Gundu H. R. Rao*
Lillehei Heart Institute, Medical School
University of Minnesota, Minneapolis, Minnesota, USA.
South Asians (Indians, Pakistanis, Bangladeshis and Sri Lankans) have the highest incidence of coronary artery disease (CAD) compared to any other ethnic group in the world. To create awareness, develop educational and preventive programs, a society (South Asian Society on Atherosclerosis and Thrombosis, SASAT) in 19931 has been started at the University of Minnesota (www.sasat.org). Since then, international conference on “Atherosclerosis and Thrombosis” have been organised, every other year in India. Three books on the subject have been published.” SASAT has partially funded a project in India, called India Heart Watch which is aimed at evaluating the role of life style of people in 21 States of India, on the development of CAD risk.
The World Health Organization (WHO) estimates that incidence of diabetes (type-2) will increase by 200% in India in the next two decades. The WHO estimates 60% of the world’s cardiac patients will be Indian by 2010 and half of all deaths in India, probably will be due to CAD by 2015. According to a recent communication (www.procor.org)5 cardiovascular diseases (CVDs) are not included in the top priority list in the Ninth-Five Year Plan for Health, prepared by the Government of India. This seems to be true of the World Health Organization agenda as well.
Indeed, it was India that was responsible for requesting the WHO to initiate a cardiovascular program some fifty years ago. At that time, probably there was no hard data available to suggest that this disease was a major epidemic or a health burden. However, now it is very well recognized that Diabetes, CAD and Cancer constitute a major health burden for the developing countries. Indeed, Cancer and Cardiovascular Diseases together, account for over 72% of the global mortality from non-communicable diseases.
INITIATIVES AND PRIORITIES
At a time like this, when immediate action is needed, there seems to be very little interest in India to create a national platform or develop action plans for primary prevention and integrated treatment of these chronic and malignant diseases. I have been watching the growth and activity of the non-communicable disease section of WHO, and I do not see any hope for its expansion or a greater role. I strongly feel the need for a renewed effort from professionals, individuals with interest in community health, NGOs, and professional societies, to develop their own action plans and find ways and means to implement such plans program.
Furthermore, every attempt should be made to convince the decision making bodies in India, to establish a national platform for the fight against non-communicable diseases. Individual Nations should approach WHO, and request them to prioritize their programs and play a significant role in alleviating these chronic and malignant diseases.