It was the winter of 1777. Soldiers of the newly formed continental army under George Washington had encamped at Valley Forge. Over the next four months, typhoid, dysentery and small pox swept through the camp decimating an already weak force. Washington and his medics decided to act on a rumor that small pox could be prevented. They decided to rub the pus of already affected individuals into wounds of unaffected men. Of the men inoculated, only a small number went on to develop the disease but the rest were rendered immune for life. This along with measures to improve sanitation with a dedicated corps of doctors and nurses helped the army recover and reengage the British with new confidence, eventually winning independence.
History is replete with such instances where health was often the decisive factor in shaping events. In the turmoil following World War II, when Asian nations took the form they have now, healthcare was acknowledged as an important factor in the road to prosperity.
In the year 2000, The World Health Organization (WHO) conducted its first-ever analysis of the health systems of 191 member states. The top 50 included 12 countries from Asia. But a disproportionate number among those nine belonged to oil producing nations. The subsequent decade played host to numerous stories of Asian nations coming into their own with robustly growing economies weathering the global economic storm, and yet there has a been a sense of disquiet when it comes to healthcare. Despite noises made at the beginning of the millennium, expenditure in this sector by governments across the region has often been seconded in preference to measures that reaped quick rewards, such as physical infrastructure and arms, in terms of economic growth and a greater diplomatic punch. As a result, Asian countries continue to lag behind in healthcare as can be seen by the dreadfully high numbers in infant mortality in South Asia 52 per thousand in India alone.
Another worrying trend is the paucity of healthcare professionals. India has approximately 70,000 doctors, working out to 7 per 10,000 people, and 1.5 million nurses and technicians for her 1.2 billion strong population (WHO data). Compare this with countries with strong healthcare satisfaction levels which average above 25 doctors per 10,000. Within the WHO list, Singapore was the highest ranked Asian country at 6, while Myanmar brought up the rear at 190. China came in at 144 and India was placed at 112. Contrast this with the size of their economies. China is the second largest economy in the world and India the fourth largest. Yet, the investment made in this sector has a lot of catching up to do.
Why is it so important for healthcare to refine its act?
In 2003, a paper by David Bloom and his team highlighted that one year's improvement on a population's life expectancy could result in a 4% increase in output. Illness and disability reduce hourly wages earned, an effect especially seen in developing countries. It's imperative therefore that a nation looking to move forward also allocates resources to ensure that her people can function at their best. Interestingly, the success of the existing system in reducing mortality due to infectious diseases with a changing lifestyle means that Asian people have a greater life expectancy and in turn have begun to face a new spectrum of chronic disorders.