Health

India - Health overview

Country profile

• According to the WHO Global Health Expenditure Database, India spends a total of 4% of GDP on healthcare, approximately 1% of which is public government expenditure.
• India’s national health profile is released annually by the Indian government and by the WHO.
• Healthcare in India: Vision 2020, a report by NITI Aayog (National Institute for Transforming India), captures India’s challenges and future prospects in the health sector.

Policies and initiatives

• The National Health Policy (2017) seeks to universalise access to basic healthcare by making essential drugs and basic health services free at public hospitals.
• The Ayushman Bharat scheme, launched in September 2018, aims to deliver universal healthcare to all Indians by providing the world’s largest national health insurance scheme combined with a large network of health and wellness centres.
• The Ayushman Bharat Digital Mission (previously known as the National Digital Health Mission) was announced in 2020, and aims to be the backbone of India’s integrated digital health infrastructure, providing citizens across the country with connectivity to India’s healthcare system.

Governance structure

Public health in India is the responsibility of the states under the Constitution, however, the central government is the key actor in designing health policies and programmes. The Ministry of Health and Family Welfare is the central government ministry charged with health policy in India. It is assisted by the National Centre for Disease Control, the National Health Systems Resource Centre and the Indian Council of Medical Research (ICMR).

Australia - Health overview

Country profile

• According to the WHO’s Global Health Expenditure Database, Australia spends approximately 9% of GDP on health, of which 6% is public government expenditure.
• Australia’s national health profile is released annually by the government and by the WHO.
• The Government’s Long-Term Health Plan is to build the best healthcare system in the world.
• View more information about Australia's healthcare overview from the Australian Institute of Health and Welfare.

Policies and initiatives

• Medicare has been Australia’s universal health care / health insurance scheme since 1984. Its 3 major parts are: medical services, public hospitals and medicines.
• The Medicare Benefits Schedule (MBS) is a list of all health services that the Government subsidises. A team of medical experts keeps the list up to date, safe, and in line with best practice.
• The Pharmaceutical Benefits Scheme provides government subsidies to a list of deemed-necessary medicines, reducing out-of-pocket expense for pharmaceuticals for Australian citizens. This list is negotiated with suppliers and is kept up to date.
• The Medical Research Future Fund (MRFF) is a research fund established by the Australian Government in 2015. It helps shape the future of health and medical research, and contributes to an innovative and sustainable health system, with a focus on collaborative and translational research. The grant assessment processes embrace diverse perspectives, including alternative disciplines, industry, health care and consumer experience. In July 2020, it grew to be a $20 billion long-term investment.

Governance structure

The Australian health system is jointly run by all levels of Australian government – federal, state and territory, and local. The Australian health system features a mix of federal and state government funding and responsibility, interspersed with services delivered through public and private sectors.

Bilateral frameworks for cooperation between India and Australia

• The Australia-India Strategic Research Fund (AISRF) is Australia’s largest bilateral research fund with any country.  Established in 2006, the fund covers pertinent fields of science including health research. The AISRF 2020 round was focused on Covid-19 research collaboration.
• The Bilateral MoU on Health and Medicine was signed in April 2017 by Prime Ministers Modi and Turnbull, to promote greater collaboration between Australia and India in the health sector. The Health and Medicine MoU identifies areas where the two countries can collaborate and work together.
• The Comprehensive Strategic Partnership 2020 was signed in June 2020 by Australia and India. The first commitment is to Science, Technology and Research, under which there is a strong focus on health.

Trade and Investment Opportunity

• The India Economic Strategy to 2035, released in 2018, identifies health as an emerging sector. It states that Australian institutions could pursue partnerships in India in drug or technology development, conduct joint research, commercialisation and licencing partnerships (including for biomedical and genomic capabilities) and conduct clinical trials - leveraging India's large population and the possibility for cost effective, large-scale roll out. The updated five-year action plan outlines a number of initiatives to support greater health cooperation, including building Australian MedTech awareness of Indian market opportunities and undertaking an Australia India digital health standard and harmonisation gap analysis. 
• The Confederation of Indian Industry (CII) works in the space of Public Health, with the vision of catalysing enhanced private sector response to Public Health challenges in India.
• The Business Council of Australia aims to unshackle Australia’s health system to enable it to be a powerhouse exporter - particularly in goods and services, devices and diagnostics.
• The Federation of Indian Chambers of Commerce and Industry (FICCI) has been working in the health sector as a change agent for more than a decade, to bring about requisite policy changes that can provide quality healthcare for all. The FICCI Health Services Committee, established in 2006, has been pivotal in facilitating interaction among stakeholders to jointly work towards creating the building blocks for achieving quality healthcare through several initiatives.

Sub-themes in Health Collaboration and Research

As per the Health and Medicine MoU, India and Australia have agreed to collaborate on the given themes:

1. Communicable diseases such as malaria and TB
2. Mental health and non-communicable diseases
3. Anti-microbial resistance and responding to public health emergencies
4. Regulation of pharmaceuticals, vaccines and medical devices
5. Digital health
6. Tobacco control

Cooperation and collaborations

Australia and India have a number of successful collaborations in the health sector:

• The George Institute for Global Health (affiliated with UNSW) has an office in New Delhi, and is undertaking a number of areas of research in non-communicable diseases and health systems. Partners include the Public Health Foundation of India (PHFI), the All India Institute of Medical Sciences (AIIMS) and the Postgraduate Institute of Medical Education and Research (PGIMER). Specific investigations have included research into road trauma injury, women's health, and the use of salt in the average diet and its link to hypertension. On health systems, The George Institute has collaborated with the Government of India on digital health.
• The Doherty Institute (affiliated with The University of Melbourne) was the first globally to ‘grow’ the coronavirus in a lab, allowing scientists to study the virus’s patterns, and to work toward a vaccine. This work was developed under the WHO Collaborating Centre for Reference and Research on Influenza, which cooperates with India and other global partners. The Doherty Institute also collaborates on various health issues in India.
• The All India Institute of Medical Sciences (AIIMS) has teamed up with Australia’s Alfred Health and Monash University to strengthen trauma-care systems across the country. Additionally, AIIMS has also signed an MoU with La Trobe University to provide PhD scholarships to students in India, and will also work together on a project tackling antimicrobial resistance (AMR).
• The Global Alliance for Chronic Diseases (GACD), with funding from the Indian Council of Medical Research (ICMR) and Australia's National Health and Medical Research Council (NHMRC), is working towards the prevention of Type II Diabetes in South Asian women with Gestational Diabetes. Additionally, research has been conducted by a number of institutions into the Lifestyle Intervention IN Gestational Diabetes (LIVING) program, including by the Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER).
• The University of Queensland has collaborated over the past five years with six Indian institutions on research projects spanning mental health, disease control, and food innovation - with major collaborators including the Indian Institute of Technology Bombay, Symbiosis International Deemed University, and the Schizophrenia Research Foundation (SCARF).
• The Public Health Foundation of India (PHFI) initiated and led a distance learning certificate course in STI and HIV/AIDS, in collaboration with The University of Sydney. Further, PHFI also has research collaborations with Deakin University and the University of Canberra.
• The Indian Council of Medical Research (ICMR) has various ongoing research projects with NHMRC Australia and the University of Sydney.
• Monash University’s Eliminate Dengue Program has partnered with the ICMR to trial the use of naturally-occurring Wolbachia bacteria.
• The International Research Network for Development of Antibiotic Peptides (IRNDAP) is based at the University of Melbourne. This major Australia-India research collaboration seeks to address the problem of antibiotic resistant pathogens, and to develop a new generation of antibiotics.
• The University of Western Australia conducts research into maternal and child health, family planning, and population health in India. They have facilitated a number of studies into these areas, including some undertaken by the Australia India Institute's Next Generation Network Scholars.