One of the most important challenges in health reform is to design workable systems for rural idea. Given the discrepancy in earnings between private and public medical practitioners, how do we deliver competent healthcare in villages? Primary health centres in West Bengal, Orissa and Bihar cope with less than 20 per cent of the allocated staff. One way might be to strengthen local systems of medicine, like ayurveda and homeopathy. Gujarat has tackled the problem through improved connectivity, creating an ambulance service that responds within half an hour to take villagers to medical help. What I would like to see is a programme of health education targeted at women, designed to prevent diseases like malaria, TB and diabetes, that are needlessly killing us. Medical infrastructure must be provided at the district level so as to reduce the crush of patients in cities. I would like to see an increased emphasis on prevention alongside cure.

Less illness is preferable to more hospitals. Better eating and exercise habits and basic first aid must be taught through the school system. Voluntary service schemes for doctors in remote and rural areas must be encouraged. Medical infrastructure must be provided at the district level so as to reduce the crush of patients in cities. Accessibility to reliable medical care must be increased. Technology is the key to link patients around the country to the best medical care and decongest hospitals. Admission procedures to medical schools need to be more transparent and we need a serious crackdown on spurious drugs and dangerous quackery.

Health is a priority goal in its own right, as well as a central input into economic development and poverty reduction. Health and socio-economic development are so closely intertwined that it is impossible to achieve one without the other. While economic development in India has been gaining momentum over the last decade, our health system still ranks a lowly 118 among the 191 WHO member countries on overall performance. We have clearly not recognised that health cannot be measured by swanky medical hotels for the rich, but how we provide for the poor.

Sometimes, sensible simple solutions will do. In villages, a lot of people who claim blindness, turn out to be just in need of spectacles. Primary health centres have no specialists, so villagers have no access to eye-tests and glasses. One NGO, Development Alternatives has started training teams of village youth, equipping them with eye testing kits and selling them glasses, which they sell further for between Rs 50-100. Imagine this being the price between light and darkness.

Our priorities don't seem right. Every day, 1,100 Indians die of malaria. Yet, our health efforts are preoccupied by international scares like SARs and avian flue and swine flu that peter off into nothing, while our endemic diseases get more dangerous and deadly. Only a healthy nation can be a prosperous and progressive one. Having the security of reliable healthcare allows a society to civilise, specialise and produce Michelangelos and Einsteins. That we see so few new ideas in India is not because we are incapable of them, it is because we simply do not have the time to generate them. With everyone caught up in the everyday struggle of simply staying alive, where is the time to innovate? If we can provide the security of accessible and affordable healthcare, we can find ways to do things differently and better.