India is a land of contradictions.

We are in the land of Mahatma Gandhi, the pioneer of non violence, but have terrible acts of violence in the form of terrorism on a daily basis. We worship Goddesses but inflict unspeakable misery on women. We have the world’s most expensive mansion next to the largest slum in the world.

This contradiction is reflected in the health sector too.

We are a developing country with diseases of the developed world. We are a country of poor people with maladies of the rich. We have not yet conquered infectious diseases but are grappling with non communicable (NCD) or lifestyle diseases.

We have very high IMR (infant mortality rate), MMR (maternal mortality rate), Child mortalities, death due to malnutrition, poor sanitation and diarrheal diseases due to poverty, illiteracy and lack of medical facilities but we also have Seven Star Hospitals catering to the Super rich offering the best of quaternary care.

We have serious problems of obesity and at the same time severe malnutrition related illnesses and mortality, especially in the poorer sections of society. Interestingly malnutrition in a pregnant woman may lead to increased incidence of hypertension and diabetes in the child later in life.

Today, non communicable diseases (NCD) like cardiovascular diseases, hypertension, diabetes, obesity, chronic respiratory illness, kidney disease and cancer have overtaken communicable diseases as the leading cause of death.

Our health care burden is immense, since our restricted resources are stretched and torn apart with the huge problems of Communicable diseases, Non-communicable diseases and malnutrition pulling it in different directions.

The only silver lining is that we can control the burden of Non communicable or Lifestyle diseases with relatively inexpensive interventions. Our focus should certainly move from Curative Tertiary care to Preventive Primary Care.

What is the disease burden?

We have over 60 million diabetics, an even larger no of prediabetics, a much larger no of hypertensives (almost one in three of the adult population), millions of cancers about 200000 people dying of kidney failure per year, about a lakh amputations per year and much more.

Not only are these numbers staggering but it is frightening that we see the effects of this disease much earlier and the outlook poorer compared to the western world, and the economic loss is unimaginable. Some estimates put this at 4.5 trillion dollars from now to 2030. Unless we act to control this now we will not have an opportunity to salvage ourselves tomorrow.

This not just a health issue because socioeconomic conditions influences NCD, the major determinants being poverty, illiteracy, and health care infrastructure, social inequality and demographic transition (urbanisation and increasing life span).

Why this conclave?

We need to address this monster of a problem of NCD with the greatest urgency and vigor that it deserves. It’s truly now or never and a do or die situation.

Fortunately for us it is doable if all of us, the Public, Govt, Private Sector and the media work together to battle this serious health threat. Interestingly, social economists have worked out the financials of this and believe that the ROI on this is 15%, which to any businessman would be a bargain investment.

So let if us put our minds and resources together and invest in this great opportunity to make us a healthier fitter nation in the future.

How Do We Do This?

Create massive awareness programs about lifestyle diseases especially in rural and semi urban areas.

Catch them young: Start off campaigns in schools about life style modifications like dieting, exercise, and avoiding tobacco etc. Screening and early treatment, especially, for hypertension, some cancers and diabetes.

If we can control the 6 S’s and 4 nos., we have won our battle against NCD.

The six S’s being:

  • Smoking and any form of tobacco (responsible for cancer, cardiovascular and lung diseases)
  • Sugar and any high calorie food (responsible for obesity, diabetes and cardiovascular disease)
  • Salt (excessive salt contributing to high BP)
  • Sedentary life style (contributes to obesity diabetes and related problems)
  • Stress (or shall I say distress, leading to cardiovascular problems)
  • Spirits or Alcohol (in excessive amounts could be a serious health and social hazard)

In addition, if we can monitor and keep under control the 4 most important numbers of your life you will truly be very healthy.

  • Sugar
  • BP
  • Cholesterol
  • Kidney no (creatinine clearance the parameter that reflects ones kidney function)

Eat healthy, exercise regularly, stay away from tobacco, alcohol and junk food, be stress free and start these programs early in life and you will live healthily forever.

Let’s all take a pledge today to do the best we can to control the scourge of Life Style Diseases and make India truly a healthier stronger  nation in every sense of the word.

Jai Hind!


Dr. H Sudarshan Ballal, MD, FRCP(London)

Chairman – Med Adv Board & Medical Director – MHEPL,

Manipal Hospitals, 98, HAL Airport Road, Bangalore-560017


Disclaimer: The views expressed in this article are of the writer and not of the hospital.






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