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Home / Politics / Policy /  Government reviews plan to keep non-communicable diseases in check

New Delhi: Even as non-communicable diseases (NCDs) account for 53% of deaths in India, a central government scheme to address them is facing poor implementation, as states sat on health budgets for the last two years.

The National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) was launched in 2010 with the stated purpose of checking these diseases.

The initiative includes screening and early diagnosis of NCDs, promotion activities to encourage healthy lifestyle habits, strengthening infrastructure like hospitals and health centres, deploying more health professionals like doctors and nurses and increasing access to drugs.

The scheme was proposed to be rolled out across the country by 2017 at a cost of 11,000 crore, of which three-fourths would come from the centre and the rest from the states.

However, in a meeting last week between state health secretaries and the Union health minister, it was noted that states were sitting on around 170 crore of unspent balance at the end of fiscal 2014 accumulated over the last two years.

Andhra Pradesh ( 14.12 crore), Rajasthan ( 10.38 crore) and Uttar Pradesh ( 24.31 crore) have the highest amounts of unspent balance. Other states with high unspent balance include Bihar, Himachal Pradesh, Assam and Tamil Nadu.

The information was part of the meeting’s agenda, which was reviewed by Mint.

“This is happening because of irregular fund flow and lack of clarity of guidelines from the centre. A systematic fund flow mechanism is needed to deal with this issue," said a senior health ministry official, on condition of anonymity.

In the last two years, there has been poor recruitment of personnel, which has also led to poor utilization of funds, the document said.

“For states to better utilize funds, they need to implement capacity building measures. For example, states need to build capacity of primary healthcare centres by hiring more doctors to treat NCDs," said D. Prabhakaran, vice-president, NCDs, Public Health Foundation of India (PHFI).

For improving implementation of the scheme, the centre suggested appointing state programme officers for NPCDCS who will act as focal points for all scheme-related activities, and adding a component for stroke management in the scheme.

According to a World Health Organization (WHO) country profile in 2008, over 5.2 million people died in India due to NCDs, 38% of who were under the age of 60. Of this, cardiovascular diseases accounted for 24%, cancer 6%, diabetes 2%, respiratory diseases 11% and other NCDs 10%. The burden of the disease is rising disproportionately among lower income countries, the report said.

“Today, around two-third deaths in India occur due to NCDs, of which 80% are under the age of 70," said Prabhakaran.

In 2012, 194 WHO member countries, including India, agreed to reduce premature deaths from NCDs by 25% by 2025. However, this is a challenging task which would need the government to provide adequate framework through policies and direct intervention to make healthcare accessible, Prabhakaran added.

“There has to be action at multiple levels like a ban on ads advocating children to eat unhealthy food and increasing tax on smoking and saturated fats. At primary- and community health-centre level, government needs to make drugs affordable and accessible, there should be universal health coverage for acute illnesses and control of risk factors," said Prabhakaran.

NCDs are caused by risk factors like tobacco and alcohol use, physical inactivity and unhealthy diet, including high intake of saturated fats and salt. The other risk factors include stress, obesity, high blood pressure, raised blood sugar and high cholesterol. The government needs to make an enabling environment which leads to more physical activity like creating more footpaths, Prabhakaran added.

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