providing accessibility to quality healthcare services to the people.
You have led large Technical Assistance Programmes funded by the donor agencies such as DFID, ADB, IFC and the World Bank in many states. What have been the challenges and how were they overcome?
While working with the donor agencies, it is important to ensure that both sides complement each other’s effort in terms of dedicating similar kind of resources, efficacy of work, and scaling up the initiatives to a larger framework and continuous monitoring and evaluation. These would be the key considerations from any support which is being given by the funding agencies. Typically, every programme taken up is supported by donor agencies through the initial or pilot phase. Later, the programme is driven by the state or central governments. Some of the programmes that we have driven have really worked well and have been adopted by the government scaling it up further. However, there have been few programmes, wherein the government was unable to drive it further due to lack of resources. Therefore, it is pertinent to have a knowledge management and capacity building module in all the technical assistance programmes.
- Advertisement -
Comments are closed.