India has the unenviable distinction of having the largest number of diabetics in the world, and 80% of all deaths in urban India are attributed to non-communicable diseases (NCDs). These factors are leading to tremendous costs in terms of healthcare delivery and lost productivity. So while India has experienced impressive economic growth and a rise in disposable incomes in the past two decades, the rapid rise in NCDs has taken a heavy toll on the economy.

India is not alone. Of the 57 million global deaths in 2008, 36 million, or 63%, were due to NCDs, principally cardiovascular diseases, diabetes, cancers and chronic respiratory diseases. As the impact of NCDs increases, and as the population ages, deaths from NCDs are projected to continue to rise annually worldwide. This is no longer a problem of the rich, with 80% of all NCDs deaths occurring in poor and middle income countries.

The fight against NCDs needs to be tackled on a war footing. Some challenges endemic to populations particularly prone to NCDs are a general lack of emphasis on healthy diets, physical activity and fitness, and a lack of a cogent plan to deal with the problem at a national level. I believe we are faced with the healthcare equivalent of crossing the Rubicon. As societies become increasingly democratic, with considerable freedom of exercising choices, they also need to be acutely aware of responsibilities. Indeed, when society at large is expected to bear the insurmountable burden imposed by the indiscreet actions of some, then it is not just a matter of personal choice.

India needs a concerted and robust multistakeholder approach to tackle the NCDs burden and create a healthy nation. To date, single stakeholder actions have not delivered the required outcomes; truly multistakeholder efforts will make a greater impact. A virtuous cycle with actionable steps from the following multiple stakeholders is urgently needed:

  1. Government needs to create disincentives on unhealthy products and create awareness of costs and the impact of non-compliant behaviour
  2. Politicians should exhibit the courage to systemically transform businesses that lead to ill health.
  3. Education systems should integrate health as an integral part of the curriculum.
  4. Workplace organizations should highlight workplace wellness initiatives and provide a supportive environment for creating a wellness culture.
  5. Healthcare organizations need to focus on preventive care and explore new delivery models.
  6. Medical equipment manufacturers need to reduce costs by emphasizing value-consciousness and focusing on mass diagnosis and treatment.
  7. Information technology should be selected when it is appropriate, not only because it is new. All involved need to harness the potential of digital channels to increase reach and improve health monitoring.
  8. Innovation for mass use should be balanced with expensive high-end innovation.
  9. Food and beverage producers need to recognize their role in creating a healthy nation.
  10. NGOs should help to bridge the gap between government and industry and build multi-stakeholder consensus.

Author: Malvinder Singh is the Executive Chairman of Fortis Healthcare

 Image: Medical equipment is pictured on a doctor’s desk REUTERS/Ina Fassbender