Remember ME - You Me and Dementia

Thursday, January 10, 2008


Speaking at the Launch of the Pilot Phase of the National Programme for Prevention and Control of Diabetes, Cardio-vascular Diseases and Stroke (NPCDS), here today, the Union Minister for Health & Family Welfare, Dr. Anbumani Ramadoss said that due to an ageing population and environmentally driven changes in behaviour, the Non-Communicable Diseases (NCDs), especially Cardiovascular Diseases (CVD’s), Diabetes Mellitus, Cancer, Stroke and Chronic Lung Diseases have emerged as major public health problems. To take care of these issues, the Ministry has been planning a National Programme for quite sometime and today I am happy that we have succeeded in this mission. The Deputy Chairman of the Planning Commission, Shri Montek Singh Ahluwalia formally launched the Programme wherein Smt. Panabaka Lakshmi, Minister of State (HFW), Shri Naresh Dayal, Secretary (HFW), Dr. R.K. Srivastava, DGHS, Dr. K. Srinath Reddy, Director (PHFI) and other senior officials from the Ministry were also present.

The following is the summary of the Health Minister’s speech:

Worldwide, roughly 50 million deaths occur annually, with Cardio-Vascular Diseases and stroke causing about one quarter of these deaths. Of the 50 million, about 32 million deaths are registered in the developing world, 7 million in the group of the least developed countries, 6.8 million in the developed market economies, and 4.2 million in Eastern Europe. Rheumatic Heart Disease is also a major public health problem in younger age group (5-15 years).

Current statistics on cardiovascular diseases (CVD) and stroke in India are incomplete. Surveys in India reveal that about 10 % of adults suffer from hypertension. The number of deaths due to Ischemic Heart Diseases in India is projected to increase from 1.2 million in 1990 to 1.6 million by the year 2000, and to 2 million by 2010. The premature morbidity and mortality in the most productive phase of life is posing a serious challenge to Indian society and its economy. It is estimated that in 2005 NCDs accounted for 5,466,000 (53%) of all deaths (10,362,000) in India.

Roughly more than six million people have coronary artery disease and about five million people have rheumatic heart disease. Concrete data is not available about the incidence of congenital heart diseases, but approximately 2 lakh babies are born every year with some form of congenital cardiothoracic defect. With the aging population, degenerative diseases of the aorta are also increasing. It is likely that the burden of cardiovascular disability is going to increase in the future.

While global population has increased threefold during this century, from 2 billion to 6 billion, the population of India has increased nearly five times from 238 million (23 crores) to 1 billion in the same period. India's current annual increase in population of 15.5 million is large enough to neutralize efforts to conserve the resource endowment and environment. Our population is 16 percent of the world's population on 2.4 percent of the globe's land area. If current trends continue, India may overtake China in 2045, to become the most populous country in the world.

Presently, India has largest number of diabetes in the world. India has 25 to 30 million adult diabetes (type 2) as per different estimates. At this rate, India is projected to have more than 37 million diabetics in year 2010 and more than 57 millions in year 2025. Indians are genetically predisposed to develop type 2 Diabetes Mellitus. This has been clear from the studies of Indian migrants to developed countries.It is clear therefore, that unless we confront the epidemic of diabetes on a priority basis, it is going to have a tremendous adverse effect on health and economy of our nation. India also has the largest number of potential diabetics i.e. subjects with impaired glucose tolerance (IGT), over 43 millions. Unlike frank diabetics, subjects with IGT are evenly distributed among rural and urban population and it should be our endeavour to prevent these subjects from developing diabetes.

The prevalence of stroke is about 3 per thousand population in India. Hypertension is the most important risk factor besides diabetes, smoking and hyperlipidaemia. Stroke is the cause of about 1% deaths in India.

In the current health care environment, individuals living with chronic diseases face increased burden of health care costs. As most people with NCDs use health services more frequently than the general population, the out-of-pocket payments for care can be extensive. In such a scenario, prevention is the best and a realistic option.

Indian systems of medicine have a big role to play in healthy lifestyles as they provide the options, which are healthy and relevant to the Indian culture. Yoga and Naturopathy are very good examples of healthy lifestyle promotion and we should focus our attention on these modalities.

The National Rural Health Mission (NRHM) launched by Hon’ble Prime Minister on 12th April, 2005 is an articulation of the commitment of the Government to raise public spending on Health from 0.9% of GDP to 2-3% of GDP. It aims to undertake architectural correction of the health system to enable it to effectively handle increased allocations as promised under the National Common Minimum Programme and promote policies that strengthen public health management and service delivery in the country. CVD, Diabetes & Stroke prevention and control facilities are available in the health care delivery system under the NRHM.

Health promotion for NCDs control can be carried out with simple messages e.g. use of less salt & sugar, exercise, avoiding stress, tobacco & alcohol and increased use of vegetable and fruits. These simple interventions can prevent or delay many of the NCDs. IEC would be intensified from the Central level and six video spots with healthy lifestyle messages would be appearing in the media shortly. Unless people understand that these illnesses (Diabetes, Hypertension etc.) can affect them, they would not get themselves checked-up and the disease may progress unknowingly.

The Indian Parliament has passed the Cigarettes and other Tobacco Products Bill 2003 in April 2003 and it became an Act on 18th may 2003. Rules were formulated in 1st May 2004 and are being vigorously implemented throughout India. It is hoped that Tobacco use would reduce after its implementation. This would be an effective step in the direction of prevention of major NCDs specially CVD & Stroke.

Pilot Project of the National Program for Prevention and Control of Diabetes, Cardio-vascular Diseases and Stroke (NPCDS) is being launched in seven States with one district each. These are Kerala (Thiruvanthapuram), Tamil Nadu (Kancheepuram), Assam (Kamrup), Punjab (Jalandhar), Karnataka (Shimoga), Rajasthan (Bhilwara) and Andhra Pradesh (Nellore). An amount of Rs. 49.16 lakh is being released to each of these States. Total plan allocation (tentative) envisaged for 11th Five Year Plan is Rs 1620.5 crores and final allocation would be made by the Planning Commission.


Forget yourself for others, and others will never forget you.

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