The World Bank is lending up to $1 billion to help India with preparedness for future pandemics as well as to strengthen its health infrastructure. The lending will be divided into two complementary loans of $500 million each.
Through this combined financing of $1 billion, the bank will support India’s flagship Pradhan Mantri-Ayushman Bharat Health Infrastructure Mission (PM-ABHIM), launched in October 2021, to improve the public healthcare infrastructure across the country. In addition to the national-level interventions, one of the loans will prioritise health service delivery in seven States including Andhra Pradesh, Kerala, Meghalaya, Odisha, Punjab, Tamil Nadu, and Uttar Pradesh.
The $500-million Public Health Systems for Pandemic Preparedness Program (PHSPP) will support the government’s efforts to prepare India’s surveillance system to detect and report epidemics of potential international concern. Another $500 million Enhanced Health Service Delivery Program (EHSDP) will support government’s efforts to strengthen service delivery through a redesigned primary healthcare model, which includes improved household access to primary healthcare facilities, stronger links between each household and its primary care facility through regular household visits and risk assessment of noncommunicable diseases.
Both the PHSPP and the EHSDP utilise the Program-for-Results financing instrument that focuses on achievement of results rather than inputs. Both the PHSPP and EHSDP loans from the International Bank for Reconstruction and Development (IBRD) have a final maturity of 18.5 years including a grace period of five years, stated the World Bank.
The agreement was signed by Rajat Kumar Mishra, Additional Secretary, Department of Economic Affairs, Ministry of Finance on behalf of the Government of India and Auguste Tano Kouamé, country director, India, World Bank.
“The COVID-19 pandemic brought to the fore the urgent need for pandemic preparedness and health system strengthening around the world and was a stark reminder that pandemic preparedness is a global public good,” said Auguste Tano Kouamé.
India’s performance in health has improved over time. According to World Bank estimates, India’s life expectancy has increased from 58 in 1990 to 69.8 in 2020. This is higher than average for the country’s income level. The under-five mortality rate (36 per 1,000 live births), infant mortality rate (30 per 1,000 live births), and maternal mortality ratio (103 per 100,000 live births) are all close to the average for India’s income level, reflecting significant achievements in access to skilled birth attendance, immunisations, and other priority services.
Despite these advances in the health of the Indian population, COVID-19 has underscored the need for developing capacity for core public health functions, as well as for improving the quality and comprehensiveness of health service delivery.
“The two Programs leverage the unique strengths of both the Center and the States to support the development of more accessible, high-quality, and affordable health services,” said Lynne Sherburne-Benz, the World Bank’s South Asia Regional Director for Human Development. “This strengthening of health systems, combined with attention to strong disease response, will improve preparedness and response to future disease outbreaks.”