India has a staggering burden of chronic disease arising from a variety of causes, but there is encouraging evidence to show that it can reduce both death and disability through effective low-cost measures. The key to successful intervention lies in learning from good pilot programmes and making them integral to health-care protocols in both public and private sector institutions. A new series of articles published by The Lancet on universalising health coverage in India highlights the challenge that lies ahead. In the next two decades, chronic diseases resulting from cardiovascular and metabolic disorders, respiratory conditions, mental illness, and cancer are expected to cast a long shadow over national ambitions for economic growth in terms of healthy life-years lost. The section of the population that is likely to suffer the most will be those over 45. They may find the threat of infectious and parasitic diseases reducing with better standards of living but the threat of chronic diseases will increase. This is because the incidence of hypertension, poor control of blood glucose, tobacco use, and abuse of alcohol is expected to rise. The imperative therefore is to scale up the pilot programmes that have shown good results at prevention.
Last year the central government approved two key measures — the testing of adults for chronic diseases, and an awareness campaign on healthy behaviour — as part of an integrated national programme for prevention and control of cancer, cardiovascular diseases, and diabetes. A lot more needs to be done structurally to align policies with disease reduction goals. Regulation of unhealthy foods to reduce high calorie and salt content can mitigate the risk of diabetes and hypertension but this agenda is not making speed. Also, the unhealthy effects of energy-dense foods are compounded by negative changes in the urban environment. This experience shows that an assessment of the health effects of macroeconomic policies must be made mandatory. Achieving a drastic reduction in tobacco use must be made a national priority in the fight against cancer. The State health ministers, who met recently in Hyderabad, have done well to recognise the need to curb both smoking and smokeless forms of tobacco. But even with modified lifestyles, a medicalised approach to prevention will be needed. There are examples in this area to show that population-level testing for impaired blood glucose and hypertension, followed by a protocol of lifestyle modification and low-cost drug therapy, can stop disease progression. Given such clear evidence, the campaign against chronic disease must move into high gear.
Keywords: health challenge, India, Lancet journal, chronic diseasea, health issues, government healthcare
A timely editorial from 'The Hindu'.In India the various governments have not devoted attention on Primary care systems, Pure and safe drinking water systems, Hygienic environments, and controlling pollution.The budgetory allocations are minimal and managements of such systems are far from satisfactory.The authorities claim that they have eradicated Polio,TB, Colera,smallpox,Chickenpox,Etc.India has the largest percentage of malnourished children in the world.The conditions and management of State run Health centers are not at all satisfactory.The availability of safe drinking water even in a big city like Chennai is very difficult. People overcome by buying at exorbitant prices bottled water.There is no mechanism even if it is available, how far we can trust such agencies,to check and certify such supplies.Industrial pollutions are the worst. Industries make huge money but they do not care about general public health.A standing example is Textile industry and leather industry in Tamil nadu.Schools do not have adequate water supply and Toilet facilities. Slum areas are the worst especially during rain season.Think about Villages where in some places they have to walk few miles to get a pot of drinking water.We are all glorifying India by showing some progress near the centers of POWER.Unless different levels of master plans are created from village level upwards for driking water, Primary care, improvements in the Sanitary systems, school environments Etc we cannot aspire of improvements of general health. It requires consistant, continuous allocations in Budgets and proper, corruption free implementations.Industrial Pollutions must be strictly controlled to international standards and defaulters must be severely punished.The growth of Big cities , Towns have to be properly regulated and incentives must be given to relocate some percetage of the poulations relocating slum dwellers to a better housing facilities. Simultaneously take up improvement in the basic facilities including roads.The vested interests who are beneficiaries to the high inflations of urban properties will argue against this. Such Beneficiaries are usually closely connected with the the Politicians in our country. I had occasion to go through the census figures of Important cities of USA 2000- 2010. USA perhaps only country where lot of people migrate from neighbouring states. The growth of the cities populations are less than the National average except one or two.This is possible due to implementation of strict laws to start new industries near such cities. Our Leaders, intellectuals, planners are all aware of this but they have failed in India because perhaps they have not taken long term objectives.On the whole it is a neglected area.Time to Act.
The place where the disease thrives is the most important issue here and to have comprehensive measures to eradicate it from it's origin is to be done. It's not mandatory it may spread from an slums or suburbs but even from airports and cosmopolitian sorroundings. So its better to dose each child born with suitable medicines and its later on prerequisites.
A disease-free environment is more imperative for the people for a healthy living than the prescription and consumption of drugs and medicines. If the urban or rural ambience and living conditions there in are any indication, freedom from disease is a farcry for the masses. We are aware that the suburbs are the patent receivers of the garbage generated in the cities. These breeding centres of musquitoes and other deadly insects spread a host of communicable diseases. The health authorities relent to these issues only when social unrest breaks out, that too only with some cosmetic adjustments. The real problem persists. This attitude must change. The health ministers must address this issue with a vision. The food profile our young generation adopts is really unhealthy. This is particulary so amidst the techies in the cities. Energy-dense food is not rich food. The stress must be placed on the nutrition and health value and not on the tickling of the taste buds. Our legisltions banning smoking in public places has not fetched the desired results. An awareness campaign is warranted in this aspect.
Demographically put, when you reduce the number of threats to life at early age in life, you will see a rise in the number of diseases or threats to life in later life. In this regards, as we see better and more urban life structure we will see rise in chronic diseases. Education is important but it is also imperative to understand and explain why should there be change in diet. For eg, while salt itself does not cause high BP, the fact that most people now have urban life style where they sweat much less than they used to and thus drink much less water too. However, the salt intake in their foods has not changed and that is why they need to reduce it. Same goes for food, especially the agricultural class that have recently imbibed urban life. Thus simply saying won't help, reasons and explanations are necessary too.
Provision of clean drinking water to everyone and the construction of sewage system to cover the whole country will do wonders for the health of the nation. Why spend precious economic resources on medicines and in fattening the purses of investors in pharmaceutical companies when scientific discoveries made almost three centuries ago are available free to all of us that our diseases are intimately related to the water we consume?
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