Covid shadow on Budget 2021: Health gets a vaccine shot, water in new ‘well-being’ category

Spelling out medium and long term expenditure for the public health care system, which came under severe stress during the initial stages of the pandemic, Union Finance Minister Nirmala Sitharaman pegged the total expenditure for “health and well-being” at Rs 2,23,846 crore.

With covid infections crossing the 1-crore mark, and claiming nearly 1.54 lakh lives, the Government has allocated
Rs 64,180 crore in the Union Budget presented Monday to upgrade public health care infrastructure under a new flagship PM AtmaNirbhar Swasth Bharat initiative over six years — and unveiled a new expenditure head called “health and well-being”.

Spelling out medium and long term expenditure for the public health care system, which came under severe stress during the initial stages of the pandemic, Union Finance Minister Nirmala Sitharaman pegged the total expenditure for “health and well-being” at Rs 2,23,846 crore — an increase of 137 per cent — including Rs 35,000 crore for immunisation with Covid vaccines.

The Finance Minister underlined that the Government will take a “holistic approach” this time by strengthening three critical areas: “Preventive health, curative health and well-being.”

“Even at the outset, I would like to say that the investment on health infrastructure in this Budget has increased substantially. Progressively, as institutions absorb more, we shall commit more… the Budget outlay for ‘health and well-being’ is 2,23,846 crore in BE (Budget Estimates) 2021-22 as against this year’s BE of 94,452 crore, an increase of 137 percentage,” Sitharaman said.

The Rs 2.23 lakh crore will include expenditure on six components in varying proportions: Department of Health & Family Welfare (31.83 per cent) with finance commission grant (5.89 per cent); Department of Drinking Water & Sanitation (26.81 per cent) with finance commission grant (16.09 per cent); vaccination (15.63 per cent); health research (1.89 per cent); Ministry of AYUSH (1.32 per cent); and, nutrition (1.20 per cent).

The allocation shows that drinking water and sanitation has received the biggest boost of 179 per cent, with funds for health and family welfare increasing by 9.62 percent while nutrition witnessed a drop of 27 per cent. Sitharaman said the Centre is “committed to provide further funds if required” for Covid vaccines and that the pneumococcal vaccine, presently limited to only five states, will be rolled out across the country.

Welcoming the allocation, Union Health Minister Dr Harsh Vardhan said: “The experiences of the country’s yearlong fight with Covid have shaped the Union Budget. This will give a tremendous boost to India’s health infrastructure… Investment on Health Infrastructure in Budget 2021 has increased 2.37 times or 137 per cent. The focus on strengthening three areas — Preventive health, curative health and well-being — with total allocation to the health sector being Rs 2,23,846 crore will be of immense help to the country at this critical juncture.”

Sitharaman, meanwhile, emphasised that PM AtmaNirbhar Swasth Bharat will be implemented in addition to the National Health Mission — and provide “support” for 17,788 rural and 11,024 urban health and wellness centres. “This will develop capacities of primary, secondary, and tertiary care health systems, strengthen existing national institutions, and create new institutions to cater to detection and cure of new and emerging diseases,” she said.

Under the new scheme, five key interventions will be implemented, specifically catering to new and emerging diseases: integrated public health labs in all districts and 3,382 block units in 11 states; critical care hospital blocks in 602 districts and 12 central institutions; a strengthened National Centre for Disease Control (NCDC) and its five regional branches and 20 metro health surveillance units; and, a national institution for One Health, a regional research platform for WHO (South East Asia), nine Bio-Safety Level III laboratories and four regional national institutes for virology.

The scheme will also provide funds to set up 15 emergency operation centres and two mobile hospitals, operationalise 17 new public health units and strengthen existing units at the 32 airports, 11 seaports and seven land crossings.

On nutrition, Sitharaman said that to strengthen “content, delivery, outreach, and outcome”, it has been decided to merge the supplementary nutrition programme and Poshan Abhiyan to launch “Mission Poshan 2.0”. “We shall adopt an intensified strategy to improve nutritional outcomes across 112 aspirational districts,” she said.

Sitharaman said that WHO has “repeatedly” stressed the importance of clean water, sanitation and clean environment “as a prerequisite to achieving universal health”. “The Jal Jeevan Mission (Urban), will be launched. It aims at universal water supply in all 4,378 urban local bodies with 2.86 crore household tap connections, as well as liquid waste management in 500 AMRUT cities. It will be implemented over five years, with an outlay of Rs 2,87,000 crore,” she said.

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