On cardiac care (The Hindu)

Mains Paper 2: Health
Prelims level: Cardiovascular disease
Mains level: Healthcare related issues

Context

• The reinvention of the wheel can be painful. Taking lessons from those who have already run the wheel several revolutions and tweaking (improving) those lessons for domestic conditions might not be a bad idea.
• For India, there is indeed valuable learning from the results of the Prospective Urban Rural Epidemiology (the branch of medical science dealing with the transmission and control of disease) - PURE study published in The Lancet this week.

Key highlights of the study

• Studying the situation in 21 countries across five continents, categorized by income levels, researchers showed that while cardiovascular disease (CVD) is the leading cause for death overall, there have been some transitions, particularly in the high-income countries, which have managed to reduce the number of deaths from CVD.
• In low-income countries, including India, however, CVD is still the top killer, with death three times more frequent than that due to cancer.
• What flies in the face of logic is that the risk burden of CVD-linked mortality is inversely proportional — lower risk but higher mortality in low-income countries, and higher risk but lower mortality in high-income countries.
• PURE’s analysis concluded that the higher mortality in poorer countries was likely due to other factors, including ‘lower quality and less health care’. Access to affordable, quality health care is still a dream in many pockets in India.

Steps taken by government

• A great amount of out-of-pocket expenditure (according to Health Ministry data for 2014-15, nearly 62.6 % of India’s total health expenditure) often frustrates continuation of treatment or adherence to drug regimens.
• While some States have shown limited successes with government-sponsored health insurance schemes, the Centre’s Ayushman Bharat Yojana will have to take much of the burden of hospitalization for complications of non-communicable diseases.
• National and State schemes running on mission mode, including the National Programme for Prevention and Control of Cancer - NPPCC, Diabetes, CVD and Stroke will have to step up efforts to target people at risk with life-saving interventions.
• While most of the predominant risk factors for CVD - cardiovascular disease present no startling (surprising) medical revelation, it is significant that the single largest risk factor is a low education level.
• Any plans that target the risk factors and prevent the onset of non-communicable diseases will clearly have to be truly game-changing and incorporate the environmental angle as well.
• However, governments will have to muscle up to tackle a rather startling finding — ambient air pollution and indoor air pollution have an impact on CVD and mortality.

Way forward

• It is no doubt part of the job description of the National Programme to modify this risk factor. Household air pollution is the third top risk factor in low-income countries, according to the study.
• Targeting risk factors is the key to reducing deaths due to cardiovascular diseases. The need of the hour is out-of-the-box solutions combined with inspiration from models of those who seem to have belled this particular cat.

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Prelims Questions:

Q.1) With reference to ‘NISHTHA’, which of the following statements is/are NOT correct?
1. It was launched by the Ministry of Skill Development and Entrepreneurship in August 2018.
2. It is the largest industrial training programme in the world.
3. Its objective is to motivate and equip teachers to encourage and foster critical thinking in students.

Select the correct answer using the code given below:
A. 1 and 2 only
B. 2 and 3 only
C. 1, 2 and 3 only
D. 3 only

Answer: A
Mains Questions:
Q.1) Critically examine the targeting risk factors is key to reducing deaths due to cardiovascular diseases.