Can India Lead The Way In Managing The Growing Burden Of Cardiovascular Disease?

While India is paving its way towards becoming one of the world’s leading economies, there is one key area where it is lagging woefully behind: healthcare.

In particular, the rising burden of chronic non-communicable diseases (NCD) that primarily includes cardiovascular diseases, cancers, chronic respiratory diseases and diabetes. 63 percent of all deaths in India can be attributed to these NCDs. 27 percent of all mortalities from non-communication illnesses can be attributed to cardiovascular diseases. Estimates indicate that the spending required to combat them will be around $4.8 trillion by 2030.

Of all non-communicable diseases, cardiovascular disease is the leading cause of mortality and are a collective term given to different kinds of heart ailments, stroke and diseases of blood vessels nourishing the limbs. Of all the different types, coronary artery disease and strokes account for the maximum number of deaths.

This increasing ‘cardiac crisis’ in the country can be attributed to five major factors including bad food habits (54.4 percent), hypertension (56.6 percent), air pollution (31 percent), high cholesterol (29.4 precent) and tobacco usage (smoking in particular) (18.9 percent). CVDs affect men and women alike. However, in a large number of cases, the symptoms don’t manifest until a very advanced stage, thus making the disease difficult to diagnose and treat.

Prevent, don’t treat
One of the drawbacks of the healthcare system in India has been the focus on treatment rather than prevention. However, there has been a positive change in this trend with the new generation becoming more invested in their holistic wellness – including their food habits. The health-tech sector has shown a lot of growth with several technological innovations. Clinical studies indicate that digitally-enabled cardiovascular interventions have the potential to improve outcomes for patients and reduce hospital readmissions by 23 percent.

Wearable and portable devices are now available to help keep a track of vital parameters such as blood pressure, ECG, blood sugar, etc. Most of the major diagnostic and healthcare service providers now provide ‘at-home care’ for those suffering from health conditions like CVDs apart from services that facilitate monitoring and management of triggers including stress and anxiety. Consumers are also becoming increasingly focused on tailor-made packages and organic/natural healthcare products. It is now possible to use technology to deliver care and medical advice without requiring a person to step out of their homes.

The Government lends a hand
The government is also doing its part in improving access to affordable and quality healthcare. Last year, under the landmark Ayushman Bharat Yojana, it was announced that 1,50,000 primary health centres would be converted into health and wellness centres. This will be particularly helpful given the fact that early detection is the key to managing chronic diseases and saving lives. When primary care is strengthened through health and wellness centres, and appropriate referral linkages are made with secondary and tertiary levels of healthcare, it can help bring about a ‘prevention before cure’ approach.

India has also recently considered a National Essential Diagnostics List (EDL), a country-specific set of tests for detecting common morbid conditions and priority diseases in the country. This list is expected to build on the initiatives of the Health Ministry in terms of providing an expanded basket of tests at different levels of the public health system in India. Drafted by the Indian Council of Medical Research, the list is in line with the WHO’s first-ever Essential Diagnostics List published in May 2018. This is expected to provide the much-needed direction for tackling the burden of CVDs in the country.

Apart from this, India is also one of the 130 countries to have a national-level essential medicines’ list (EML). This is a list that mentions medicines that satisfy the priority health care needs of the population. Essential medicines are selected with due regard to disease prevalence, evidence on efficacy and safety, and comparative cost-effectiveness. This list guides the safe and effective treatment of priority disease conditions; helps promote the rational use of medicines and optimizes the available health resources. Given that no other country has officially adopted an EDL, India can lead the way not only in this but also in managing CVDs. Diagnostic tests, just like medicines, are an important aspect of improving healthcare delivery and can help in effective diagnosis and management of CVDs.

The Indian healthcare industry is moving into a more holistic preventive healthcare model.

We are witnessing a successful transition of the Indian healthcare industry from remedial care to a more holistic preventive healthcare model. Alternative systems of medicine are increasingly being accepted as they can sometimes offer the only kind of solution within the physical and financial reach of the patient. Technology is proving to be an enabler in access to diagnostics and medicines. The need of the hour is a concerted effort by both the government and private entities in managing NCDs – particularly CVDs.

Question is, can India accomplish this tall order?

The author is a medical advisor at Agatsa. – First Post