In the recent years, while India has witnessed a robust economic growth, healthcare spend is still over 1 percent of the GDP and healthcare spending is the lowest in the world. Mostly, the allocations are spent on reproductive, maternal and child health programs and on communicable diseases, leaving little room for NCDs.
Latest statistics indicate in the year 2015-16, only 3 per cent of the total health budget was earmarked for NCD programs. Global evidence on health spending shows that unless a country spends atleast 5-6 per cent of its GDP on health, with the major part of it being government expenditure, basic healthcare needs are seldom met.
NCDs are not inherited diseases but manifest as a result of the individual habits and lifestyle. Health economist & the chairman of an international NGO Partnership to Fight Chronic Disease (PFCD), Dr Kenneth Thorpe has pinned the upsurge of NCDs on changing demographics and lifestyle modifications over the last few years. “NCDs are fast surpassing the traditional enemies such as infectious diseases and malnutrition, as the leading causes of disability and premature death in India. 60 per cent of all deaths in India are caused by the four leading NCDs — cardiovascular diseases, cancer, chronic respiratory diseases and diabetes," he said.
According to a report of the World Economic Forum and the Harvard School of Public Health, India is on track to lose US$4.58 trillion between 2012 and 2030 as a result of NCDs.The picture is quite grim when it comes to any private investment in the existing public healthcare system. While the insurance sector has boomed in the last two decades and extended cover for non-communicable diseases, for the vast majority of BPL families and those residing in rural India, and fringes of urban India, insurance remains aluxury. The pressure of modern life have multiplied NCDs in an unprecedented way and are also striking younger people too. Besides the male population, women too are succumbing to the perils of NCDs like heart ailments, strokes among others. Then, there are gender specific NCDs like breast cancer, ovarian cancer, fallopian tube cancer whose cases have replicated over time. Add to these escalating medical and hospitalization costs, getting the right healthcare especially for the poor, has become quite a costly affair. In the current scenario in fact, the treatment of non-communicable diseases costs twice as more as compared to other ailments.
The failure of public investment in health is reflected in the worsening situation in terms of costs of care and impoverishment of individuals and families due to rising health care costs. WHO World Health Statistics 2012 estimates that 39 million Indians are pushed into poverty due to diagnostic and treatment costs every year. Because of the limited availability of commercial insurance, health care coverage and low public expenditure on health in India, it is estimated that 60-70 per cent of health care services are paid out-of-pocket, often driving many to poverty.
In this backdrop, often critical preventive actions like an early diagnosis & preventive care of an NCD, are often missed leading to intensification of the disease, pushing up healthcare costs for the individual resulting in significant economic losses for the society.Though on its part, the Indian government has taken certain proactive measures, a lot more needs to be done. Besides the existing 9 global targets of NCDs, India has set a tenth target to address household airpollution — a major health hazard in the South-East Asian Region due to burning of solid biomass fuel.
India has also implemented WHO’s Framework Convention on Tobacco Control aimed at reducing the demand for tobacco products.To combat the menace of NCDs the government can evolve acomprehensive blueprint that ropes in both the centre and the state as major players. Expansion of commercial health insurance plans, other innovative financing models, and public-private partnerships can be explored. Varied financing and reimbursement options will help meet the health care needs of all citizens. India should increase the percentage expenditure of GDP on healthcare from the current 1.1per cent to at least 2.5-3 per cent by 2025, with an increased focus on preventing and treating NCDs.
India can establish policies and an environment conducive to attracting private investment in thehealthcare sector through incentives such as tax benefits, under writing, and facilitating bank loans,especially to supplement care in underserved and difficult to reach areas.
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