Focusing On Diseases Sidelined By COVID-19

The Hindu     23rd August 2021     Save    

Context: Strengthening the primary healthcare system will help tackle the burden of non-communicable diseases (NCDs).

Need for focusing on NCDs

  • Global prevalence: 71% of all deaths worldwide occur due to NCDs such as hypertension, diabetes, cardiovascular diseases, chronic respiratory diseases, and cancer.
    • One out of every four deaths occurs due to cardiovascular diseases, especially among younger patients.
  • India’s vulnerability: In the Indian subcontinent, there is early onset and rapid progression of such diseases and a high mortality rate.
    • Premature loss of life due to NCDs in the age group of 30-69 years is also very high among Indians. 
    • Half the deaths due to cardiovascular diseases occur in the age group of 40-69 years.

Impact of the pandemic impact on NCD patients and services

  • Widespread disruption of NCD services:  A World Health Organization (WHO) survey conducted in May 2020 among 155 countries found that low-income countries were the most affected by this disruption. 
    • 53% of countries surveyed had partially or completely disrupted services for hypertension treatment.
    • 49% for treatment for diabetes and diabetes-related complications, 42% for cancer treatment and 31% for cardiovascular emergencies.
  • NCD patients are at higher risk of COVID-19 complications: Findings from an observational study in Delhi show that 47.1% of hospitalised COVID-19 patients had diabetes.
  • Resource re-allocation and shift in policy priority: 
    • In most countries, staff working in the area of NCDs were reassigned to support patients with COVID-19, and public screening programmes were postponed.
    • Shortage of medicines and diagnostics, cancellations of planned treatments, decreased availability of public transport, and lack of staff were the most common reasons for the disruption.
  • Rise in stresses due to pandemic lifestyle disruptions: 
    • Lockdowns and reduced physical interactions led to loneliness, especially in the geriatric population. This resulted in mental health disorders such as anxiety and depression.
    • Lockdowns increase exposure to NCD risk factors as people became more likely to increase their consumption of alcohol and tobacco and adopt an unhealthy diet.

Way forward: Effective and participatory leadership with strong vision and communication is the need of the hour to tackle the silent epidemic transition to NCDs.

  • Include NCD services in COVID-19 preparedness and response plans: Although most countries reported that they had included these, only 42% of low-income countries did so.
  • Strengthening the primary health system to prevent, diagnose and provide care for NCDs
    • Incentivising already overburdened ASHA workers for health promotion and primordial prevention of NCDs.
    • Access to essential NCD medicines and basic health technologies in all primary healthcare facilities is essential to ensure that those in need receive treatment and counselling. 
  • An ‘all of society multidisciplinary approach’: 
    • Strategies must include mitigation efforts to address administration challenges, a strong health workforce, infrastructure, supplies, maintaining the standard of care, and continued access and care for the vulnerable populations. 
    • Importance of physical activity and mental health due to restrictions on movement should be brought to the forefront.
    • Utilising the existing network of NGOs while respecting local factors will go a long way in tackling the growing burden of NCDs. 
  • Tech adoption: Use of alternative modalities such as online platforms for disseminating information on exercise and mental health management must be made available to the marginalised. 
    • Telemedicine can reduce travel expenses, thus lowering patients’ expenditure burden.