The public health investment in the country over the years has been comparatively low, and as a percentage of GDP has declined from 1.3 percent in 1990 to 0.9 percent in 1999. The aggregate expenditure in the Health sector is 5.2 percent of the GDP. Out of this, about 17 percent of the aggregate expenditure is public health spending, the balance being out-of-pocket expenditure. The central budgetary allocation for health over this period, as a percentage of the total Central Budget, has been stagnant at 1.3 percent, while that in the States has declined from 7.0 percent to 5.5 percent. The current annual per capita public health expenditure in the country is no more than Rs. 200. Given these statistics, it is no surprise that the reach and quality of public health services has been below the desirable standard. Under the constitutional structure, public health is the responsibility of the States. In this framework, it has been the expectation that the principal contribution for the funding of public health services will be from the resources of the States, with some supplementary input from Central resources. In this backdrop, the contribution of Central resources to the overall public health funding has been limited to about 15 percent. The fiscal resources of the State Governments are known to be very inelastic. This is reflected in the declining percentage of State resources allocated to the health sector out of the State Budget. If the decentralized pubic health services in the country are to improve significantly, there is a need for the injection of substantial resources into the health sector from the Central Government Budget. This approach is a necessity – despite the formal Constitutional provision in regard to public health, -- if the State public health services, which are a major component of the initiatives in the social sector, are not to become entirely moribund. The NHP-2002 has been formulated taking into consideration these ground realities in regard to the availability of resources.

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The immediate objective of the NPP 2000 is to address the unmet needs for contraception, health care infrastructure, and health personnel, and to provide integrated service delivery for basic reproductive and child health care. The medium-term objective is to bring the TFR to replacement levels by 2010, through vigorous implementation of inter-sectoral operational strategies. The long-term objective is to achieve a stable population by 2045, at a level consistent with the requirements of sustainable economic growth, social development, and environmental protection.

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National Health Policy, 1983, refers to our rich, centuries - old heritage of medical and health sciences. The Policy outlines that although vas infrastructure is available in the Indian Systems of Medicine and Homoeopathy for addressing health care of our people, they are under utilized. The Policy suggested that it was necessary to initiate measures to enable each of these various systems of medicine and health care to develop in accordance with its genius. Simultaneously, planned efforts should be made to integrate their services, at the appropriate levels, within specified areas of responsibility and functioning in the over all health care delivery systems, specially in regard to the preventive, promotive and public health Objectives. The Policy emphasized the need for a meaningful phased integration of Indian Systems of Medicines with the modern medicines, and also outlined the need to secure complete integration of all plans for health and human development, particularly agriculture and food products, rural development, education and social welfare, housing, water supply and sanitation.

In many places, the Indian Systems of Medicine & Homoeopathy continue to be widely used due to their accessibility, and sometimes, because they offer the only kind of medicine within the physical and financial reach of the patient. The Indian medicine system is also embedded in the beliefs of a wide section of the public and continues to be an integral and important part of their lives and for some, it is also a way of life. Complementary and Alternative Medicine or Traditional Medicine is rapidly growing worldwide. In India also, there is resurgence of interest in Indian Systems of Medicine. People are becoming concerned about the adverse effects of chemical based drugs and the escalating costs of conventional health care. Longer life expectancy and life style related problems have brought with them an increased risk of developing chronic, debilitating diseases such as heart disease, cancer, diabetes and mental disorders. Although new treatments and technologies for dealing with them are plentiful nonetheless more and more patients are now looking for simpler, gentle therapies for improving the quality of life and avoiding iatrogenic problems.

India possesses an unmatched heritage represented by its ancient systems of medicine which are a treasure house of knowledge for both preventive and curative healthcare. The positive features of the Indian Systems of Medicine, namely, their diversity and flexibility; accessibility; affordability; a broad acceptance by a section of the general public; comparatively low cost; a low level of technological input and growing economic value have great potentials to make them providers of health care
that the larger sections of our people need a huge infrastructure already exists comprising thousands of hospitals and dispensaries, registered practitioners and twice the number of Indian Systems of Medicine & Homoeopathy colleges as available for allopathy. Many Post-Graduate institutions offer doctoral courses. Four researches councils and several apex scientific institutions and universities have also contributed to clinical research, ethno-botanical surveys, pharmacological and pharmacognostical studies on plants and drug standardization of simple and compound ISM formulations. Clinical research studies covering the use of ISM drugs for a range of diseases and public health problems conducted over the last thirty years have led to many useful conclusions about the use of single and compound ISM drugs to treat numerous intractable problems. Although Govt. set up an independent Department in 1995 to give focus to these issues, ISM has not been able to play a significant role in health care delivery services for want of their legitimate involvement in public health programmes.

A well organised Blood Transfusion Service (BTS) is a vital component of any health care delivery system. An integrated strategy for Blood Safety is required for elimination of transfusion transmitted infections and for provision of safe and adequate blood transfusion services to the people. The main component of an integrated strategy include collection of blood only from voluntary, non-remunerated blood donors, screening for all transfusion transmitted infections and reduction of unnecessary transfusion.

The Blood Transfusion Service in the country is highly decentralised and lacks many vital resources like manpower, adequate infrastructure and financial base. The main issue, which plagues blood banking system in the country, is fragmented management. The standards vary from State to State, cities to cities and centre to centre in the same city. In spite of hospital based system, many large hospitals and nursing homes do not have their own blood banks and this has led to proliferation of stand-alone private blood banks.

The blood component production/availability and utilisation is extremely limited. There is shortage of trained health-care professionals in the field of transfusion medicine.

For quality, safety and efficacy of blood and blood products, well-equipped blood centres with adequate infrastructure and trained manpower is an essential requirement. For effective clinical use of blood, it is necessary to train clinical staff. To attain maximum safety, the requirements of good manufacturing practices and implementation of quality system moving towards total quality management, have posed a challenge to the organisation and management of blood transfusion service.

Thus, a need for modification and change in the blood transfusion service has necessitated formulation of a National Blood Policy and development of a National Blood Programme which will also ensure implementation of the directives of Supreme Court of India - 1996.