India has nearly one third of the world?s tuberculosis (TB) cases. Two people die of TB in the country every three minutes, over a 1,000 everyday and 500,000 every year. Even as the government tries to get a grip of the situation, TB comes as an opportunity to some.
On his way back to office after a hectic day at the Sarvajanik Medical Centre (SMC), a TB directly observed therapy centre (DOT) at Gajraula, Uttar Pradesh, A K Ghose, president, CSR, Jubilant Organosys Ltd, has just done some stock-taking at the unit. ?About 98% of the affected people visiting us at the centre are treated successfully. The people, who fail to visit on a regular basis, are tracked down by our men and given their regular dose of medicine,? he says. So far, the story of this DOTS centre run by Jubilant Organosys has gone beyond a modest public-private partnership to a speciality centre to which other five centres (government-run) in the neighbourhood refer their cases.
And it?s not just Gajraula and stories of its beneficiaries like 25-year-old Janki or 40-year-old Raja Ram. The next beneficiary could be you, if the plans of Venkat Changavalli, CEO, Emergency Management and Research Institute (EMRI), bear fruit. The institute, the country?s first national private player in addressing emergency services and saving lives, will soon be functional in Rajasthan, Tamil Nadu, Madhya Pradesh and Tamil Nadu. The programme, up and running in Gujarat, Andhra Pradesh and Uttranchal, by 2010, will cover the whole country through its organised, integrated, accessible
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A centralised helpline for medical, police and fire emergencies, the initiative, started with an initial support of Rs 34 crore by the Raju brothers of the Satyam Group, in two years will address 75,000 emergencies a day through its wide network of 10,000 ambulances. There?s more. ?Looking at the possible annual expense of Rs 2,000 crore a year on the project, we are also working on possible collaborations with global emergency health delivery services to make it better. Through our current dealings with people, we are also researching on the reasons that lead to emergencies and their possible long-term solutions,? says Changavalli. Looking at these two ambitious case studies ? both public-private partnerships with corporate India as partner ? it?s clear that CSR initiatives are taking social responsibility quite seriously. ?The professionalism gained over the years in handling health menaces and our growing connect with the community have made us more responsible towards them. Today, we have a four-pronged model: catering to communities in urban areas, rural belts, one dedicated to family health and mobile reaching remote areas, empowering us to know problems emerging well ahead in time. HIV/AIDS is just one example here,? says Homyar K Gardin, head, family initiatives & convener core group, AIDS, Tata Steel.
Health has always enjoyed the attention of corporates under the social responsibility frame. Surveys done by watchdogs like Partners in Change suggest majority of the companies (62% surveyed by them) run a policy towards health (either for their people or community at large). The tasks taken under these could range from providing clean drinking water to preventing and curing diseases like malaria, TB, HIV or cancer. The ways to go about this is largely through partnerships either with the government, other corporate bodies, management institutes, NGOs or community. ?Through our surveys and other researches, we can say that around 30% of the companies have their CSR in the field of achieving the millennium development goals of which health is an important aspect. Under the health aspect, most of the companies are working in the field of HIV/ AIDS as for them this is a business case today,? says Khurram Naayaab, programme manager, Partners in Change.
Agrees Shefali Chaturvedi, director and head, Social Development Initiatives, Confederation of Indian Industry (CII). According to her, the focus of corporates on CSR in health has today taken a holistic approach. ?Considering that failing health of the infant at a worker’s home or death of the worker himself disturb the work at the
office, it has made them see their initiatives as tools in accomplishing a bigger task. Many of the new initiatives are towards filling the gaps like bolstering the delivery mechanism of the government. Our initiatives like the Healthy Villages programme too are gaining corporate support, giving public-private partnership the way to go and build on,? she says.
CII?s Health Village programme integrates primary education with all the components vital for the health of every community. ?India had committed to providing minimum standards of healthcare to all its citizens by 2000 under the Alma Ata Declaration of 1978. However, India is dismally lagging behind and we need to make an investment of $25 million over the next 10 years to meet the commitment. As the cost of healthcare delivery is huge, especially in India, corporates have come forward in order to reduce the disease burden. While working at Joniawas village in the NCR, we realised that a simple intervention could reduce incidence of infectious diseases in the village by 70%,? says Naresh Trehan, chairman, CII Task Force on Rural Health, who hopes to have more interventions.
While some CSR watchdogs pat the corporates? back on their health-related initiatives, some wish they would adopt a district each and work for its development the way the Tatas have done in Jamshedpur. Some others from the health sector want corporates to straighten their acts and speak up if their peers fail to do so.
Mira Shiva, director, Initiative for Health Equity & Society and chairperson, Health Action International ? Asia Pacific, can?t forget the 1980s when commercial infant foods were aggressively marketed, brainwashing young mothers into believing that this was superior to breast milk. For her, David Werner?s Questioning the Solution addresses the issue, highlighting the role of corporations in the health sector at large. ?When we look at children from the public health or public interest perspective, it?s very different than looking at them from a corporate perspective, which looks at them as a market. Their goal after all is to make a profit.
Aggressive sales of large number of non-essential, irrational, over-priced medicines have been a matter of concern. The numerous books, reports and investigation documenting unethical marketing practices of potentially hazardous drugs or promotion of medicines with false claims still leave us wondering about corporates? actions and strategies,? she says.
For Shiva, what she would like to see happen as part of CSR, as a public health person, is shift of production pattern to essential, rational, need-based, ethically promoted practices and products at affordable prices. ?I would like to see the anti-health industry curtailed. I would like to look forward to the day, when even at the cost of lesser profits, corporations can proudly say that their products, processes and projects genuinely promote public health, which includes human health and the environment.?