Why India needs a multi-sectoral approach to non-communicable diseases

Consider these facts: -India to lose USD 4.58 trillion between 2012 and 2030 as a result of Non Communicable Diseases (NCDs): (World Economic Forum & Harvard School of Public Health reports). - In India, the probability of dying between ages 30 and 70 from four major NCDs for both sexes is as high as 26%: (WHO Statistical Profile 2015). - NCDs are estimated to account for 60% of total deaths. Keeping with the alarming statistics and aiming at supplementing government’s efforts to combat NCDs, a comprehensive document—‘Sankalp’ has been developed recommending an evidence-based action plan that can be adopted both by the government and private sectors. [caption id=“attachment_2522550” align=“alignleft” width=“380”] Representational image. Image courtesy: Reuters[/caption] Developed by the Partnership to Fight Chronic Disease (PFCD), an international organisation of patients, providers, community organisations, business and labour groups, and health policy experts, ‘Sankalp’ identifies three core areas to combat NCDs: · Policy and Surveillance · Strengthening of Healthcare Systems, · Healthcare Financing. According to PFCD, it aims to adopt a robust engagement plan to access the feasibility of the recommendations proposed in the National Blueprint. Aman Gupta, country representative, PFCD India says, “PFCD aims to adopt a robust engagement plan with the target audience identified in the document and work with them to access the feasibility of the recommendations proposed in this document. With a sharper focus on states in India which are home to a significant burden of NCDs, the team intends hosting periodic consultations adopting a multi-sectoral approach and engaging relevant stakeholders from the state, private sector, patient groups, NGOs, etc. A phase-wise approach will be adopted to undertake deeper engagement with the states and in turn identify and further the repertoire of best practices in the country.” The PFCD’s blueprint has proposed following recommendations: Policy and Surveillance: · Steps for an integrated policy and uniform surveillance mechanism. · Strengthen the NCDs department within the Ministry of Health and Family Welfare at the centre and states. · A three-tier committee on secretaries, sub-committees and health consultants, which will identify and engage relevant departments and stakeholder groups for a multi-sectoral approach, evaluate evidence-based policies based on disease trends, cause-specific mortality, etc. Strengthening of healthcare systems for chronic diseases: · Scale-up NCD clinic model, a government initiative at primary healthcare level. · Train healthcare workforce at primary, secondary and tertiary levels on integrated NCDs management. · Include a dedicated module on NCDs within MBBS curriculum. Healthcare Financing: · To strengthen financing in the form of public investment in healthcare from current 1.1% to 2.5-3% by 2025. · Encourage public-private partnership for training, medical education, diagnostic equipment and preventive care delivery. · Establish policies to attract private investment in the healthcare sector. Dr Kenneth E Thorpe, chairman, PFCD in his message says “First, India is home to an array of best practices, which exist in pockets. These programmes have witnessed long-term results but are sparsely recognized or are in need of scaling up. Second, NCDs are recognized as a huge threat, but the interventions are restricted to ‘issue stating’.” “PFCD launched the second phase of the programme – an extensive advocacy campaign aimed at bringing about a shift in the current conversations from issue stating to problem solving. This phase focussed on creating an ecosystem of stakeholders from all relevant groups to advocate for action on the issue, and the identification and development of concrete solutions. The final phase is an attempt to develop an evidence-based plan of action for integrated chronic disease management in the country,” adds Thorpe, also Robert W Woodruff professor and chair of the Department of Health Policy and Management in the Rollins School of Public Health, Emory University.