The Harvard T.H. Chan School of Public Health has numerous and diverse engagements with India across a wide range of important scientific and policy areas. To strengthen these engagements for mutual benefit, the School has developed a new partnership with Indian scientists and public health experts. This partnership will facilitate exchanges between the School faculty and students working in India, Indian faculty and students interested in collaboration with the School, and other groups at Harvard interested in collaborating with partners in India on public health-related issues. This initiative, the India Health Partnership (IHP), will help bring together students and faculty working in and on India for mutual benefit and greater impact.
The IHP will encourage and increase the School’s collaboration with India on public health research, teaching, and action of joint interest and benefit. IHP is a cross-cutting initiative to promote and develop partnerships and enhance the quality, sustainability, and impact of the School’s India partnerships to improve public health. IHP will:
- Facilitate new and existing partnerships and collaborations;
- Enable greater learning and capacity development across diverse the School-India collaborations, leveraging current efforts in a time and cost-efficient manner;
- Provide a communications platform that will make the School-India partnership activities more visible and impactful; and
- Strengthen the strategic vision and direction for collaborations between the School and Indian partners.
Beyond India, the School is also engaged with many partners in other South Asian countries such as Bangladesh, Nepal, Sri Lanka, and Pakistan. IHP will initially focus on developing the School-India collaborations, but future evolution may include the wider South Asian environment.
See more in the July 15, 2013 The School’s news article introducing IHP.
In the world’s second most populous country (and projected to become its most populous by 2030), public health in India can be hugely influential not only for its own well-being but for global health more broadly. India has made dramatic progress in recent years; for more than a decade, it has experienced record-breaking economic growth that has been accompanied by significant reductions in poverty. In recognition of its importance and status, India has taken up a prominent position in global affairs. Its health conditions have also dramatically improved – with infant mortality falling from 64 to 47 per 1000 live births from 2000 to 2011, life expectancy at birth increasing from 61 to 65 years, and the maternal mortality ratio falling from 390 to 200 per 100,000 live births over the same period.
Despite this progress, India faces persistent and daunting public health challenges. Although it has achieved much, it is unlikely to fulfill many of the health-related Millennium Development Goals by 2015. Child undernutrition and low birth weight remain alarmingly high despite significant public investments to improve it.
Neonatal and maternal mortality are stubborn problems resistant to rapid improvement. India is experiencing many elements of the global epidemic in non-communicable diseases and risk factors including obesity, diabetes, tobacco use, and road traffic accidents. The burden of health needs and problems falls heavily on India’s poor and women and children and there are wide disparities in conditions within and between India’s numerous states. Poor health and nutrition in India is also strongly associated with social and economic disparities, gender discrimination, and the urban-rural divide.
India’s health system is an area of deep concern and paradox. India spends $54 per person per year on health. That is all that is available to meet all of the health needs at all levels from simple immunization to sophisticated surgery. The government share of this total is only about 30% ($18). Out-of-pocket spending is very high and health is widely reported to be a major cause of household impoverishment.
Government health services perform poorly in much of the country, providing a low quality of care and producing waste (despite resource shortages). Recent efforts to inject more funds have shown some results, but the gaps remain substantial. A large, diverse, and under-regulated private health care delivery system is relied on by most Indians to meet their needs. New government-financed health insurance programs are increasing coverage, but insurance remains limited. In contrast, India also has dynamic pharmaceutical and biotechnology industries, world-class scientists including a burgeoning clinical trials industry, and leading hospitals which attract foreign patients and treat its better-off citizens.
India’s rapidly growing health system is placing huge demands on the country’s capacity to educate the next generation of clinical and public health professionals and health system policy makers and managers. Education and training programs, especially in the private sector, are being rapidly created to meet the rising demand. New models for human resource development for public health may be needed to meet future needs. Educators often lack up-to-date and India-relevant materials for teaching as well as newer technologies to expand their reach and impact.
Engagement with India and its other south Asian neighbors is an essential element of the School’s commitment to accelerating global health and equity progress through its missions of knowledge production, knowledge translation, and knowledge communication. IHP will be a vital instrument to strengthen that engagement.