Care for the Vulnerable Population
As mentioned earlier, approximately one-third of the people
of our country, particularly living in the tribal, hilly and
arid as well as feudal areas have a critical health status.
Their health problems are very much associated with the issues
of food security and underdevelopment. The health of this
population is directly linked to their economic, social and
political status. It is quite clear from the findings of all
social development ministries that there is a need to think
of a Sub-Plan for the vulnerable and deprived regions. Major
thrust should be to help them reverse the situation through
a well-planned, adequately financed community-oriented Integrated
Health and Development Programmes with substantial participations
from voluntary organisations. There has been several efforts
in the Planning Commission in identifying these vulnerable
some of the more critical areas of these vulnerable
regions, the situation is not expected to improve
permanently within the foreseeable future.
it is proposed that in these pockets, subsidised supply of
basic staple food be introduced. Given the fact that our country
has additional food grain lying in stock as well as the fact
that similar approach has given extremely good dividends in
Andhra Pradesh and Tamil Nadu, this should not be a difficult
proposition. This will ensure food security and health security
for the most vulnerable population of the country.
Impact of Developmental Projects
Many of the emerging health problems of rural areas are
related to the development processes. It is essential to look
at the health impact of these projects during planning. Incidence
of pesticide poisoning, pollution and gradual degradation
of ground water and emergence of malaria in desert areas are
examples of some of the problems which are directly linked
with developmental projects. We should ensure that health
hazards of development projects are properly looked at before
Similarly, serious efforts should be made to educate and diagnosis
sexually transmitted diseases including AIDS in the rural
areas. With the very large migration of workers from rural
to urban areas, health problems from these diseases are gradually
taking alarming proportions.
In the past thirty years, there has been a great improvement
in tackling the problem of Leprosy. The lessons of this success
should be utilised to mount similar attacks on other National
Health Programmes. There should be sufficient financial allocations
to ensure that the problem of malaria and TB are tackled substantially
if not fully, within the next few years.
The changes in the Industrial Policy 1991 and the advent
of the New Liberalized Economic Policy resulted in the New
Drug Policy of 1994, further spiralling drug prices and increase
in drug imports, while the formulation of the Essential Drug
List, withdrawal of irrational and hazardous drugs, provision
of consumer caution, e.g. for drugs which have teratogenic
effect and unbiased drug information are still to take place.
Areas needing urgent attention are:-
of the National Drug Authority
of the concept of Essential Drugs in public and private
of Graded Essential Drug List for different levels.
of clear therapeutic guidelines to health professionals
in public and private sectors on National Health Programmes
e.g. TB, Malaria, STDs, rationalisation of drug purchase,
drug distribution to primary health centres and subcentres
through fair price drug outlets etc.
up of Adverse Drug Reaction Centres and the reporting
of their findings.
post-marketing surveys and studies on drug prescriptions
and drug consumption patters related to specific health
problems like TB and STDs.
and reporting of court cases related to sub-standard,
hazardous and banned drugs.