India still largely tends to be associated with infectious diseases that plague the tropics - malaria, cholera or dysentery. Yet according to a report that the WHO launched last week in Moscow, more people in India die of chronic diseases such as heart disease and diabetes than of anything else.
The numbers are striking: while deaths from maternal illness and infectious diseases are set to fall by 15%, deaths from chronic diseases (especially diabetes) will rise by 18%.
India and other developing nations have known for some time about the silent killers lurking in their populations' changing lifestyle. In Indian cities especially, the metamorphosis is staggering. Young women are just as likely to drink and smoke as heavily as young men, and fast food has changed from relatively low-fat street food to burgers and pizzas. Preaching against smoking and unhealthy eating from a Western country that has already overindulged itself is tricky. But when more than 60 million are set to die in India over the next decade, not taking any action is not an option.
Earlier this year, a special series on Indian health by The Lancet called for India to boost its spending on health from 1% of its GDP to 6%. In the crowded press room in New Delhi, journalists and scientists seemed equally sceptical that India had the financial clout, or willingness, to do so, but the rallying call might have had some effect. Now, the Indian government is finally agreeing to step up the amount of money it spends on health to 2 or 3%. This is long overdue, as out-of-pocket spending on health in the private sector is skyrocketing, threatening the financial stability of many families.
Driving down chronic diseases will also have a major effect on the country's economy, because fewer people will need to take time off work or lose their jobs entirely. As the Indian government's one key imperative seems to be to grow its economy whatever the financial climate, this may be the one incentive that pushes it to fix the health of its people. The WHO says that even a 2% reduction in chronic disease deaths would mean an economic gain of US$15 billion. Can India afford not to act?
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