Shantanu Parihar, Head of Research, Positive Bioscience, in this article opines that as NCDs have the potential to wreak havoc on India’s socio-economic structure, there is a need for stakeholders involved to work together to find solutions
In the past few decades, India has taken considerable efforts to reduce premature deaths and disability caused by communicable diseases such as pneumonia, small pox, diarrhoea, and polio. However, there is scope to focus and invest more in the prevention of chronic non communicable diseases (NCDs) such as diabetes, cardiac problems, and cancer and thereby avoid the significant costs these diseases generate for the individual, the family and the society. In 2014, the Organisation for Economic Co-operation and Development (OECD), cautioned that it saw India’s poor health outcome as a major developmental challenge. India lags in healthcare outcomes not only by OECD standards, but also by the standards of the developing world. Indeed, as per a study done by the World Economic Forum and Harvard School of Public Health, India will lose at least $4.5 trillion before 2030 because of the economic impact of NCD.
Poorly managed chronic diseases such as Type 2 diabetes mellitus, cancer, cardiovascular diseases, and the complications they induce result in significantly high rate of hospital admissions, increasing the cost of care and consumption of healthcare resources, creating a substantial burden on India’s already strained healthcare systems. Besides the significant healthcare burden on the country, chronic diseases also pose a severe risk to the quality of life and productivity of patients.
NCDs are the leading cause of death and disease burden worldwide. India’s weak healthcare system is particularly threatened with this growing problem. The ramifications of growing NCDs are serious and need to be dealt with on a war footing. Its potential to wreak havoc on India’s socio-economic structure means that a wide range of stakeholders involved need to work together to find solutions.
Let’s look at diabetes. Deaths due to diabetes in India doubled in 20 years from 1990 to 2010, this, when the International Diabetes Federation estimates that about 33 per cent of diabetics are undiagnosed, and the Council of Medical Research-India Diabetes (ICMR-INDIAB) has pegged the number of pre-diabetics and diabetics at 139.6 million. All the major NCDs including cardio vascular disorders, present a similar picture.
The possible negative impact of diseases on output, revenue, profitability, business performance, and potential for economic growth can be substantial for the individual, the family, the company and the society. However, as NCDs are erroneously perceived to be ‘diseases of prosperity’, the role and responsibility of creating awareness on screening and prevention to contain this alarmingly growing burden is often not seen as a priority.
Cancer negatively impacts the ability of families to earn an income, with the patient and caregivers having to lose working days to focus on treatment. Combined with high treatment costs, the impact on the economics of the families can be severe. Indeed, as per some estimates, around 39 million Indians are pushed into dire financial situations due to the healthcare costs.
Cancer treatment runs into lakhs of rupees specially when detected in advanced stages requiring expensive treatment, including surgery, new drugs and diagnostics. With the lack of awareness of tests available for risk assessment of cancer, a majority of cancer cases in India are detected at the late stage. This is a cause for alarm. Government of India’s National Cancer Control Programme estimates that there are between 2 and 2.5 million cancer patients in the country at any given point of time.
Let’s look at heart diseases. About 12 per cent of those experiencing heart attacks in India are below 40, while around 20 per cent victims of heart strokes are between the age group of 25 and 40. Together, heart disease and stroke are amongst the most widespread and costly health problems facing the country. On a personal level, the family of the individual who is a victim of heart disease or stroke has to deal with medical bills, lost wages and the real potential of a decreased standard of living. However, economic and social losses due to NCDs are not inevitable. The first step in tackling NCDs is to create an awareness of its prevalence, causes, and prevention.
Interventions that focus on preventive steps such as identifying genetic risks for instance must be incorporated to begin with in the workplace such as health programmes aimed at prevention, early detection, treatment, and care. Higher investment in strong healthcare foundation and early screening for diabetes, hypertension, and cancer, show a good return of investment and those models need to be practiced widely.
An Assocham report on preventive healthcare and its impact on corporate sector stated that ‘One rupee spent on prevention saves Rs 133 in absenteeism costs and Rs 6.62 in healthcare costs’. Reducing ‘out-of-pocket’ expenditure that pushes hundreds of thousands of Indians to below poverty line each year is an issue that must be addressed by the healthcare industry.
Preventive healthcare measures should be part of overall company strategy for a healthy workplace. This can bring down the company’s and the employee’s expenditure on healthcare insurance.
The positive socio-economic impact of preventive health care on well-being of an individual and the potential decrease of total health care expenditure are strong arguments for looking at the healthcare sector from a different perspective—going back to the old adage—prevention is better than cure.