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NT Bureau
Chennai, Feb 11:

        Economic progress alone would not guarantee a sound healthcare delivery which was influenced by inequality of status, lack of political freedom and social discrimination.

        Thus summed up Nobel laureate and economist Amartya Sen at the 14th K S Sanjivi Endowment Lecture organised by the Voluntary Health Services, Adyar, at its premises yesterday. Healthcare to all was a basic human right for being healthy was an integral part of life as there was an overarching connection between longevity and 'feeling pleasant' on the one hand and staying healthy on the other, he postulated.

        Good health enhanced one's capability to accomplish things, and contribute to society in many forms. Also, physical wellness allowed a person to take care of others during the lifetime. 'Good health is sought not just for pleasure, or for reducing pain, but also for expanding a person's capabilities and freedom in a significant way,' he said.

        Life expectancy was one of the three key components in the human development index (HDI) and longevity data figured prominently in the growth literature not only as one of the indicators of medical achievement, but also as a social measure of progress.

        As the value of life reflected the importance of one's capabilities, the focus of longevity was on its valuation of human freedom — the capacity to do or achieve tasks in a lifetime. Drawing up a strong link between human rights and healthcare to all, Professor Sen said critics have found the extension of minimum healthcare as a basic right was not feasible and hence wanted it outside the domain of human rights. There was a need to expand both the scope and feasibility of the present set of human rights to include medicare in that list.

        'VHS is an example of what can be done even without any legislative recognition of health as a human right,' he said. In dealing with policy making, it was important to go beyond healthcare into general economic and social arrangements which impact on societal health. Calling for both public and private intervention to extend medicare, Amartya Sen pointed out social infrastructure like public schools, insurance sector and government hospitals could play a big role in healthcare delivery to rural India.

        Post 1979 reforms, China's astounding progress in health and life expectancy got slowed, whereas Indian longevity has, on the average, grown three times as fast than China during that period. 'But India has a lot of catching up to do in reducing the gap behind China and we must not attach too much importance in the growth rate of our life expectancy,' he said. However, States which compared well with China even before 1979 like Kerala have continued to expand growth in longevity and mortality reduction. As of now, Kerala was 4 - 5 times ahead of China in life expectancy with infant mortality rate of 12 per thousand (against 28 per thousand in China).

        'The abolition of public insurance of health sector (post 1979 reform) had a big role in the slow down of longevity growth in China,' he said and called for re-introducing such a facility for China to re-establish its trajectory in life expectancy. In India the general state of healthcare was poor, despite the availability of medical facilities and top doctors.

        A wide range of policies and actions have strong influence on health and all of them have to be taken into account for scrutiny which would result in better understanding for advancing good health across the world, he concluded.

        In his welcome address, VHS president M S Swaminathan the Voluntary Health Services was started by Dr K S Sanjivi 50 years ago with an objective to provide healthcare to all sections of people. 'Over 70 per cent of patients were treated free of cost at VHS which has 15 mini-health centres (MHCs) in and around Chennai catering to 2,000 families,' he said. These MHCs followed a hub and spoke model in organising medical services in rural and semi-urban areas and the M A Chidambaram Institute was set up by the VHS to oversee this programme.

        Now Gates - Melinda Foundation has taken up the AIDS Prevention Control Project started at VHS with funding from USAID and was a nodal agency for programmes covering 13 districts of the State. VHS scretary Dr N S Murali was also present on the occasion.