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Published on: March 30, 2022, 11:47 a.m.
Tackling non-communicable diseases
  • Sri Sathya Sai Central Trust at Prasanthi Nilayam delivers comprehensive healthcare completely free of cost

By Dr. V. Mohan. The author is Chairman, Dr. Mohan’s Diabetes Specialities Centre & Madras Diabetes Research Foundation

Until recently, communicable diseases contributed to over 60 per cent of all deaths globally. Today, they contribute to less than 40 per cent of all deaths. However, non-communicable diseases (NCDs) like diabetes, hypertension, heart disease, cancers, and mental health contribute to 55-60 per cent of deaths in most countries, including India. Diabetes is an excellent example of measuring the burden due to NCDs in a country. The reason is that it is extremely easy to measure the prevalence of diabetes even using a simple hand-held glucose meter and thereby get a good handle on the burden of NCDs in general. 

According to the 10th Diabetes Atlas published by the International Diabetes Federation in December 2021, there are 74 million people with diabetes in India. The rise in NCDs like type 2 diabetes is driven essentially by lifestyle changes, particularly, unhealthy diets and lack of physical activity. It would be tempting for someone to say, ‘why can’t people just eat healthy diets?’ One must appreciate that ‘healthy foods’ like fruits, vegetables, and nuts are expensive and often beyond the reach of the common man. This leads to consumption of fast foods and junk foods, which are mass produced, and therefore cheap. This has resulted in a massive increase in obesity rates, which is the forerunner of diabetes, hypertension, heart disease, and even some forms of cancer. 

Physical inactivity is another major driver of the epidemic of NCDs. Again, it is wrong to assume that it is because people are lazy, that they don’t do any physical activity. The truth is that we do not have safe environment for people to walk or exercise. Our cities are polluted. There are no safe footpaths for people to walk and the greenery, the so-called ‘lungs’ of every city are fast disappearing and being replaced by concrete jungles. It is no longer safe for children to play outside their homes, and playgrounds are being rapidly converted into commercial buildings. The increasing pressure on children and youngsters to perform academically leads to mental stress, which is the underlying cause for anxiety and depression, resulting in high suicide rates. 

Thus, it is clear that a completely new paradigm using a multi-sectoral approach needs to be urgently adopted by policy makers, healthcare administrators, governmental and non-governmental agencies, educational institutions, and various ministries including agriculture, health, education, and sports, if the epidemic of NCDs is to be slowed down. The introduction of Yoga, Pranayama, and meditation right from the school level will help to improve physical and mental health. Apart from academic excellence, importance must be given to sports and extracurricular activities for entry into professional and other courses.

Due to advances in technology, healthcare costs are rising astronomically. As much as 70 per cent of healthcare in India is ‘private’ and therefore out of reach for many people. On the one hand, we promote medical tourism, on the other hand, our own countrymen are unable to afford high quality healthcare services. The introduction of universal healthcare with medical insurance coverage for the masses, can ensure that people do not fall into the ‘debt trap’ due to poverty. Schemes such as Ayushman Bharat taken up by the Government of India could be ideal solutions to offer optimal healthcare to people. Universal health coverage would include financial risk protection providing essential healthcare services and medicines, and also accessibility to safe, effective and affordable medicines for all as proposed by the World Health Organization. 

A look at the SDG India Index 2020-2021 and the performance of the states, as published by the NITI Aayog shows huge discrepancy in the achievement of SDGs between different states. We must ensure a more equitable distribution of healthcare indices in all states of India. 

The National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Disease and Stroke (NPCDCS) was launched in 2010 as part of the National Health Mission (NHM). The programme focuses on strengthening infrastructure, human resources development, health promotion and awareness generation for prevention, early diagnosis, management, and referral to an appropriate level of healthcare facility for treatment of NCDs. Under NPCDCS, 677 NCD clinics at district level, 187 district cardiac care units, 266 district day-care centres, and 5,392 NCD clinics at community health centre level have been set up to ensure the treatment of common NCDs. In addition, NPCDCS gives financial support under NHM for awareness generation activities.

  • On the one hand, we promote medical tourism, on the other hand, our own countrymen are unable to afford high quality healthcare services. The introduction of universal healthcare with medical insurance coverage for the masses, can ensure that people do not fall into the ‘debt trap’ due to poverty

Healthy eating is also promoted through FSSAI. The Fit India Movement implemented by the Ministry of Youth Affairs and Sports, and various yoga related activities carried out by the Ministry of AYUSH are noteworthy. 

A model for comprehensive healthcare: An excellent example of how comprehensive healthcare can be delivered completely free of cost in a holistic and humane manner and sprinkled with a large dose of spirituality and empathy, is demonstrated by the Sri Sathya Sai Central Trust at Prasanthi Nilayam which runs Super Specialty Hospitals and General Hospitals at Puttaparthi (Andhra Pradesh) and Whitefield in Bengaluru, which treat several lakh patients every year, completely free of cost. Nearly 1 crore out-patients and in-patients have been treated in these institutions since their inception. 

Models such as this can be replicated as India has enough resources and philanthropists and corporates who can come forward to help India achieve the SDG health indices. Each corporate can identify one key area to support. Examples include promotion of healthy diets and physical activity, and stress reduction. Even small steps in these could play a big role in bringing down the mortality and morbidity due to NCDs in India. 

With the emergence of telemedicine, it is now possible to reach the rural poor in remote areas of India. Again, the experience of Sri Sathya Sai Medical Mission is worth mentioning. Telemedicine centres were set up in Odisha, West Bengal, and Madhya Pradesh. This helped in regular follow up of patients who had been treated at the Super-Specialty Hospitals at Puttaparthi and Whitefield, and patients who needed to be referred again for further treatment. Such successful programmes can be adopted by others to ensure long-term follow up of patients who need chronic care.

Corporations can play a big role in spreading important public health messages through social media as well as print and electronic media, as their reach is huge. I am confident that if the business leaders come together to tackle NCDs and also join hands and support the government, mortality and morbidity due to NCDs can be drastically reduced. This will not only help achieve SDG-3 targets, but also improve the quality of life of millions of people in India.

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