BEYOND BORDERS
Health Care in the Most Populous Country of the World
by VASUDEVA IYER , MD
India is currently the most populous country in the world with 1.45 billion people . Understandably , it is a formidable task to provide adequate and equitable health care to this massive population , especially the 60 % who live in rural areas . In 2019 and later in 2023 , the United Nations ’ declaration affirmed “ the right of every human being , without distinction of any kind , to the enjoyment of the highest attainable standard of physical and mental health .” The UN recommitted to achieve universal health coverage by 2030 . This is a lofty goal , but it remains to be seen how many countries of the world will accomplish it . The World Health Organization ( WHO ) estimates that a minimum of 2.5 medical staff per 1,000 people is required to provide adequate primary care . During the past seven decades , India has managed to cut down infant mortality rate from 88 per 1,000 live births to 28 , maternal mortality from 556 to 99 per 100,000 live births and to increase the life expectancy from 40 to 70 years : impressive achievements , indeed . 1 Nevertheless , India must overcome several problems such as inadequate infrastructure , shortage of health care professionals , urban-rural disparities , the growing burden of communicable and non-communicable diseases , high out-of-pocket health care expenses and a fragmented health care system to achieve the UN-stipulated goal . 2
India is a highly diverse country with several languages , religions , traditions and customs that evolved over thousands of years . Health care is no exception with many different treatment systems including modern medicine , Ayurveda , homeopathy and Unani to mention the most prevalent ( Unani practice is based on the balance of one ’ s four humors and four temperaments ). A meaningful analysis of health care in India must look at the different systems of medical practice that currently exist .
Before colonization by the British , who introduced the highly regarded and popular “ western / modern medicine ,” the prevalent medical system was Ayurveda , a form of holistic medicine , prac-
12 LOUISVILLE MEDICINE