"You may have to fight a battle more than once to win it." - Margaret Thatcher
India is fighting a tough battle. With a burgeoning population of over 1.2 billion, the nation has a daunting task at hand -- ensuring healthy living for all alike.
With the Millennium Development Goals in place, considerable success has been achieved in healthcare, especially areas like child mortality, maternal health, HIV /AIDS and polio. Here, it is important to keep in perspective, the changing disease profile. With rapid urbanisation and globalisation, unhealthy lifestyles have taken root. Non-communicable diseases (NCDs) account for up to 60% of deaths in India. Worldwide, too, NCDs have overtaken infectious diseases as the biggest cause of sickness and mortality.
The fear of the grim effects of communicable diseases and the criticality of looking into maternal and child health is understandable. This, however, does not justify the casual approach to the growing incidence of non-communicable diseases that has long eluded public consciousness. The inclusion of NCDs as an emerging public health issue for the first time in the new National Health Policy 2015 that is under revision after almost 13 years gives some hope!
The battle to fight non communicable diseases puts the country in a situation where we strive to achieve victory through the consistent efforts of stakeholders at all levels. Surprising as it may seem, these diseases are affecting more people below the age of 60 years, indicating a paradigm shift in the health profiles of people. I attribute this trend to the massive transition in the lifestyle and consumption patterns of the people, which include unhealthy eating habits, lack of physical activity and insufficient knowledge of lifestyle -related problems.
"With rapid urbanisation and globalisation, unhealthy lifestyles have taken root. Non-communicable diseases (NCDs) account for up to 60% of deaths in India."
According to a report released by the World Economic Forum and Harvard School of Public Health, India is set to lose USD 4.58 trillion on account of NCDs between 2012 and 2030. Due to the shifting profiles of people suffering from NCDs, economic development is predicted to experience a setback with dropping productivity rates of the workforce.
For India, the challenge is twofold - even as it grapples with fairly newer lifestyle diseases, it is still threatened by its traditional foes. Clearly, the health of the nation is at stake.
What can be done
Innovative mechanisms to tackle NCDs can build a sustainable health environment. With new found challenges, there is an urgent need to craft a creative approach to provide a broad health-promoting ecosystem with the individual at the core. Collective action backed by multi-sectoral and inter-sectoral collaboration could be the real game changer.
To begin with, it is important to understand the gaps and challenges that exist in addressing the growing incidence of NCDs in the country and identify opportunities for different stakeholder groups. There are four key areas of focus which need strong government intervention, namely - role of health policymakers, training and development of para-medical staff, need for healthcare financing and requirement of surveillance for understanding the magnitude of the disease hub.
A look at the healthcare infrastructure and best practices present in the states shows that the progress has been very sporadic, with few states showing remarkable performance (e.g. Tamil Nadu) as against the others, which have failed to even crawl up to a satisfactory level. This calls for a dedicated committee or nodal body to develop a framework for tackling NCDs and ensure effective implementation of the same.
There is room for creative thinking, not only in taking corrective action but also while planning preventive methods well in advance. Proper surveillance infrastructure and epidemiology data is of prime importance to understand the progress of the health policies for NCDs and ensure regular revision of the same. To further strengthen this, the para-medical staff needs to be highly trained so that they can promptly detect multiple diseases when patients approach them. Timely diagnosis and control of NCDs can go a long way in reducing their burden for the patients. The health spend also needs to be aligned to meet the demands of the changed health scenario with specific focus on promotion of healthy behaviours and undertaking initiatives to limit disease progression.
India has in the past, demonstrated in its polio eradication and vaccination programs that dedicated efforts can reach the most vulnerable populations. A more recent win is the elimination of tetanus and progress made by India in this regard has been remarkable. The government, therefore once again would need to go on a mission mode to combat the challenges presented by chronic lifestyle diseases.