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The 15th Finance commission held a detailed meeting with representatives of the World Bank, Niti Aayog and member of its High-level Group (HLG) on the health sector.The Chairman N.K Singh and all members and senior officials of the Commission were present at the meeting. The World Bank was represented by Dr Junaid Ahmad, Country Director, Muhammad Ali Pate, Global Director, and other senior officials. Dr. Randeep Guleria, Director, AIIMS, Dr VK Paul, Member Niti Aayog, Dr Indu Bhushan, CEO, Ayushman Bharat also took part in the meeting.The meeting started off with Dr. Junaid Ahmad stating that the World Bank has been engaged in India's health sector for a long time. Recently, in the context of the pandemic, a billion-dollar loan has been given by World Bank to the Government of India.It has been engaged in helping State governments to strengthen service delivery through district hospitals. World Bank has recently successfully concluded a 20-year long partnership with the Government of India in the area of HIV.He stated that States in India are going to be the anchor in the implementation of health programs. As States are so different from each other, the solutions for them will be custom made.Dr. Junaid Ahmad also stressed on the importance of engagement with Centrally Sponsored schemes with Government of India for implementation of these programs. He cited the example where the World Bank had engaged in the implementation of Samgra Shiksha Abhiyan with five States of India.A presentation made by World Bank Highlighted that: There is scope for service delivery reforms by using innovation, leveraging technology, institutional strengthening, coordination and empowering of States.The adverse economic impact is likely to be proportionally larger than the direct impact of the coronavirus on morbidity and mortality. For example, as per projections done by IMF, per capita GDP is projected to decline by six per cent which is one of the largest contractions the country has ever seen.Quality of care has emerged as a key issue in India's health system. Also, there is huge variability across states and care providers.To ensure a better quality of spending, there is a need for PFM reforms to improve budget execution, resource allocation formulas from states to districts should better reflect population need (mortality/morbidity/equity) rather than historical norms, reduce fragmentation of health protection schemes and a gradual shift to demand-side financing modalities.Dr Paul, member, NITI Aayog emphasised on the importance of local bodies in the delivery of health care services. He also emphasised that 65 per cent of public spending on health comes from State Governments while 35 per cent come from the Union Government. There is an enhanced need to increase the overall expenditure on the health sector.Dr Guleria, Director, AIIMS, emphasised that public-private partnership in the health sector should be encouraged. He also asked for an enhanced focus on the investigative infrastructure of health.Dr Indu Bhushan stressed the need to cover the 'Missing Middle' population in PM-JAY. He also stated that private hospitals need help as they are stressed with falling revenues and rising cost. He also emphasised that health should be a concurrent subject.Chairman N.K. Singh recollected the Finance Minister's intention to increase the budgetary outlay Ministry of Health in her announcement of the special package for the economy.( With inputs from ANI )

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