Vice President M Venkaiah Naidu Friday stressed the need to promote indigenous manufacturing of medical equipment to overcome a "paradoxical" situation in the health sector where a range of treatments are available for foreigners but are out of reach for many local people.

Addressing the 46th annual convocation of AIIMS, Naidu said it is estimated that the out-of-pocket expenditure constitutes more than 60 per cent of all health expenses, a major drawback in a country like India where a large segment of the population is poor. Approximately 63 million people fall into poverty each year due to lack of financial protection for their health-care needs. "We have a paradoxical situation when it comes to health sector. On the one hand, India is making rapid strides in medical tourism with people from other countries coming to our country for a range of treatments -- from liver transplant to knee replacement. However, the same treatment is out of reach for many Indians. "We need to overcome this paradoxical situation by ensuring that treatment is affordable for all Indians," Naidu said.

He said an important step in this direction will be to promote manufacturing of state-of-the-art devices and equipment in the country, particularly under the 閃ake in India' programme. "Such a move will not only save precious foreign exchange for us but also bring down the costs of the devices," he said. Naidu also said that with a majority of the population, particularly from poor and low middle classes, meeting most of the health expenditure on their own, the government has launched 羨yushman Bharat Yojana' to cover more than 10 crore vulnerable families by providing a coverage of up to Rs 5 lakh per family per year.

This will be a game-changer in terms of accessing health-care services in India, he said. Expressing concern over the absence of qualified medical practitioners in rural areas which is making people to go to quacks in rural areas, Naidu said there was a need to increase the number of doctors available at health care centres in rural area and incentivize rural doctors. Naidu pointed out that there was a significant urban-rural divide in the health sector. Citing a report, he said, 的ndia has only 1.1 beds per 1000 population compared to the world average of 2.7. Seventy per cent of India's health care infrastructure is in the top 20 cities." "We have to bridge this urban-rural divide in providing state-of-the-art health care services. The highest priority has to be accorded to strengthening primary health care and tertiary care."

Naidu said in the present times of specialization and super specialization, greater focus needs to be paid to the disciplines of family and community medicine. A major challenge we have to overcome is the need to provide quality health care at all levels, he said. He said that India is faced currently with double burden of disease. On the one hand, we are still grappling with dengue, swine flu, chikangunya, malaria and HIV. On the other hand, non-communicable diseases are taking a heavy toll. Cardiovascular diseases, respiratory diseases and diabetes are contributing to substantial chunk of total deaths in India. "Not only in terms of expanded access to medical education but also in terms of quality, much more needs to be done," he said.

"Recent studies reveal that India still accounts for 16 pc of the global share of maternal deaths and 27 pc of global newborn deaths. Deaths continue to occur due to communicable diseases, with 22 pc of global TB incidence in India. India's non-communicable disease burden continues to expand and is responsible for around 60 pc of deaths in India," he said. "India has achieved significant economic growth over the past decades, but the progress in health has not been commensurate. Despite notable gains in improving life expectancy, reducing fertility, maternal and child mortality, and addressing other health priorities, the rates of improvement have been insufficient, falling short on several national and global targets," he said.