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India faces new health threat

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 growing health and economic impact of NCDs can be averted. 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.

Experts claim that ill health is directly proportionate to poverty leading to an impregnable vicious cycle in countries such as India. According to WHO World Health Statistics 2012, 39 million Indians are pushed to poverty due to diagnostic and treatment costs every year4. The report also claimed that nearly 60 per cent of total health expenditure in India was paid by the common man from his own pocket in 2009. Also, about 47 per cent and 31 per cent of hospital admissions in rural and urban India were financed by loans and sale of assets.

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.

Past initiatives of the Government of India have seen policy premiums priced as low as Re1 per day and Rs. 5 or Rs. 10 per month. While such schemes have been welcomed, they have faced key implementation barriers, such as lack of qualified healthcare service providers and proper understanding of the concept of health insurance.

Salvaging India from this fast ticking time bomb needs a realistic policy intervention, efficient surveillance, robust healthcare financing system and last but not the least, strengthening the existing healthcare systems. But what is equally important is for the states to be innovative with the implementation of the action plan. States are the custodian of India’s health – Innovative mechanisms, cross-functioning of existing resources and effective surveillance mechanism adopted by state governments is the solution to safeguard India from NCDs

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.

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