Congratulations to Puja Changoiwala (cpuja) for winning ASJAhq’s 2022 Annual Writing Award in the Opinion/Op-Ed category for her story on how the privatization of India’s health care exacerbated social and economic inequalities.
After devastating India’s cities, COVID-19 is now ravaging the country’s hinterlands. Over half the new infections and deaths in the country are being reported from rural areas. In the small village of Shertha in the western Indian state of Gujarat, for instance, 64 persons lost their lives this April, many because they failed to access timely medical care and essential supplies like oxygen.
The structural adjustment program sparked rapid economic growth, but also ensured that most of the gains would go to the wealthy, exacerbating social and economic inequalities. In effect, the international financial institutions demanded that India lower the standard of living of the bulk of its people.
The economic reforms also meant that the poor would have to pay for medicines, bandages and other supplies, even in publicly funded facilities. In accordance with SAP conditionalities, the Indian government introduced “user fees” in public hospitals.
But private health care costs four times more than public health care in India. In the fiscal year 2011–2012 alone, 55 million Indians fell below the poverty line because of out-of-pocket health expenses. Making matters worse, economic reforms percolated to the pharmaceutical industry with the Drug Price Control Order of 1994. Thereafter, most drugs were free from statutory price control, leading to a steep rise in drug prices.
The impacts of SAPs on the world’s poor populations have only compounded over the past decades. The ongoing pandemic has exposed the most lethal fault lines of these policies, which, with their enduring legacies, have also contributed in marring their fight against COVID-19. In Cameroon, for instance, structural adjustments increased poverty, and 37.5 percent of its population now lives below the national poverty line.
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