Editorial: Step up healthcare spending
The WHO report is a grim reminder of the true scale of the threat posed by non-communicable diseases
With one of the worst indicators in the world, India’s healthcare sector needs urgent treatment. Accounting for just 1% of the GDP, the country’s healthcare spending is one of the lowest in the world while maternal and infant mortality rates and deaths due to non-communicable diseases (NCDs) are among the highest. According to the latest report by the World Health Organisation (WHO), over 66% of all deaths in India can be attributed to non-communicable diseases, with cardiovascular diseases accounting for 28% of these deaths and chronic respiratory diseases 12%. In 2019, India had one of the highest death rates from chronic respiratory diseases. Tobacco use, unhealthy diet, harmful use of alcohol, physical inactivity and air pollution are the main risk factors contributing to these conditions. Increased public investments to prevent and treat these diseases can reap major economic benefits for society. Over 60.46 lakh people died due to NCDs in 2019 in India and the probability of 30-year-old-people in the country who would die before their 70th birthday due to NCDs is 22% while it is 18% at the global level. The WHO report is a grim reminder of the true scale of the threat posed by NCDs. The clock is ticking towards the 2030 deadline for achieving the Sustainable Development Goal target to reduce premature mortality from NCDs by one-third. Currently, India is very far off track. Over 25.66 lakh deaths in 2019 in the country were due to cardiovascular diseases while 11.46 lakh deaths were due to chronic respiratory diseases. Cancer led to 9.20 lakh deaths while 3.49 lakh deaths in the country were attributed to diabetes.
What is significant is that most of these premature deaths are preventable, with timely clinical interventions, lifestyle modifications and better nutrition. The largest burden of NCDs falls on low- and middle-income countries, which account for 86% of these premature deaths. The pandemic took an especially heavy toll on the people living with NCDs, highlighting how these diseases undermine the very foundations of good health. Patterns emerging from Covid management across the country indicate that people with co-morbidities of NCDs have a higher mortality rate than those who do not. This has grave implications for the country not only because of mortality and years of healthy lives lost but also because of India’s health infrastructure. There is a need for robust health system programmes that help in early detection, controlling risk factors early and treating diseases in a cost-effective manner. The NCDs need to be accorded higher priority in financial allocation, with a strong emphasis on primary care. The pandemic has exposed India’s creaky healthcare system and abysmally low public spending. The budgetary spending on the healthcare sector must be increased substantially.
