Did Our Public Health Fail to Keep its Tryst with Destiny?

Sir Joseph Bhore, after a long career shaping India’s healthcare system, died ironically on 15 August 1960, India’s Independence Day, making his passing on the very day India gained freedom a poignant coincidence. Did our public health fail to keep its tryst with destiny envisaged by this great visionary? Bhore was an Indian Civil Servant during the colonial rule of India. During the Second World War and in the aftermath of the Quit-India movement, the Government of India, on 18 October 1943, set up the Health Survey and Development Committee under the chairmanship of Sir Joseph Bhore.[1,2] During this time, the health of women and children in India was poor compared to Europe, with high infant and maternal mortality rates. The determinants were: (i) Insanitary conditions; (ii) poor nutrition; (iii) lack of access to preventive and curative healthcare, and (iv) illiteracy and lack of health education.[1] The Bhore Committee did not consider these factors in isolation but stressed that they interact with each other, driven by unemployment and poverty, constituting the social background to illness. Regrettably, even after decades, we are still struggling with the same fundamental problems. Recently, there were deaths from water pollution in Indore,[3] and a typhoid outbreak in Gandhinagar.[4] Last year, there was an outbreak of Guillain–Barré syndrome in Pune, with 230 reported cases and 12 deaths, suspected to have been triggered by infection with Campylobacter jejuni due to consumption of contaminated drinking water.[5,6] All these occurrences bear testimony to the fact that we still have not been able to tackle the issues of safe water and basic sanitation, which had been prevalent when the Bhore Committee tabled its health survey report. On the nutrition front, too, our report card is unsatisfactory. We have a high rate of childhood malnutrition, with over one-third of children under 5 stunted or underweight, while around 19% are wasted, according to the latest National Family Health Survey (NFHS-5).[7] The maternal mortality rate in India is still high compared to most developed countries. Equitable and quality health care still eludes the majority of our population, with wide interstate differences in both access and quality.[8] While India’s literacy rate shows a steady increase, the rural–urban and gender divide persists.[9] Having missed the tryst, we should not abandon the road leading to the destination. However, increasing privatization of healthcare with a focus on tertiary care at the cost of primary and secondary care is going to make it difficult to stay on the path. Conflict of interest None. Data availability statement Not applicable. Author contribution AB was responsible for concept, draft, revision, and final approval of the manuscript.