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In poor health

Reducing preventable disease should be a developmental priority. Government needs to invest in a healthier future.

Written by Nandita Murukutla | Updated: July 14, 2015 12:43 am
health programmes, public health,  disease, preventable disease, health, disease control, Nandita Murukutla column, ie column, indian express column India accounts for a third of the world’s poorest 1.2 billion people and 21 per cent of the world’s disease burden. Our poor health is making us poorer still.

Indians are famous for our savings mentality. The 2014 Towers Watson Global Benefits Attitude Survey found that Indians had the second-highest savings rate, after the Chinese. We save for a variety of reasons, to create a safety net and to yield returns in future. While there is a time to save, there is also a time to invest. And for India’s government, that time is now.

World leaders — including the government of India — meet in Addis Ababa this week at the Third International Conference on Financing for Development to discuss how domestic and global development efforts may be sustained and financed. This marks an important opportunity for India to conclude that judicious investment in development, particularly in public health, is critical to the country’s future economic growth. Failing to proactively address significant and growing health challenges will increase our health costs and impede future development.

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The scale of the problem is significant. India accounts for a third of the world’s poorest 1.2 billion people and 21 per cent of the world’s disease burden. Our poor health is making us poorer still.

India contends with a triple health threat — infectious diseases, violence/ injuries and non-communicable diseases (NCDs), like cardiovascular diseases, cancers, chronic respiratory disease and diabetes. According to the Institute for Health Metrics and Evaluation (IHME), the burden from infectious diseases reduced between 1990 and 2010 — but premature deaths and disability due to injuries and NCDs significantly increased.

India loses 6 per cent of its annual GDP to preventable illnesses and premature deaths. NCDs are responsible for 60 per cent of deaths in India, account for 40 per cent of hospital stays and 35 per cent of outpatient visits. Since public health expenditure in India is less than 1 per cent of GDP — among the lowest in the world — individuals and their families bear the brunt of the cost. The World Health Organisation (WHO) says this pushes an estimated 2.2 per cent of Indians into poverty each year.

The future outlook is even more bleak. Poor diets (including high caloric diets), household air pollution and tobacco use are the top three risk factors for NCDs in India, according to the IHME. The toll of NCDs is expected to rise further with increased urbanisation, which is associated with lower levels of physical activity and increased consumption of commercially processed, energy-dense (nutrient deficient) foods that fuel obesity. According to the Harvard School of Public Health, NCDs and mental health conditions will cost India $4.58 trillion in economic losses by 2030.

This anticipated escalation in cost is due to India’s demographic profile. Our population is among the youngest in the world, with a third aged between 10-24 years. The disease burden, particularly from NCDs, is borne by those in the most productive years of their life — aged between 30 and 70 years.

Fortunately, there are proven, cost-effective solutions. Investment in primary prevention — reducing the four big “behavioural risk factors” of tobacco and alcohol consumption, poor diet and physical inactivity — could halve the rate of NCDs. It would also improve the outcomes for patients suffering from infectious diseases like tuberculosis and HIV, which continue to be major killers in India.

This is highly feasible. Successful policy interventions require comparatively few resources but have population-wide reach. Increasing the prices of and taxes on unhealthy products (for example, tobacco taxes) is the most effective solution, reducing consumption and presenting government with a source of revenue for continued health programmes. Bans or restrictions on the advertising, marketing and promotion of unhealthy products, public education campaigns that warn about the harm they do health, clear labelling (pack warnings for tobacco) and smoking bans are all proven to be highly effective. Effective implementation of tobacco control alone could save five million lives from tobacco-related deaths in 23 low- and middle-income countries, including India.

Most importantly, this approach is highly affordable. As reported recently in the WHO’s Global Tobacco Control Report, the World Lung Foundation found that mass media campaigns successfully motivated smokeless tobacco users to attempt to quit, at the cost of just Rs 5 ($0.07) per person. The WHO estimates that the combined cost of implementing programmes on the four behavioural risk factors in India would cost $0.30 per person.

Reducing preventable disease should be a development priority, and now is the time to invest in a healthier, wealthier future for India.

The writer is Country Director, India and Director (Global), Research and Evaluation, World Lung Foundation

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  1. R
    Ramesh Grover
    Jul 17, 2015 at 10:24 am
    A very informative , useful, and pointed write up. It should alert policy makers in India including our parliament, state legislatures, governments, NGOs, media and others about the urgency and priority to be accorded to this aspect of our health stategy.
    1. D
      Dr. Vijaya
      Aug 5, 2015 at 7:14 pm
      I am taking the liberty of introducing myself to you – I am Dr. Vijaya Venkat of The Health Awareness Centre, Mumbai. We encourage people to live a healthy life, by knowing the needs of the body according to natural law and our genetic blueprint...a design perfected by nature through millions of years of evolutionary choices. It is a choice still accessible today, though widely ignored or forgotten. Modern, so called scientific medical knowledge, is primarily pathologically oriented, allopathic medicine - a recent and dominant system today. It’s chief feature being to cure symptoms by fragmenting and treating only the physical body as parts. Nowhere does it consider the study, practice or emphasis on health and wellbeing- the way ahead for any future! Poor health will be the consequence as long as the focus is only on disease, illness and suppressing symptoms. Can diseases be cured without understanding their cause? Don't symptoms have an underlying reason? What are we curing? What are we preventing? Is it possible to develop policies (both long or short term), without developing a perspective on nature and how natural laws operate within our body? As with the World Lung Foundation, perhaps we can very soon expect, a World Toe Foundation! Am I being Sarcastic? NO. Just being pragmatic about where we seem to be heading in the future- as far as health and its policies are concerned... totally removed from the biological blueprint of our body and its needs. To invest in a healthier future, the starting point is to re-evaluate current mainstream health policies- from the view-point of the body. The differences in methodology and treatment is the difference between poor health and wellbeing. Dr.Vijaya Venkat The Health Awareness Centre PROFILE OF THE HEALTH AWARENESS CENTRE The first of its kind, The Health Awareness Centre (THAC) was started in 1989 in Mumbai by Dr Vijaya Venkat. It was inspired by the belief that the key for wellness, for health and healing, of ourselves and the planet, lies within each and every one of us. THAC celebrates the miracle of life unfolding within the 75 trillion cells within our body by bringing to light, the simple basic functions of our body from digestion to elimination, it’s resilience, and to remove the layers of confusion created by our so called scientific information and our education, to unfold the innate intelligence of the body and to let it shine in its full glory. The Centre was created to educate and motive people to take CARE of their own health, by helping them to make correct health choices (SELF CARE). The emphasis is on understanding the underlying causes of disease and putting illness in the right perspective. We do not offer a fad diet or a miracle pill, nor do we ask you to take myriad tests, we only ask you to trust your own body and to listen to its signals. We help you understand these signals, and to guide you on a path of optimum health, where fear evolves into faith, where you care rather than cure yourself, where your mind is not riddled with the fear of death due to disease.