Few days back Super Religare Laboratories (SRL), a multinational company with the largest diagnostic services network of South Asia, launched a joint venture in Nepal with Life Care Services of NE Group. Dr. Sanjeev K Chaudhry, the CEO of SRL India says that the company plans to have up to 40 percent market share in the next two or three years. He is also confident that it will increase the services, employees and investment with time and plan to open “international standard” hospital in the next two years is underway. Dr. Chaudhry mentions that SRL Nepal has eight collection centers across the country and its new lab has different segments of clinical pathology, including biochemistry, microbiology and hematology which will provide “accurate solution with ethical standards”. He concludes that it will become cheaper for people to have all the necessary tests in his/her country itself. Also stressing that the company will give special prices to “needy people if approached by government hospitals”.
While I read the entire interview I was pinched with humiliation at the way the representative of SRL summed up the sorry state of our public health care services to market his company. I request the readers to go back to the last two sentence of the first para and ask themselves , doesn’t it imply- sick people in this country would eternally be going to other countries for treatment and spending millions if this generous multinational company hadn't come to our rescue? Angry as we have right to be at this crude(but nearly accurate) assessment of our health sector, we also need to question our government- are we ever going to have a good public health care system or are we doomed forever to empty our national wealth on hospitals and diagnostic centres in other countries? The fact that these hospitals have now come to our doorsteps does not change the fact that our national wealth will still be drained away in profits. Yesterday if hundreds of Nepalese including our heads of state went to Appolo in Delhi and Bumrungrad Hospital in Bangkok and spent millions of rupees in treatment, tomorrow when multinational health companies capture our health sector, billions of rupees will be drained out in profits. Bringing these multinational companies into the nation does not change their multinational character and economics. Why cant the government focus on building and improving its own capacity and infrastructure to provide a better health services to the people? To celebrate that SRL is willing to give “special price” to the needy if government hospitals approach them is to accept that our government hospitals will never ever be able to provide its needy citizens good hospitals with equipped laboratories. What prospect of a better Nepal do we have then when government has to commercialize most basic of public services in order to maintain standard? Drinking water has been privatized, education sector is already one of the most commercialized sector and now the entry of a multinational company in health sector only makes the picture more grim.There is frankly nothing to cheer about it. An upper middle class or a rich Nepali might save a couple of million for himself but Nepal will loose billions of rupees in profit every year.
The only argument I am trying to make here is that lack of quality public health care services in the country demands its extension through investment in public sector. Privatization and commercialization of basic public amenities is neither its substitute nor can it be good for a nation’s health, especially if it involves a multinational company. Markets are for trading consumer goods and services not basic public amenities. Apart from these ethical and principle arguments, what should also deter government is the potentially devastating impact the country might face during global recession(a recurring phenomenon) if its economy is exposed to hazards of international market through multinational companies. Besides, when subsidiaries of multinational companies violate law in the host country, victims can encounter significant obstacles in obtaining effective redress both in the host and the home country. Weak judicial and enforcement capacities, in some cases combined with apparent corporate pressure exercised over decision-makers and local communities, can impede effective access to justice in the State where the violation occurs. At the same time, the current international legal framework makes it difficult for third-country victims to hold corporations accountable in their domestic courts for abuses committed by their subsidiaries in the host country. Do the decision makers sitting in the government have slightest idea about all these ? What is their proposed response to such situation if and when they arise? We have seen powerful government like Indian government fail to secure justice for its victimized citizens of Bhopal against DOW chemicals, an American multinational company.
Therefore, the government must immediately take measures to discourage expansion of multinational companies into our health sector. And the most effective way of doing this is to invest in the domestic health care system, to maintain its quality and make it accessible to all at the same time. Even countries like Cuba which has been under heavy international economic sanctions for 6 decades is able to provide its people with free health services. Why can Nepal, then not afford to keep its population healthy by itself? Is it really about scarce resources or is there a genuine deficit of political will on the part of our political leadership?
