Prof. (Dr.) Prashant MehtaM.Sc, Ph.D. (Chemistry), MBA, Ph.D. (Management)

National Law University, Jodhpur

DECODING THE INDIAN HEALTHCARE SYSTEM Waste Trail

• Residential

• Commercial

• Institutional

• Construction Waste

• Municipal services

• Treatment plant sites

• Industrial

• Agricultural

• Healthcare Waste

Municipal Solid Waste (MSW)

Industrial Solid Waste

Bio-Medical / Hospital Waste

Agricultural Waste

International ImperativesWHO preamble defines Health as “a state of complete physical, mental and social wellbeing and not merely the absence of disease”

International Treaties, Conventions, Conferences, and Protocols resulted in regulatory legislation toprotect and improve environment in several countries. It included framing policies to protect and improveenvironment, preventing pollution of all kinds, punishing environmental crimes, and compensating thoseaffected environmental crimes or by breach of protective provisions.

• UN International Conference on the Human Environment, Stockholm 1972 - It is the duty of every personto protect the environment and prevent its pollution. Domestic laws and international treaties impose thisduty on individuals and states.

• Brundtland Report, 'Our Common Future' was presented to UN General Assembly. It stimulated a debateon development policies and practices in developing as well as industrialized countries.

• The UN General Assembly adopted World Charter for Nature in 1982. It explicitly states that thegovernments have a duty to pass on their natural heritage to future generations.

• "Earth Charter” / "Rio Declaration” made a strong pitch for: maintenance of ecological balance,prevention, and control of environmental pollution, preservation of our natural resources, disastermitigation and sustainable development .

• It was followed by review meeting at World Summit on Sustainable development in Johannesburg, 2002.

Constitutional Provisions: India

• The Constitution of India indirectly provides right to health as a fundamental right.

• The power of Supreme Court to issue directions under Article 32 and that of High Courts under Article 226 haveattained greater significance in environmental litigation where in they relaxed Locus Standi norms inenvironmental cases where third party could directly petition through Public Interest Litigation.

• Part III (Fundamental Rights) and Part IV (Directive Principles of State Policy) of Indian Constitution provides aa framework for regulating relation between the state and its citizens and between citizens inter-se.

• The achievement of the objectives laid down in the preamble has been amplified and elaborated in Part IV ofthe Constitution (Directive Principles of State Policy), which contains provisions from Article 36 to Article 51.

• The Constituent Assembly included Directive Principles of State Policy as goals or aspirations to embody theconcept of a Welfare State. These principles are fundamental in the governance of the country and theysupplement the fundamental rights for achieving welfare state. It shall be duty of the State to apply theseprinciples while enacting laws.

Keshavananda Bharati vs. State of Kerala (AIR 1973 SC 1461)

• Parliament can amend the fundamental rights for implementing these directives, so long as the amendmentdoes not touch the basic features of the constitution.

Chandra Bhavan vs. State of Mysore (AIR 1970 SC 2042)

Directive Principle of State Policy

• Article 38 impose liability on State to secure a social order for the promotion of welfare of the people whichcannot be achieved without good public health.

• Article 39(e) is related with protecting the health of workers.

• Article 41 imposed duty on State to provide public assistance basically for those who are sick and disable.

• Article 42 makes provision to protect the health of infant and mother by way of maternity benefits.

• Article 47 considers that it the primary duty of the state to secure the improvement in public health (sickness,old age, disablement, and maternity benefits) and the prohibition of intoxicating drinks and drugs.

• Article 21 guarantees the right to life and personal liberty in accordance with the procedure established by lawof the Indian Constitution. This right is available to both citizens and non-citizens.

• The scope of Article 21 have been expanded through judicial pronouncements which expressed ‘PersonalLiberty’ in the widest amplitude.

• The Supreme Court has brought the ‘Right to Health’ and ‘Right to Education’ under the preview of Article 21 in

Paschim Banga Khet Mazdoor Samity and Others vs. State of West Bengal and Others, (1996 SCC (4)37)

Constitution 42nd Amendment

• Taking note of the mandate of the Stockholm Declaration of 1972 the Indian parliament passed historicamendment – 42nd Constitution Amendment Act, 1976.

• The amendment introduced principles of environmental protection in an explicit manner into the Constitutionthrough Article 48A and 51A(g).

• Article 48A obligated the State to protect and improve the environment, safeguarding forests including wildlife,and impose the pollution free environment for good health. Under Directive Principles of State Policy and stateneeds to enact legislation to realize these rights.

• Article 51A(g) obligated the Citizens to protect and improve the environment.

• The 42nd Amendment also moved the subjects of ‘forests’ and protection of ‘wild animals’ and ‘birds’ from statelist to concurrent list.

M.C. Mehta vs. State of Orissa (AIR 1992 ORI 225) laid the foundation for jurisprudence of environmentalprotection.

Sachidanand Pandey vs. State of West Bengal (AIR 1997 SC 1109) courts recognized DPSP in decidingenvironmental cases in light of Article 48A and 51A(g).

Directive Principle of State Policy

• It is established law laid down by the Supreme Court of India that this Directive Principle is to be read along withArticle 21 and Article 51A(g) as mentioned in Subhash Kumar vs. State of Bihar (AIR 1991 SC 420)

• Our constitution framers were much aware about the public health or right to health. As such they theyimposed liability on State by different provision like (Article 38, 39(e) 41, 42, 47, 48A).

• Thus the Constitutional mandate is very clear for the State to protect the environment.

• Part XI of the Constitution of India deals with relations between Union and States (Article 245-263).

• On the subject of Public health and sanitation; hospitals and dispensaries, the State Legislature has legislativecompetence under Article 246(3) in enacting legislation in matters enumerated in List II (State List) in the 7th

Schedule of the Constitution of India including management of Bio-Medical Waste generated from anyestablishment within its territorial limits.

Land Mark JudgmentsEnvironmental Jurisprudence

• The Supreme Court in Rural Litigation and Entitlement Kendra vs. State of Uttar Pradesh (AIR 1987 SC 359)took note of consciousness for environment protection, which is of recent origin.

• In M.C. Mehta vs. Union of India and Others (1991, 2 SCC 353) the court observed, “Man has the fundamentalright to freedom, equality, and adequate conditions of life, in an environment of a quality that permits a life ofdignity and well-being, and he bears a solemn responsibility to protect and improve the environment forpresent and future generations”.

• In Virender Gaur vs. State of Haryana (1995, 2 SCC 577 (at 580)), the Supreme Court held that environmental,ecological, air, and water pollution should be regarded as amounting to violation of right to health guaranteedby Article 21 of the Constitution.

• In T. Ramakrishna Rao vs. Hyderabad Development Authority (2002 (2) ALT 193), the Andhra Pradesh HighCourt observed: Protection of the environment is not only the duty of the citizens but also the obligation ofthe State and it’s all other organs including the Courts.

• The enjoyment of life and its attainment and fulfillment guaranteed by Article 21 of the Constitution embracesthe protection and preservation of nature’s gift without which life cannot be enjoyed fruitfully.

Land Mark JudgmentsEnvironmental Jurisprudence

• The most important judgment which reflects the modern environmental jurisprudence is the KarnatakaIndustrial Areas Development Board vs. Sri. C. Kenchappa and Ors (AIR 2006 SC 2038, [para 13]).

• This judgment try to bring consonance with the principle of 'Sustainable Development', where a seriousendeavour has been made to strike a balance between the industrial development and ecologicalpreservation. While exploring its model for environmental jurisprudence, court has resorted to its famousjudgment and expressed:

“While economic development should not be allowed to take place at the cost of ecology or by causingwidespread environment destruction and violation; at the same time the necessity to preserve ecology andenvironment should not hamper economic and other developments. Both development and environment must gohand in hand, in other words, there should not be development at the cost of environment and vice versa, butthere should be development while taking, due care and ensuring the protection of environment”.

• The “Polluter Pays Principle” implies that all producers of waste are legally and financially responsible for thesafe and environmentally sound disposal of the waste they produce and it also assigns liability to the party thatcauses damage.

Polluters Pay Principle Indian Judgments

• The principles was partly adopted in Bhopal Gas case in which the Supreme Court overruled to accept any of thedefence of Rylands vs. Fletcher case, and while deciding the case it enunciated the principles of Polluter PaysPrinciple.

• In Indian Council for Enviro-Legal Action vs. Union of India, AIR 1996 SC 1466, the Court observed that: “ThePolluter Pays principle demands that the financial costs of preventing or remedying damage caused by pollutionshould lie with the undertakings which cause the pollution, or producer of the goods which cause the pollution.Under the principle it is not the role of Government to meet the costs involved in either prevention of suchdamage, or in carrying out remedial action, because the effect of this would be to shift the financial burden ofthe pollution incident to the taxpayer”.

• In Vellore Citizens Welfare Forum vs. Union of India 1996(5) SCC 647, (at 659), the court observed that: the“Polluter Pays Principle” and the “Precautionary Principle” are essential features of sustainable developmentand have been accepted as part of the law of the land on the basis of provisions under Articles 47, 48A, and51A(g) of the Constitution of India.

• The Supreme Court interpreted the Polluter Pays Principle as the absolute liability for harm to the environment,extends to the principle of compensating the victim, and restoring the environmental degradation. It is laiddown in Sec. 3 of the National Environment Tribunal Act, 1995.

Precautionary PrincipleIndian Judgments

• The precautionary principle came to be included as a general principle of environmental policy and it was alsoextended to protection of coastal areas, marine pollution, and fisheries sector.

• In Vellore Citizens’ Welfare Forum v. Union of India (1996(5) SCC 64731), Supreme Court referred to theprecautionary principle and declared it to be part of the customary law in our country.

• The Principle is contained in Principle 11 of the principles laid down in the UN General Assembly Resolution onWorld Charter for Nature, 1982 and was reiterated in the Rio Conference of 1992 in its Principle No. 15. Thesame principle was reiterated in the case of A.P. Pollution Control Board (1999(2) SCC 718).

• The Prevention Principle takes care of reckless polluters who would continue polluting the environment in asmuch as paying for pollution is a small fraction of the benefits they earn from their harmful acts or omissions.Environment Impact Assessment is the crucial procedure which seeks toward off prevention. This is reiterated inPrinciple 17 of the Rio Declaration.

• In Vellore Case (1996(5) SC 647) p 658 para 11, the court observed that: “The ‘onus of proof’ is on the actor orthe developer/industrialist to show that his action is environmentally benign.”

Hazardous Substances - Absolute LiabilityIndian Judgments

• Absolute or strict liability is one where fault need not be established.

• In M.C. Mehta vs. Union of India (AIR 1987 SC 1086), the Supreme Court laid down that an enterprise which isengaged in a hazardous or inherently dangerous industry which poses a potential threat to the health andsafety of persons working in the factory and to those residing in the surrounding areas, owes an absolute andnon-delegable duty to the community to ensure that no harm results to any one on account of hazardous orinherently dangerous nature of the activity which it has undertaken.

• The enterprise must be absolutely liable to compensate for such harm and it should be no answer to theenterprise to say that it had taken all reasonable care and that the harm occurred without negligence on its part.

• The larger and more prosperous the enterprise, greater must be the amount of the compensation payable forthe harm caused on account of an accident in the carrying on of the hazardous or inherently dangerous activityby the enterprise.

Principle of New Burden of ProofIndian Judgments

• The `Uncertainty' of scientific proof and its changing frontiers from time to time has led to great changes inenvironment concepts during the period between the Stockholm Conference of 1972 and the Rio Conference of1992.

• In Vellore Citizens' Welfare Forum v. Union of India and others, 1995(5) SCC 647, a three Judges Bench of thisCourt referred to these changes, to the `precautionary principle' and the new concept of `burden of proof' inenvironmental matters.

• In A.P. Pollution Control Board (1999 (2) SCC 718 (at p 734)) case, it was explained that the ‘precautionaryprinciple’ has led to the ‘ new burden of proof’ principle.

• In environmental cases where burden as to the absence of injurious effect of the actions proposed, is placed onthose who want to change the status quo. This is often termed as a reversal of the burden of proof, becauseotherwise, in environmental cases, those opposing the change could be compelled to shoulder the evidentiaryburden, a procedure which is not fair. Therefore, it is necessary that the party attempting to preserve the statusquo by maintaining a less polluted state should not carry the burden and the party who wants to alter it, mustbear this burden.

Sustainable DevelopmentIndian Judgement

• Environment is a NATIONAL ASSET.

• It is also to be remembered that most of the environmental cases have come before the court through PIL(public interest litigation) either under Article 32 or under 226 of the constitution.

• In Vellore Citizens Welfare Forum v. Union of India (AIR1996 SC 2715), Supreme Court acknowledged that thetraditional concept that development and ecology are opposed to each other, is no longer acceptable. It saidthat Sustainable development is the answer.

• Some of the salient principles of "Sustainable Development" as taken out from Brundtland Report and otherinternational documents. It refer to Inter-Generational Equity (better quality of life for present and futuregenerations).

• In Karnataka Industrial Areas Development Board v Sri. C. Kenchappa and Ors. (AIR 2006 SC 2038, [para 29]),the Court observed that “Precautionary Principle" and “ Polluter Pays Principle" are essential features of"Sustainable Development”

• In Narmada Bacho Andolan vs. Union of India (2000 (10)SCC 664), Sustainable development means a type ofdevelopment which can be sustained by nature/ecology with or without mitigation.

Principle of Public Trust and BalanceIndian Judgment

• In M.C. Mehta vs. Kamal Nath (1997(1) SCC 388), Supreme Court referred to the concept of ‘Public Trust’doctrine.

• The Public Trust Doctrine primarily rests on the principle that certain resources like air, sea, waters, and forestshave such a great importance to the people as a whole that it would be wholly unjustified to make them asubject of private ownership. The said resources being a gift of nature, they should be made freely available toeveryone irrespective of the status in life.

• The doctrine enjoins upon the Government to protect the resources for the enjoyment of the general publicrather than to permit their use for private ownership or commercial purposes. The State is holding the naturalresources as a trustee and cannot commit breach of trust.

• In T.N. Godavarman Thirumalpad vs. Union of India and Ors., ((2002) 10 SCC 606, 2003 AIR SCW23,[Para 40]),The concept of "balance" under the principle of proportionality applicable in the case of sustainabledevelopment is lucidly explained. The court observed that we have to balance the priorities of development onone hand and environmental protection on the other hand.

Article 21Indian Judgement

• Environment is a national asset and the object is to protect “nature” on whom our survival depends.

• Natural resources are brought into Article 21 by invoking the doctrine of Public Trust.

• In Subhas Kumar v. State of Bihar (1991 AIR 420, 1991 SCR (1) 5), the Court has given directions that, underArticle 21 of the Constitution, pollution free water and air are the fundamental rights of the people.

• In the case of A.P. Pollution Control Board II vs. M.V. Nayudu ((2001) 2 SCC 62)) the Court observed that theright to have access to drinking water is fundamental to life and it is the duty of the State under Article 21 toprovide clean drinking water to its citizens.

Land Mark Judgment Healthcare Waste

• In Dr. B. L. Wadehra vs. Union of India and Others (1996 SCC (2) 594), Supreme Court in its judgment inconnection with safe disposal of hospital waste ordered that:

• All hospitals with 50 beds and above should install either their own incinerator or an equally effectivealternative method of safe disposal before 30th November 1996.

• The incinerator or the alternative method should be installed with a necessary pollution controlmechanism conforming to the standard laid down by Central Pollution Control Board (CPCB).

• Hazardous medical waste should be segregated as source and disinfected before final disposal.

• Health as a human right has a wider community orientation. The human rights continuum, as conceived inthe constitution of India and in several international covenants, is perennially progressive and life rises tohigher forms and fuller manifestations. Environmental protection therefore has now become a matter ofgrave concern for human existence.

• Promotion of environmental protection implies that is duty of every citizen to maintain, to conserve, toprotect, and to preserve the purity and sanctity of the environment. Following these landmark judgments,India enacted various laws to protect its citizens and environment.

Regulatory Framework: India

• Bureau of Indian Standards (BIS), brought out first standard IS 12625:1989, entitled 'Solid Wastes HospitalsGuidelines for Management' (Annexure 7.1) but it was unable to bring any improvement in the situation.

• The Water (Prevention and Control of Pollution) Act, 1974, Amended 1988 - The introductory provisions of theAct explain that the legislation was introduced to provide for the prevention and control of water pollution andthe maintaining or restoring of wholesomeness of water.

• The Air (Prevention and Control of Pollution) Act 1981, Amended 1987 and the Air (Prevention and Control ofPollution) Rules, 1982 - This Act was established to prevent, control and abatement air pollution and for theestablishment of boards with the power to implement the Act.

• The Environmental Protection Act, 1986, aims to establish a sufficient protection system for the environment. Itgives the power to the central government to regulate all forms of waste and to tackle specific problems thatmay present themselves in different regions of India. It is the primary legislation that must be considered as itcontains important provisions concerning the environment.

Regulatory Framework: India

Environmental Protection Rules, 1986 - This regulations were drawn up by the government under the powersconferred on it in terms of the Environment Protection Act, 1986.

1. The Municipal Solid Wastes (Management and Handling) Rules 1999

2. The Hazardous Waste (Management and Handling) Rules, 1989

3. The Plastics (Manufacture, Usage and Waste Management Rules), 2009

4. The E-Waste (Management and Handling Rules), 2010

5. National Rural Health Mission (NRHM) under Ministry of Health and Family Welfare, in 2007 developed andadopted an Infection Management Environment Plan (IMEP) which outlines a comprehensive framework forimplementation of infection control measures and effective healthcare waste management generated byhealthcare facilities.

6. The issue of Bio-Medical Waste Management (BMWM) in India has attracted the attention of the highest judicialbody at the level of Supreme Court of India.

7. It has issued instructions regarding management of Bio-Medical Waste and Government of India was one of thefirst countries to frame and implement Bio-Medical Waste Management and Handling Rules, 1998 (lateramended in 2000 and 2003) in the exercise of power conferred by Sections 6, 8, and 25 of the Environment(Protection) Act, 1986.

Bio-Medical Waste Management and Handling Rules

• Definition of biomedical waste - Any waste that is generated during the diagnosis, treatment, or immunization of human beings or animals, or in research activitiespertaining to or in the production or testing of biologicals.

• Application of the Biomedical Waste Rules - The rules apply to all persons who generate, collect, receive, store, transport, treat, dispose, or handle BMW’s in any form.

• Duty of occupier (operator) - of a healthcare facility (hospital, nursing home, clinic, dispensary, veterinary institution, animal house, pathological laboratory, blood banketc) to ensure that BMWs are handled without any adverse effect to human health and the environment, and according to the prescribed treatment and disposalrequirements as per the Biomedical Waste Rules.

• Prescribed authority - State Pollution Control Boards (SPCBs) in States and Pollution Control Committees in territories are responsible for permitting and enforcing therequirements of the Biomedical Waste Rules.

• Permit - Each occupier (operator) handling BMW’s and providing services to 1,000 or more patients per month is required to obtain a permit from the prescribedauthority.

• Recordkeeping - Each occupier (operator) is required to maintain records on the generation, collection, reception, storage, transportation, treatment, and disposal ofBMWs. All records are subject to inspection and verification by the prescribed authority at any time.

• Accident reporting - Each occupier (operator) is required to report any accident related to the management of BMW’s.

• Annual reporting - Each occupier is required to submit an annual report to the prescribed authority to provide information about categories and amounts of wastesgenerated and treated, and modes of treatment used.

• Common disposal/ Incineration sites - Local public entities are required to provide common disposal / incineration sites, and the occupiers (operators) of such sites arerequired to comply with the Biomedical Waste Rules.

• Segregation, Packaging, Transportation, and Storage - BMWs are not to be mixed with other waste. According to the Rules, BMWs are to be segregated into labelledbags/containers. Transportation of BMWs is to be conducted in authorized vehicles. No untreated waste is to be stored more than 48 hours, unless special permission isobtained from the regulatory authorities.

• Standards - Technology and discharge standards for incineration, autoclaving, microwaving, liquid waste discharges, and deep burial are prescribed in the BiomedicalWaste Rules.

Conclusions: Judicial

• Right to health is enforceable in the Indian context. In interpreting right to health, the courts have blurred thedistinction between judicial functions and administrative functions. In a traditional framework, an adjudicatingbody is not expected to go into the measures adopted by the executive branch. In the select cases analyzedpreviously, the Courts have gone into the micro management issues alternatively referred as JUDICIALACTIVISM.

• Coming specifically to accessibility, the Indian courts have dealt with this issue in all its dimensions viz., Nondiscrimination, Physical accessibility, Economic accessibility, and Information accessibility.

• Many a time the governments find it difficult to implement such decisions. Most of the time what is prescribedas guidelines by the judiciary are in a way directions tending towards policy making which is and should beconfined to the powers of the State.

• It is noted that the Governments (Central and States) brings in policy changes and legal amendments and alsoappoints commissions and notify such changes to the satisfaction of the Court.

• ‘Health’ being a State subject in the Constitution, the decision of the Supreme Court and the respective HighCourt adds to multitude of other issues. Invariably what is being pleaded by many states is the lack of financialand manpower resources to undertake massive health schemes.

Recommendations: Caring For Billion+Health is not everything but everything else is nothing without health

• Development of Efficient Delivery Mechanism and Efficient Consumer Response

• Need for Balanced and Equitable Healthcare System at all levels

• Needed Government Initiatives: Taxation, Industry Status, Comprehensive Legislation, Eliminatingmultiple clearances, Licenses, Increase Public Finance Expenditure etc.

• Making Healthcare Affordable by Developing Alternative Methods of Financing

• Developing Sustainable Public Private Partnership

• Strong Focus on Research and Development Activities

• Mechanism to Tackle Regulatory Deficiency must be developed

• Extensive Use of Technology: Electronic Health Records, Database, Social Networking Sites etc.

• Develop Value Based Healthcare System

• Develop Healthcare and Bio-waste Awareness

• Waste Management and Disposal should be made mandatory at both urban and rural level

ReferencesCORPORATE RESEARCH REPORTS:

• HEALTHCARE IN INDIA: A REPORT BY BOSTON ANALYTICS, JANUARY 2009• GLOBAL INFRASTRUCTURE: TREND MONITOR INDIAN HEALTHCARE EDITION: OUTLOOK 2009 –2013 BY

KPMG• STRATEGIES FOR PROVIDING EQUITABLE HEALTHCARE, BY ECS LIMITED, MARCH 2008• PHARMACEUTICAL OFFSHORING LANDSCAPE, ZINNOV MANAGEMENT CONSULTING, SEPTEMBER 2008• INDIAN PHARMACEUTICAL INDUSTRY ON COURSE OF GLOBALIZATION, DEUTSCHE BANK RESEARCH,

APRIL 2008• HEALTHCARE IN INDIA: EMERGINGMARKET REPORT 2007 BY: PRICEWATERHOUSE AND COOPERS (PWC)• HEALTHCARE OUTLOOK, TEN INDUSTRY TRENDS 2007, A QUARTERLY REPORT BY TECHNOPAK, FEBRUARY

07 / VOLUME 1• HEALTHCARE OUTLOOK, NEW PARADIGMS IN HEALTHCARE DELIVERY 2007, A QUARTERLY REPORT BY

TECHNOPAK, FEBRUARY 07 / VOLUME 2• HEALTHCARE OUTLOOK, TRENDS IN HEALTHCARE DESIGN 2007, A QUARTERLY REPORT BY TECHNOPAK,

FEBRUARY 07 / VOLUME 3• HEALTHCARE, MARKET OVERVIEW, INDIA BRAND EQUITY FOUNDATION (IBEF) OCTOBER 2007• OVERVIEW OF THE HEALTHCARE INDUSTRY IN INDIA, THE INDO ITALIAN CHAMBER OF COMMERCE AND

INDUSTRY, APRIL 2007• HEALTHCARE REPORT: BY ERNST & YOUNG, INDIAN BRAND EQUITY FOUNDATION (IBEF), 2006• BOOMING CLINICAL TRIAL MARKET IN INDIA: RNCOS REPORT, NOVEMBER 2007• DRAFT NATIONAL PHARMACEUTICALS POLICY, 2006, PART - A (CONTAINS ISSUES OTHER THAN

STATUTORY PRICE CONTROL), DEPARTMENT OF CHEMICALS AND PETROCHEMICALS, GOVERNMENT OFINDIA, DECEMBER 28, 2005

• HEALTH ATTAINMENTS AND DEMOGRAPHIC CONCERNS: NATIONAL HUMAN DEVELOPMENT REPORT,2001: CHAPTER 5

• THE STATE OF HUMAN DEVELOPMENT: NATIONAL HUMAN DEVELOPMENT REPORT, 2001: CHAPTER 1• HEALTHCARE IN INDIA, CARING FOR MORE THAN A BILLION: BY SRIVATHSAN APARAJITHAN Y, MATHUR

SHANTHI, MOUNIB EDGAR L., NAKHOODA FARHANA, PAI ADITYA AND BASKARAN LIBI, IBM INSTITUTEOF BUSINESS VALUE, IBM GLOBAL BUSINESS SERVICES

• CASE STUDY ON MANIPLE CURE & CARE: INDEGENEOUS CONCEPT THAT COMBINES HEALTHCARE ANDRETAIL IN A SINGLE FORMAT: BY PRICE WATER HOUSE AND COOPERS(PWC) AND DYNAMIC VERTICALSOLUTIONS

• INDIAN PHARMACEUTICAL INDUSTRY: ISSUES AND OPPORTUNITIES: RESEARCH AND MARKETS REPORT (http://www.researchandmarkets.com/reports/35229)

SUMMARIES:

• INADEQUATE REGULATIONS UNDERMINE INDIA'S HEALTHCARE: BY: MUDUR GANPATI: BMJ 2004;328;124- DOI:10.1136/BMJ.328.7432.124-A

• HEALTH CARE IN INDIA: LEARNING FROM EXPERIENCE: BY THEWORLD BANK GROUP• HEALTHCARE INDICATORS: BY MS. MUKHERJI SRIMOTI, COMMERCIAL SPECIALIST, THE U.S.

COMMERCIAL SERVICE IN INDIA, THE AMERICAN CENTER, NEW DELHI• INDIA’S NATIONAL HEALTH SYSTEM PROFILE:WHO• OPPORTUNITIES IN HEALTHCARE: “DESTINATION INDIA”: FICCI AND ERNST & YOUNG.• RURAL HEALTH CARE SYSTEM: THE STRUCTURE AND CURRENT SCENARIO• INTRODUCTION TO NURSING AND HEALTH CARE DELIVERY SYSTEM IN INDIA• A POLICY FRAMEWORK FOR REFORMS IN HEALTH CARE, PERSPECTIVES ON HEALTH CARE IN INDIA: BY

PRIMEMINISTER’S COUNCIL ON TRADE AND INDUSTRY• FAILURE OF PUBLIC HEALTHCARE SYSTEM: CJ: BY SINGH CHANDRA SHEKAR, FEBURARY, 2008• FINANCING THE HEALTH CARE SECTOR IN INDIA: BLOG BY DR SINGH HARMEET, MBA (BIRMINGHAM)• IN CHINA, INDIA, HEALTH CARE BURDEN SHIFTS TO POOR, GROUND-LEVEL IMPLEMENTATION 'IS SIMPLY

NOT THERE': BY POWELL ALVIN, HARVARD NEWS OFFICE• STRENGTHEN THE INDIAN HEALTHCARE INDUSTRY (RECOMMENDATIONS): MODE 1 GATS REPORT INDIA

PAGE 83, 84• ROLE OF PRIVATE SECTOR IN HEALTH CARE IN INDIA CHALLENGES, OPPORTUNITIES & STARTEGIES: BY

LATH G K, CEO, APOLLO HOSPITAL BILASPUR, MP• UNHEALTHY PRESCRIPTIONS: THE NEED FOR HEALTH SECTOR REFORM IN INDIA: BY SUNIL NANDRAJ,

INFORMING REFORMING, THE NEWSLETTER OF THE INTERNATIONAL CLEARING HOUSE OF HEALTHSYSTEM REFORM INITIATIVES ICHSRI, APRIL-JUNE 1997, PP. 7-11.

• MEDICAL TOURISM IN INDIA: ISSUES AND CHALLENGES: BY CHACKO PHEBA, THE ICFAI UNIVERSITYPRESS.

• HEALTH INSURANCE IN INDIA: OPPORTUNITIES, CHALLENGES AND CONCERNS: BY MAVALANKAR DILEEPAND BHAT RAMESH, IIM AHMEDABAD

• INDIA BRAND EQUITY FOUNDATION (IBEF), MARCH 2013, AUGUST 2013 REPORT (WWW.IBEF.ORG)• HEALTHCARE INDIA SECTOR NOTES, MAY 2014, (WWW.IIMJOBS.COM)• INDIAN HEALTHCARE SYSTEM – OVERVIEW AND QUALITY IMPROVEMENTS, DIRECT RESPONSE, 2013:04,

SWEDISH AGENCY FOR GROWTH POLICY ANALYSIS , WWW.GROWTHANALYSIS.SE• INDIAN PHARMA, INC.: CAPITALIZING ON INDIA’S GROWTH POTENTIAL, www.pwc.com/India• INDIAN PHARMA INC. CARING FUP OR NEXT LELVEL OF GROWTH, www.pwc.com/India

ReferencesWebsites:

• www.technopak.com• www.kpmg.com/infrastructure• www.ibef.org• www.dbresearch.com• www.dynamicverticals.com• www.bostonanalytics.com• www.ibm.com/healthcare/hc2015• www.pwc.com/globalhealthcare• www.wikepedia.com/healthcare• www.ficci.com• www.timeswellness.com• www.fortishealthworld.com• www.whoindia.org• www.who.int• www.mohfw.nic.in• www.crisil.com• www.pharmabiz.com• www.pharma.org

Journals

• JOURNAL OF THE ACADEMY OF HOSPITAL ADMINISTRATION• INDIAN JOURNAL FOR THE PRACTICING DOCTOR• JOURNAL OF HEALTHCARE AND MEDICAL TECHNOLOGY AND MANAGEMENT• INDIAN JOURNAL OF MEDICAL ETHICS• THE PHARMA REVIEW AND PHARMA TIMES• JOURNAL OF HOSPITAL PHARMACY

Other Publications:

• MINISTRY OF HEALTH, GOVERNMENT OF INDIA• INDIAN MEDICAL COUNCIL & INDIAN DENTAL COUNCIL• EXPRESS HEALTHCARE MANAGEMENT• INDIAN HEALTHCARE FEDERATION• MEDICA: PHARMACEUTICAL INDUSTRY PUBLICATIONS• MEDICA: HEALTHCARE SERVICES PUBLICATIONS

Chapters:

• COMPETITION CONCERNS: THE PHARMACEUTICAL INDUSTRY BY CUTS INTERNATIONAL• CHAPTER 10: DRUG PRICE DIFFERENTIALS ACROSS DIFFERENT RETAIL MARKET SETTINGS: AN ANALYSIS

OF RETAIL PRICES OF 12 COMMONLY USED DRUGS: BY GODWIN S K AND VARATHARAJAN D., HEALTHADMINISTRATOR VOL: XIX NUMBER 1: 41-47

• HEALTHCARE POLICY AND ADMINISTRATION IN INDIA: BY SAPRU R K, STERLING PUBLICATION, IIEDITION, CHAPTER 15, PAGES 228-249.

My Books:

• Indian Health Sector and Healthcare System: A critical Insight, LAP Lambert Academic Publishing,Germany, 2012, ISBN-10: 3659268895, ISBN-13: 978-3659268892, Prashant Mehta

• Indian Retail Analytics: An In-depth Study of Indian Retail Market, its Dimensions, Opportunities,Problems, and Prospects, LAP Lambert Academic Publishing, Germany, 2012, ISBN-10: 3659147303,ISBN-13: 978-3659147302 PrashantMehta

My Publications:

• Legal Provisions and Management Perspectives of Biomedical and Hospital Waste in India. JournalClub for Management Studies (JCMS),1(II), 11-36 (2014).Dr. Prashant Mehta. ISSN No : 2394 - 3033, V –1, I – 2, 2014

• Biomedical Waste Disposal: Indian Perspective: Scholasticus, Journal of National Law University,Jodhpur Vol. 5 No. 1, September 2007, Prashant Mehta, ISBN: 0975-1157, Indexed