An epidemic of non-communicable diseases may seem like an oxymoron. But there is no better way to describe India’s NCD burden. A report published in The Lancet shows that, for people between the age of 30 and 70 in India, the risk of dying from one of the four major NCDs is 20 per cent in women and 27 per cent in men. Needless to say, India is unlikely to meet the sustainable development goals for 2030. The first challenge in fighting NCDs is skewed policies. The curative approach — which was the norm for communicable diseases — does not work with NCDs, many of which, once contracted, are only treatable, not curable. Detection and screening are the first step to managing NCDs. This leads to the next obstacle. The poor primary healthcare infrastructure in India means that few professionals at the grass roots have the acumen to recognize symptoms or link these to complications that may arise in the future. For instance, the early indications of chronic obstructive pulmonary disorder — cough, cold and fever — are seldom diagnosed correctly. Then, symptoms of many NCDs manifest differently in men than they do in women. Further, any policy initiative aimed at promoting lifestyle changes has to contend with the marketing efforts of multimillion-dollar global enterprises such as the alcohol, tobacco and fast-food industries.

The exorbitant costs of treating NCDs, including lengthy and expensive treatment along with possible loss of income, make tackling these more difficult. But the launch of the government’s flagship health programme, Ayushman Bharat, could have gone a long way towards reducing the out-of-pocket expenditure associated with NCDs. But the insurance component of the scheme is inextricably tied to extensive hospitalization, something that most NCDs do not require. For preventive and promotive healthcare, the scheme proposes the creation of 1,50,000 health and wellness centres — nothing but a renaming of primary healthcare centres. Again, the idea has potential, but it suffers from a lack of funds. The last budget allocated Rs 1,200 crore for these centres, which comes to around Rs 80,000 per centre per year. This is will allow little more than cosmetic repairs. Without proper funding, even the most imaginative and comprehensive health project is bound to fail.