In a step which will significantly improve the management of preventable disorders, Prime Minister Narendra Modi has initiated a time-bound process to bring the public health framework up to speed. It will refocus on containing mortality and morbidity due to cancer, diabetes and cardiovascular conditions, whose incidence has risen in recent times, in parallel with development. Cancer and lifestyle disorders have become the great slayers, appearing to overtake traditional threats like gastroenteric conditions, malaria, typhoid and tuberculosis. The ministries of health, family welfare and Ayush are to deliver the framework within three months and roll it out within the next financial year. PM Modi has given special importance to plans for screening for oral, breast and cervical cancers, which can be prevented or managed better by intervention at the pre-malignant stage.
Governments come and go, and so do their plans for public health and education, the two sectors that are crucial to human development. However, the proposed framework appears to be credible because all the important innovations are deadlined. The National Health Protection Scheme is to be actionable within six months, for instance. Long-awaited reforms to the Medical Council of India are to be delivered within two months and 3,000 Jan Aushadhi stores must be open for business within a month. Some of the deadlines enumerated actually derive from global frameworks: The 2017 target for the elimination of kala azar and filariasis, for instance, is mandated by the WHO. Even so, the insistence on deadlines is welcome. As new scourges replace the epidemic killers of old, public health in India has suffered for want of a regime for early detection. However, the government must be aware that a refocus on new disorders draws attention away from programmes against older threats to the poor — filariasis was supposed to be history in 2015, but is still out there.
The prime minister has also provided a welcome antidote to the rather unusual statement of the minister of state for Ayush, Shripad Naik, who had claimed that yoga can cure serious diseases, including cancer, and that the government would back his claim with scientific evidence within the year. Yoga and other wellness regimes play a significant role in reducing the burden of disease and help in the management of existing disorders. They should be worked into the health system, in tandem with established medical protocols. But alternative methods cannot replace mainstream protocols wholesale.
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