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Wanted: a roadmap to tackle non-communicable diseases

KENNETH THORPE A report that will be released later this month underlines the need for an evidence-based action plan to treat NCDsSeptember brought good news for India. It emerged a top foreign investment destination, leaving behind the United States and China.It also showed an improvement on the global competitiveness index — reflecting the success of India’s policy initiatives.But India’s population and its healthcare challenges are increasing and diverse. And though the draft Health Policy did well to include non-communicable diseases (NCDs), sadly there is one gaping hole in most conversations on the subject — a universal chronic diseases management framework.Raising awarenessUnder the Partnership to Fight Chronic Disease (PFCD), we have been working in India over seven years to understand and raise awareness on NCDs. Later this month, the PFCD will release a national blueprint in consultation with NCD experts from across India to help address and manage the problem through improved surveillance, data and intervention.A look at the disease landscape in India reveals why this is important. The country is experiencing an epidemiological transition from infectious to chronic diseases with over 20 per cent of the population in India having at least one chronic disease and more than 10 per cent have more than one (see infographic).It’s well known that behavioural changes, eating habits, lower physical activity, increasing rates of smoking and alcohol intake and other high-risk behaviours have resulted in this significant rise in the burden of NCDs, and the related increase in health-care costs. Focused actions can make a difference in affecting the growth of illnesses like heart disease, lung diseases and diabetes.Given the magnitude and complexity of the NCD burden, the central point of India’s future health strategy should be the formation of an evidence-based action plan for the government and private sector towards achieving superior healthcare outcomes.For instance, people are not aware of the importance in early diagnosis and prevention of NCDs. Establishing a separate nodal body for NCDs, revising policies to reduce alcohol and tobacco consumption, devising an effective monitoring and surveillance framework are a few possible solutions to tackle NCDs.Scattered and varied epidemiological data is a hurdle in monitoring NCDs. An important first step in addressing the growing burden of NCDs is to measure it appropriately.It is also important to strengthen health information systems through robust surveillance to identify key disease hubs and generating data that can be used as a basis to formulate corrective measures.Patients with more than one NCD require a comprehensive treatment plan delivered by a multi-disciplinary health professional team.Hence, a patient-centric approach rather than a disease centric approach is the need of the hour.Integrated treatment and management guidelines should be formed outlining the best practices in prevention and chronic-care programs. In line with this, it is important to train health workers at the primary, secondary and tertiary levels.Increased expenditureThe need for increased public expenditure on healthcare and encouraging private investment in the healthcare sector cannot be emphasised enough. Public insurance and expansion of commercial insurance are small steps in helping the patient during treatment.These guiding principles should form the foundation to develop a policy for a universally “effective” healthcare system that delivers patient-centred quality care.But its real efficacy will, however, depend upon its verifiable implementation.Source: writer is Chairman, Partnership to Fight Chronic Disease and Chair with the Department of Health Policy & Management, Rollins School of Public Health, Emory University, US. Views expressed are personal.