A damning international report released in 2020 has highlighted a critical vulnerability in India's public infrastructure, revealing that the country's health budget was among the lowest in the world just as it was grappling with the world's fastest-growing COVID-19 outbreak.
Global Health Spending in the Spotlight
The 'Commitment to Reducing Inequality Index 2020', published by the international charity Oxfam, placed India's health spending under a harsh microscope. The report found that India allocated a mere 4% of its total government budget to health, a figure that placed it at a dismal 155th position on the global health spending index.
This level of expenditure was shockingly low, representing just over a quarter of the internationally recommended 15% of a national budget that should be dedicated to health. For perspective, the report noted that this was only one-third of what Burundi, the world's second poorest country, spent on health during the same period.
A Woefully Unprepared Nation
The consequences of this chronic underfunding were severe and directly impacted the country's capacity to handle a health emergency. According to the Oxfam statement, this underinvestment left India "woefully ill-prepared to deal with the coronavirus pandemic." The report detailed that just 55% of India's population had access to even the most essential health services.
Compounding the problem was the financial burden on citizens. The analysis found that more than 70% of health spending in India was being met directly from household budgets, marking one of the highest out-of-pocket expenditure levels anywhere in the world.
Broader Economic Vulnerabilities Exposed
The report did not limit its critique to the health sector alone. It also pointed to India's precarious economic preparedness for a crisis like the pandemic. India ranked eighth from the bottom on the index for economic fallout preparedness, with the report citing weak labour rights and a high incidence of vulnerable employment, affecting about 75% of workers.
Most workers in the country earned less than half of the minimum wage, 71% lacked a written job contract, and 54% were not entitled to paid leave. The formal workforce, which enjoys safe working conditions and social security, constituted only about 10% of the total workforce in India.
The data, sourced from the World Bank, confirmed the trend, showing that India was the 13th lowest among 206 countries in terms of the percentage of total government expenditure dedicated to health in 2017, with a figure of just 3.4%. This stood in stark contrast to the 18.6% average for high-income countries and even the 5.1% average for lower-middle-income countries, the group to which India belongs.
