Address at the Dhanvantri Sewa Samman felicitation function by Chikitsasansaar

Friends ,

Thanks a lot for bestowing me this honour and giving me an opportunity to visit this historic city

I am thankful to the jury for having selected me for this honour though I am not a doctor !

It is a real pleasure to be speaking with such an audience in the land of famed rulers like Chandragupta I, Vikramaditya , Ashoka & Poet Kalidasa.

“The town fallen from heaven to bring heaven on earth” wrote Kalidasa about Ujjain. It is a twin blessing for me , first to visit Ujjain and second to get the award !!

I have been asked by the organizers to speak for a few minutes on

• India’s healthcare system versus the World Healthcare system & the future of the India’s healthcare system
• Retail Chains in India
• Indian Economy and its future

These three topics are loaded ones , and I need to dwell briefly on the same


Healthcare in India & the way forward : All across the world the healthcare systems have failed . In India, we are placed at a point in time when we can chose what we want, as we are about to build our healthcare system. We are here not by design but by default ! I have always said , we must not import failures !! Recently , i have sent out a detailed note to the Prime Minister and our Health minister on healthcare reforms . Imagine , we do not even have a epidemiological survey in India , so how can we build a healthcare policy without it ? We need to build more preventive care then tertiary care , unfortunately , we are doing the reverse . NRHM & NUHM can spend a lot of money but these adhoc schemes cannot build a lasting and a result oriented healthcare system

Health Insurance : People are very gung ho about Health insurance , we need to check if this is the right model for India !!! Government run blanket insurance schemes make people irresponsible and careless and the systems go bankrupt , this is what the failures in USA & Europe prove. Taking cue from this, India must re-look into the entire insurance business

Technology is advancing fast and becoming cheaper day by day and this must be used extensively at the PHC’s and PHC should become Panchayat Health centres with basic telemedicine facilities . India is the youngest nation with an average age around 26.5 years. If we don’t focus on healthy diet , fitness & chronic care , our economy will collapse due to exorbitant healthcare costs and an ailing and non-productive population over the next 30 years .

Retail chains in India .

Retail sector is the key to India’s economy. We have more than 12 million retailers and many times the multiple of 12 million earn their livelihood from this sector . Whilst the media opened the eyes and exposed us to the western world, we have got carried away and are trying the cut , copy and paste model to imitate what happens in other parts of the world , without even caring for the basics !!

I will limit my references here to the pharmacy chains here, though most of what I say applies to other general retailers as well.

Pharmacy trade has to be looked upon from three players perspective :

Independent retailers , organized chains and AIOCD Venture for retail

We have about 20 + retail pharmacy chains and trust me , all are having serious issues with scaling up and profits !! This leaves us with one learning , the current organized pharmacy model does not seem to be working .

Ironically, even AIOCD got carried away with organised retail . Though my understanding is that it will never be successful in getting into total pharma distribution , retail and market research; as their history shows them as a cartel extensively into boycotting and arm twisting pharma companies to accede to their demands. With such a history , and with same people at the helm of affairs , think what will happen if the pharmaceutical companies become totally dependent on AIOCD for their market research reports & distribution !! Also that, AIOCD is looking at private labels , manufacturing , retail chain companies , distribution and market research . Last thing for them to do is to appoint their health minister !! Result is a foregone conclusion

Retail chains have their own set of problems and will take time before they get the ‘right’ funding & the right people which has become the biggest bottle neck for the success of the pharmacy chains in India . If this continues , the organized pharmacy retail will be eaten up the MNC chains that will find a way in India in the next 3 years . Also that, the pharmacy chains are not united to present themselves as one voice and this is telling its tale with AIOCD tightening its noose around them . Overall , the next three years will see more deaths in the trade . Already a few players have started showing up symptoms of Asphyxia

Independent retailers : Two places where no one can defeat them is a sense of ownership and cost advantage !! Most of the organized retailers are losing money in monitoring their business with its supervisory infrastructure . Where you need to gear up is customer record keeping and satisfaction . Add adequate stocks and join hands to do good marketing by adapting to latest standards. Most importantly, please look at offering basic health checks for the part of the population you service . In the next two years , I expect pharmacies in India offering chronic care programs . This is what the pharmacies should be doing in India . Think small , act fast and aim big !!

Focus on basic cold chain infrastructure , join hands and approach the government for putting you in ‘Essential Population health services’ and offer you discounted electricity charges and lower taxes so that you could have the standards to maintain efficacy of medicines or else , ask the government to increase margins to 25 % for retail and 12 % for distribution. We have enormous potential for employment and pharmacies can bring about change that can make the healthcare system more result oriented as it the first and the last point of care for the common man . I see a bright future for small & independent retailers and big MNC chains !!

Indian Economy & Future :

We must not forget that India is a great country and we call ourselves a ‘developing country’. Now we need to change from being identified just as a ‘developing country’ ! We have much more than our economy for the world . The World cannot ignore our contribution to science , spirituality and peace . Ironically, our lack of public activism has given us a self seeking political leadership that lacks original ideas and for years, they leaned on Russia and then USA and in all probability , will lean on China in the next decade. We are trying to copy models from abroad . Even most of our Prime Minister’s advisors come from Abroad or foreign universities . Trust me , we are importing failures . China built SEZ’s , we tried to do the same ………………why , no one asks how many people have exited the SEZ business !! What kind of tax loss will the government have when we are currently under a huge budget deficit by promoting SEZ’s !!

We are living in a country with enormous potential . Just check that 1/6th of India is under naxals , 4/6th lives under less than Rs. 80 a day. So effectively , what you read in the news as growing India is just 1/6th of India . We have started measuring our growth with the growth of the sensex . If the sensex grows , we see growth . Unfortunately , not even 1 % of the population trades in shares . Ground situation is that we have a very high inflation , lawlessness and insecurity, and we push more poor people below the poverty line due to healthcare costs and price rise than we push above the poverty line every year

Go and check a crowded general compartment in Indian railways . People are seated in toilets to reach their destination. Looks like a scene of partition days . Why do we witness such a scene after more than 60 years of Independence ? Can railways not increase the coaches or trains ? Will this not make the lives of a common man better and earn more revenue for the government & add to the development of this nation ?

A few days back there was a hue and cry on Shashi Tharoor and S.M.Krishna staying in five stars hotels. Government announced an austerity drive. This week , government passed a bill allowing ministers to travel with families and relatives 48 times a year !!! Don’t forget , government’s money is not someone else’s , it is our money and we are letting all this happen with our eyes open and mouths closed. A time to get into action . But the government is least concerned as we are . We only speak , government also speaks; when we will act , government will also act! Government mirrors its citizens in actions

Finally , I must say that the government must focus on Agriculture , industrial production and SME’s for making India a progressive nation . All industries can fail but not agriculture & industries into daily needs

Lastly, i must touch the topic all the major nations for fighting for – Climate change

We should carefully commit to emission cuts keeping in view that we are far from industrialized . India must focus on emission per capita rather than ‘committing percentage cuts’. If you see the rough emission trends of the global emissions , India emits about 5%, Europe about 11 %, China about 15 % and USA about 20 %. Compare the population size and emissions and then decide . At maximum , we must stick to standards for emission norms and not commit summary cuts , even self imposed .

Even the World Bank’s study has contradicted the governments claims made that India can achieve an emission intensity target of 20-25 % below 2005 levels by 2020. It wonders how it is possible when the capital costs in setting up cleaner grid power could rise by 15-25 %. Though capital cost is only one of the several cost factors . Government’s claim was based on the home work done by the planning commission .

With this , i must thank you for patiently hearing me and enjoy the speakers ahead

Rajendra Pratap Gupta

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