Why Healthcare Needs CSR Boost?

Despite being a major destination for medical tourism and the fastest growing economy, India’s progress in healthcare is slower not just by OECD standards but also as per the standards of the developing world. When compared with emerging economies and its neighbours, India faces a bigger disease burden.

Here are some of the facts which highlight the state of health care in India:

1. India has one of the highest disease burdens (20%) in the world.

2. More people die in India of preventable diseases than anywhere.

3. India still accounts for 27% of neonatal deaths, 23% of infant deaths and 23% of TB deaths in the world. Out of the total neonatal deaths, 35% are due to lack of nutrition.

4. Every fifth person in India suffers from a chronic disease and more than 6 out of 10 people die from non-communicable diseases.

5. Cancer cases in India are also likely to rise by 25 per cent by 2020 from 1.4 million to 1.7 million by 2020.

6. Disease burden to cost India $6.2 trillion by 2030.

7. Between 1990 and 2010 premature deaths from cardiovascular diseases increased by 59 per cent to 37 million from 23.2 million.

8. Nearly 40% of the Indian population of all ages has mycobacterium tuberculosis infection; and there are about 85 lakh people with TB at any given time.

9. The US has 2.5 doctors and 11.1 nurses per 1000 population, while India has 0.7 Doctors and 1.1 Nurses per 1000 population.

10. India’s ambitious National Health Policy plans to increase public spending on health from 1.15% to 2.5% by 2025, when only 17.33% of the lower income classes having access to free health care.

It is clear that the government alone won’t be able to address all the health care issues. Although the National Health Policy 2017 has been approved, the target set promises little.

Corporations should see this gap as an opportunity to partner with the government to play a responsible role in improving the health care system. What we have been witnessing so far is their focus on health camps, building hospitals or donating equipment to hospitals. Most of these activities can only generate short-term impact and the targets are poorly set.

Instead, businesses can train local youths while pharmacists can be trained to prescribe medicines for minor ailments. One example is the Fiinovation and RPG foundation partnership to train youths in ‘patient care’. Similarly, companies could fund medical education to reduce the significant shortage of doctors and nurses. The concept of barefoot doctors in China can be implemented in rural areas. Additionally, CSR funds can also be utilized to provide medical treatment and promote traditional medicines.

 

By Rahul Choudhury

Media & Communications, Fiinovation

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Fiinovation Reviews India’s Migration and Malnutrition Problems

The rising disparity among the people of India is a stark reminder that growth after the liberalisation, privatisation and globalisation reforms of 1991 has not been inclusive. Although, the country developed significantly, yet the development ripples have not reached the remote villages. The initial plan of focusing on the service sector to reduce the dependency of the Indian GDP on the primary sector (Agriculture, Animal Husbandry, Dairy, etc.) paid off well, but didn’t solve the problem of the rural population which is nearly 70 per cent of the total Indian population.

As the primary sector didn’t receive as much investments, there wasn’t much growth to improve the standard of living of the rural population. The problems associated with agriculture and allied sector ensured that millions had to migrate to the urban areas for employment opportunities. Migration is not a recent phenomenon, rather the pace of it has increased in recent times due to widespread distress in the rural areas. As per the Census 2011, there were about 45.36 crore migrants. In fact last year 2.06 crore people migrated looking for employment opportunities and education.

It is understandable that the impact of migration is one the entire family and it’s the children who suffer immensely. It has been observed that the rapid development which ensured India becomes the fastest growing major economy in the world is not helping to curb poverty and malnutrition. As per the global hunger index, India ranks abysmal 97 out of 118 countries which much worse that its neighbours Sri Lanka, Bangladesh, Myanmar and China. Fiinovation reviews that about 38 per cent children living in India are stunted or too short for their age. There seems to be a link between growing urbanisation and increase in malnutrition as it has been observed that significant proportion of children living in urban areas are stunted.

Alarmingly, it is estimated that 90 crore people will be added as urban residents in just three countries (China, India and Nigeria) by 2050. It seems that there is a paradigm shift of the burden of malnutrition from rural areas to urban areas, especially due to persistent child undernutrition. Fiinovation reviews that the problem of malnutrition is evident amongst the 6.5 crore slum dwellers in the country. Hence, the reason behind urban poverty and malnutrition is definitely India’s incapability to develop the rural areas while promoting inclusive and sustainable growth.

The road ahead will not be easy as the government plans to double the farmers’ income by 2022. Currently, there is very less industrial development in the rural areas. Agriculture in India is a seasonal activity with majority of the regions being mono-cropic, especially due to lack of irrigation facilities and dependency on the monsoon. Therefore, it is important to create livelihood opportunities and promote healthy lifestyle amongst the rural population. If the migrant population start finding employment opportunities in their inhabited regions, it will reduce migration, poverty and malnutrition significantly.

Hence, Fiinovation urges the government to implement policies which promote growth of the rural economy. Efforts to increase the farmers’ income will definitely pay huge dividends for the country. The impact of this will also be visible on the global hunger index and help the country eliminate extreme poverty as per the Sustainable Development Goals. However, this massive task cannot be done only by the government and the role of the private sector will be significant in providing resources for the development of rural infrastructure. The businesses should also contribute towards betterment of the farming community and the people residing in the rural areas through their corporate social responsibility funds. Investments in the agriculture sector by the businesses supported by agriculture credit from the government will significantly boost the primary sector thereby reducing the burden of the rural households.

Let us hope that the next two decades India grows inclusively and sustainably becoming one of the largest economies of the world with a higher human development index ranking.

 

By Rahul Choudhury

Media & Communications, Fiinovation

FIINOVATION REVIEWS – THE NEW MATERNITY BENEFIT BILL

The Government gifts the Amended Maternity Bill as the Woman’s Day gift for the working women in India as the Parliament approves the Maternity Benefit (Amendment) Bill, 2016. The Bill was introduced in Rajya Sabha on August 11, 2016 by the Minister of Labour and Employment, Mr. Bandaru Dattatreya and passed on 9th March, 2017.

“This is my humble gift to women, a day after the world celebrated International Women’s Day,” he said after about a four-hour debate in the Lok Sabha. He also informed that while finalising the Bill, few amendments were made in the old law to ensure that pregnant women derive maximum benefit from the law.

Fiinovation applauds the move as India joins the league of small consortium of countries with progressive maternity leave policy in system for the working women. Now, India ranks third in terms of number of weeks allotted for maternity leave with Canada and Norway leading at 50 and 44 weeks respectively.

The Maternity Benefit Act, 1961 was introduced to protect the health and employment of working women during their maternity tenure. As per this Bill, the women employed in companies with minimum 10 employees were entitled to 12 weeks of paid maternity leave. However, the new bill has increased the tenure of paid maternity leave for first two children from 12 weeks to 26 weeks. However, for the third child it will be limited to 12 weeks. It also includes the 12 weeks paid leave provision for women legally adopting children under three months and mothers having children through surrogacy. In the later case, the 12-week period will commence from the date when the child is handed over to the mother. As per the Bill, every company employing 50 or more women employees is entitled to provide the creche facilities within a prescribed distance, allowing at least four visits to the creche during the day.

Other major amendments allows a woman to avail work from home opportunity after joining back from the maternity leave on mutually agreed terms between the employer and the woman. It mandates all the organisations to inform a woman about all the benefits included in the bill during the time of her appointment through both written and electronic medium.

Additionally, there are various other labour laws like the Employees’ State Insurance Act, 1948 which entitles the payment of wages to an insured woman, during her 12-week maternity leave. Even, the women employed in newspapers or working as journalists are entitled to similar maternity leave under the Working Journalists (Conditions of Service) and Miscellaneous Provisions Act, 1955. Further, women employed in the central government are provided about 24 weeks of paid maternity leave and additional child care leave up to a period of two years.

Although progressive and applauding but still it has left many important aspects untouched. Fiinovation reviews that this bill is entitled to benefit only 1.8 million women working in the organised sector as they constitute only 10% of the women workforce. It fails to include the women belonging to the weak and marginalised sections of the society as 90% of the women workforce is employed in the unorganised sector belong to the lower strata of the society. It includes women working as seasonal labourers working at construction and agricultural sites, contractual labours and domestic workers. The Bill lacks to cover them under its ambit as they lack eligibility under the 1961 Act such as continuous employment or a period of 80 days in the one year prior to the date of delivery. Hence, it portrays a huge disparity among the allotted benefits amongst the different sections of the society.

Experts also argue that the Bill could have an adverse impact on the job opportunities available for women. As it requires an employer to pay full wages during the maternity leave, many companies may consider it as a financial burden and prefer to hire male candidates on critical positions. Although, International Labour Organisation (ILO) Maternity Protection Conventions has proposed that the complete burden should not be borne by the organisations as suddenly the compensation period has increased from 12 to 26 weeks. It recommends compensating through public funds, insurance schemes, etc. Various countries like UK, Germany, Australia and Norway compensate by combining funds from the government and employer or national security fund.

A government official, who has been part of the debate in parliament argued that, “A father also has equal responsibility towards the child like a mother and paternity benefits would help a couple to raise their child together as majority are now nuclear families”. In fact, another government official from West Bengal shared saying that the government in its state is already providing the paternity leave of 30 days. Additionally, the benefits should extend to single father adopting children who are currently excluded from the Bill.

Fiinovation recommends that instead of introducing different bills and schemes, the government should introduce a uniform policy to benefit every employed woman rather parent in the country. Not only this, a strict monitoring mechanism should be implemented to ensure that women receive these benefits as currently only a handful of leading corporates in India have been strictly following these norms.

As quoted by in a report by Mckinsey Global Institute “Achieving gender equality in India would have a larger economic impact there than in any other region in the world – $700 billion of added GDP in 2025 – but comprehensive change is needed.” Fiinovation second with the though and feels that the New Maternity Bill is an important step towards the same and will certainly act as an impetus for women empowerment since they will be able to strike a healthy balance between personal and professional life.

By Manisha Bhatia

Media & Communications, Fiinovation

Fiinovation Reviews: Need of Stringent Policy on Rare Diseases

In the year 2013, a petition was filed in Delhi High Court by the seven-year old Mohammed Ahmed suffering from the rare disease Gaucher. It is a hereditary disorder which is caused by the absence of enzyme which breaks down fat and releases energy. The absence of this enzyme leads to fat building all over the body and patients suffer from bone pain and anemia. In some cases, it may also lead to death. Although, this disease can be treated through the replacement therapy of enzymes and the person can lead a normal life under all medications and precautions, however, it can never be completely cured. The cost of therapy is Rs. 6 lakh per dose and has to be administered every month till the patient is alive. Since, his father is a rickshaw-puller and earns daily wages for survival he knocked the door of High Court for help.

Gaucher is one of the 7,000 rare diseases that afflict less than 6% of the global population. Looking at the rare phenomenon of this disease, pharmaceutical companies don’t consider it as an economically viable drug and end up pricing them as high as possible to derive profits. Even these companies don’t invest much on the research of the Orphan Drugs making them almost inaccessible for the weak and marginalised sections of the society.

In order to encourage the pharmaceutical companies to stimulate research for the treatment of rare diseases, the Orphan Drugs Act was passed by the US government in 1983. The law offered different incentives like smaller clinical trials, higher rates of regulatory success, extended exclusivity and tax rebates. Laws on similar line have been replicated in other countries such as European Union, Japan and Australia making it economically viable and commercially attractive for investing in the Research and Development (R&D) of the rare diseases. However, these companies ignore the incentives offered by the government and sell the orphan drugs at inflated prices. Rituximab, an orphan oncology drug, is one such drug in this category which is also the second highest selling drug in the world. The patients of developed country have higher per capita income and also governed by good government health policies hence they can afford them whereas it is completely unaffordable for the patients of developing countries considering their economic status and flaws present in the healthcare policies.

The Delhi High Court gave full attention to the case of Mohammed Ahmed causing lot of stir and scrutiny in the existing healthcare policies governing the nation. Before giving his judgment, Justice Manmohan analysed many other cases which have proved that the right to health and access to healthcare is implicit in Articles 21, 38 and 46 of the Indian Constitution.

He concluded that “every person has a fundamental right to quality health care – that is affordable, accessible and compassionate.” While recognizing the fact that every citizen cannot expect to receive free medical treatment at the state expense he also held the government responsible for not devising favorable policies for ensuring that every citizen can afford the treatment of rare diseases.

The court suggested the government to increase investment in the healthcare sector and formulate best practices and polices related to the treatment of rare diseases. It also confirmed that the act of financial aid treatment of rare diseases will be qualified as a CSR activity. It also directed the state government to arrange treatment for Mohammed Ahmed free of cost at AIIMS whenever he requires it, as per his constitutional right.

Learning lessons from this case, Karnataka became the first state in India to release a Rare Diseases and Orphan Drugs Policy. It recommended to implement the preventive and carrier testing, which is a means of reducing morbidity and mortality. Considering the fact that around 80% of the rare diseases` have genetic connection, it also suggested to the pharmaceutical companies to use genetic testing for accelerating the identification of the critical genes involved in rare diseases.

The state also highlighted about the flaw present in the Insurance Laws of India due which often acts as huge disadvantage for the patients suffering from the rare disease in India. The private insurance companies of India consider the genetic disorders as pre-existing conditions, hence, on that basis doesn’t provide any insurance cover for the same. Since, most of the rare diseases are genetic in nature; hence patients don’t get any support from the existing insurance policy.

The state emphasised on the awareness programmes to combat delay in diagnosis and treatment. It also called for the enactment of an orphan drugs statute to allow for tax breaks, funding and exclusive marketing rights as incentives for orphan drug discovery.

The policy has requested the IRDA (Insurance Regulatory and Development Authority) to re-consider this exclusion from the above mentioned laws and at least provide basic coverage of rare diseases at reasonable premiums.

Fiinovation recommends the other states of India to follow the footsteps of Karnataka to ensure every citizen of India has access to affordable healthcare facilities. The state-led PSUs and private companies can utilize their CSR funds to undertake healthcare initiatives involving rare diseases for extending support to the weak and marginalized sections of the society.

 

By Manisha Bhatia

Media & Communications, Fiinovation

 

India Celebrates – The 68th Republic Day

The Constitution of India came into force on 26th January 1950 and the day is marked as the Republic Day which gave power to the people from the hands of a few. It was in 1930 on January 26th when the most powerful political entity in India, the Indian National Congress declared ‘Purna Swaraj’ opposing the Dominion status offered by the British, suggesting another importance of selecting the date as Republic Day.

The day’s highlight has always been the celebrations at Rajpath before the President of India. The Republic Day Parade in Delhi showcases the nation’s Defence Capability, Cultural and Social Heritage. The celebrations goes on for a period of 3 days and ends with the Beating Retreat conducted on the evening of 29th January.

Being a high profile event, a lot of thought goes into choosing the Chief Guest for the Republic Day Parade. The first Republic Day Parade in 1950 was attended by the Indonesian President followed by the King of Nepal in 1951. In the past two years of the present government, the former US President Barack Obama and French President Francois Hollande were invited with a motive to have the best possible ties with the western powers. This year, the chief guest for the Republic Day is Crown Prince Sheikh Mohammed bin Zayed of UAE. Last year, French troops marched along with the Indian troops in the Republic Day Parade. This time troops from UAE are expected to lead the Parade. Clearly, the focus have shifted towards India’s neighbourhood, especially the Gulf region. The Comprehensive Strategic Partnership which has been spoken about in 2015 will materialise this time with major focus on joint defence production.

With such high profile guests including Prime Minister Narendra Modi and President Pranab Mukherjee at the venue, Delhi is likely to be under ground-to-air security cover with more than 60000 armed personnel keeping a tight vigil. From anti-drone technology to prevention from chemical attacks, the national capital region is expected to be on high alert with Delhi borders being sealed and cars entering being thoroughly checked.

The Republic Day Parade will showcase aerial fly-past by the Indian Air Force with Light Combat Aircraft making its debut in the Parade. The Indian Navy will highlight the indigenously built Kolkata class destroyer along with Kalvari class next generation attack submarines. Audience will also be witness to tableaux from 17 states and union territories and 6 Union Ministries. There will be tribute to Lokmanya Tilak on his 160th birth anniversary with the ‘Swaraj Rath’, other than promotional tableaux of Skill India, Digital India and Beti Bachao Beti Padao which the pet schemes of the central government.

As citizens, the Republic Day enables us to re-think on the lines of our founding fathers who wanted to make this country a sovereign, secular and democratic republic. It is a day to be proud of ourselves who have given each other the constitution by having solemnly resolved our differences and pledging to secure all the citizens of Justice, Liberty Equality and Fraternity. The day reconfirms our faith on the fact that all the power emanates from the people and the political system will always be accountable and responsible to the people of the great country.

Swaraj is everyones birthright, and everyone must have it.

Happy Republic Day

By Rahul Choudhury

Fiinovation Observes – International Volunteer Day

Across the globe, several initiatives are being implemented to solve prevalent issues of the society. The International Volunteer Day or International Volunteer Day for Economic and Social Development provides an opportunity for volunteers (both individuals as well as institutions) to contribute at local, national and international levels towards achievement of the socio-economic and environmental goals.

The day was adopted by the United Nations General Assembly through a resolution on 17th December, 1985. Every year on 5th December, the day provides opportunities to volunteers for causes such as eradication of poverty, hunger, disease, illiteracy, degradation of the environment, discrimination against women, etc. Over the years, the International Volunteers Day has been utilised strategically by governments and corporations to encourage volunteerism aligning them with the Millennium Development Goals.

Fiinovation, with its vast experience in social development initiatives, has been encouraging corporations to urge their employees to volunteer for social causes. Although, cost involved in volunteerism doesn’t fall under the CSR rules in India, yet it is definitely a positive process to engage with the local communities. It is observed that volunteers around the world work tirelessly to craft a better future for everyone, especially during crisis situations. On this day, Fiinovation acknowledges the efforts of more than 6700 UN volunteers, 12,000 UN online volunteers and 1 billion community volunteers for their selfless contribution in the upliftment of society.

Understanding the prevalent crisis situations such as in the middle-east, Africa and other parts of the world, volunteers have risen up and provided shelter and requisite support to millions of refugees who have been forced to flee from their homes. The floods in Haiti and malaria outbreak in Sri Lanka are examples in the recent months where volunteering has helped in saving thousands of lives. “Founded on the values of solidarity and mutual trust, volunteerism transcends all cultural, linguistic and geographic boundaries. By giving their time and skills without expecting any material reward, volunteers themselves are uplifted by a singular sense of purpose,” was the message from UN Secretary General, Ban Ki-moon. In his message he pressed on the need to lend a hand and applauded volunteers for their commitment towards building a peaceful, prosperous and a dignified future for all.

Fiinovation believes that the role of volunteers will be crucial in achieving the Sustainable Development Goals by 2030. Therefore, let us all increase the awareness of voluntary contributions, thereby motivating more people from different walks of life to offer their services as volunteers.

By Rahul Choudhury

Media & Communications, Fiinovation

Fiinovation Observes – WORLD TOILET DAY

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Every year, 19th November is recognised as the “World Toilet Day” across the globe. The day is celebrated to spread awareness about the issues related to sanitation and eradicate taboos related to health and hygiene. The United Nations passed a resolution in July 2013, recognising World Toilet Day as an official International Day for drawing the world’s attention on the current sanitation crisis. On this day, several campaigns are run worldwide on educating the world about benefits of sanitation, health, and hygiene. This year the World Toilet Day is based on the theme, “Toilets and Jobs”.

As per the World Health Organization (WHO), it is estimated that around 2.5 billion (about 1 out of 3) people lack access to improved sanitation facilities and around 1 billion of them still practice open defecation. The forced unhealthy sanitation habits lead to chronic diseases such as diarrhea, malnutrition, soil-transmitted heminthiasis and schisosomiasis. It is estimated that around 58% of the diarrhea cases are caused due to poor sanitation, poor hand-washing and lack of hygiene. In 2013 alone, around 340,000 children under 5 years of age have succumbed to death due to unhealthy sanitation habits. Not only this, open defecation is also an infringement of privacy and dignity of young girls and women bringing them embarrassment and fear exposing them to sexual assault, violence, harassment and psychological trauma. However, this menace can be put to end by providing them access to toilets and basic sanitation facilities.

In India alone, around 55% of people out of 1.2 billion people have no access to toilets mostly comprising the people living in urban slums and rural areas. The central government has taken the uphill task of creating an open defecation free country by 2nd October 2019, the 150th birth anniversary of Mahatma Gandhi. They have pledged to construct 12 million toilets in rural India at the cost of Rs. 1.96 lakh crore. In his speech Prime Minister Narendra Modi said, “Has it ever pained us that our mothers and sisters have to defecate in open? Poor womenfolk of the village wait for the night; until darkness descends, they can’t go out to defecate. What bodily torture they must be feeling, how many diseases that act might engender. Can’t we just make arrangements for toilets for the dignity of our mothers and sisters?”

Deriving inspiration from the Prime Minister’s Swachh Bharat Mission, many states in India have done commendable work in the field of sanitation. In a press note released by the Ministry of Drinking Water and Sanitation on the progress of the Swachh Bharat Mission Gramin, around 15.04 lakh toilets have been built under the MNREGA scheme across rural India. Under this mission, 446 percent increase in construction toilet work has been observed. One lakh villages have been targetted under 35 districts to declare them as open defecation free. Sikkim has been declared as the first open defacation free state followed by Himachal Pradesh and Kerala.

Even the United Nations Millennium Development Goals (MDGs) has been actively working towards providing people safe access to toilets and end open defecation in the world. The Government of India and World Bank has inked a $1.5 billion loan agreement for supporting the nation’s sanitation initiatives. Additionally, the World Bank will also extend technical assistance of $25 million to capacitate selected states in implementing community-led behavioral change programmes, to end the toilet related taboos and spread awareness about the regular usage of toilets by rural households.

“Sustainable development goal 6 calls on the international community to ensure access to toilets by 2030. Delivering on this basic human right — the right to water and sanitation — is good for people, business and the economy.” — UN Secretary-General, Ban Ki-moon

Manisha Bhatia

Media & Communications

Fiinovation