The report, tabled in Parliament on Monday, noted that public health expenditure as a percentage of GDP has been increasing since 2015-16 but it has remained within a narrow band of 1.02 – 1.28 per cent of GDP.
The budgetary estimate of Rs 65,037.88 crore for 2019-20 to the Ministry of Health and Family Welfare and AYUSH is way short of the target of Rs 1 lakh crore central allocation for the health sector by 2019-20, the report pointed out.
The new National Health Programme 2017 is set in the context of Sustainable Development Goals (SDG) and the central outlay on health was envisaged to increase to Rs 1 lakh crore by 2019-20.
The 70th session of the United Nations General Assembly adopted the resolution titled ‘Transforming our World: the 2030 Agenda for Sustainable Development’ consisting of 17 SDGs and 169 associated targets.
The CAG noted that in NITI Aayog‘s mapping document released in August 2017, the Ministry of Health and Family Welfare has been identified as the nodal ministry along with nine other implementing ministries with respect to SDG’s Goal 3 — ‘Good Health and Well Being’.
The report said following projections of the ‘Three Year Action Agenda (2017-20)’ to increase the Central allocation for the health sector to Rs 1 lakh crore by 2019-20, the government allocated Rs 54,852 crore in 2017-18 (RE), Rs 57,671.60 crore in 2018-19 (RE) and Rs 65,037.88 crore in 2019-20 (BE) to the health ministry and AYUSH, which is far short of the target.
The report further said the NHP prescribes increasing health spending to more than 8 per cent of the States’ Budget by the year 2020.
Audit examination of records in the seven selected States revealed that the achievement ranged between 3.29-5.32 per cent, said the report of Comptroller and Auditor General of India (CAG).
“Annual financial allocations for the health sector has been rising but targets for outlays in 2019-20 had been missed which indicated that there is a long way to go before the goal of raising Public Health Expenditure to 2.5 per cent of GDP by 2025 could be met,” it said.
Besides, providing adequate physical infrastructure and human resources critical for achievement of Goal 3 targets would be an area of challenge, CAG added.
The report also notes that Niti Aayog, identified as nodal agency for coordination and overseeing implementation of SDGs, has undertaken various activities.
A multi-disciplinary Task Force has been set up to analyse and review implementation of SDGs. States have also identified nodal agencies for SDGs.
However, the CAG expressed conern that a roadmap is yet to be aligned with defined milestones for SDG targets to be achieved in the year 2020, 2025 and 2030.
The CAG has made several recommendation for implementation of the 2030 Agenda.
It has suggested that Niti Aayog in association with the finance ministry must make an assessment of requirement and availability of financial resources for implementing SDGs for different time frames.
It has also made a case for use of ‘Direct Benefit Transfers’ should be expanded and strengthened to avoid leakages and to improve efficiency in usage of financial resources.