Preventive Health From the PROs

For one and a half years, the coronavirus pandemic has overwhelmed healthcare systems across the world. While this pandemic deserves its status of paramount priority, it is imperative to note that its onset has derailed the medical community from one of its most critical objectives: to fight the scourge of Non-Communicable Diseases (NCDs).

Non-communicable diseases are those illnesses that are not directly transmissible from one person to another. Some examples of NCDs are cardiovascular diseases (stroke, heart attacks, etc.), cancers, respiratory diseases, obesity, diabetes, Alzheimer’s, arthritis, autoimmune diseases, Parkinson’s, etc. One’s genetic, physiological, environmental, and behavioural conditions may cause one to be afflicted by an NCD, due to which people across ages, regions, and socioeconomic groups are susceptible to it. Most people cite unhealthy lifestyles, ageing populations, and rapid urbanisation as the main reasons that NCDs have permeated the world population so prolifically.

Since these diseases are relatively well-researched and cannot “spread” in the conventional sense, we often neglect the threat they pose to public health. To put things into perspective, NCDs are responsible for 71% of all annual deaths globally, claiming 41 million lives a year, around 15 times the average number of lives claimed by the coronavirus in a year globally. Note that 37% of these deaths are premature (between the ages of 30 and 69 years). The annual death tolls of the most lethal NCDs are: cardiovascular disease (17.9 mil), cancers (9.3 mil), respiratory diseases (4.1 mil), diabetes (1.5 mil).

Going beyond public health, NCDs also threaten nations’ economies. The increased cost of treating NCDs coupled with the incapacitation of working members of the family puts a significant financial burden on low and middle-income households across the world, where 85% of “premature” NCD deaths occur. This puts individuals in the unenviable position of having to choose between their health and their livelihood, as if they are mutually exclusive entities. All this is to say that NCDs pose a substantial threat to our collective well-being, and are worth combatting with urgency as a global healthcare community. This is why the agenda of manifesting a 30% reduction in premature mortality due to NCDs even made it onto the United Nations’ list of Sustainable development goals to achieve by 2030.

Needless to say, the coronavirus pandemic threw a significant spanner in the works of the UN’s grand plan. The WHO has revealed that since the onset of the COVID-19, essential health services dedicated to the treatment of NCDs have been dislodged in 90% of the countries, with NCD-intended resources (manpower, funds, and physical assets) being partially/fully redirected towards treating COVID patients in 94% of countries. Low and middle-income countries, where the burden is most felt, were found to be the least likely to prioritise NCDs at this time.

We are not currently in a position to foresee when this pandemic is likely to plateau and relieve our healthcare systems sufficiently to shift their focus to NCDs. In such an environment, the platitude “prevention is better than cure” is worth bringing to action. The one saving grace with NCDs is that they can be prevented by controlling a range of lifestyle-related risk factors. Excessive alcohol consumption accounts for 3.3 mil annual deaths, 3.2 mil due to physical inactivity, 6 mil due to smoking tobacco, 1.7 mil due to poor diet. Additionally, almost every NCD on the list is brought about or exacerbated by an amalgamation of such poor habits. Preventive health is a cocktail of clinical preventive services and diagnostic tests aimed at identifying and getting a head-start on treating NCDs to avoid graver health issues downstream. There are 4 levels of prevention: primordial, primary, secondary, and tertiary. At the primordial level, a population health approach is employed to address fundamental health determinants like sanitation, childhood lifestyle, etc. Examples of primary interventions are lifestyle changes, and vaccinations, both with attention to disease-specific risk factors. Secondary prevention, which we believe to be the most important, involves diagnosing and treating pre-clinical conditions through screening tests and economical interventions targeted at specific NCDs. Diseases are delayed, reversed, or arrested at the tertiary level with high patient contact.

Therefore, the establishment of preventive health services across the world could simultaneously temper NCDs’ burden on health systems, and set the world back on track for the 2030 agenda.

Apollo ProHealth is a pioneer in India’s secondary preventive health prerogative. We offer a range of packages with comprehensive end-to-end preventive healthcare tailored to specific target health groups. Each package typically comprises a health risk assessment, custom diagnostic tests, physician consultation, and most distinctively, an app to provide long term personalised preventive health services (goal-setting, parameter tracking, health mentor checkups, wellness/fitness/medical consultation, etc.) outside the confines of the hospital, so as to keep patients on the path to a healthier life.