U.S. Engagement in Indian Health Care
November 17, 2010
When India became independent in 1947, the country was known for its grinding poverty, crushing illiteracy, and omnipresent illness. Six decades later, India has made enormous advances in both economic development and human quality of life. Compared to pre-independence levels, life expectancy has doubled, infant mortality has dramatically fallen, smallpox has been eliminated, traditional scourges like leprosy and polio have almost disappeared, population growth rates have dropped by more than half, and there has been substantial progress in containing malaria and tuberculosis. At the same time, India is home to more poor people than any other single country. It bears a burden of disease out of proportion to its share of the world’s population, including an estimated one-third of diarrheal diseases and major nutritional deficiencies. It lags behind its neighbors in some basic health indicators such as access to clean water.
This report assesses the impact of U.S. engagement with India’s health sector in the past six decades. Creating institutions, providing scope for innovation, privileging relationships of professional equality, and remaining engaged for at least a decade were characteristics that showed up in most of the successful ventures. Short-term impact on health did not necessarily correlate with long-term impact on the health system. Perhaps the most encouraging observations stem from the fact that the major participants in U.S. engagement with the health sector in India all seem to have contributed to some of the projects that have had a particularly strong impact, including SIFPSA (State Innovations in Family Planning Services Agency), the National Family Health Survey, the collaboration that gave birth to India’s National AIDS Research Institute, and the Bill & Melinda Gates Foundation’s Avahan project. That suggests that the secrets to success are widely distributed in the U.S. public and private health establishment, and that as India’s economy and global footprint grow, this dynamic partnership should expand as well.