Government alone can’t fight cancer, diabetes and strokes

Cancer, diabetes, cardiovascular diseases and stroke —- these were never in the spotlight in India as recently as 15 years ago. But given the geometrical spread of these diseases in the country in the last few years, it is hardly surprising to see the government step up mass-scale intervention exercises.

According to a government press release sent out earlier this month, the Cabinet Committee on Economic Affairs approved the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke as part of its 11th Five Year Plan.

The allocated fund is to the tune of Rs 1,230 crore and will be shared between the Centre and the State governments in a ratio of 80:20. Intervention for diabetes and cardiovascular diseases will take up Rs 500 crore, while over Rs 700 crore will be allocated for cancer control.

The contours of usage of these funds are not yet clear, but there is a role to be played by the National Rural Health Mission in seeing that the programme is run with all fairness and an impact could be felt in the areas where the programme is sought to be implemented.

The government has showed a great degree of flexibility in allowing a limited transfer of funds from one component of the programme to another if a need is recognised by the approving authorities. The extent to which the programme will be expanded can be gauged from the fact that 20,000 sub-centres and 700 community health centres in 100 districts in 15 states and Union
Territories will be pressed into spreading health education and opportunistic screening of persons above 30 years of age.

To give a lasting effect to its aims, the government will work on establishment of non-communicable diseases at the community health centres. Over the next few years, the government estimates it can screen 7 crore people, helped by 32,000 trained health personnel.

For the government to take such steps on a mass scale is commendable.

The note sums up the alarming situation succinctly. “The country is experiencing a rapid health transition with a rising burden of non-communicable diseases (NCDs) which are emerging as the leading cause of death in India accounting for over 42% of all deaths with considerable loss in potentially productive years (aged 35-64 years) of life. According to a 2002 WHO report, cardiovascular diseases will be the largest cause of death and disability in India by 2020,” it says.

In this light, it is essential to see how the Indian pharmaceutical companies are crafting out their strategies. Most Indian companies have their own diabetes and cardiovascular divisions, they all work on combinations of the known ingredients and of late there is a big rush for the rural markets.

There are exceptions, though. A few are going beyond these known drills and are trying to build bigger awareness about lifestyle diseases. More than flooding the market with new combinations, they are developing ways in which the Indian population can understand the ways to manage the diseases well.

More often than not, lifestyle diseases are a result of indiscipline and companies are taking a step forward in educating the patients about their own responsibilities in disease management.

The most ideal situation will be to look at ways in which the government agencies can collaborate and work on mutually beneficial terms. The vast presence of the government health machinery may be pooled with the manufacturing capabilities of the industry. It can work in getting the industry the huge untapped volumes, while the government can keep a tight control over the new cases that are detected.

There could be ways in which the large numbers of private hospitals and diagnostic centres can contribute in deploying their own resources to serve the screening and testing requirements.
With over 42 million diabetes patients and still growing at a rapid rate, it will not be enough for just the government to work on mitigating the losses.

That, added to a large number of stroke and cancer patients, makes it even more difficult for the state machinery to work in isolation. Solutions are possible if there is an all-round effort and companies think beyond the bottomline.

Pillman is an executive closely linked to the global pharma industry.