Battling Development Challenges

India is known to have poor health statistics and indicators in the global context, even when compared with many other developing countries. For the vast majority, the key barriers to good health are not the lack of technology but poverty and lack of access to healthcare.

Healthcare facilities in urban India continue to be inadequate with over 180 million urban poor having only 1,083 family welfare centres to diagnose their diseases. At least 300 additional urban health and family welfare centres need to be set up annually to cater to the needs of 215 million urban poor by 2020, says a report by the Associated Chambers of Commerce and Industry of India (ASSOCHAM).

Historically, India has spent far too little on health, partly because health has not been seen as a “productive” part of the economy and also because of low national income. But income growth in India should mean that it is now able to increase its public spend.

Rapid economic growth does not guarantee rapid improvements in healthcare or health outcomes. Current income growth in India is accompanied by the increasing prevalence of chronic diseases such as diabetes mellitus, cardiovascular disease and orthopaedic disorders, health threats that pose considerable challenges to the fragile healthcare system in the country. The fallout of chronic diseases does not simply translate into major health repercussions, but also economic and financial costs.

The prevention of chronic diseases is a clear necessity. Basic preventive measures can significantly address the burden of chronic diseases in this country. The five constituents of this non-pharmacological approach entail avoiding central obesity, consuming unrefined foods, abstaining from smoking, keeping salt intake low and exercising daily.

Despite the notion that these are diseases of the affluent, much of the burden of chronic diseases and their risk factors is concentrated among the poor.

Effective control of chronic diseases can reduce poverty by upping productivity and resultant income. The inequity currently prevailing between the economically advantaged and the economically deprived is telling: whereas those not classified as poor spend around four percent of their annual incomes on healthcare, the poor expend approximately 25 percent of theirs on health-related services and products.

A single sector cannot tackle this issue. Only collaboration between various sectors, organizations and thought leaders can bring about change. It is within the private sector’s ambit to set an example by enhancing the accessibility of medical assistance to the urban poor. This must be coupled with governmental backing to make medicines and other essential items available at an affordable rate at urban healthcare centres; renovate urban hospitals and dispensaries by properly equipping them with adequate manpower, essential drugs and supplies; and establish and promote public-private partnership to ensure the urban Poor’s access to healthcare services.

Community involvement is the key to success. A health worker positioned in every poor urban pocket can assist in ensuring that healthcare services reach the community. The government and communities must work together to establish a viable food economy to which the poor can gain access, promote environmentally friendly urban agriculture, create the necessary infrastructure for a clean and healthy physical environment and disseminate information about good health and nutrition practices.

Much of what we know about chronic disease will be greatly enhanced by priority research on the relationships among known risk factors, such as smoking, blood pressure and blood lipids, but also by a better understanding of the complex interactions of obesity, diabetes, urbanization and vascular disease and the beneficial implications of low-cost combination drug therapy for vascular disease and diabetes. It is critical that information about risks is created and then communicated to and used by the public.