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: 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