Rural workforce is being rendered unfit by NCD (Non Communicable Diseases)
‘Health for all’ is a prerequisite for sustainable development. If we cast a cursory glance at nations which have progressed in terms of development, they first focussed on state health because only a healthy workforce can contribute to sustainable development. India is unique in the sense that it is in a hurry to become an economic giant before being healthy. We think health can be postponed till we amass wealth. That is why the goal post for health for all is being perennially shifted. We are postponing this goal from 2000 onwards. And as a consequence of such thinking we have the ‘trophy’ of ignominy on us for not being able to meet Millennium Development Goals (MDG).
The rural health is still on back burner. It can spell disaster for ambitious economic and sustainable development of India because rural populace can only contribute human resources for propelling development engine. India would never become an economic giant and developed country without addressing pressing health issues of rural India. Despite a decade-long run of much flaunted National Rural Health Mission (NRHM), a vast majority of Indians remains out of the heath care-for-all umbrella. Non Communicable Diseases (NCD) are eating into the vitals of rural populace and rendering them disabled in productive age.
After MDG, it is our opportunity to race for meeting United Nations’ 2030 agenda for sustainable Developments Goals (SDG), which has underlined health as a very critical component. Sustainable development means meeting human development goals along with sustaining the ability of natural systems to continue to provide the natural resources upon which the economy and society depends. It is the organizing principle for sustaining finite resources necessary to provide for the needs of future generations. It is a process that envisions a desirable future state for human societies.
The SDG targets are specific and strict, but must be attained if we are to provide good health to all of our people. It is must for economic development and also a hallmark of civilized society. The problems of health are increasing in both spatial and temporal dimension to many newer places, especially in the rural areas due to increased risk of disease transmission fuelled by developmental activities, demographic changes and introduction of newer products.
Life style diseases that used to be the preserve of urban populace are now not percolating down to rural areas but becoming worse therein. Limited physical access to primary health care is a major factor contributing to the poor health of rural populations in India. Primary health centres are still in a shambles.
Since health is central to Sustainable Development, this state of sustained ill health in rural areas is prohibitive. If we prioritize sustainable development, we have to commit to fourfold progress: economic development including the eradication of extreme poverty, social inclusion, environmental sustainability, and good governance. Each of these dimensions of sustainable development connects to others, and progress across all four templates is required for the well being of society. Health is inherently important as a human right too.
National aspirations for economic growth can never be achieved without a healthy and productive population. No doubt economic growth leads to improved health but health itself is a critical catalyst for development. It is why health-related goals were centrally positioned in the MDGs.
Child and maternal mortality is a measure of a nation’s overall development, along with poverty eradication, the empowerment of women, and environmental sustainability. Combating the spread of HIV/AIDS and mitigating the burden of TB and malaria is critical to human progress, as these diseases have disproportionately impacted the development a number of countries. Further evidence of the importance of health to sustainable development is the growing number of reports emphasizing the need for greater investments in health through increased public financing.
These reports, including that of WHO, have highlighted the multiplier effects of investment in health and have also underlined the perils and consequences of neglecting rural health. These reports have emphasised not only the need to address just diseases but also the wider dimensions and determinants of health. As for Sustainable Development Goals (SDGs), the health goal proposed by the SDSN (Achieve Health and well being At All Ages) is being recognized as pivotal to global development.
Even as the world is pursuing economic development with whole might to reverse the economic downturn of the past years, it must be clearly recognized that economic and social progress can neither be secure nor sustainable if sufficient investments are not made to protect and promote the health status of all people across the world. Rural health should become fulcrum of this health development. Health is crucial for sustainable human development, both as an inalienable human right and an essential contributor to the economic growth of society.
Health is also a good measure of the progress of nations in achieving sustainable development. It contributes to national development through productive employment, reduced expenditure on illness care and greater social cohesion. By promoting good health at all ages, the benefits of development extend across generations. Investments in primary health care can promote health across all social groups and reduce health inequities.
The potential for providing large-scale employment as frontline health workers, particularly to women and young persons, should be utilized to strengthen the economy and improve health services. Universal health coverage is the need of the hour. Universal health coverage must ensure equitable access to affordable and quality health services.
The Sustainable Development Goals (SDGs), the successor of United Nations Millennium Development Goals (MDGs) will act as the compass for global development efforts during 2016-2030. On the face of it, it appears that the importance accorded to health has been relegated in SDG but on close reading, it is revealed that health has indeed been given a broader and better place within the single goal.
The MDGs focused on maternal and child health and major infections, assuming that these were the main public health challenges of the low and middle income countries. They served a useful purpose by mobilising global and national resources for galvanising action to achieve targets in these areas by 2015. But they ignored the huge and rising burden of non- communicable diseases (NCDs), mental illness and traffic injuries that were also afflicting these countries, straining their health systems and threatening their economies. The SDGs are applicable to all countries.
The health goal in it calls on all nations to ensure healthy lives for all and promote wellbeing for all at all ages. The mission now does not focus only on preventing deaths; it also addresses the protection of health and promotion of wellbeing as important priorities. Some major causes of death and disability include cardiovascular diseases, cancers, diabetes, chronic respiratory diseases, mental illness, traffic injuries, substance abuse and pollution. The unfinished agenda of the MDGs- improvement of maternal and child health and control of infectious diseases- continues with renewed commitment, in the health SDG.