The challenge of non communicable disease
The findings of the National Family Health Survey-4 bring good news: infant mortality has fallen, the sex ratio has improved and vaccine coverage has spread. It also brings bad news: non-communicable diseases are gaining ground — the incidence of diabetes is 20.3 per cent and that of hypertension, 22.2 per cent. These, once regarded as the diseases of the rich, call for new thinking and an innovative response. These chronic diseases, left medically unmanaged, increase the possibility of infectious diseases. That at least one-fifth of the population suffers from chronic diseases making them vulnerable to infectious, life-threatening diseases presents a public health challenge. The Indian healthcare system, though woefully inadequate in terms of access and delivery, has been more concerned with tackling infectious diseases. While these can be tackled through mission-mode vaccination efforts, diseases like hypertension and diabetes require sustained medical care, besides lifestyle modification. Given the high levels of out-of-pocket expense in healthcare, coupled with poor access and delivery, the poor are more likely to go without medical care, leading to higher instances of disability that would impact their productivity and income earning capability, besides pushing them into a debt trap as they borrow to treat illnesses. The government needs to focus on improving healthcare access and delivery, ensuring availability of medical personnel and affordable medicine to manage chronic ailments. It needs to take serious measures to improve sanitation and address air and water pollution that contribute to aggravate non-infectious diseases. All this requires higher levels of investment, smart policy, leveraging of available funds and accountability in the system.
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