As we observe our 75th independence anniversary, we have cause to celebrate. India is steadily improving its health infrastructure and its health parameters. The life expectancy of our men and women has increased to 67.5 and 69.8 years in 2020, compared to less than 40 years at the time of our independence.¹ We have made great strides in maternal and child health, with the maternal mortality ratio falling to 103 deaths per 1,00,000 live births, and infant mortality rates dropping from 162 to 27 deaths per 1000 childbirths, respectively, over the past 7+ decades. Infectious diseases like smallpox, guinea worm, and polio have been eradicated, while maternal and neonatal tetanus and yaws have been eliminated. The country is focusing its efforts on eliminating tuberculosis and leprosy in the coming years.²  We have also been able to contain COVID-19 through a massive immunization program that has been applauded throughout the world.

With an increasingly aging population, India’s health faces new challenges. Non-communicable diseases (NCDs) have become a significant concern for our health system. The prevalence of diabetes, obesity, and cardiovascular diseases, including hypertension, stroke, and cancer, has increased markedly over the past few decades. Other NCDs such as mental health, chronic obstructive pulmonary disease (COPD), and non-alcoholic fatty liver disease (NAFLD) have also increased, which will burden the health system.³ The impact of NCDs is enormous, not only at the individual level but also at the societal and national levels. Moreover, the countrys earning capacity is also compromised as the probability of dying during the most productive years (ages 30-70) from one of the four main NCDs is a staggering 26%. Overall, the cost of managing NCDs can overwhelm our health system, and India is expected to lose around 4.58 trillion dollars due to NCDs between 2012-2030.⁴

Keeping this reality in mind, we must realize the full potential of being the citizens of an emerging super-power in the world and contribute our full potential to the nations development. The concept of healthy Azadi depends upon the Amrit of health. Prevention of NCDs is the only way to prevent premature morbidity and mortality attributed to NCDs. While primordial prevention offers maximum benefits, adults with complex lifestyles can adopt primary and secondary preventive measures in the early stages of their life or whenever possible to reap maximum benefits. It is pertinent to understand the economic gains made by a country when the majority of its citizen can pledge to stay at an optimal weight, be physically active, and adhere to their medications. The money thus saved can be used for other developmental projects instead of paying for health conditions.⁵  As patriotic Indians, let us pledge to optimize our lifestyle, and motivate our patients and the public to optimize theirs, for the sake of our country.

No nation can be considered independent if it is unable to safeguard the health of its citizens. The Amrit of Azadi, therefore, needs continuous care, from the Amrit of health. Let us care for ourselves, our fellow citizens, and our country.

Jai Hind, Jai Bharat!

References

1. Yadav S, Yadav PK, Yadav N. Impact of COVID-19 on life expectancy at birth in India: a decomposition analysis. BMC Public Health. 2021 Dec;21(1):1-9.
2. Menon GR, Singh L, Sharma P, Yadav P, Sharma S, Kalaskar S, Singh H, Adinarayanan S, Joshua V, Kulothungan V, Yadav J. National burden estimates of healthy life lost in India, 2017: an analysis using direct mortality data and indirect disability data. The Lancet Global Health. 2019 Dec 1;7(12):e1675-84.
3. Sarin SK, Prasad M, Ramalingam A, Kapil U. Integration of public health measures for NAFLD into Indias national programme for NCDs. The lancet. Gastroenterology & Hepatology. 2021 Oct 1;6(10):777-8.
4. Bloom, D.E., Cafiero-Fonseca E.T., Candeias V, Adashi E., Bloom L., Gurfein L. et. al. Economics of Non- Communicable Diseases in India: The Costs and Returns on Investment of Interventions to Promote Healthy Living and Prevent, Treat, and Manage NCDs. World Economic Forum, Harvard School of Public Health, 2014
5. Johnson TJ, Schoeny ME, Fogg L, Wilbur J. The cost of increasing physical activity and maintaining weight for midlife sedentary African American women. Value in Health. 2016 Jan 1;19(1):20-7.