Exclusion is not uncommon in India’s healthcare system. Worryingly, this kind of exclusion has been exacerbated by the pandemic. A pertinent example to illustrate this point would be the slowing down in India’s efforts to detect and treat tuberculosis and other serious ailments because of the dominance of the coronavirus on healthcare policy and interventions. The first half of 2021 witnessed a 25 per cent fall in the count of new tuberculosis patients in comparison to the same period in 2019; this decline has sparked fears among experts that patients are going undiagnosed because most of the available medical resources are being routed to tackle Covid-19. This, however, is not the only challenge. A report in The Lancet has now revealed that the rate of non-communicable neurological disorders and neurological injuries of the total disease burden — strokes, dementia, epilepsy, cerebral palsy, Parkinson’s disease and so on — has more than doubled between 1990 and 2019.

The battle ahead will be tough and twofold. Studies have shown that ‘lifestyle diseases’ claim more lives in India than their infectious counterparts. An ageing population, urban congestion, poor diet and hygiene, lack of exercise as well as climate change are some of the factors that have aggravated the risk. Second, given its evolving, highly-infectious variants, Covid — comorbidities exacerbate its risks — will remain a challenge in spite of the presence of vaccines. The dual threat must be met with robust investments. Dedicated systems of scrutiny and care — disease-specific funding, trained medical personnel, reliable supply chains, efficient care facilities, roping in of private players — must be conceived and implemented. Some of these measures would address the existing paucities in disease surveillance systems and poor access to diagnostic services and insurance. This must be accompanied by an unambiguous signal in favour of changes in lifestyle. The use of bicycles, the taxing of packaged food or introducing nutritious food in dietary preferences need to be contemplated. The edifice of a strong nation does not rest on hollow political signals. It can only be built by safeguarding the health of its citizens.