India on March 28, 2006 announced plans for a network of public health institutes that will aim to provide a much-needed managerial cadre for its inefficient and inequitable healthcare system.

Inspired by the success of India's world-renowned institutes of technology and management, five Indian Institutes of Public Health will produce 10,000 health professionals a year once fully operational.

"We face a major gap in human resources in health," Manmohan Singh, India's Prime Minister, said at the launch of the initiative. "Programmes for the poor will degenerate into poor programmes if these deficiencies are not corrected."

Mr. Singh said the institutes would also boost India's capacity to meet the needs of the global medical tourism industry and enhance the country's reputation as a destination for cheap and high-quality healthcare.

Government investment in the health system has fallen to 0.9 per cent of gross domestic product from 1.3 per cent in the 1990s, leaving it starved of resources and unable to attract competent administrators capable of overseeing complex programmes.

The absence of skilled personnel able to deliver state-funded healthcare compels most Indians to seek private treatment. Current annual per capita public health expenditure is Rs200.

More than 40 per cent of hospitalised Indians have to borrow heavily or sell assets to pay for their treatment and more than 25 per cent fall into poverty. Life expectancy at birth, at 66, is lower than in Bangladesh and Sri Lanka, while infant and child mortality levels are higher.

In a red-hot labour market, the health sector has lost out in the war for talent, according to Ashok Alexander, head of the Gates Foundation in India, which is the single largest source of funds in India's fight against the spread of HIV/Aids.

"Public health is a very unattractive career and needs upgrading," he says. "There are only 300-350 people trained in it a year. It is very badly paid and unattractive to high-fliers because you need to work in unattractive locations."

Labour shortages are starting to bite throughout the service sector, pushing up wages at a double-digit rate, according to a recent survey by Mercer. Salaries rose 11.5 per cent a year in India during the past five years, against 7.5 per cent in China. McKinsey, the consultancy, estimates that India's information technology industry faces a shortfall of 500,000 professionals by 2010.

The institutes will be a public-private initiative. Funding has been secured for the first two institutions, with a third of cash coming from the Indian government, another third from non-governmental organisations such as the Gates Foundation and the remainder from individual philanthropists.

( http://news.ft.com)