India's universal healthcare rollout to cost $26 billion

Thu, Oct 30 2014

By Aditya Kalra

NEW DELHI (Reuters) - India's universal health plan that aims to offer guaranteed benefits to a sixth of the world's population will cost an estimated 1.6 trillion rupees ($26 billion) over the next four years, a senior health ministry official said.

Under the National Health Assurance Mission, Prime Minister Narendra Modi's government would provide all citizens with free drugs and diagnostic treatment, as well as insurance cover to treat serious ailments.

The proposed plan would be rolled out in phases from April 2015 and will cover the entire population by March 2019, C.K. Mishra, an additional secretary at the health ministry, told Reuters. When the entire population is covered, it would cost an estimated $11.4 billion annually.

"If you want to deliver the service, that is what it will take," Mishra said, disclosing for the first time an expert group's cost estimates that will be considered by the finance ministry for inclusion in the government's spending plans.

Healthcare experts caution that it could take decades before India's 1.2 billion people are adequately covered and that the costs of provision could face significant upward pressure.

If approved, India would need to drastically raise its healthcare spending. In the current financial year, the budget allocated about $5 billion to healthcare.

"We are not in a position to implement it across the regions, states (right now). It's impossible. So we are choosing number of districts each year," said Mishra.

Despite rapid economic growth in the last 20 years, the government spends only about 1 percent of gross domestic product on healthcare. That compares to 3 percent in China and 8.3 percent in the United States.

More newborns die in India than in poorer neighbours such as Bangladesh, and preventable illnesses such as diarrhoea kill more than a million children every year.

Government hospitals are overcrowded and lack resources to meet the growing demand, while access to basic health services in rural areas and smaller towns remains poor.

"I can say that you are covered, but your closest facilities are 100 kilometres away. You are limited by that fact," said Rana Mehta, leader of healthcare at consultants PwC India.

"To build infrastructure and then provide care over a period of time would obviously take decades."

A 2012 study by Indian business lobby FICCI and consultants EY estimated that universal health cover in India was feasible in a decade and would require government health spending to rise to 3.7-4.5 percent of GDP.

PLAN STRUCTURE

The new plan will focus on improving preventive healthcare services by ensuring adequate availability of medical practitioners in rural areas, while new infrastructure will be created under existing welfare programmes, Mishra said.

Tertiary care services would be provided through an insurance-based model and the government will offer more than 50 drugs free to all its citizens.

Along with the drugs, about 12-15 diagnostic treatments will be offered in the package.

Mishra said states will be encouraged to enter into outsourcing agreements for the provision of treatment.

In recent years, thousands of small private hospitals and test centres have flourished, betting on high demand created by lack of adequate public facilities. Such providers opened 80 percent of India's new hospital beds during 2002-2012, according to a PwC-NatHealth report.

While private players will be involved in the ambitious programme, the government will need to ensure speedy payments for the partnership to work, said Harish Pillai, chief operating officer at private healthcare group Indus Health.

"Private providers can definitely help and execute it better, but the government should not only see us as commercially-driven entities," said Pillai.

The World Bank and Britain's health cost-effectiveness agency NICE are also assisting India, providing technical assistance and advice on treatments the government should offer in the package, the bank said last week.

($1 = 61.4200 rupee)

(Reporting by Aditya Kalra; Editing by Douglas Busvine and Simon Cameron-Moore)

http://in.reuters.com/article/2014/10/30/uk-india-health-idINKBN0IJ0VN20141030

Tehran tries to inspire residents to follow 'Islamic lifestyle' via comics

Tehran tries to inspire residents to follow 'Islamic lifestyle' via comics

• photo
 
• Iran

An ad in a Tehran bus. The man on the right says, “Why are you staring at my wife? She’s just wearing a tight manto [an Iranian coat], and her hair is peaking out of her scarf, and she’s wearing a little makeup! That doesn’t mean you can stare at her!” The man on the left answers, “Sir, I swear to God that I’m blind! But the way you described her, it’s normal that everyone stares at her!”

This week, the city of Tehran has rolled out an advertising campaign aimed at getting people to adhere to what its leaders consider a proper Islamic lifestyle. The comics, which have been put up in buses across the city, have amused some of our Observers and angered others, but either way, they’ve missed their mark.

The adverts are mainly aimed at getting women: to cover up, to ask their husbands permission to leave the house, to spend thriftily, and not to ask their husbands for too much money.

In Iran, the government has two main ways of enforcing Islamic rules, in particular women wearing the hijab. There is the morality police, which employs both full-time officers and volunteers; under a new bill, these volunteers could soon be given expanded powers. Then there’s the softer manner, through the form of advertisements. Such ads have existed since the Islamic revolution be they in newspapers or billboards. However, these are usually done by state religious organizations; this is the first time the city of Tehran has launched such a campaign. The comic format is a new twist, too, and seems to be aimed specifically at Iran’s younger generations.

These are the hardest citizens to reach: Iranian politicians and clerics have repeatedly warned that the youth is living in increasingly “Westernised” ways.

U.S., Iran Relations Move to Détente

Interests Align Over Fight Against Islamic State, Other Policies

The U.S. and Iran have moved into a state of detente as they engage in aligned interests regarding nuclear negotiations and fighting Islamic State. WSJ's Bill Spindle reports. Photo: Getty

By 

JAY SOLOMON and

 

MARIA ABI-HABIB

Oct. 28, 2014 7:41 p.m. ET

109 COMMENTS

The Obama administration and Iran, engaged in direct nuclear negotiations and facing a common threat from Islamic State militants, have moved into an effective state of détente over the past year, according to senior U.S. and Arab officials.

The shift could drastically alter the balance of power in the region, and risks alienating key U.S. allies such as Saudi Arabia and United Arab Emirates who are central to the coalition fighting Islamic State. Sunni Arab leaders view the threat posed by Shiite Iran as equal to or greater than that posed by the Sunni radical group Islamic State, also known as ISIS or ISIL.

Israel contends the U.S. has weakened the terms of its negotiations with Iran and played down Tehran’s destabilizing role in the region.

Over the past decade, Washington and Tehran have engaged in fierce battles for influence and power in Iraq, Syria, Lebanon and Afghanistan fueled by the U.S. overthrow of Iraqi strongman Saddam Hussein and the Arab Spring revolutions that began in late 2010. U.S. officials still say the option of military action remains on the table to thwart Iran’s nuclear program.

Pakistani Taliban pledges support for IS militants

The Pakistani Taliban announced its allegiance to the Islamic State group on Saturday and ordered its jihadists to help the militants in their campaign to set up a global Islamic caliphate.

In a message to mark the Muslim holy festival of Eid al-Adha, the Pakistani Taliban said they fully supported the goals of the Islamic State group.

“Oh our brothers, we are proud of you in your victories. We are with you in your happiness and your sorrow,” Taliban spokesman Shahidullah Shahid said in a statement emailed to Reuters from an unknown location.

Islamic State militants already control large stretches of land across both Syria and Iraq but have recently begun making advances into South Asia, which has traditionally been dominated by local insurgencies against both the Pakistani and Afghan governments.

India, Pakistan Trade Gunfire 

on Border, Killing Nine

Two Sides Have Long Been Locked in 

Dispute over Kashmir

By SAMEER YASIR and NIHARIKA MANDHANA 
Updated Oct. 6, 2014 11:35 a.m. ET

Kashmiri Muslim protesters and Indian paramilitary soldiers clashed during protests after Eid al-Adha prayers in Srinagar. European Pressphoto Agency

SRINAGAR, India—At least nine civilians were killed and dozens more injured Monday as Pakistani and Indian forces exchanged fire along the two nations’ tense border, the latest in a series of deadly clashes in recent months.

India and Pakistan each blamed the other for starting the violence, which further undermined an increasingly tenuous 2003 cease-fire agreement designed to keep the peace between the nuclear-armed rivals.

Mortar shells and gunfire killed five people, including a 13-year-old girl, on the Indian side, local Indian officials said. Pakistani authorities said the death toll there was four, including two children.

The two countries share a long, volatile border, and are embroiled in a long-standing dispute over Kashmir. Each administers part of the region; both claim it in its entirety.

US, Afghanistan sign long-delayed security pact

Latest update : 2014-10-01

Officials from Afghanistan and the United States on Tuesday signed a long-delayed security agreement to allow American troops to stay in the country after the end of the year, filling a campaign promise by new President Ashraf Ghani.

National security adviser Hanif Atmar and U.S. Ambassador James Cunningham signed the bilateral security agreement in a televised ceremony at the presidential palace, one day after Ghani was inaugurated.

“As an independent country ... we signed this agreement for stability, goodwill, and prosperity of the our people, stability of the region and the world,” Ghani said in a speech after the signing.

Ghani’s predecessor, Hamid Karzai, had long refused to agree to the deal, souring his ties with the United States. Karzai cited his anger over civilian deaths and his belief that the war was not fought in the interests of his country.

U.S. President Barack Obama, in a statement, said the pact reflected America’s continued support for Afghanistan’s unity government.

“We look forward to working with this new government to cement an enduring partnership that strengthens Afghan sovereignty, stability, unity, and prosperity, and that contributes to our shared goal of defeating Al Qaeda and its extremist affiliates,” he said.

Cunningham said the pact showed the United States remained committed to Afghanistan, where foreign forces have helped provide security since the 2001 toppling of the radical Islamist Taliban government over its sheltering of planners of the Sept. 11 attacks.

“It is a choice by the United States to continue cooperating with our Afghan partners on two important security missions: training and equipping Afghan forces and supporting cooperation against terrorism,” Cunningham said.

Minutes after the security pact was signed, a similar agreement with NATO was ratified to allow the alliance’s European members to contribute to a residual foreign force.

Ghani said in his speech that the agreement did not compromise Afghanistan’s sovereignty and that either side has the right to withdraw from the pact within two years.

“The right to use force will be based on decisions by the Afghan government,” Ghani said. “Our air space will be under our own control. International forces will not be able to enter mosques or other holy sites.”

Modi: Al-Qaeda's South Asia plan 'delusional'

Prime minister says Indian Muslims "will not want anything bad for India" in first reaction to Zawahiri's announcement. Last updated: 19 Sep 2014 12:17

Modi: Threat from armed groups is 'a crisis against humanity, not a crisis against one country or race' [AP]

India's prime minister has dismissed al-Qaeda's plan to set up a South Asia branch, saying it was "delusional" to think the country's Muslim minority would follow orders to wage a struggle based on religion against their country. It was Narendra Modi's first reaction to al-Qaeda chief Ayman al-Zawahiri's announcement this month that the group would set up a new operation to take the fight to India, which has a large but traditionally moderate Muslim population, as well as to Myanmar and Bangladesh. "They are doing injustice towards the Muslims of our country," Modi, 64, who led his Bharatiya Janata Party (BJP) to a landslide victory in India's general elections in May, said in an interview with broadcaster CNN on Friday. "If anyone thinks Indian Muslims will dance to their tune, they are delusional. Indian Muslims will live for India, they will die for India - they will not want anything bad for India." There have been relatively few reports of young Indian men leaving to fight causes abroad, which experts say is because local grievances have kept them at home. Modi's BJP was accused by its rivals and some commentators during the election campaign, which it won, of trying to polarise votes along religious lines. He said the threat from armed groups was "a crisis against humanity, not a crisis against one country or one race". "We have to frame this as a fight between humanity and inhumanity, nothing else," Modi told CNN's Fareed Zakaria. In the run-up to a visit to the US, Modi also said the world's two largest democracies were natural allies. He acknowledged there had been "ups and downs in our relationship" but said that both countries shared common values. "India and the USA are bound together, by history and culture. These ties will deepen further," Modi said. He said that the US history of immigrant absorption and the vast Indian diaspora showed the people of both countries were inherently tolerant. "America has absorbed people from around the world, and there is an Indian in every part of the world," Modi said. "This characterises both the societies. Indians and Americans have co-existence in their natural temperament." http://www.aljazeera.com/news/asia/2014/09/modi-al-qaeda-south-asia-plan-delusional-2014919102516379117.html

Rival Afghan Leaders Sign Power-Sharing Deal

Rival Afghan Leaders Sign Power-Sharing Deal

Months after disputed presidential elections, the opposing candidates agree to form a unity government in a US-brokered deal.

3:50pm UK, Sunday 21 September 2014

Abdullah Abdullah and Ashraf Ghani shake hands after signing the agreement

• Email

A deal to create a power-sharing government in Afghanistan has been signed by the rival presidential candidates after months of wrangling following a disputed election.

Former finance minister Ashraf Ghani, who will become president under the deal reached on Saturday night, embraced rival Abdullah Abdullah, who takes the new role of chief executive, after they signed the agreement in a ceremony broadcast live on television.

The deal, brokered by US Secretary of State John Kerry, was swiftly welcomed by Washington.

"This agreement marks an important opportunity for unity and increased stability in Afghanistan," said a statement issued by the White House.

"We continue to call on all Afghans - including political, religious, and civil society leaders - to support this agreement and to come together in calling for co-operation and calm."

Iran has role to play in fight against IS militants, Kerry says

US Secretary of State John Kerry said on Friday that Iran had a role to play in a global coalition to tackle Islamic State militants who have seized swaths of Iraq and Syria and proclaimed a caliphate in the heart of the Middle East.

“The coalition required to eliminate ISIL (Islamic State) is not only, or even primarily, military in nature,” Kerry told a United Nations Security Council meeting on Iraq.

“It must be comprehensive and include close collaboration across multiple lines of effort. It’s about taking out an entire network, decimating and discrediting a militant cult masquerading as a religious movement,” he said. “There is a role for nearly every country in the world to play, including Iran.”

Kerry’s remarks appeared to represent a shift away from previous US statements indicating a reluctance to cooperate with Iran to confront the threat of Islamic State. The United States cut off diplomatic ties with Tehran during a hostage crisis after the 1979 Islamic revolution.

The United States, president of the UN Security Council for September, called the meeting on Iraq as it builds an international military, political and financial coalition to defeat the radical Sunni Muslim group.

Iran’s supreme leader, Ayatollah Ali Khamenei, this week said he had rejected an offer by Washington for talks on fighting Islamic State. Kerry said he refused to be drawn into a “back and forth” with Iran over the issue.

Anger mounts in Indian Kashmir after worst flood in over century

BY KRISTA MAHR

SRINAGAR India Sat Sep 13, 2014 12:18pm EDT

1 OF 4. An Indian Air Force helicopter flies above flooded-affected areas of Kashmir region September 13, 2014.

CREDIT: REUTERS/INDIA'S PRESS INFORMATION BUREAU/HANDOUT VIA REUTERS

(Reuters) - Residents of revolt-torn Indian Kashmir turned their wrath on state administrators for failing to provide them with succor after the worst flooding in over a century, angrily dumping food parcels into gutters.

A week into the disaster, large parts of Srinagar, the capital of Jammu and Kashmir, lay under water with many people still trapped atop their homes, and others crowded in relief camps.

Their misery has added to problems of the administration in a Muslim-majority region where a revolt against Indian rule has simmered for nearly a quarter century.

Many complain that the government, which has maintained a heavy presence in the territory to keep a lid on the revolt, has left them to their fate.

Residents stranded for days by the floodwaters said that the army has selectively evacuated tourists and people according to a pre-set priority list, leaving locals to be rescued later by volunteers.

“Helicopters came, and we waved our arms,” said Aasiya Kutoo, who was living at a temporary shelter. “Nobody came for us. Nobody in our area was rescued by air.”

Outside one mosque-turned-camp in Srinagar, food supplies dropped earlier in the day by a military helicopter were strewn in a gutter, rejected.

    “People said we don’t need this government food,” said Nayeem, who lives in the neighborhood. He said since the state of India occupied Kashmir, they were only providing relief out of duty. “If another state occupied this land, they would be bound to do the same.”

Both the Indian and Pakistan sides of the disputed Himalayan territory have been hit by extensive flooding since the Jhelum river, swollen by unusually heavy rain, surged last week. The river flows from Indian Kashmir to the Pakistan side, and then down into Pakistan's lower Indus river basin.

The Indian government has put the death toll at 200 in the part of Kashmir it controls but there are fears that number will rise as the damage to Srinagar, a city of one million, and villages in southern Kashmir is fully revealed.

On the Pakistani side, officials put the death toll at 264 on Friday.