Many of us have grown up listening to our grandparents talking about how people were healthy in the olden days and how this generation is weak and remains sick. I am no exception.
Often my grandmother would regale me with stories of how her brothers or uncles had superhuman strength. A closer examination of the family revealed that while she had 5 siblings, she almost had a few who had died young under 5 years mostly. We call this infant mortality or under 5 mortalities.
Today we stand at infant mortality, the number of deaths for every 1000 live births is 27, way lower than during independence but much higher than we want to be. So, while those who survived as children grew up to be very strong and healthy, many of these infants never saw the light of day.
This is probably our greatest achievement in the healthcare industry in India.
Similarly, if we cast a look at life expectancy, we have outdone ourselves, adding almost 5 years to our lives every decade. In 1950 our life expectancy stood at 46; today it is almost 70. It is expected that the person to live to 150 has already been born in Japan and India will soon follow suit.
Why is this happening? Did we grow suddenly strong on our worn? The answer is obviously no. We improved on healthcare parameters due to a combination of factors
- Government Spending on Health – The British hardly spent on our healthcare infrastructure. This became very apparent during the plagues that consumed India in the early 1900s and the Spanish Flu in 1914. Since independence, the government spending on healthcare has increased every year, with a few exceptions, areas like
- Public Health- Health Information, Disease Surveillance
- Primary Health- Vaccination Programs, preventive schemes
- Care for Expecting Mothers- Mid Wives Schemes
- Care for children- Mid-Day Meal Schemes
- Setting up of District Hospitals, PHCs, and CHCs
- Medical Colleges – MAMC, KGMC Etc.
- Specialty Hospitals- AIIMS, PGI, etc.
- Nutrition Standards – There was an increase in the standards of nutrition after independence. While the Green Revolution led to increased grain production, programs like NDDB and AMUL led to self-sufficiency in dairy, and Silver Revolution led to increased egg production. These were critical to our improved health standards
- Growth of economy- The economic growth created a model for the consumption of better health services that spurred the private section to set up institutes like Apollo Hospitals, Manipal, etc that not only attracted the top talent to take up medicine, but also investment in areas like drug discovery, pharmaceuticals, diagnostics and technology that is siding this growth in our healthcare parameters
- Education- An increase in education levels led to awareness about bad habits like Smoking and the impact that they had on health. Interestingly literacy rates are high as 74%, which has improved the growt5h of the economy but also has led to an increase in awareness about good health practices. The smoking rate for example has fallen to almost 27%, from a high of 40 %.
So, what can we expect in the next 25 years as we would reach 100 years of freedom? These are some of my insights.
- Health would become a national obsession, and individuals armed with data and technology on their personal devices would take charge of their health, relying more on prevention and proactive intervention
- Research and Development will see an increased focus, with investments both in human capital, processes, innovation, strategy as well as technology. I shared some thoughts on this issue some time ago.
- Genetic Mapping would a play role in the diagnosis and treatment of chronic as well as lifestyle diseases, medicine as we know it will change forever.
- Noninfectious diseases especially the ones we call Non-Communicable Diseases would become the new battleground, where measurement and constant monitoring would be key
- India or some sections of it would achieve literal immortality as organ transplants would become more common. Bionic transplants would become commonplace, with those who can afford these transplants going in for 5 yearly replacements to enhance functionality and quality of life
- The focus would switch from life expectancy to quality of life, today while we are living longer we still spend almost 50% of that life in poor health.
In conclusion, we have come a long way. But this is a good time to reflect and get more ambitious about our healthcare goals for the future.
What should be some of these goals? As always look forward to your comments and questions on the same.