Resource Devolution from the Centre to States: Enhancing the Revenue Capacity of States for Implementation of Essential Health Interventions

Access to adequate health care services is an important component of empowering people with human capital. This, however, can be achieved only when the spending on health care is adequate and delivery systems efficient. Improving health indicators is an important component of the Millennium Development Goals (MDGs) set by the United Nations. There are also important targets on health status achievements set for the Tenth Plan. The Common Minimum Programme of the ruling UPA government also seeks to increase the public expenditure by the Centre and States on health and family welfare schemes from the present level of less than 1% to 2%-3% of the gross domestic product (GDP). The provision of health and family welfare services falls in the realm of concurrent responsibility of the Centre and the States, but the latter have a predominant role in the delivery of these services. However, fiscal pressures at the State level lead to compression of expenditures by the State Governments resulting in an increase in Central financing of these services, particularly for some prioritized programmes implemented through the Centre and Centrally sponsored schemes. Thus, over 85% of the public expenditure on medical and public health is incurred by the State Governments, though the proportion of financing the expenditure by the State Governments is lower. This paper identifies the resource gap between the desired and the actual health expenditure in 15 major States in India (14 large, non-special category States and Assam), and highlights the extent to which the gap can be reduced by augmenting resources at the State level. Further, it estimates the resource gap that cannot be met through States’ own resources and therefore, requires Central transfers. The design of Central transfers needed for meeting the required health expenditure of various States is also discussed.Federal Transfers to Provinces; Public Expenditure on Health

Resource Devolution from the Centre to States: Enhancing the Revenue Capacity of States for Implementation of Essential Health Interventions

Access to adequate health care services is an important component of empowering people with human capital. This, however, can be achieved only when the spending on health care is adequate and delivery systems efficient. Improving health indicators is an important component of the Millennium Development Goals (MDGs) set by the United Nations. There are also important targets on health status achievements set for the Tenth Plan. The Common Minimum Programme of the ruling UPA government also seeks to increase the public expenditure by the Centre and States on health and family welfare schemes from the present level of less than 1% to 2%-3% of the gross domestic product (GDP). The provision of health and family welfare services falls in the realm of concurrent responsibility of the Centre and the States, but the latter have a predominant role in the delivery of these services. However, fiscal pressures at the State level lead to compression of expenditures by the State Governments resulting in an increase in Central financing of these services, particularly for some prioritized programmes implemented through the Centre and Centrally sponsored schemes. Thus, over 85% of the public expenditure on medical and public health is incurred by the State Governments, though the proportion of financing the expenditure by the State Governments is lower. This paper identifies the resource gap between the desired and the actual health expenditure in 15 major States in India (14 large, non-special category States and Assam), and highlights the extent to which the gap can be reduced by augmenting resources at the State level. Further, it estimates the resource gap that cannot be met through States’ own resources and therefore, requires Central transfers. The design of Central transfers needed for meeting the required health expenditure of various States is also discussed

The angiogenic asset of soft tissue sarcomas: a new tool to discover new therapeutic targets

STS (soft tissue sarcomas) are rare malignant tumours deriving from cells of mesenchymal origin and represent only 1% of all malignant neoplasms. It has been extensively demonstrated that angiogenesis has an important role in cancer malignancy. Particularly, a lot of studies demonstrate the importance of angiogenesis in the development of carcinomas, whereas little is known about the role of angiogenesis in sarcomas and especially in STS. This review aims at summarizing the new discoveries about the nature and the importance of angiogenesis in STS and the new possible therapeutic strategies involved. Only a few studies concerning STS focus on tumour neovascularization and proangiogenic factors and look for a correlation with the patients prognosis/survival. These studies demonstrate that intratumoural MVD (microvessels density) may not accurately represent the angiogenic capacity of STS. Nevertheless, this does not exclude the possibility that angiogenesis could be important in STS. The importance of neoangiogenesis in soft tissue tumours is confirmed by the arising number of publications comparing angiogenesis mediators with clinical features of patients with STS. The efficacy of anti-angiogenic therapies in other types of cancer is well documented. The understanding of the involvement of the angiogenic process in STS, together with the necessity to improve the therapy for this often mortal condition, prompted the exploration of anti-tumour compounds targeting this pathway. In conclusion, this review emphasizes the importance to better understand the mechanisms of angiogenesis in STS in order to subsequently design-specific target therapies for this group of poorly responding tumours