The Indian healthcare system showcases a strong bias towards curative rather than preventive care. This reliance on a treatment model is evident from the insufficient number of screening and surveillance programs marking the undertone of the healthcare delivery model. I believe there is a strong need to change the focus of our health plans diametrically and move from treatment model to preventive model.
The establishment of disease surveillance programs for a timely response to outbreaks will not only facilitate in catching any illness young but also minimize the cost burden of these diseases along the treatment cycle, therefore strengthening the healthcare system in its totality.
In 2015-16, only 3% of the total health budget was earmarked for NCD programs. This needs to change.
I have a variety of reasons to call for increased focus on prevention.
Firstly, over the past few years, India’s disease profile has changed drastically from communicable to non-communicable diseases, which now account for 53% of the disease burden and 60% of total deaths in the country. These lifestyle diseases are mostly preventable, and even in the cases where there is a strong genetic connect, they can be delayed and pared down substantially, provided prevention is where our focus is.
Secondly, this way the limited resources our country can spare for health can be stretched to the maximum, and cover a much wider section of people. The shooting figures of the disease burden and deaths in the country are not met with equivalent figures of public spend on healthcare. Low public spends are driving an escalating number of people towards NCDs and leading to high out-of-pocket expenses that are pushing millions of Indians to poverty. It’s a fact that contrary to India’s strong economic growth over the years, its spend on healthcare is still pegged at a little more than 1% of the GDP. Also, despite the changing disease profile, the majority of the funds are spent on reproductive, maternal and child health programs and on communicable diseases, with little allocation for NCDs. In 2015-16, only 3% of the total health budget was earmarked for NCD programs. This needs to change. And switching to a prevention format will help bring about this change to quite an extent, by stretching resources much further.
To make the necessary shift in social behaviour and begin instilling “healthy living” as a norm, it is essential to start the interventions at a youth level.
Thirdly, if patient-cure policies are revised to include preventive-care policies, the move will ultimately lower the cost of health services for those with chronic disease and subsequently reduce the cost of insurance operations, including a reduction in claims. Ignoring preventive care only means that the chances of disease progression and complications requiring hospitalization are inevitably higher.
For the prevention mindset to work, we need to catch people young. To make the necessary shift in social behaviour and begin instilling “healthy living” as a norm, it is essential to start the interventions at a youth level. While policy shift from curative to preventive care is important, we also need to work on war levels to promote healthy habits as the only way to live. Some suggestions: encourage voluntary exercise or yoga across all educational institutions, healthy food items and menus must be chalked out by state-identified nutritionists, in line with WHO recommended sugar, salt and trans-fat content, and these should be communicated extensively via talks, social media and other mediums.
Strategic public-private partnerships can and must be tapped to help prioritize NCDs and preventive care by infusing more funds, attracting active global involvement and creating necessary policies to help reversal from the debilitating scenario we are currently facing in the health sector.
We all — the government, medical fraternity and industry — need to work together to change the health status scenario in the country.
Partnership to Fight Chronic Disease (PFCD)