What sets India truly apart in today’s economy is its gigantic workforce. The country has the largest number of young workers in the world, with 12 million joining the workforce every year. But the question is, how productive can these people be if they suffer from frequent illness and poor health?
India, along with most other nations, has fallen victim to a lethal modern day scourge — non-communicable diseases (NCDs). Cardiovascular diseases, cancer, chronic respiratory diseases and diabetes could cost the world $47 trillion in lost economic output from 2010 to 2030 if urgent action is not taken to prevent and treat them, say experts.
India’s condition is particularly serious. NCDs are estimated to account for a chilling 60 per cent of all deaths in India, making them the leading cause of death — ahead of injuries and of communicable, maternal, prenatal, and nutritional conditions. Further, NCDs account for about 40 per cent of all hospital stays and roughly 35 per cent of all recorded outpatient visits. NCDs not only affect health, but also productivity and economic growth. The probability of death during the most productive years (ages 30-70) from one of the four main NCDs is a staggering 26 per cent. Moreover, as India ages, it is likely to find the burden even heavier.
The good news is that the NCD menace can be avoided. There are options that policymakers can take today, and businesses may contribute as well through workplace health programmes aimed at prevention, early detection, treatment, and care. Is India prepared to take up the challenge? Its track record is far from promising.
Global evidence on health spending shows that unless a country spends at least 5-6 per cent of its GDP on health and the major part of it is from government expenditure, basic healthcare needs are seldom met. Government spending on healthcare in India is only 1.86 per cent of GDP, which is about 4 per cent of total government expenditure, less than 30 per cent of total health spending.
Union Budget 2015 follows the same pattern. It spends less than a ten-year average on public health care. The alarms sounded across the country have not been able to shake off the indifference of policymakers regarding NCDs. They remain exclusively focussed on communicable diseases and the classic “diseases of poverty”, paying scant attention to emerging menaces, even the most virulent ones. So, while NCDs now constitute the bulk of the country’s disease burden, National Health Programmes to tackle and treat these are extremely limited in coverage and scope.
The scenario, however, must change, as India has too much at stake. In terms of tangible assets, it stands to lose U.S. $4.58 trillion before 2030. But the real cost of carrying the burden of a mammoth population that is growing steadily sicker would be far more debilitating.
Readying the arsenalHow can NCDs be contained and kept at bay. Primary prevention, built upon a robust early screening system, and a strong healthcare infrastructure, are the two main arms of the solution.
To enable this solution to act swiftly and with precision, it is imperative to build a comprehensive base of relevant data, which can be used as points of reference. This again envisages close and continuous collaboration among the public and private sectors and civil society. Most importantly, the medics and the researchers require uninterrupted infrastructural support that includes the following:
– Robust mechanisms for data collection, data sharing, and knowledge transfer
– Systems for monitoring and evaluation
– Clearing houses for people to share and learn about what works and what doesn’t in various contexts
Finally, what role can we, the potential victims, play in this battle? We can launch a double-pronged attack. First, we work, as pressure groups, forcing the authorities to take NCDs out of dusty policy documents and introduce them into business and policy-making debates. The purpose would be to stimulate discussion on the extensive impact of NCDs on Indian families, businesses, and society.
The second option would probably be the most damning attack against the NCDs. We decide to make the correct choice. If we learn the skills of maintaining a healthy and active lifestyle, then we can break the back of the NCD menace.
Are we ready to take the plunge? More importantly, is our workforce ready for it?
(Kenneth E. Thorpe is Chairman, Partnership to Fight Chronic Disease; Robert W. Woodruff Professor and Chair of the Department of Health Policy & Management, in the Rollins School of Public Health of Emory University, Atlanta, Georgia.)
