A Good First Step, But A Long Way To Go
 There are other positive signals – the allocation for the Integrated Child Development Scheme [ICDS] has taken what the Ministry of Finance called a “quantum jump” from Rs.1,623 crore in 2004-05 to Rs.3,142 in the budget proposals for 2005-06. The Finance Minister has ear marked Rs.100 crores for “Rural Knowledge Centres” as part of “Mission 2007” to set up a Knowledge Centre in every village by the 60th anniversary of Independence Day. And the Mid-Day Meal Scheme has increased allocations as well, from Rs.1,675 crore in 2004-05 to Rs.3,010 crore in the new proposals. Each of these measures carries the capacity to bring about change where it is required most, and has a direct bearing on health and population issues. The allocations in themselves may not be enough but they set a tone and direction that future governments can hardly ignore. To that end, the finance minister deserves to be complimented. The budget is not an annual mela for business or industry. It is essentially an opportunity when the government takes stock and makes course corrections so that it reaches out to the most needy even as it seeks to power the economy. It is therefore unfortunate that in the endless “analysis” on the budget, the social sector is rarely, if ever, spoken about. This year, too, we find that budget “talk” in the immediate aftermath is limited to a narrow, industry or corporate-specific outlook which misses the long awaited increase in allocations. After all, how can India become an economic giant and how can all the goods and services be bought by its people if the vast majority do not have access to an adequate standard of living and basic health and medical care? In allocations to the health sector, India has ranked rather poorly with a public allocation of 0.9% of GDP for 2001, amongst the lowest in the world, according to the United Nations Human Development Report 2004. The report names only four countries with a lower public allocation for health: Indonesia, Myanmar, Sudan and Nigeria. It must be understood that India can never become the super power it seeks to be while sitting so low down on the socio economic issues. While increased allocations are the key first step, this is not enough. We must now look forward to better governance so that every Rupee reaches the intended beneficiaries if we are to bring about change in society. BUDGET REACTIONS Money Is Good, But We Need Ideas Prof. Ashish Bose, Population Expert & Member of Advisory Council, POPULATION FIRST The health budget has been increased substantially. I welcome that. The Prime Minister has also announced that there will be a Rural Health Mission. I understand that on World Health Day, the PM is going to formally announce the mission. However, it is my view that the people in the government are quite lost about what exactly is to be done and how to operationalise it. ‘Mission’ is a military term, and it implies a command and control structure, and specific, fixed time bound goals. Unfortunately, the rural health infrastructure has collapsed in India, and no where in India is the functioning of the Community Health Centre, the Primary Health Centre and the Sub Centres really fully functional. By fully functional, I mean when the doctor is there, the nurse should be present; and vice versa; when the jeep is present, there should be budget for fuel. So what we have is mismanagement of the health programme by bureaucrats. I don’t think the bureaucracy is capable of running the Health mission. So organisations like Population First, Population Foundation of India, the Chambers of commerce and the corporate sector have a great role to play. The Health Mission calls for strategic thinking. The Population commission of 117 members ought to be wound up – it is the most foolish way of managing anything. We should get rid of these obsolete methods for managing the health of one billion people, and we have no models to turn to. So allocations are good but it is not a question of money. More than money, you need ideas and an operational strategy and the district level. We need a people oriented programme. Much Of Stated Good Intentions, Not Enough Operational Mechanics NISHIT KUMAR, Director General, I-CONGO [Confederation of Indian NGOs] I like the overall social feel of the budget but a lot of the social feel is offset because it desn’t say how it’ll work. Just good intentions. The second thing is that the tax structure simply takes out the value of 80G benefits under which 50% tax benefit goes social giving. By enhancing exemptions on savings to one lakh and changing tax slabs, a lot of people who used to give for social causes might stop giving to the Non Government Organisations. So on one hand there is this overall social feel, and also a recognition of NGOs in many parts, but 80G will impact NGOs heavily. This should have been addressed. Last year, the Finance Minister spoke of food coupons. This year, he has not even referred to this. So last year’s good intentions have been thrown out of the window, and how do we know this year’s good intentions will not end up similarly the next year. The exemptions for disabled have been retained but these should have been raised given the rising medical costs. If you really want a socially conscious budget, these things don’t cost the government much. We Must Reach Out During Pregnancy Dr.Duru Shah, President-elect, FOGSI [Federation of Obstetric & Gynaecological Societies of India] I’m very happy to know that allocations for health have increased and the only question is that this be used in the right direction. How much really trickles down to the women is the key question. If more funds are allocated to health, I think it is time we cover pregnancy under insurance schemes. Women need their health to be looked after during pregnancy. Maternal mortality and morbidity is high because of poor nutrition and lack of antenatal care. The BJP government had proposed a scheme under which FOGSI members would keep the 9th of every month reserved for free medical advice and attention to pregnant women to encourage them to seek medical help during pregnancy. Somehow, we must reach medical services to the pregnant women if we have to make a difference. The allocations this time are definitely better than they were earlier but we also have to look at the allocations against the requirement. For an example, we have a higher HIV population as compared to other countries but the funds we have for HIV/AIDS are far lower.
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