Government funding on health care is “a long way” before it can meet the development targets India has adopted as part of the United Nations’ Sustainable Development Goals (SDGs), the country’s apex auditor CAG has said, pulling up the Union government, the Niti Aayog and the governments of the states it surveyed.
The SDGs relate to a set of 17 objectives that include improving poverty, hunger and health by 2030 and the Comptroller and Auditor General (CAG) was reviewing work done in the context of health in several central ministries and Assam, Chhattisgarh, Haryana, Kerala, Maharashtra, Uttar Pradesh and West Bengal.
“There is still a long way to go before the target of public health expenditure is achieved and the central allocation for health for 2019-20 was far short of target. In states, health spending as a percentage of total states expenditure, ranged from 3.29 to 5.32% which shows that this need considerable augmentation,” CAG said in its report.
The report, tabled in Parliament on Monday, noted that public health expenditure as a percentage of Gross Domestic Product (GDP) had been increasing since 2015-16 but remained within a narrow band of 1.02-1.28 % of GDP.
“While it is recognised that projecting financial resources for achieving the Targets by 2030 is a challenging task, ministry of finance and state governments are yet to integrate SDG related financial resources in national budgeting for implementing SDGs,” it said.
According to the auditor, the problems went beyond allocation of funds.
“Data for certain health indicators were not regularly or uniformly available,” the report said.
The audit was taken up to ascertain the ‘Preparedness of the Government for the Implementation of SDGs’, covering aspects such as extent to which the 2030 agenda had been adapted. It selected ‘Goal 3- Good Health and Well-Being’ for a detailed examination.
The 2030 target is being coordinated by the NITI Aayog, which too came under the CAG’s criticism.
“A roadmap is yet to be aligned with defined milestones for SDG targets to be achieved in the year 2020, 2025 and 2030,” the report said in the context of the Aayog’s role as the coordinator.
A key action plan that the NITI Aayog was supposed to prepare was still not complete, the report noted.
“States are yet to prepare policy documents. Mapping of goals/targets undertaken by NITI Aayog and selected states is still ongoing.”
Efforts to raise public awareness about SDGs and initiatives in the selected states were not comprehensive, focused or sustained, the report said.
The auditor in its recommendations said a comprehensive charter and action plan with well-defined milestones for implementing SDGs should be formulated after due consultations.
It also suggested the use of Direct Benefit Transfers (DBT) should be expanded and strengthened to avoid leakages and to improve efficiency in usage of financial resources.