According to the commission’s website, the need for this has come into focus due to the Covid pandemic Universal health coverage To promote UHC in India, a Lancet Citizens Commission was formed in 2020 to pave the way for achieving UHC in India in the coming decade. “The Commission’s work is underpinned by a normative commitment to strengthen India’s UHC public health “The health system should promote sustainability in all its dimensions, including promotive, preventive and curative care. The state should play a leadership role as provider, financier, regulator and manager of the health system,” said a paper published in The Lancet in April 2021 on the commission’s work.
The paper says key questions include negotiating the interoperability and complementarity between public and private health provision, and the design of a regulatory structure that holds each component of the health system accountable. The commission’s funders include the Azim Premji Foundation, Rohini Nilekani Philanthropies, Vikram Kirloskar and the Lakshmi Mittal & Family South Asia Institute. Harvard University,
Dr Yogesh Jain, a well-known public health physician who has worked extensively on developing a blueprint for UHC in India, was among the first to withdraw from the commission. “I did not like the idea of a pharma company chief being one of the four co-chairs of the commission. There is such a clear conflict of interest that a person who is openly pushing for this cannot be included in the commission. Privatization “We will look at creating a public health system,” Dr Jain said.
Dr Srinath Reddy, former president of the Public Health Foundation of India (PHFI) and chairman of the 2010 High Level Expert Group (HLEG) on Universal Health Coverage, was also listed as a member. Dr Reddy confirmed that he was not a member of the commission and did not contribute to its report. He did not give reasons and said he would comment on the report when it was published.
Sujatha Rao’s tweet said the commission is “proposing corporatisation of primary care and copying the US model, the only country that has not built any UHC despite spending 18% of GDP on health. In an already unequal society, this is a recipe for disaster”.
Dr Rakhal Gaitonde, professor of public health at the Achutha Menon Centre for Health Science Studies at the Sree Chitra Tirunal Institute for Medical Sciences and Technology, whose work includes research on health inequalities and health policy and systems research, will remain a member of the commission but has recused himself from the authorship team of its report. He, however, did not wish to comment until the report is published.
Many of the members TOI wrote to did not respond, while some replied that since the commission’s report was under review, they were not authorized to speak to the media. Interestingly, three members of the commission are directly involved in the case. Narayana HealthA for-profit healthcare company that recently launched a subsidiary for managed care, including preventive and primary care.
Narayana Health founder and chairperson Dr Devi Shetty and the company’s independent director Nachiket More are among the 20 commissioners. Narayana Health chairperson and MD Kiran Mazumdar Shaw Biocon Ltd. is a non-executive director at Narayana Health and one of the co-chairs of the commission. Tarun Khanna of Harvard Business School and director of the Lakshmi Mittal & Family South Asia Institute at Harvard University, another co-chair of the commission, was the one who wrote the case study on Dr Shetty and Narayana Hrudayalaya in 2005 for the Harvard Business School case collection.
Some experts believe it is better to remain on the commission and be involved in the process, rather than be sidelined from it. According to some members, there will be disclaimers by some authors about some recommendations or sections of the report. The commission’s report, which has gone for peer review, is expected to be published before the end of the year.
Co-chairs
1. Vikram Patel is the founder of mental health consulting firm Librum and co-founder of Sangat, India.
2. Kiram Mazumdar-Shaw is the chairperson and managing director of the biopharmaceutical company Biocon.
3. Tarun Khanna is the co-founder of Jan Care, a chronic disease diagnostics company, but he has no operational role or board management role in the company.
4. Gagandeep Kang serves on the boards of the Epidemic Preparedness Innovations Coalition and Hillman Laboratories Pvt Ltd. PD declares no competing interests.
Commissioners Knife
The members of the Citizens Commission are:
1. Devi Shetty (Chairman, Narayana Hridayalaya Limited)
2. Nachiket Mor (Visiting Scientist, The Banyan Academy of Leadership in Mental Health)
3. Mirai Chatterjee (Director, Social Security Team, Self Employed Women’s Association (SEWA))
4. Poonam Muttreja – Executive Director, Population Foundation of India
5. Sharad Sharma (Co-founder, iSPIRT Foundation)
6. Yamini Iyer- Former President of Center for Policy Research
7. Bhushan Patwardhan (Distinguished Professor, School of Interdisciplinary Health Sciences, Savitribai Phule Pune University; Vice Chairman, University Grants Commission
8. Arnab Mukherjee – Professor of Public Policy, Centre for Public Policy, IIM Bangalore
9. Thelma Narayan – Director, Academic and Policy Action, Sochara
10. Sapna Desai – Associate, Population Council
11.Leila E Caleb Varkey-Independent Public Health Researcher
12. Vijay Chandru – Professor, Interdisciplinary Research, Indian Institute of Science
13. Atul Gupta – Assistant Professor, Department of Health Care Management, The Wharton School, University of Pennsylvania.
.14. Sandhya Venkateswaran-Senior Fellow, Centre for Social and Economic Progress
15. Sandra Albert – Director, Indian Institute of Public Health Shillong and Professor of Public Health
16. Preeti John – Associate Professor and Deputy Director, UCL Global Business School for Health; Faculty of Population Health Sciences, UCL, London, UK
17. Rakhal Gaitonde – Professor of Public Health, Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute of Medical Sciences and Technology
18. Indu Bhushan-Chairperson, Partnership for Impact (P4I) and former CEO of National Health Authority
