Edition 1 | September 20, 2021
Letter from the Co-Chairs
Dear Friends,

We are delighted to present to you the first edition of the monthly newsletter by the Lancet Citizens' Commission on Reimagining India’s Health System. This newsletter offers a glimpse into the variety, scale, and rigour of work that we do at the Commission. You will find it in your inbox every month.
There is an urgent need for a resilient healthcare system that offers comprehensive, accountable, accessible, inclusive, and affordable quality healthcare to all citizens in India.
The Lancet Citizens’ Commission on Reimagining India’s Health System is an ambitious, cross-sectoral endeavor to lay out the roadmap to achieving universal health coverage (UHC) for the people of India.
A guiding principle for this Commission is that structural change towards UHC can only be attained through consultative and participatory engagement with the diverse sectors involved in healthcare and, most importantly, with India’s citizenry. The Lancet Commission has brought together leaders from academia, the scientific community, civil society, and private healthcare to spearhead this effort. The announcement comment in the Lancet can be found here.
The Commission aims to publish its report in 2022, in the 75th year of India’s independence. The Lakshmi Mittal and Family South Asia Institute, Harvard University, India office is serving as the secretariat.
Since December 2020, the Commission members have been closely tracking and studying the Indian healthcare system, including the challenges the pandemic has brought to the forefront, to respond to the particular healthcare challenges we now confront. In this newsletter, we bring you an analysis on how India can commit to building national health coverage and the pathways to reimagine commercial health insurance in India. In addition, we bring you a breakdown by the Commission community on the implications of these developments for India and what our response should look like.

As a Citizens’ Commission, we invite the public to participate, provide input and continue to engage with this new initiative.

Co-Chairs, The Lancet Citizens' Commission on Reimagining India’s Health System

Gagandeep Kang, Clinician Scientist and Professor in the Department of Gastrointestinal Sciences, Christian Medical College
Kiran Mazumdar-Shaw, Executive Chairperson, Biocon Ltd.
Tarun Khanna, Jorge Paulo Lemann Professor, Harvard Business School; Faculty Director, The Lakshmi Mittal and Family South Asia Institute, Harvard University
Vikram Patel, The Pershing Square Professor of Global Health, Harvard Medical School; Professor, Harvard TH Chan School of Public Health; Co-founder, Sangath
This Month's Highlight
The Commission is organising a web-panel discussion on medical and nursing education in India and how it can be reimagined to create a learning system that will produce a health workforce that responds to the needs of the system and has pathways for growth. The panel discussion is scheduled for Thursday, September 23 at 5:30-7:00 pm IST/8:00- 9:30 am ET.
News from the Commission

"The Lancet Citizens' Commission will place citizens at the heart of India's healthcare vision", our Co-Chairs Tarun Khanna, Kiran Mazumdar Shaw, Vikram Patel, and Gagandeep Kang write in Hindustan Times.

Moonshot thinking requires understanding the scientific and technological trajectories today to realise access to healthcare as a fundamental right for the Indian citizenry. Our Commissioners Vijay Chandru and Sharad Sharma embrace this approach in the article describing the vision for the technology workstream. 

Ensuring proper financing is a key step in the journey towards universal healthcare. The Lancet Citizens' Commission expects to engage in-depth with this issue to arrive at recommendations on the best pathways for India to follow, writes our Commissioner Nachiket Mor.
Work of the Commission
In this paper, Dvara Research explores how India’s growing commercial health insurance (CHI) segment can be used to deliver adequate financial protection and good health outcomes. The paper lays out the critical issues in demand- and supply-sides of the insurance market that need to be addressed for CHI to set the pathway to universal health coverage (UHC).
Recently the Commission, in a Lancet Comment, called for India's central and state governments to take eight urgent actions to address one of the greatest humanitarian crises facing the country since its independence.
Views & Opinions 

If India had invested three per cent of GDP on health over the last 30 years, we would have been in a much better position to face the Covid-19 pandemic, write Dileep Mavalankar & K. Srinath Reddy.

ASHA workers have been leading the way in the fight against Covid-19 in rural India. This, even though they haven’t received the protection or training required to respond to a global pandemic. Read what *Geeta Rani has to say about the situation on ground in Sonepat, Haryana as she, and other ASHA workers continue to shoulder crucial responsibilities despite the lack of institutional support.

*Name changed to maintain confidentiality.

How can new philanthropic investments support a sustained response to COVID-19 that also strengthens the health system in the long run? Nachiket Mor & Sapna Desai offer some suggestions.
Workshops & Events
Our recent monthly webinar was a joint Lancet Citizens’ Commission on Reimagining India’s Health System event with Dvara Research and Harvard Business School Health Care Initiative on the role of commercial health insurance in providing better health outcomes and improved financial protection in India. 
Watch our public webinar on the Political Determinants of Health System Improvements. Here, our panelists discuss cross-national variations in levels of public health investment and political prioritisation of health system improvements.
Commission Members in Spotlight 
"Any discussion of the pathways that India needs to take towards UHC needs a clear understanding of how it is to be financed. Questions around financing can tell us how much money is available in the system, how this money is raised and how it is utilised. It ultimately helps determine who has access to how much and what kind of health.", says Nachiket Mor, Visiting Scientist, The Banyan Academy of Leadership in Mental Health.

"One of the key elements to introducing and successfully implementing UHC is political attention to and interest in health. Leaders, both at national or sub national level, have multiple competing asks for their attention and resources. Prioritising one over another is driven by the national context, political incentives, citizen demand, amongst other factors.", says Sandhya Venkateswaran, Former Country Lead for Policy and Strategic Partnerships, BMGF.

Featured Partner
Dvara Research is a policy research institution based in India. Their mission is to ensure that every household and every enterprise has complete access to suitable financial services and social security through a range of channels that enable them to use services securely and confidently. Dvara Research tries to layout pathways to enhance health financing in India to achieve universal healthcare. Dvara Research is providing research support to the financing workstream of the Commission.
Help us develop a roadmap to achieve universal health coverage in India by visiting our website: https://www.citizenshealth.in/

We love hearing back from you! Please send your comments, suggestions, and contributions for these newsletters, including research highlights and published features to info@citizenshealth.in