India's health budget among the smallest globally; maternal mortality rate one of the highest in South Asia: WHO

India grapples with one of the highest Maternal Mortality Rates (MMR) in South East Asia, has one of the highest incidences of Neglected Tropical Diseases (NTD) but has one of the smallest health budgets globally, a new World Health Organisation (WHO) report shows.

The MMR for India is 174 per 1,00,000 live births which is higher than Bhutan, Sri Lanka, Maldives, Thailand and Indonesia among the WHO-designated South East Asia Region (SEAR), says the World Health Statistics 2017 report, released ahead of the World Health Assembly to be held at the end of this month.

The healthy life expectancy at birth for India is 59.5 years. This is lower than all figures in the neighbourhood but for Pakistan, which has a health life expectancy of 57.8 years.

The neo-natal mortality rate is around 37 and the under-five mortality rate is 47.4 per 1,000 live births.

Representational image. Getty Images

Representational image. Getty Images

With 4,97,396, who needed interventions for NTD in 2015, India topped the list on this count among the SEAR countries. NTD comprises diseases like leprosy, kala-azar, river blindness and rabies. The high number is also because of India’s large population size as compared to its smaller neighbours. But the number remains huge even if one compares it to China which had 26,101 patients needing interventions for NTD in 2015.

There is a 23.3 percent chance of dying from a non-communicable disease (NCD) — cardiovascular disease, cancer, diabetes, chronic respiratory disease — between the age of 30 and the exact age of 70 if you are born in India. This is one of the highest in South East Asia. The WHO has been recording a spike in NCD in middle-income and developing countries. India’s percentage is comparable to Russia (29.3), Pakistan (24.7), South Africa (26.5) but higher than China (18.3) and Brazil (16.9).

India has the highest mortality rate in South East Asia owing to the lack of water, sanitation and hygiene (WASH) at 27.4 deaths for 1,00,000 population as per 2012 data.

Mortality rate attributed to household and ambient air pollution is 133.7 per 1,00, 000 population in India, again, according to 2012 data and is only less than North Korea among SEAR countries. This is more than the rate for almost all African nations except Sierra Leone as well as Afghanistan. But it remains lower than China.

The suicide mortality rate of 15.7 per 1,00,000 people in India as per 2015 data is more than many war-torn African nations like Nigeria and South Sudan but is comparable and less than many European nations like Sweden and Poland. China, with its large population, has a rate of 10 per 1,00,000 people.

Stunting among Indian children is one of the highest in the world and lower only than Timor-Leste in SEAR.

Only 34 percent of the Indian population relied on clean fuels as of 2012.

In spite of such concerning numbers, the General Government Health Expenditure (GGHE) as percentage of government expenditure in 2014 of five percent was one of the lowest in the world, and the same as Angola. The GGHE has gone down further since 2014. Compare this with other BRICS countries: Russia (9.5), China (10.4), South Africa (14.2) and Brazil (6.8). Switzerland is one of the highest spenders on health in Europe with a whopping 22.7 percent invested as health budget.

A separate report published on Thursday called the Global Burden of Disease in TheLancet that assesses the mortality rate from 1990-2015 for 32 diseases that should not cause death gives India a lower health care index than Sri Lanka, Nepal, Bhutan and Bangladesh.

Global numbers

As many as 2.1 million people were estimated to have become newly infected with HIV in 2015 and an estimated 1.1 million people died of HIV-related illnesses.

The global under-five mortality rate in 2015 was 43 per 1,000 live births, while the neo-natal mortality rate was 19 per 1,000 live births – representing declines of 44 percent and 37 percent respectively compared to the rates in 2000.

Tuberculosis (TB) “remains a major global health problem” with an estimated 10.4 million new TB cases and 1.4 million TB deaths, with an additional 0.4 million deaths resulting from TB among HIV-positive people in 2015, says WHO.

Globally in 2016, there were 155 million children under the age of five who were stunted (too short for their age), 52 million wasted (too light for their height) and 41 million overweight.

The number of global deaths in 2015 attributable to hepatitis is estimated to be in the order of 1.3 million.

The number of global deaths in 2015 attributable to hepatitis is estimated to be in the order of 1.3 million with about 257 million people living with hepatitis B virus infection, and 71 million people were living with hepatitis C virus infection.

In 2015, of the total of 56 million deaths, about 40 million deaths occurred due to NCD, accounting for 70 percent of all deaths.

Majority of such deaths were caused by the four main NCDs, that is, cardiovascular disease (17.7 million deaths accounting for 45 percent of all NCD deaths); cancer, 8.8 million deaths (22 percent); chronic respiratory disease (3.9 million deaths which is 10 percent of all deaths); and diabetes (1.6 million deaths which is 4 percent of the total NCD deaths).

In 2014, 92 percent of the world population was living in places where WHO air quality guideline standards were not met.

Published Date: May 20, 2017 01:15 pm | Updated Date: May 21, 2017 01:14 pm

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