Eleventh Five Year Plan

76 Eleventh Five Year Plan3.1.71 During the Eleventh Five Year Plan period, thefollowing will receive priority:• Establishment of Hospital Development Committeesin all government hospitals.• Improvement of infrastructure and facilities indistrict hospitals.• Provision of high-quality secondary health careservices for every block in the country.• Creation of state-of-the-art medical education,research, and care institutions in all disciplines ofmedicine.• Creation of new institutions and upgradation ofexisting tertiary care hospitals.• Mainstreaming of AYUSH systems to activelysupplement the efforts of the allopathic systems.ACCESS TO ESSENTIAL DRUGS AND MEDICINES3.1.72 Drugs and medicines form a substantialportion of the out-of-pocket spending on health byhouseholds (Table 3.1.7). The poor are the worstaffected because they are frequently affected by diseasesand are least able to purchase and utilize the healthservices, such as drugs. On the other hand, the componentof drugs and medicines accounts for a mere10% of the overall health budget of both the Centraland State Governments. Timely supply of drugs ofgood quality that involves procurement as well aslogistics management is of critical importance in anyhealth system.3.1.73 An essential component of strengthening primaryhealth facilities will be a system of guaranteeingessential drugs. Standard treatment guidelines will beavailable for doctors at PHCs and CHCs. Under theNRHM, experiences of efficient procurement and distributioncould be rapidly adapted and generalized toall States. Although the World Health Organization(WHO) has its essential list of drugs yet all of theseare not required at all levels. Each State will decide foreach level the essential list based on epidemiologicalsituation. Availability of essential drugs in every PHCand CHC will increase people’s confidence in the publichealth system.3.1.74 Analysis of drug prices indicates that publiclyprocured drugs are cheaper. Assuring regular supplyof drugs in public facilities would improve utilizationof public sector services and reduce out-of-pocketexpenditures. The NCMP also committed to ensureavailability of life saving drugs at reasonable prices.During the Eleventh Five Year Plan, all efforts willbe made to encourage States to model the public procurementsystems on the lines of the Tamil NaduMedical Services Corporation (Box 3.1.7). Effortswill be made to experiment available models inRajasthan and Delhi for making drugs available tohospital at cheaper rates. In order to take up drug pricing,quality, clinical trials, etc. as recommended bythe Mashelkar Committee (2003) and NCMH (2005),a National Drug Authority (NDA) with an autonomousstatus was to be set up during the Plan. Accordingly,Central Drugs Authority of India has been setup. The present National Pharmaceutical PricingAuthority, created under the aegis of the Ministry ofChemicals and Fertilizers, is proposed to be mergedwith the NDA. The Central Government will provideassistance to States for strengthening the drug regulatorysystem. During the Plan, the following will beemphasized:• Developing essential drug lists for all levels of institutions• Making available essential drugs of good qualityin adequate quantities in all government healthfacilities• Increasing efficiency, economy, and transparency indrug procurement, warehousing, and distribution• Initiating strategies in coordination with professionaland consumer bodies to ensure safe drugsand rational use of drugs• Disseminating information on essential drugs tomedical professionals, pharmacists, and to thepeople• Including all essential drugs under a system of pricemonitoring• Implementing and reinforcing the concept of StandardTreatment Guidelines in the in-service and preservicetraining programmes of the doctors andhealth workers.FOOD SAFETY AND QUALITY CONTROL3.1.75 To tackle the issues of pesticide residues in food/beverages, additives and contaminants, and nutritional