The National Health Policy, drawn up last year, acknowledged a public health challenge that academic discourse had recognised at least five years ago. It underscored the need to focus on non-communicable diseases (NCDs) like heart ailments, diabetes and respiratory afflictions. The policy marked a paradigm shift from the times when government health programmes were geared towards dealing with infectious diseases. However, policymakers were hamstrung by a dearth of studies that provided a comprehensive assessment of diseases across all states of the country. It was this concern that led the Union Ministry of Health and Family Welfare to collaborate with the Indian Council of Medical Research, Public Health Foundation of India and the Institute for Health Metrics and Evaluation on a two-year long study that mapped NCDs across the country. The results of the project — also a part of the Global Burden of Disease Study that was released on Wednesday — throw light on the challenges at hand for the National Health Policy.
India with 18 per cent of the world’s population bears more than 30 per cent of the global burden of respiratory diseases, the study reveals. The problem is compounded by the fact that two of India’s least developed states, Rajasthan and Uttar Pradesh, are hotspots of not just lung afflictions but also bear a heavy burden of heart disease and diabetes. The study also draws attention to a little-understood disease, COPD (Chronic Obstructive Pulmonary Disease) — it constitutes more than 75 per cent of the country’s burden of respiratory diseases — and shows how pollution has become the major reason for stressing the lungs of people in different parts of the country.
With the launch of the government’s flagship health programme, Ayushman Bharat, less than 10 days away, the salience of the study cannot be overstated. The much-publicised insurance component of the programme has little relevance for people who suffer respiratory diseases. Very few of them require extensive hospitalisation — the precondition for availing insurance under Ayushman Bharat. However, the government has responded to criticism about the overwhelming emphasis on the insurance component of the programme by planning for more than 1,50,000 primary healthcare centres. This is welcome. But several studies have also shown that respiratory diseases like COPD evade diagnosis because doctors do not follow the protocols for treatment and most often target the symptoms — cough, cold and fever. The challenge for Ayushman Bharat would then be to equip doctors at these healthcare centres with the diagnostic acumen to tackle respiratory diseases and to make sure that drugs are available at all public dispensaries.