Nirmal Gurbani
Access to health stands as fundamental to human rights under UN charter. In India, health spending by the State is very low (nearly 1% of the GDP) and 79% spend on health is out-of-pocket with major spending (about 80%) is on cost of medicines. Almost 30% of the households slide into poverty due to high treatment costs. It is imperative that access to quality essential medicines directly affects the access to health. Though, India is considered as pharmacy for developing countries, yet due to poor regulatory control there is huge price variation in off-patent branded generics, making the affordability at the mercy of prescribers and dispensers. Basically, essential medicines are not costly but are made expensive. By adopting and improving Tamil Nadu model, the Government of Rajasthan has launched a scheme called Mukhyamantri Nishulk Dawa Yojana (MNDY), i.e., Chief Minister’s Free Drug Distribution Scheme (CMFDDS) for providing free essential medicines to all irrespective of their economic status through establishing an autonomous Rajasthan Medical Services Corporation (RMSC). Utilization of available pricing information of quality medicines along with transparent pooled procurement through prequalification measures for products and suppliers and proper distribution system, RMSC, has made it possible to make free access to medicines, especially underserved population. Educational, managerial and regulatory strategies have been used to promote compliance by stakeholders. Resistance by healthcare providers on pretext of quality of supplies and confusion created in public was countered with proper information, education and communication (IEC) activities. Strong political will with proper administrative and technical support has made it possible to reach the unreached, as a first step towards universal access to health.
