Universal Coverage seems to be the mantra of the week with India planning a new cess  to fund free healthcare for all by 2020 and South Africa unveiling its Green Paper on National Health Insurance. Come next budget, Indians and South Africans can expect to contribute dearly into their tax kitty. India’s Planning Commission expert panel aims to hike public spending on health from about 1.4% of GDP to at least 3% by 2020 and voted to fund the proposed plan via a health surcharge on taxable income rather than a securities transaction tax. Talk about being ambitious! Though considering what is happening in India right now to Anna Hazare and Co., we have to wait and see whether this effort will at least go through without lining the pockets of all those in between!

South Africa plans to completely overhaul its healthcare system, including its basic structures, funding models, and priorities and roll out its version of Universal Coverage with a pilot version next year and this effort will also be tax funded. Health Minister Aaron Motsoaledi is definitely making all the right noises. The quality of care in public health institutions was “often totally unacceptable”; “If you earn above a certain income …… required by law to make a contribution ……… will not be possible to opt out of this responsibility”; “reducing the deep inequality between rich and poor, between privilege and deprivation” and so on. Very appropriate and inspiring! Let’s keep our fingers crossed that these plans go through till fruition.  Cheers! Two major decisions from two key global democracies.

Still on the subject of India, folks, we have decided that we are no longer content to just receive aid and meekly ‘obey’ the terms and conditions imposed by our donors. Henceforth, we would also like to ‘own’ a piece of the action. Having been the world’s biggest aid recipient for decades we have now decided to turn donor, by setting up our own aid agency, no less!  It is hard to say at this point whether this is one of our bright ideas that is destined to fall flat or whether it will trigger a new trend in the world aid order. Should we worry whether our present donors will look askance: why should they give us aid if we are capable of distributing the same? On the other hand, why shouldn’t we? After all we are in a better position to ensure that the aid is utilised well because we would be closer to our recipient’s ground realities than European or American donors. However, I think a more significant question would be: what is our motive? As a nation struggling to deal with corruption at every level, do we have the strength to adopt strong principles and stand by them while disbursing aid to vulnerable countries? Are we strong enough to decide that we will not meddle where we ought not? That we will aim for overall integrated development wherever possible and refrain from vertical programs and projects with hidden agendas that will serve nobody’s interests but our own. Remember SAPs! That is really the million dollar question. Hazare ’s anti-corruption wave sweeping the country has effectively demonstrated that we are a strong nation with strong desires. Whether he is a new age Gandhi or an aspiring politician albeit a cunning one out to gain whatever mileage he can does not really matter in the grand scheme of things. The crux of the matter is that Indians have decided that we want change.  So let us surprise ourselves, why not buck the aid trend and see what India can contribute?

Meena Daivadanam

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