Sangeeta Sharma, Ranjit Roy Chaudhury
India has made tremendous progress in the pharmaceutical sector and medical tourism but faces mindboggling shortfalls in healthcare delivery to its population. Poor access and mortality due to non-availability of medicines is among the highest in the world. Access to essential medicines remains limited and inequitable. In a move towards Universal Health Coverage (UHC), the National Health Assurance Mission (NHAM) has been announced by the Central government for providing assurance to make 50 priority essential medicines available at all times at all levels to the citizens of India living below poverty line. This paper reviews, assesses and compares the strategies adopted by various Indian States for improving availability and access to medicines. The strengths and weaknesses of the two most challenging functions i.e., procurement and supply chain management are discussed in the paper. Centralized procurement of carefully selected priority essential medicines along with Supply Chain Management (SCM) by an outsourced agency appears promising under given constraints. Alternatively, SCM can be continued to be managed by states themselves but with adequate utilization of digital technology. Access to essential medicines as part of the right to the highest attainable standard of health ("the right to health") is not only a social right but is also well-founded in country's constitution and health policy. It is, therefore, the responsibility of the government to ensure that this initiative is taken forward. Limited resources should not hold back this very important social commitment. Providing medicines to all, being an essential component of health care, should be implemented immediately to reduce out- of- pocket expenses for medicines
