Editorial 1 : Prescribe preventive medicine for a healthy India

Context

With India dealing with a rising number of non-communicable diseases, it’s important to understand that prevention is better than cure.

Introduction

India is on the brink of economic success, aiming to become a $5 trillion economy and a global leader. However, a “silent epidemic” of non-communicable diseases (NCDs) is threatening our progress. NCDs are now the top cause of death in the country, making up about two-thirds of all deaths. To ensure a healthy and prosperous future, India must quickly adopt a preventive health-care approach — one that focuses on preventing problems before they arise.

The rising tide of NCDs, their economic toll

• Shift from Communicable Diseases to NCDs
  • Over the last few decades, India has undergone an epidemiological transition.
  • Communicable diseases (such as infections) have been largely brought under control.
  • However, NCDs (chronic conditions) like heart disease, diabetes, cancers, chronic lung diseases, and stroke have become more prevalent.
• Impact of NCDs on India
  • Annual Mortality: Approximately 5-6 million Indians die each year from NCDs.
  • Young Population Affected: NCDs are increasingly affecting younger Indians, including those in the working-age population.
  • Economic Impact:
    • NCDs are having a significant economic cost due to loss of productivity and reduced workforce participation.
    • Cost to GDP: Estimated loss to India’s GDP is between 5%-10%.
    • A study by the World Economic Forum and Harvard School of Public Health projected a loss of $3.5 trillion–$4 trillion to the Indian economy between 2012 and 2030.

Key Stats and Trends

Statistic	Value
Indians at Risk of NCDs	22% of adults over 30
Premature Deaths from NCDs	Risk of dying before 70 years
Adults Overweight	22%-23% of the adult population

Health and Economic Implications of NCDs

• Workforce Impact: India’s youthful demographic dividend is threatened as the working-age population is increasingly affected by NCDs.
  • Rising cases of heart disease, diabetes, and other NCDs among individuals aged 30 to 40 pose a significant challenge.
• Economic Strain: Beyond the human toll, NCDs are estimated to cost India 5%-10% of its GDP.
  • Projected Economic Loss: $3.5 trillion to $4 trillion (2012-2030).

The Preventability of NCDs

• Key Causes of NCDs: Lifestyle Factors: Sedentary lifestyles, unhealthy diets, tobacco and alcohol use.
  • Environmental Factors: Air pollution.
  • Genetic Predisposition: Family history of certain conditions.
• Prevention Strategies:
  • 80% of Cases Preventable:
    • 80% of premature heart disease, stroke, and diabetes cases can be prevented by modifying lifestyle factors.
  • Addressing Obesity:
    • Around 22%-23% of adults are overweight.
    • Addressing obesity through lifestyle changes is crucial for reducing NCD risks.
• Key Lifestyle Modifications:
  • Exercise: At least 30 minutes of moderate exercise daily (e.g., walking, yoga, sports).
  • Diet: A healthy diet with plenty of fruits, vegetables, and proteins while limiting sugar, salt, and unhealthy fats.
  • Pollution Control: Air pollution is a major factor in respiratory diseases like COPD, lung cancer, and heart attacks. Pollution control should be integrated into preventive health measures.

Role of Regular Health Screenings

• Importance of Early Detection: Regular screenings, starting at age 40 (or earlier for those with a family history), can save lives.
  • Early detection leads to timely intervention, preventing severe conditions like stroke, cancer, or heart disease.
• Types of Screenings: Blood Pressure Monitoring: Preventing strokes by controlling blood pressure.
  • Cancer Screenings:
    • Mammograms for early breast cancer detection.
    • HPV tests for early detection of cervical cancer.
    • Colon cancer screenings to detect precancerous polyps.

The Role of Digital Health Technology in Preventive Care

• Digital Health Technology as a Game Changer
  • Smartphone Apps and Wearables are revolutionizing healthcare delivery.
  • India, with over 750 million smartphone users, has the potential to provide health advice, reminders, and risk assessments directly to individuals’ hands.
  • Wearable devices and health trackers allow users to monitor their health in real-time, helping track vital statistics like heart rate, sleep patterns, and physical activity.
• Artificial Intelligence (AI) in Predictive Health Modelling
  • AI algorithms can analyze large datasets to predict health risks with high accuracy, offering valuable insights for preventive care.
  • Health Risk Score: AI tools can create a personalized health risk score, predicting the likelihood of conditions such as heart attacks or diabetes within the next decade.
  • Early Diagnostics:
    • Machine learning models can scan X-rays or CT scans to detect conditions like lung nodules or fatty liver at early stages, which may be missed by human doctors.
    • Pre-emptive action: AI enables early intervention by identifying potential health issues before they become critical.

Key Benefits of Digital Health and AI Integration

Technology	Benefit
Smartphones & Wearables	Provide health advice, reminders, and assessments directly to individuals.
AI Algorithms	Analyze large datasets to predict health risks.
Health Risk Score	Forecast the likelihood of NCDs such as cardiac events or diabetes.
Early Diagnostics	Detect early signs of diseases (e.g., lung cancer, fatty liver).

Ensuring Patient-Centric and Compassionate Care

• Human-Centered Approach: While AI can revolutionize preventive medicine, it is essential that it remains humane, compassionate, and patient-centric.
  • Ethical Use of AI: Digital health and AI should be used responsibly to ensure they support, rather than replace, human judgment and empathy in healthcare.
• The Future of Preventive Care: Digital health technologies and AI, when used together, can make preventive care more proactive, precise, and accessible, helping to reduce the burden of NCDs across India.

Fostering a ‘preventive mindset’

1. Preventive Medicine: A Mindset, Not Just a Service

• Health-First Mindset: Preventive medicine is a mindset that should be adopted by individuals, corporates, communities, and governments.
• Individual Responsibility:
  • Become the champion of your own health.
  • Schedule that postponed check-up and make small changes like taking the stairs or reducing sugar intake.

2. Corporate Role in Wellness

• Workplace Wellness: Corporates should invest in employee wellness programs, including annual health checks, in-house counselors, and fitness sessions.

3. Shift in Health-Care Models

• Preventive Care Focus: Health-care providers must shift from a reactive cure model to a preventive care model.

4. Government Initiatives

• Key Government Programs:
  • National Programme for Prevention and Control of NCDs and Health and Wellness Centres focus on screening and prevention.
  • Public Policies:
    • Urban planning should include green spaces.
    • Education should include health and nutrition.
    • Food industry regulations should promote lower salt and sugar.

Conclusion

Over the years, as I’ve worked to make preventive care more accessible and effective, I’ve seen countless lives changed by catching a disease early or managing a risk factor in time. Every person has the ability to make choices that protect their health. When these choices are made by 1.4 billion Indians, they can shape the health and happiness of our nation and help us achieve our economic goals.

Editorial 2 : Health and sanitation as the pillars of a healthy India

Context

The story of modern India is connected to each link in the sanitation chain that results in the healthier and safer society.

Introduction

On this World Health Day (April 7), as nations reflect on the essentials of human well-being, India stands strong with a transformative message: health and sanitation are inseparable, being two sides of the same coin. Led by Prime Minister Narendra Modi, India has launched a sanitation and water revolution that has not only reshaped the way we live but also how we prosper.

Rural missions that made a difference

• The Swachh Bharat Mission (SBM) Grameen and Jal Jeevan Mission (JJM) have played a crucial role in transforming modern India.
• These programs go beyond just toilets and tap water; they represent a shift in the nation’s soul, symbolizing dignity, equity, and health.

1. Swachh Bharat Mission (SBM)

• Launch and Impact
  • Launched by Prime Minister Modi in 2014 from the Red Fort, SBM sparked a Jan Andolan (people’s movement) focused on behavioral change and inter-generational equity.
  • 2019: India declared itself Open Defecation Free (ODF), achieving this milestone 11 years ahead of the target.
• Health and Environmental Benefits

Impact	Outcome
Diarrhoeal Deaths Averted	3 lakh deaths avoided (2014-2019), as per WHO report.
Child Health	58% higher cases of wasting in non-ODF areas (Gates Foundation, 2017).
Women’s Safety	93% of women felt safer with toilets at home (UNICEF, 2017).
Groundwater Contamination	12.7 times less likely in ODF villages, ensuring long-term health resilience.
Child Death Prevention	60,000-70,000 child deaths prevented annually (Nature, 2024).

2. Jal Jeevan Mission (JJM)

• Mission Launch and Vision Launched in 2019 to provide clean drinking water to every rural household via a tap connection.
  • It’s an investment in human potential with profound socio-economic impacts.
• Health and Socio-Economic Impact

Impact	Outcome
Infant Deaths Prevention	30% reduction in infant deaths with access to safe drinking water (Dr. Michael Kremer).
Child Deaths Prevention	1.36 lakh child deaths (under five) can be prevented with universal tap coverage.
Diarrhoeal Deaths Averted	4 lakh diarrhoeal deaths prevented with safe drinking water at home (WHO estimates).
Time Saved by Women	5.5 crore hours saved daily by women who no longer have to fetch water.
Economic Impact	Increased participation of women in agriculture and allied activities (State Bank of India research).

3. Sujal and Swachh Gaon Campaign

• Integration of Water, Sanitation, and Hygiene: The Sujal and Swachh Gaon campaign integrates water, sanitation, and hygiene at the village level, galvanizing communities.
  • Thousands of villages have been declared Swachh Sujal, marking a milestone in holistic public health transformation.

Economic and Health Benefits for Rural Households

• Reduced Health Expenditure: Improved sanitation and water access lead to lower out-of-pocket healthcare costs for rural families.
• Preventive Healthcare: The focus on water, sanitation, and hygiene strengthens the preventive healthcare model, improving the overall health of communities.

Sanitation and Water: The Foundation of Public Health

• First Line of Defence: Sanitation and water act as the invisible shield protecting communities from disease, women from indignity, and children from lost opportunities.
• Impact on National Health: A healthy nation is a productive nation, and a clean nation is a resilient one.
• Tap Water Connections: Over 80% of India’s rural households now have tap water connections.
• Open Defecation Free (ODF) Status: More than 96% of villages have been declared ODF Plus.
• Waste Management Systems:
  • 5.07 lakh villages have solid waste management systems.
  • 5.23 lakh villages have liquid waste management systems in place.

Empowering Women in Sanitation and Water

• Role of Women: Women are not just beneficiaries but also water testers, sanitation entrepreneurs, and local leaders.
• Training and Leadership:
  • Over 2.48 million women trained to test water quality.
  • Women-led Self-Help Groups manage sanitation assets, recycling centres, and even sanitary napkin production.

The Vision of a Viksit Bharat (Developed India)

• No Child Misses School: No child misses school due to lack of water.
• No Woman Carries Water: No woman walks miles with a pot on her head.
• No Preventable Illness: No family loses a loved one to preventable illness.

Linking Health, Dignity, and the Sanitation Chain

Sanitation Link	Impact
Toilets	Privacy and dignity for individuals, especially women.
Clean Water	Brings opportunity, reduces waterborne diseases, and empowers communities.
Waste Management	Protects the environment and improves overall public health.

• The Journey to Health: The journey to health is ultimately the journey to dignity.
• Collaboration for Success: The lessons learned emphasize the importance of inter-ministerial collaboration, which is non-negotiable for sustained success.

It is about convergence

• Health as a Collective Responsibility: Health outcomes result from collaborative efforts across sectors like water, sanitation, nutrition, education, and rural development.
• Global Model: India’s approach is not isolated but offers global solutions, especially for the Global South.
• Innovations and Technology:
  • Real-time dashboards to track progress and ensure transparency.
  • GOBARdhan biogas plants promoting clean energy and waste management.
  • Plastic waste management units focused on recycling and sustainability.
• Investment in WASH: Every rupee invested in Water, Sanitation, and Hygiene (WASH) yields significant returns in:
  • Health
  • Productivity
  • Gender equity
  • Environmental sustainability

Conclusion

India is dedicated to advancing the United Nations Sustainable Development Goals. This World Health Day, it is crucial to recognize that good health begins not in hospitals, but in homes with access to clean water, safe sanitation, and a shared resolve. As we progress, India remains committed to sharing its journey, collaborating globally, and co-creating a cleaner, healthier, and more resilient world.