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Diabetes, heart disease pose huge challenges

May 14, 2018 05:12 AM


SALEE RAZVI BJORN LOMBOR Bjorn Lomborg is president of the Copenhagen Consensus Center, and Saleema Razvi, Senior Research Advisor for India Consensus The views expressed are personal
Diabetes, heart disease pose huge challenges
Analysis shows that both ailments will cost the economy dearly if immediate corrective measures are not taken
Chronic diseases claim more Indian lives than infectious diseases, and take a huge toll: Between 2012 and 2030, non-communicable diseases and mental health conditions are expected to cost India $4.58 trillion. The government supports states to respond, but much more needs to be done. New research for India Consensus, a collaboration between Tata Trusts and Copenhagen Consensus, reveals some strategies should be prioritised against specific diseases. The analysis by Professor Shreelata Rao Seshadri of Azim Premji University with Vijayalakshmi Hebbare fills evidence gaps by identifying the costs and benefits of responses to non-communicable diseases.

■ The cost of cardiovascular diseases between 2012 and 2030 is almost the equivalent of wiping out an entire year of India’s gross domestic product
Diabetes will cost India ₹9.7 trillion between 2012 and 2030. The situation varies from state to state, but taking the example of Andhra Pradesh, about one in three people are overweight or obese, and one in 10 have high blood sugar. On current trends, diabetes will kill 159,000 adults in AP in 2030. The new research shows screening and therapy would cost around ₹2,000 per person annually, or about ₹590 crore over the next 13 years, and save more than 11,000 lives annually. Putting those benefits into economic terms, every rupee would achieve more than 18 times costs. Cardiovascular disease (CVD) is a killer with such a high national burden that its cost between 2012 and 2030 is almost the equivalent of wiping out an entire year of Indian GDP. In AP, it will claim the lives of nearly one lakh adults this year. The answer is screening and cheap medicine for those at risk. This could avoid more than 2.6 lakh deaths over 13 years, at an average cost of about ₹4,000 per treated person. The total cost of ₹4,400 crore will result in benefits worth 31 times the costs. The researchers also look at cervical cancer and breast cancer, both killers of women. Coverage of screening services is poor: only about one-third of women in AP have had a cervical exam, and about 5% have had a breast exam.

But screening and treatment for cervical cancer costs about ₹3,200 crore, to save around 600 lives. This means the return on each rupee is a modest ₹1.6 in social benefits. And using the Clinical Breast Exam would only avoid about 10% of the 3,000 lives claimed by breast cancer each year, but is the most expensive approach studied, at about ₹5,600 crore.

Cervical and breast cancer screening and treatment are important for closing gender gaps and ensuring women access high-quality health care. But a broader view at benefits and costs indicates that resources spent averting a cervical cancer death could save 18 women from CVD death. Making trade-offs is in the domain of policymakers , but the project’s research provides costs and benefits for a range of policy choices in health, education, environment and the economy, which means new evidence to help tough decisions. Across India, financing chronic disease, particularly CVD and diabetes, should be a priority.

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