Chairman, IIHMR University, Jaipur
India is slated to become the third-largest economy in the world within a decade, according to various global brokerage firms like Morgan Stanley and Bank of America Merrill Lynch. However, in contrast to that, the country is also saddled with the third-largest population base of HIV+ people globally. India had a whopping 21 lakh people with AIDS in 2014, according to a report by the UN. But AIDS is just one example. The disease burden that our country is weighed down with comes across rather starkly with the growing economic prowess of the country, and threatens to jeopardise India’s chances of breaking into the top global league of nations. The starkness shows in the current rankings. At the moment, even though India is the fourth-largest economy, its current ranking in the healthcare index is 154th out of a total of 195 countries, according to a study published in the medical journal The Lancet.
There are a host of diseases and medical conditions that are rising menacingly fast and gaining epidemic proportions. In fact, 6-7 lakh people lost their lives in India in 2012 fighting cancer, according to The Lancet. The year 2012 was not an exception. There are over 10 lakh people who are diagnosed with cancer every year, and the figure is only rising. Worse, cancer is claiming lives of younger people also, with many of them being in their 30s or 40s. The cost involved in the treatment of cancer is huge and often pushes a family into the abyss of poverty. These factors do not auger well in our stride to become one of the wealthiest and most advanced countries. Given the abysmal track record in fighting some of the basic malpractices which are causing deaths in the country, cancer seems to be too advanced a medical problem. About 10% of all deaths among children below the age of five were because of diarrhoea, a problem associated with food contamination, in India. The country is still battling issues of food contamination because of unwanted and unregulated microbial activity especially at roadside food stalls. Then, there are deaths due to heart attacks. India is already being infamously called the ‘the heart attack capital of the world’ and the incidence of heart diseases is increasing by the day. Cardiovascular diseases, in fact, are claiming a humongous 30 lakh lives every year. A whopping 2 lakh open heart surgeries take place every year in India, and there are projections that this number will rise dramatically in the near future.
The heart failure burden in the country ranges from 13 lakh to 46 lakh cases every year, according to the Heart Foundation. The cost involved in the treatment are making families poorer, and hence the society and hence the nation. Here again, the young are losing their lives, depleting the workforce that will be required to make India wealthier. About 25% of all heart attacks in India happen before the age of 40, according to the Indian Heart Association. The number of people living with diabetes in the country is about 5.08 crore, which is the highest in the world, according to the International Diabetes Federation. Indians are getting diabetic at a relatively young age of about 45 years, which increases the lifetime risk of heart disease in them. There are a plethora of diseases that are either causing or threatening to cause a serious dent to the workforce in the country. Non-communicable diseases (NCDs) are straining the financial resources of families, and when the medical insurance penetration is just about 20%, it will definitely have a profound impact on our ability to move forward as a nation. About 63% of the 5.7 crore deaths globally that happened in 2011 took place because of NCDs, according to the World Health Organisation. It is estimated that there will be 15% increase in deaths due to NCDs in the decade 2010-20 globally. The scenario is not expected to be different in India. Over 60 lakh people died of NCDs in the country in 2016. Ischemic heart disease, or the coronary artery disease, was the leading cause of death. Seven of the top 10 reasons of death among all age-groups in India are NCDs, and deaths due to diabetes and chronic kidney disease have increased over the past decade, according to a study published in The Lancet.
India is ranked 127th among 188 countries in terms of achieving UN’s health-related Sustainable Development Goals. India scored poorly in sanitation, air pollution, hepatitis B and child waste. Children’s death below 5 years of age continues to be a grave concern for the country, as the highest number of deaths, at 9 lakh in 2016, was registered in the country, according to The Lancet. The pollution levels are only aggravating the problem at hand. Air pollution can be carcinogenic, increasing the incidence of cancer. Toxic chemicals in the air may contaminate plants along with drinking water, and can enter the food chain, harming humans. There are social costs attached with the menace of pollution. Schools are shut when pollution levels exceed a certain limit in metros and other cities. As a nation, we cannot afford it. We should rather be promoting schooling and education in our quest to become a wealthy, advanced and educated society. A serious attempt has to be made to ensure that people do not fall prey to these diseases and do not require healthcare, or require it the least. It can be done by making physical education a must till class 12th in schools, discouraging fast food or at least limiting fat content in fast food and snacks, and incentivising good health through cheaper or subsidised public utilities like electricity and water. Greater regulation of quality of roadside food and other places should be introduced. Pollution has to be curtailed on a war-footing.