Cardiovascular diseases in India
Challenges and way ahead
In the last couple of decades the disease burden across the world has shifted from communicable diseases to non-communicable diseases (NCDs). Moreover, a majority of people suffering from NCDs reside in the developing countries. These nations, not having completely dealt with the scourge of communicable diseases yet, are now facing the additional burden of NCDs. The already inadequate and stretched healthcare systems in these countries has meant that the mortality from NCDs is also higher, with more than 80% of premature deaths occurring in low and middle-income countries.
Cardiovascular diseases (CVDs) were once thought to be impacting the rich and affluent, but it is now well established that they afflict the poor as well. While changing lifestyles, unhealthy eating habits and declining physical activity are the key reasons for high incidence rates in the rich population, the issues of access and affordability account for higher mortality amongst the urban poor and rural population. These diseases impact not only the well being, but can also hold back the economic growth of the country due to increased healthcare expenditure and diminished productivity. India is projected to lose approximately USD 236 billion between 2005-2015 due to CVDs and diabetes.
To address the issue of rising CVDs, urban India has made considerable progress in delivering high quality diagnostics and interventional cardiac care. Indian hospitals perform heart surgeries with outcomes that are comparable to the best in the world. However, this level of care is available only to the select few – those that can access and afford it. Though Indian hospitals conduct over ninety thousand heart surgeries a year, this is a small fraction of the 2.5 million required.
While there is increasing availability and focus on curative care in urban areas, this alone cannot solve the problem of CVDs. There is a need to focus on prevention and early diagnosis. The solution to this problem does not lie with the healthcare providers alone. There is an urgent need for the Government, urban planners, educational institutions, employers, food and beverage industry, and wellness and fitness players to take up the challenge and work towards behaviour and life style changes through positive and negative reinforcements.
The issue in rural India is relatively more complex and is one of improving awareness, access and affordability. The lack of awareness coupled with the inadequate access to diagnosis leads to a very large number of patients needing tertiary care. The shortage of such high end facilities as well as their inability to pay, leads to high mortality among the rural population.
To tackle this problem there is need for innovation across the cardiac value chain and collaboration amongst the various stakeholder groups including the Government, providers, pharmaceutical companies, medical technology firms and health insurers. There has been some movement in this direction, with the Government launching the National NCD programme which focuses on prevention and awareness, and sporadic examples of innovations in medical and mobile technology that allow early detection and monitoring. There are also examples of models of affordable cardiac care interventions. These however need to be scaled up and supported.
ASSOCHAM’s International Heart Protection Summit is an ideal forum to bring together all the potential stakeholders in this arena and discuss the way forward. Deloitte is privileged to collaborate as the knowledge partner for the conference.