The Prime Minister, Dr. Manmohan Singh, has exhorted
the Government, health policy planners and the medical fraternity to work on the
task of exploring ways and means, by which the health status of the country can
be improved in the next decade.
Launching the commencement of the golden jubilee celebrations of the All
India Institute of Medical Sciences, here today, the Prime Minister said that
only when the society, at large benefits from the investments made by the
Government in high-class medical care, that investments can be said to have
borne fruit. Dr. Manmohan Singh pointed
out that the Government proposed to support the establishment and growth of
Schools of Public Health, which could provide the framework for
multi-disciplinary partnerships in education, research and health action.
Pointing out that private care could not be the
immediate answer to the needs of those who do not have basic purchasing power,
the Prime Minister said that medical institutions like AIIMS and national
policy makers would have to refashion the health care system to meet the needs
of this segment of the society. Dr.
Manmohan Singh said, “so long as wide health inequalities in our country and
access to essential health care is not universally assured, we would be falling
short both in our economic planning and in our moral obligations to all our
citizens. He also exhorted young health
professionals and scientists to aim to contribute to the greater good of
humankind.
The Prime Minister also expressed serious concern
over the fact that the nation’s health indicators were among the worst in the
world. He highlighted the fact that
the legitimate expectations of the society and the mandate of governments must
extend to encompass health promotion and disease prevention. The Prime Minister expressed the hope that
AIIMS would become a thought leader in promoting a broad understanding of
health through trans-disciplinary education.
The Prime Minister was also conferred upon with the
Honorary Fellowship of AIIMS for his outstanding contribution as an economist
and a visionary statesman. He also
unveiled the logo of the golden jubilee celebrations of AIIMS on the
occasion. The Prime Minister gave away
medals and book prizes on the occasion of the annual convocation of AIIMS. Union Health Minister, Dr. Anbumani
Ramadoss, Director, AIIMS, Prof P. Venugopal were among the members of the
distinguished gathering.
The following is the text of the Prime Minister’s convocation
address on the occasion:
“I am
truly delighted to be present at this historic occasion when the All India
Institute of Medical Sciences (AIIMS) is commencing its Golden Jubilee
Celebrations. I am also honoured to
participate in the 34th Convocation of this great national
institution and be conferred with the Honorary Fellowship of the Institute.
Golden
Jubilees of institutions offer us an occasion to reflect on their
accomplishments and plans for future.
AIIMS is undoubtedly an institution of excellence in medical education
and research and health care, and is rightly regarded as a valuable national
asset. It must be our endeavour not only to sustain past performance, but
strive day after day to improve upon it so that the next 50 years will be still
more productive, still more fruitful in the service of the people of our
country.
The
establishment of AIIMS in 1956, through an Act of the Indian Parliament,
reflected our commitment to achieve self-reliance in key sectors of the economy
and human development. It also bore
testimony to the value our national leadership placed on the attainment of
excellence in all such endeavours.
Speaking in Parliament on the Bill on AIIMS, the then Union Health
Minister said: “It has been one of my cherished dreams that for post-graduate
study and for the maintenance of high standards of medical education in our
country, we should have an Institute of this nature in India which would enable
our young men and women to have their post-graduate education in their own
country”. She went on to say, “Medical
education must, above all, take into account the special needs of the country
from the point of view of affording health protection to the people”.
This was
also the vision of India’s first Prime Minister Pandit Jawahar Lal Nehru, who
believed that institutions like AIIMS would be regarded as the temples of
modern India. The time has come for us,
therefore, to rededicate ourselves to the mission of these visionaries and
pioneers.
AIIMS has
indeed fulfilled its mandate of establishing high standards of excellence
in undergraduate, postgraduate, doctoral and post-doctoral
education. It has designed, established and evaluated innovative models
of education and assisted in their replication across the country. It has gained a well-earned reputation for
providing the highest standards of clinical care in many specialties. This
is on par with the best medical centres in the world. It has been the leading contributor to published medical research
in India, with scientific output of high impact. Its faculty has assisted national and international agencies in
developing policies and programmes for health care. Its alumni have provided leadership to academic departments in India
and abroad. The cumulative contributions of AIIMS amply validate its claim
to be the premier medical institution in India and among the very best in
the world – exactly as our Parliament hoped it would be. The country is truly
proud of this great national institution that AIIMS is.
I, on behalf of our nation, salute AIIMS for
its glorious accomplishments, and express our nation’s collective gratitude to
the many individuals who have contributed to its growth over the past 50
years. Shunning greater riches and
greener pastures in the private sector, or in other countries, they have worked
selflessly to build AIIMS to its present position of pre-eminence. We need to draw our inspiration from them
today as we look to the future of AIIMS.
While we all are truly proud of our
accomplishments in medical science and technology, we must be aware that the
health indicators of our country do not do us proud. While working on the
frontiers of science and technology is absolutely necessary, we cannot be
mesmerized by technological solutions and fixes. We must realize that health is
the result of many factors of which medical care is just one. It is a matter of
serious concern that after so many decades of our effort, our health indicators
are among the worst in the world. Our infant mortality rates, our maternal
mortality rates and the incidence of easily controlled diseases and epidemics
are unfortunately among the worst in the world.
This
golden jubilee therefore is a time for the entire medical fraternity to reflect
on the ways by which we could improve the basic health levels of our
population. Kerala, with its world class health indicators, has shown that
there is no necessity for high standards of living or high per capita income
and high cost medical care to improve the health of our population. I request
all those connected with planning of health services in our country, those who
are in the Government, those who are health policy planners, AIIMS and the
medical fraternity with the task of exploring ways by which we can bring the
health status of the rest of the country to the levels prevailing in Kerala in
the next one decade. I think that’s a
challenge which can be met and which should be met and I suggest that AIIMS
must take a leadership role in this. It is only when society at large benefits
from government investment in high-class medical care that we can truly say
that the investments have borne fruit.
In this background,
we must ask whether AIIMS continues to imbibe and uphold the values of its
founding generation. Have growth and expansion created bureaucracies? Has
bureaucratism robbed individuals of initiative? Has the surge of patients
reduced time for research? Has the pressure of quantitative growth impacted
qualitative development? Has the emergence of for-profit corporate health
care created new temptations that attract better talent away from institutions
like AIIMS? Has Government interference discouraged professionals and hurt
professionalism? How do we strike a balance between the needs of intellectual
and functional autonomy while maintaining societal accountability? We must
address these questions before we rush to create new institutions. AIIMS can take a lead in nurturing many state
institutions to higher standards of medical care so that the patient pressure
on it reduces and it can focus on the frontier areas of research.
Just as
the mandate of AIIMS 50 years ago was defined in the historical context of our
national aspirations then, we now need to redefine that mandate in the context
of the current environment. There are new issues, new challenges arising out of
the growth of private healthcare, the increasing demand for advanced medical
care and the government’s own obligations to primary healthcare. I strongly
believe that the bulk of the provision of basic health services and medical
care, particularly for the poorer sections of society will continue to be in
the public domain for many many decades to come. I do believe in liberalisation.
I do believe in giving greater play to market forces, but I also
recognize that markets serve those who are part of the market system. When millions and millions of people live on
the edges of subsistence, market signals can have no meaning for them and
therefore, it is the responsibility of society at large, to take care of these
disadvantaged and under-privileged sections of our population. The expansion of private health care, which
is a happy phenomenon, will address the needs of the affluent and those covered
by organized medical care programmes.
However, millions of people living below the poverty line and in our
rural areas will continue to depend on government as the primary health care
provider. Private care cannot be the immediate answer to the needs of those who
do not have basic purchasing power.
Therefore,
AIIMS and other similar institutions and national policy makers will have to
refashion the health care system to meet the needs of this segment of society.
We need to adopt a holistic approach to the whole issue of national health
care. And when I look at the
literature, I am struck by the fatness of the report like the Bhor’s committee
report, which reported on this vital issue even before India became
independent. We have launched a
National Rural Health Mission. I hope
it will take care of the primary health care issues, but we cannot be satisfied
with the status quo. We must look at
the mechanisms and changes that we are planning to introduce, whether they
really live up to the challenges that our health care system faces. Policies must be framed to meet the hospital
care needs also. A balance needs to be struck between government and private
initiative in this context.
Investments
in health, while essential for economic progress, are not motivated, as I said,
cannot be purely by economic considerations alone. We recognize health as an
inalienable human right that every individual citizen can justly claim, so that
he or she can develop to his or her full potential. So long as wide health inequalities exist in our country and
access to essential health care is not universally assured, we would be falling
short in both our economic planning and in our moral obligation to all our
citizens, particularly those who are at the bottom rung of social and economic
ladder.
Science
and technology are indeed the fertile fields from where innovative
contributions to health can and must emerge.
The ability of health professionals to investigate the causes of
disease, and to intervene effectively to treat disease, is now greatly enhanced
by a range of new technologies that have emerged from biomedical sciences as
well as other scientific disciplines.
From stem cells to nano-technology, the rapidly expanding frontiers of
science have the immense potential for improving our ability to provide better
health to our people. I am very happy to learn that AIIMS is operating on the
frontiers of all such new technologies.
However,
health care for treating health disorders is only one component of health. The
legitimate expectations of society and the mandate of our governments must
extend to encompass health promotion and disease prevention. These require multi-sectoral actions in
several spheres, which influence health.
Many of these lie beyond the traditional health sector. Issues like provision of education,
nutrition, health care, often require policy initiatives in agriculture, food
processing and commerce. Even fiscal measures are needed to ensure the greater
availability of essential foods and discourage the consumption of unhealthy
ones. Even the control of infectious diseases requires integrated planning for
provision of a clean environment.
At the
same time, health professionals are beginning to acknowledge that interventions
in health cannot be driven by medical sciences alone. For the optimal use of scarce resources, comparative
cost-effectiveness of different health interventions has to be evaluated.
Whether it is the promotion of responsible sexual behaviour, or avoidance of
tobacco, medical sciences will have to form an alliance with social and
behavioural sciences to achieve positive outcomes. We are, therefore, witnessing an exciting era of the integration
of multiple streams of learning and diverse spheres of activity into a combined
effort to enhance the health of our people.
Medical scientists have to recognize the value of such new partnerships,
even as they ceaselessly strive to advance in their own fields. To enable such constructive and productive
collaboration, our government proposes to support the establishment and growth
of Schools of Public Health, which can provide the framework for
multi-disciplinary partnerships in education, research and health action. AIIMS should rightly play a pivotal role in
catalysing such a network of public health institutions.
The Nobel
laureate, the Late Gunnar Myrdal aptly observed that ‘Health leaps out of
science and draws nourishment from the totality of society’. While science provides the tools to identify the causes and cures
of disease, we must also strive to create the social conditions that promote
and protect health. As health
professionals you must therefore, draw upon the strength of science to improve
health care, while we as policymakers, should aim to provide the supportive
environment for safeguarding health.
However, the best results are likely to be achieved when all segments of
society work together to positively influence the multiple determinants of
health. AIIMS, I suggest, should become
a thought leader in promoting this broad understanding of health through
trans-disciplinary education. It must also become a catalyst for multi-sectoral
applications of such an integrated approach.
We must also
recognize and respond to the great need for empowering our people with health
related information. Health literacy
needs to be enhanced, both through our formal education system and informal
means, including the increasing use of mass media. The pattern of health care needs to change
from an outmoded paternalistic, prescriptive, provider-driven model to a partnership-based
collaborative model. It must bring together patients and communities.
You must help not only to create new knowledge, but to also disseminate
it among the masses at large.
On behalf
of the government and our country, I would like to assure all of you that we
will continue to provide full support to this great, national institution of
excellence to retain its pre-eminence in our national life. The institute’s commitment to the pursuit of
excellence in social equity is something, which we need to nourish day in and
day out. We will continue to take pride in your achievements and will act
promptly to remove the obstacles that threaten to limit your potential.
To the
young health professionals and scientists who are receiving their degrees
today, I offer my heartiest congratulations. I have only one word of
advice. You are now stepping forth from
the portals of this great institution, with the promise of a bright future
beckoning you. Please remember the
contributions of the many who have laid the foundations for your future. Use
your own knowledge and skills to prepare an even better future for the generations
that will follow you. By all means, pursue your personal career goals, but do
also aim to contribute to the greater good of humankind. Please try to
translate your own success into gains for our nation. Your own future is best
guaranteed when the whole of society moves to a higher level of health and
stability.
Neither institutions
nor individuals can survive as islands of excellence in an environment of
mediocrity. Both ennobling altruism and self-interest should motivate us to
improve the environment in which we all have to work. The commitment to excellence
and social equity that AIIMS inspires in you should shape the manner in which
you function in your own new work environment. You must become, therefore,
agents of change wherever you are, improving the knowledge and skills of people
around you. As our ancient sages taught
us, knowledge is the only wealth that multiplies when shared. Each one of
you can and should become a beacon of enlightenment, so that collectively
you can illuminate the whole Indian society.
I am confident that you will be motivated by such impulses to excel
and to care. I wish you the very best in your future pursuits”.
HK/VSR
(Release ID :12227)