India on the verge of becoming World Capital of all NC diseases

In National Health Conclave, healthcare leaders huddled to avert this impending crisis

New Delhi: After the ignominy of failing to meet global Millennium Goals, India is faced with the grim prospect of becoming the world capital of all the Non Communicable Diseases, leading causes of mortality and morbidity globally.

Healthcare leaders heaped together in 2 day National Health Conclave starting July 10 in Delhi underlined this impending catastrophe and deliberated hard upon the ways to stall the perilous progression of NCD. World Health Organization (WHO) has recognized diabetes, cardiovascular illness and stroke, cancer and chronic lung ailment as major non-communicable diseases.

The National Health Conclave (NHC) confronted the same old questions of low public healthcare spending, treatment cost increasingly becoming prohibitive, primary healthcare being in a shambles, lack of accessibility to quality healthcare etcetra. But Dr. Srinath Reddy, chairman, Public Health Foundation of India (PHFI), one of the greatest global health policy experts and architect of much talked about Universal Health Coverage (UHC), saw a silver lining. Dr. Reddy seemed to pin his hopes on recently unveiled National Health policy (NHP) with the rider that outcome would largely depend upon its implementation. Though Dr. Reddy finds it less than optimal, he underlined avowed aim of refurbishing Primary Healthcare as the strongest aspect of NHP. It talks of spending two thirds of all the resources available on making Primary Healthcare system robust. He said if implemented verbatim, healthcare scenario in India would for sure witness a sea change for the better in times to come. Dr. Reddy also stressed the need for UHC and generic drugs to make healthcare affordable to the poor.

Some off the cuff comments by members of parliament in the concluding session on the theme ‘Role of the political will and media in shaping health policy in India’ were incisive and deserve quoting. Dr. Kirit Prem Bhai Solanki, the BJP parliamentary law maker from Ahmadabad, said, touching upon dismally low public expenditure on healthcare, ‘it should be understood that if you spend more of GDP on health, the GDP will go up.’ He was inferred as saying that India is a country which wants to become an economic power before being healthy. India spends a little more than 1 percent of its GDP on health. Of course, the newly released National Health Policy after 15 years talks of enhancing the expenditure to 2.5 percent till 2020, still a dismal one.

R.K. Singh, former Union home secretary and now the BJP parliamentarian, caught the crux of the matter by its horns saying, ‘Health is a public good and must remain in public sector. Public health system needs more and more investment and should be first priority of any government.’ Mr. Singh, member of parliamentary committee on Health, added that private care and insurance together are pushing the healthcare costs up.’ He bemoaned the direction of the healthcare in India, saying, ‘The direction India is taking in health is not right’. He advocated strengthening of public health system. Dinesh C Sharma, reputed health and science journalist, as moderator, tried to provoke the law makers by wondering why health is never an election issue in India.

The upshot of the two deliberations was – The ever rising burden of NCD on India is staring into its stride towards being a global economic power. It calls for immediate policy intervention for stemming the NCD epidemic that might sap the energy of the nation and leave it quite unequal to the task. Increasing burden of NCD coupled with still raging communicable diseases may spell disaster for Indian economy on a roll.

In his inaugural video address JP Nadda, Union Minister for Health and Family Welfare, acquiesced in the sober fact that combating NCDs is one of the most significant challenges for the public health community globally. He assured the congregation that central government is geared up to tackle the chronic disease epidemic efficiently and effectively. He said the conclave was the need of the hour.

In her address, Dr Soumya Swaminathan, Director General, Indian Council of Medical Research lauded the organisers AHPI and PHFI for getting a huge number healthcare organizations and relevant stakeholders together to discuss and create a strategy to tackle the prevalence of NCDs in the country under the umbrella of National Health Conclave Alliance. She said, ‘NCDs requires action at different levels and at various times we have been flagged about the high prevalence of NCDs, especially after multiple data has raised concerns over India’s alarming malnutrition rates and disease burden. There is a huge potential for control and prevention of NCDs through early screening and we need to emphasize on understanding the social-economic and cultural contexts in countering the rising NCDs, further laying stress on social behavior change. I am glad that this conclave has a multi-sectoral and convergent approach for prevention and control of NCDs, and can advise the government on advocacy, awareness, access, alliance and accountability towards NCD control in India.’

Dr Alex Thomas, Organising Chairman of the Conclave and President, AHPI in his address said ‘we are now being faced with an alarming increase in the number of Non – communicable diseases. Most of the NCD’s are chronic and are associated with a huge loss of potentially productive years (35-64yrs) and also account for 42% of all deaths.  NCD’s are a great “equaliser” affecting both sexes, rich and poor, urban and rural in almost equal proportions.

Prof D Prabhakaran, Vice President, Research and Policy, PHFI, said, “As a key partner to this Conclave, PHFI reaffirms its commitment to embark upon a renewed roadmap to address the current constraints in the health system to effectively manage NCDs and its associated complications in India. Through our globally acclaimed courses, quality educational and research initiatives coupled with technology wherewithal, we are confident that the healthcare community will be able to clinically diagnosis and manage NCDs through a more systematic and structured approach, augmenting the government’s agenda towards successfully rolling the National Health Policy 2017 and meeting the Sustainable Development Goal on health.’

Recognising that India is experiencing a rapid health transition with a rising burden of NCDs, now considered as a developmental burden, Association of Health Providers India, Public Health Foundation of India, Indian Council of Medical Research, Indian Space Research Organisation, National Board of Examinations along with other key partners from government, research institutions, academia and international agencies joined hands to organise the National Health Conclave 2017 with the theme Chronic Care – Innovation, opportunities and Challenges.

NCD contribute to huge losses in productive years of individuals resulting both in catastrophic health expenditure at individual level and macroeconomic loss at national and international level. Accounting for 63% of the annual global death toll and for untold morbidity and disability, non-communicable diseases (NCDs) have become the dominant public health challenge of the 21st century. NCDs not only have a serious impact on human health, but also on economic growth as India stands to lose $ 4.58 trillion (Rs 311.94 trillion between 2012 and 2030 due to non-communicable diseases.

Indian Space Research Organisation (ISRO) launched its first healthcare intervention, Health Quest, a compendium of best practices on Emergency Medicine and Critical Care jointly developed by ISRO along with representatives of specialists from Society of Emergency Medicine India [SEMI], Indian Society for Critical Care medicine [ISCCM], National Accreditation Board for Hospitals and Healthcare Providers  [NABH]  Consortium of Healthcare Organizations [CAHO], Association of Healthcare Providers India  [AHPI], Public Health Foundation of India and NBE. The conclave brought together all stake holders, including the Government, Research Institutions, Academia, Industry, Public health experts, community and International agencies on one platform to deliberate and evolve strategies to combat the looming threat of NCDs where India is unfortunately slated to become the country with the largest number suffering from NCDs in the world. Through various targeted sessions, the Conclave deliberated on knowledge on innovation, quality improvement, policy regulations and human resource development with regard to chronic care diseases. The Conclave declared developing a ‘White paper’ that would contain useful policy advocacies and resource requirements to enable the Government to arrive at a more meaningful, outcome oriented resource allocation in health.

Burden of NCDs and their risk factors in India contribute to around 5.87 million deaths that account for 60 % of all deaths in India. India shares more than two-third of the total deaths due to NCDs in the South-East Asia Region (SEAR). Four behavioural risk factors are responsible for significant proportions of these diseases—tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol. Major metabolic risk factors are obesity, raised blood pressure, raised blood glucose and raised blood total cholesterol levels.

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