Risky bite

New Delhi, Jan. 4: Health messages warning of the risks of fat-laden delicacies and flaunting the virtues of good diet and exercise will begin seeping into schools and workplaces in seven districts of India.

India has launched its first public-funded effort to prevent illness and premature deaths from lifestyle-related diseases, expected to cause losses of about $230 billion in the next decade.

The National Programme for Prevention and Control of Diabetes, Cardiovascular Diseases and Stroke, promised in the Union budget of 2007-08 and which kicked off only today, begins in seven districts but is expected to spread across the nation within five years.

Public health experts have long urged the government to focus on prevention, warning that the nation could not afford the economic and human toll that lifestyle-related diseases will extract in the coming years.

The number of people with diabetes in India is expected to double from the current estimate of 35 million to 70 million by 2025. And in the next 20 years, India will have an additional 100 million people with high blood pressure, a risk factor for heart attacks and stroke.

“We’re seeing premature deaths of people below 60 years of age. We’re haemorrhaging human resources,” said K. Srinath Reddy, president of the Public Health Foundation of India.

The new programme with a financial outlay of Rs 5 crore will promote health messages, survey risk factors in communities and provide diagnosis and treatment to patients detected with problems.

The programme will be launched this year in Kamrup (Assam), Jalandhar (Punjab), Shimoga (Karnataka), Nellore (Andhra Pradesh), Kancheepuram (Tamil Nadu), Thiruvananthapuram (Kerala) and Bhilwara (Rajasthan).

“I’d like to ask why we didn’t start this 30 years ago. But it’s better late than never,” health minister Anbumani Ramadoss said at the launch.

The health ministry expects Rs 1,650 crore to expand the programme to all districts across India in the next five years, Ramadoss said.

But public health experts caution that besides health promotion, the government also needs to introduce appropriate policies to push people towards engaging in the right lifestyle behaviour.

“Possible options are taxes on tobacco, health warnings on processed food with high fat content, a ban on transfats (the worst among fats) and the creation of urban spaces for exercise,” said Reddy.

But the focus and the exact direction of the prevention and control programme remains unclear, sources said. “We want the focus to be prevention through health messages,” one official said.

By introducing elements of control — diagnosis and management — it is possible the programme might end up identifying thousands of people who need to be treated for diabetes, high blood pressure or high cholesterol.

“The government programme will identify them as needing treatment, but who’ll pay for it?” asked one diabetes specialist in New Delhi.

“It’s great that such a programme has taken off, but the concern I have is whether by also focusing on control, would we be spreading our resources too thin,” said the specialist who requested anonymity.

A health ministry document on the programme makes it clear that the private sector is the “main provider” of management and care for high-risk conditions.

It said there is a need to shift the focus from high cost and low yield (medical) technologies to more cost effective medical care.