Before it’s too late India needs to get into top gear to fight diabetes
India’s transitioning disease burden, from communicable to non-communicable diseases (NCDs), has left more than 53 per cent of the country’s people in the grip of chronic illness. Diabetes, cancer, cardiovascular disease and hypertension are the four most detrimental diseases, causing 60 per cent of the total deaths in India.
The Government of India has recognised the threat from the growing health burden of non communicable diseases to the social and economic wellbeing of the society. In response it has initiated several measures to address the growing burden of NCDs. Including the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) for interventions up to district level under the National Health Mission (NHM). However, the disease burden still remains high due to increasingly unhealthy, sedentary lifestyles and increasing consumption of processed foods.
Diabetes capital of the world
With more than five per cent of the population suffering from lifestyle related type 2 diabetes, India has been called the diabetes capital of the world. The World Health Organization (WHO) estimates that the number of diabetic cases in India will increase from 51 million people in 2010 to 87 million in 2030, a 58 per cent increase1. The WHO also reports that 80 per cent of diabetes deaths currently occur in low and middle-income countries and these deaths are expectd to double between 2016 and 20302. According to the International Diabetes Federation (IDF), the estimated cases of diabetes in India in the age group of 20-70 years were 66.8 million and 69.1 million in 2014 and 2015 respectively3.
With such a high disease burden to deal with, India desperately needs a coherent, systematic and well planned approach to yield impactful results. It is unlikley that any single entity or organisation alone will be able to deliver sufficient impact, what’s needed instead is a multi-sectoral approach with high involvement of several government departments, non-governmental organizations, media and individuals.
National blueprint for action
Defining a clear pathway to manage and address the growing burden of NCDs including diabetes, the Partnership to Fight Chronic Disease released a National Blueprint, SANKALP – Disha Swastha Bharat Ki, in October 2015. The National Blueprint makes recommendations for effective policy implementation and promotes a multi stakeholder role in fighting the NCD burden.
Some of the key action points suggested by the Blueprint include encouraging voluntary exercise across all educational institutions and workplaces, providing healthy eating options at subsidised rates in office and school/college canteens, organising annual medical check-up camps for students and employees, and prohibiting the use of alcohol and tobacco in workplaces and educational facilities and banning cigarettes sales in a two kilometer radius of all schools, colleges and offices across the country.Patient education will also be critical if the rising burden of diabetes is to be addressed, as unhealthy lifestyle and dietary habits contribute largely to the medical condition. Low awareness of risk factors, limited access to public health services and poor quality treatment have all contributed to the steady rise in diabetes.
The challenge for India’s healthcare sector are the three A’s – access, affordability and awareness – which are also the backbone of any healthcare system. Diabetes can be easily prevented and controlled through simple lifestyle modifications, which includes adopting the combination of diet, exercise, behavioral modification and stress reduction. There is also an urgent need to create awareness about the chronic disease, resulting in early detection of NCDs.
India’s level of public spending on health remains one of the lowest in the world. Substantial investment in public health services is needed if India is to secure access to basic health services and medicines to create a stable and secure environment for its people.
Aman Gupta is the Managing Partner at SPAG Asia, a specialized advocacy and government relations firm. He is also the Country Representative of Partnership to Fight Chronic Disease (PFCD). He is an associate of Baird’s CMC and consultant with Hyderus Cyf.