Diabetes on the rise in India

White paper at national summit emphasises capacity building, training of healthcare workers

By Jyotsna Singh
Published: Tuesday 11 June 2013

Photo credit — Heather Aitken

With more than 100 million people in India likely to develop diabetes by 2030, a white paper released at the recent national summit on non-communicable diseases (NCDs) described ambiguous policies by the government as a hurdle to containing diseases such as diabetes. The paper on management and care of diabetes in India states that “clarity on roles and responsibilities of existing manpower, with clear delegation of funds, functions and functionaries” is the need of the hour.

Speaking at the National NCD summit on June 7, Union health secretary Keshav Desiraju also expressed the need for a dedicated work force of intermediate level public healthcare workers apart from accredited social health activists (ASHAs) to focus on tackling NCDs. He suggested that there should be specific models of public private partnerships evolved with clear identification of roles and responsibilities.

Capacity building is key

The recommendations presented in the white paper are aimed at strengthening national policies and programmes for the management of diabetes. They were prepared with inputs received from five state roundtable forums with multi- stakeholder groups organized at state capitals of Rajasthan, West Bengal, Kerala, Maharashtra and Chhattisgarh.

Counting costs
  • A diabetes patient in India spends on average about Rs 3,500 on hospital outpatient costs
  • The costs double to Rs 7,500 on average for a patient who has to seek hospital inpatient care as a result of diabetes
  • Once complications arising from diabetes turn severe and require surgical intervention, costs can balloon to Rs 100,000 on average
  • Diabetics with renal, cardiovascular and retinal complications spend three times more than patients with only diabetes
One of the major recommendations is to focus on building capacity of the primary healthcare workforce. The paper also suggests introducing innovative educational tools for training, such as diabetes conversation maps.

Jagdish Prasad, director general of health services, health ministry, said his department is planning to introduce health education courses at the school level. The move is necessary keeping in mind changing life style leads to early onset of the disease, he said.

Expenses mount

Diabetes caused almost one million deaths in India in 2012, becoming one of the highest contributors to mortality in the country. At present more than 61 million people in India have diabetes – 12 per cent higher than last year’s figure of 50.8 million. The International Diabetes Federation estimates that 9.2 per cent of adults in India have diabetes, making India the second country after China to have the highest prevalence of the disease. This results in high cost of treatment.

Talking about the economics of diabetes, Kiran Mazumdar Shaw, chairman and managing director, Biocon Limited, and chairperson, National Committee on Biotechnology of the Confederation of Indian Industry (CII), said healthcare spending on diabetes in India is estimated at $2.8 billion. “This represents less than 1 per cent of the $ 310 billion global expenditure. The US spends about $176 billion, or 56 per cent of global expenditure on the disease,” she said. The poorest persons with diabetes in India spend an average of 25 per cent of their family income on healthcare, she added.

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