New Delhi: In the first initiative of its kind, the Indian government has started a programme to prevent as well as map the extent of diabetes, cardiovascular diseases and stroke—chronic ailments that could cause life expectancy in the country to fall and have economic implications as well.
Creating awareness: Planning Commission deputy chairman Montek Singh Ahluwalia with health minister Anbumani Ramadoss during the launch of the pilot programme in New Delhi on Friday.
Launched on a pilot basis in seven states—Assam, Punjab, Rajasthan, Karnataka, Tamil Nadu, Kerala and Andhra Pradesh—for the first year, a budget of Rs1,620.5 crore has been allotted for the national programme to check these diseases in the five-year plan to fiscal 2012.
“This marks the transition from focusing largely on the Big Three (HIV, tuberculosis and malaria) to Big Five (diabetes, cardiovascular diseases, stroke, cancer and chronic lung diseases),” Union minister for health and family welfare Anbumani Ramadoss said at an event to launch the programme. Experts in his ministry feared “life expectancy in India could actually fall” on account of these diseases, he added.
According to the World Health Organization, the “Big Five” accounted for 53%, or 5.47 million, of the total deaths in India. K. Srinath Reddy, president of the Public Health Foundation of India, estimates the country could lose 18 million man years in 2030 on account of the ailments, double the number lost in 2000.
“Educational interventions that target behavioural change are important, but not sufficient. They need to be buttressed by policy interventions,” said Reddy.
The national programme—in the pilot stage, it will be run in one district in each of these seven states— has a three-pronged strategy. It will focus on surveillance or assessment of the prevalence of risk factors through Non-Communicable Diseases (NCD) cells established at the state and district levels. The surveillance will analyse tobacco consumption habits, blood pressure, body mass index, NCD mortality and episodes of stroke and paralysis in the population. The other two components are health awareness programmes for the general population and focused diagnosis, screening and disease management counselling for high risk sections as well as those suffering from these ailments.
“Awareness is a major problem with up to 60% population even in metros not knowing how to prevent diabetes. Out of every Rs100 spent in the programme, three quarters should be only spent on creating awareness on the risk factors,” said Delhi-based diabetologist Anoop Misra.
Another concern is the increasing incidence of diabetes and hypertension—two critical conditions leading to cardiovascular diseases—in rural areas, said Misra, due to urbanization, nutrition switches to high fat diets, migration and reduced physical activity.
Recognizing that these so-called “lifestyle diseases” no longer affect only the rich in urban setting, the new programme will be scanning the rural areas extensively.
One health activist said the government was trying to pack too much into the programme. A. Ramachandran, president of India Diabetes Research Foundation, called the Rs1,650 crore budget “a drop in the ocean”.
“The government has also diluted the programme by clubbing three diseases together. This may dissipate focused effort on diabetes which is a big problem for India,” he said, adding the US, UK and Australia had dedicated national diabetes programmes.
Allaying apprehensions on funding, minister Ramadoss said, “The outlay for health ministry has gone up to Rs136,000 crore in the Eleventh Five-Year Plan, up from Rs45,000 crore in the last, so funding is not going to be a hurdle at all.” The five-year plan runs between 2007 and 2012.