Preventive Healthcare in India- Explained Pointwise

India’s economic aspirations of becoming a $5 trillion economy are threatened by a “silent epidemic” of Non-Communicable Diseases (NCDs), which account for 66% of all deaths (WHO 2023). With 5-6 million annual NCD deaths and 22% of India. These chronic illnesses, often preventable, are fast becoming the leading cause of mortality and morbidity, placing massive strain on India’s healthcare system and economy.

What is the “Silent Epidemic”? Understanding NCDs

Non-Communicable Diseases (NCDs) refer to chronic conditions that are not caused by infectious agents and typically progress slowly. Major NCDs include:

1. Major NCDs:

• Cardiovascular diseases (CVDs): Leading cause of death (28% share).
• Diabetes: 101 million cases (highest globally, ICMR 2023).
• Cancer: 1.4 million new cases yearly (National Cancer Registry).
• Chronic Respiratory Diseases: Linked to air pollution (COPD affects 55 million).

2. Early Onset: Heart attacks in 30–40-year-olds rising due to sedentary lifestyles, E.g. Delhi NCR reports 25% increase in young stroke patients (AIIMS 2024).

Impact:

1. Economic Cost: NCDs drain 5-10% of GDP (~$3.5–4 trillion loss projected by 2030, WEF-Harvard Study).

2. Risk Factors: 80% of heart disease, stroke, and diabetes cases are preventable (WHO).

3. Lifestyle Crisis: 23% adults overweight, 30% hypertensive (NFHS-5).

4. Death Parameters: NCDs account for nearly 66% of all deaths in India. (WHO India, 2023). An estimated 5-6 million Indians die annually due to NCDs. 22% of Indians aged 30+ are at risk of dying from an NCD before age 70.

5. Diabetes/ Cancer Capital of the World: Increasing incidence in the 30–40-year age group — especially cardiac diseases and diabetic complications.

6. Productivity Loss: WHO estimates that India may lose $3.5-$4 trillion between 2012 and 2030 due to NCD-related productivity losses.

What is Preventive Healthcare?

Preventive healthcare focuses on averting the onset of diseases through:

1. Primary Prevention: Vaccinations, anti-tobacco campaigns (e.g., COTPA Act). E.g.  Kerala’s “Aardram Mission” reduced CVD risks via screening.

2. Secondary Prevention: Early detection, Mammograms, HbA1c tests for diabetes.

3. Tertiary Prevention: Rehabilitation, post-stroke physiotherapy, Use of wearables and mobile apps to monitor vitals like heart rate and activity levels.

It is guided by the principle of “catching the disease before it catches you”.

What is the significance of Preventive Healthcare in India?

1. Demographic Dividend & Workforce Productivity: NCDs are affecting the working-age population, undermining India’s economic potential. E.g. 65% population under 35—NCDs threaten labor productivity.

2. Economic Imperative: NCDs cost India an estimated 5%-10% of GDP annually. A World Economic Forum-Harvard study projected $3.5-$4 trillion losses by 2030.

3. Health System Burden Reduction: Preventive models reduce strain on secondary and tertiary care systems. E.g. Early diabetic care avoids need for dialysis or amputations.

4. Digital & AI Integration: India has 750+ million smartphone users — offering a wide digital reach. AI tools can create personalized health risk scores, enabling early alerts. E.g. Machine learning to detect early signs of lung nodules or fatty liver.

5. SDG Alignment: SDG 3.4, reduce NCD deaths by 30% by 2030.

What are the Government Initiatives for Preventive Healthcare?

1. National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS): It is part of the National Health Mission (NHM) which focuses upon community-based screening, diagnosis, and health promotion. E.g. 677 NCD clinics and 187 District Cardiac Care Units set up (MoHFW, 2023).

2. Ayushman Bharat – Health and Wellness Centres (HWCs): Over 1.6 lakh HWCs operational as of March 2024. It provides preventive, promotive, and curative services at the grassroots. It provides services like screening for hypertension, diabetes, oral/breast/cervical cancers.

3. Fit India Movement & Eat Right India: Behavioral change campaigns promoting active lifestyle and healthy eating. E.g. #22KStepsChallenge.

4. School Health Programme: Joint initiative by the Ministry of Education & Health under Ayushman Bharat. Focuses on health education and screening of school children.

5. National Tele Mental Health Programme (Tele-MANAS): Addresses mental health, a rising component of the NCD burden.

6. National Clean Air Programme (NCAP): To address air pollution, a contributor to COPD and cardiac issues.

7. Pradhan Mantri Jan Arogya Yojana (PMJAY): Covers NCD treatments for 500 million.

8. Disease Surveillance: India’s Integrated Health Information Platform (IHIP) and the Integrated Disease Surveillance Programme (IDSP) enable real-time disease tracking, vital for early detection and response to outbreaks.

What are the challenges to Preventive Healthcare in India?

1. Low Public Awareness: Health-seeking behavior is often reactive, not preventive. Screening is often neglected until symptoms arise. E.g. Only 12% Indians access preventive screenings (NITI Aayog 2023).

2. Fragmented Healthcare System: Preventive services are underfunded and lack integration with curative services. E.g. Out-of-pocket expenditure on health: 47% (NHA Estimates, 2023).

3. Inadequate Screening Infrastructure: Shortage of trained personnel and equipment at the primary level. E.g. Low availability of mammography and HPV testing facilities.

4. Urban-Rural Divide: Rural India lacks access to digital health tools and diagnostics.

5. Air Pollution as a Urbanization Hazards: India has 7 of the world’s 10 most polluted cities (IQAir, 2024). Contributes to lung disease, strokes, and even cardiac problems. E.g. Air pollution causes 1.6 million annual deaths (Lancet).

6. Behavioral Barriers: “Chalta Hai” attitude toward health checks. E.g. NFHS-5: Only 38% women get blood sugar tests.

What should be the Way Forward?

1. Strengthen Primary Health Infrastructure: Expand HWCs with adequate staff, diagnostics, and telemedicine. Invest in rural digital infrastructure to support tech-driven preventive care. E.g. Economic Survey 2022-23, emphasizes the shift towards preventive and promotive healthcare as a long-term cost-saving strategy.

2. Leverage AI and Big Data: Use AI algorithms for predictive modelling and risk mapping. Partner with private tech companies for scalable health solutions. Use Aayushman Bharat Digital Mission (ABDM) for predictive analytics. E.g. Telangana’s “eHealth” app tracks NCD risks.

3. Regulatory Action: Enforce food labeling norms, sugar/fat/salt limits, and junk food taxes. Implement urban planning reforms to create more walkable green spaces.

4. Corporate, Schools and Community Engagement: Mandate employee wellness programs. Encourage community health volunteers and local schools for awareness campaigns. E.g. Google India’s Fit Weeks.  “Health Olympics” in schools (modeled on Australia’s “Active Kids”).

5. Integrate Health into All Policies (HiAP): Kasturirangan committee: suggested health literacy in school curriculum. Embed health concerns in education, transport, housing, environment, etc. Health Impact Assessments (HIA) before approving infrastructure projects. E.g. NITI Aayog Health Index, also recommends states to prioritize health education and preventive spending.

6. Fiscal Measures: Increase health spending to 2.5% of GDP (currently 1.28%, Economic Survey 2024). Additionally Sin Tax on ultra-processed foods (like Mexico’s soda tax). Insurance discounts for healthy habits (e.g., Singapore’s “Healthier SG”).

7. Behavioral Nudges: Use “nudge theory” for behavior change — reminders, gamification, rewards for healthy choices.

8. Global Best Practice/ Models:

• Japan’s “Specific Health Checkups”: Mandatory annual screenings cut metabolic syndrome by 25%.
• Finland’s North Karelia Project: Reduced CVD deaths by 80% via diet/exercise campaigns.
• Singapore’s “War on Diabetes”: Nationwide screening + sugar tax.

 Conclusion

The battle against NCDs is not just a medical one — it is a societal and economic challenge. A shift to a preventive mindset, where individuals, communities, corporates, and the government all prioritize “health-first”, is essential. As the article rightly states — “an investment in preventive healthcare is our best insurance policy for sustainable development.” The power to transform lies in our daily choices. If scaled across 1.4 billion Indians, these choices will not only create a healthier nation but also propel India towards its economic and developmental aspirations.