India – Health

Created for U3A-Okeover.orgArindam Basu

University of Canterbury, arin.basu@gmail.com

About India

• Located in South Asia• Himalayas to the North• Indian Ocean to the South (Indian Ocean?)• About 10 hours flight from New Zealand

Neighbours

Indian States

Himalayas to the North

Indian Ocean to the South

Some of the Oldest Continually Lived Cities are in India, for instance, Varanasi

Complexity of India

• One of the Oldest Continually Lived Countries in the world

• 1.2 Billion People• 35 states, federal republic, Westminster type

government• Wide Disparity in Wealth Distribution

(“Northern Californias within Subsaharan Africas” – Amartya Sen)

Health Workforce Issues

• Crude Birthrate 23 per 1000• Fertility Rate: 2.3 (~2 children per woman)• Ratio of Health Professionals per population:

1.9 (~ 2 health care workers per 1000 people!)

India’s population growth rates

India’s Health Problems: Illnesses

India’s Health Problems: Deaths

India’s Health Issues: Risk Factors

Different Systems in India

Evolution of Indian Health Systems

• Ancient Era (Ayurveda Mainly)• Advent of the Persians and Mughal Rule in

India (Unani and Middle Eastern Traditional Medicine)

• East India Company and the British Raj (Establishment of the Modern Allopathic Medical Care) but also Complementary and Alternative Medicine

• Integrative Medicine in India and Innovations

Ayurveda: Susruta the Surgeon

Susruta was a surgeon whose techniques of rhinoplasty are relevant even today

Ayruveda: Charaka-Samhita

System of Natural Medicine Developed Indigenously in IndiaThe Experts Travelled far and WideIndian Medicine Was Known throughout the Greek and Roman Empire

Advents of the BritishEstablishment of East India Company

Established in 1600 to trade in the East Indies in opium, saltpetre, dye, tea, cotton and Silk by the Royal Charter

Covenant of the Crown and Established its first Medical College in India in 1835

Medical College Calcutta

Calcutta Medical College was the Medical College Established in 1835 , and the first medical school in Asia, and one of the firsts anywhere outside of Europe

Indians Have Pioneered Several Landmark Medical Drugs & Devices

Dr. Kedar Nath Das Invented Forceps that are used for difficult delivery of babies

Sir Ronald Ross and Malaria ResearchRoss won Nobel Prize in 1902 for his work on MalariaThe work was accomplished at the Post Graduate Institute of Medical Education and Research

Sir Upendranath Brahmacari identified the causal agents of Kala Azar, a protozoan parasitic fever (Leishmaniasis)

The work was accomplished at the School of Tropical Medicine and Hygiene in Calcutta

Post Independence, Indian Excellence in Medical Care Continued … But there are Challenges and New Turns …

• Highly Fragmented

• Private Sector: 80-85%

• US $6.5 Billion

• total investment US $86 Billion

• Spends 4.2% GDP on Healthcare (World Average: 8.5%)

• Healthcare spend: US $65 Billion

• Projected to: US $100 billion by 2015

Vignette of Indian Healthcare Industry

Major Players in Indian Hospital Systems

Does India-New Zealand Partnership Matter?

• India & NZ: Long standing Friendship, • Shared legacy, lots of commonalities: British

Colonial Recent Past, English Language, Cricket, Westminster type governance, democracy …

• Yet they shared flip-flop relations …

• NZ welcomes India to Commonwealth, helps to set up All India Institute of Medical Sciences under Colombo Plan

• NZ sided with India during the 1962 war with China, & again in 1971 Bangladesh War

• PM Norman Kirk played proactive role during his tenure as Labour PM (1972-1974) despite India’s first nuclear explosion

• PM Robert Muldoon’s Time, NZ decided to sell the Chancery plot in New Delhi,

• Consulate in New Delhi was closed and reopened

• PM David Lange: Sir Ed was appointed as NZ’s ambassador to India

• Again took a turn for the worse following 1998 Pokhran Nuclear Blast

Where do we build this friendship to develop health care?

• Share our Expertise in Public Health

• Our expertise in applying evidence based healthcare and public policy translations