Burden of Disease in India - World Health Organization

1 MINISTRY OF Health AND FAMILY WELFAREGOVERNMENT OF India , 2005 Background Papers of theNational Commission onMacroeconomics and HealthEQUITABLE DEVELOPMENT HEALTHY FUTUREB urden of Diseasein IndiaBurden of Disease in IndiaBackground Papers of the National Commission on Macroeconomics and HealthBackground PapersBackground PapersBackground PapersBackground PapersBackground PapersNational Commission onNational Commission onNational Commission onNational Commission onNational Commission onMacroeconomics and HealthMacroeconomics and HealthMacroeconomics and HealthMacroeconomics and HealthMacroeconomics and Health324 NCMH Background Papers Burden of Disease in

2 IndiaGururajNCMH Background PapersBurden of Disease in India324 NCMH Background Papers Burden of Disease in IndiaGururajNCMH Background PapersBurden of Disease in IndiaNational Commission on Macroeconomics and HealthMinistry of Health & Family Welfare, Government of India , New DelhiSeptember 2005lR;eso t;rsivNCMH Background Papers Burden of Disease in IndiaNCMH Background Papers Burden of Disease in India (New Delhi, India ), September 2005 Ministry of Health & Family Welfare, Nirman Bhawan, Maulana Azad RoadNew Delhi 110011, IndiaThe report has been technically edited byBYWORD EDITORIAL CONSULTANTSNew Delhi, Indiae-mail: at Shree Om Enterprises Pvt.

3 Ltd., A-98/3 Okhla Industrial Area, Phase II, New Delhi 110020 Dosage schedules are being constantly revised and new side-effects recognized. The reader is thusstrongly urged to consult the printed instructions of drug companies before administering any ofthe drugs recommended in this book. It is possible that errors might have crept in despite our bestefforts to check drug dosages. 2005 National Commission on Macroeconomics and Health , Government of IndiavNCMH Background Papers Burden of Disease in IndiaContentsPreface .. Burden in India : Estimations and causal I: NATIONAL Health PROGRAMMES: COMMUNICABLE DISEASES,AND REPRODUCTIVE AND CHILD HEALTHN ational Health ProgrammesProgrammes for the control of leprosy, tuberculosis and TA R SINGH DUAB urden of tuberculosis in India for the year 2000.

4 24 TUBERCULOSIS RESEARCH CENTRE, CHENNAIC ausal analysis and treatment protocols for tuberculosis .. 26 TUBERCULOSIS RESEARCH CENTRE, CHENNAIC ausal analysis and treatment protocols for vector-borne diseases: Malaria, dengue, Japaneseencephalitis, kala-azar, lymphatic filariasis .. 30 VECTOR CONTROL RESEARCH CENTRE, PONDICHERRYHIV/AIDSC ontrolling the HIV/AIDS epidemic in India .. 44 YING-RU J. LO, PADMAJA SHETTY, REDDY, SALIM HABAYEBHIV-1 trends, risk factors and growth in 58 RAJESH KUMAR, PRABHAT JHA, PAUL ARORA, NEERAJ DHINGRA, INDIAN STUDIES OF HIV/AIDS WORKING GROUPC ausal analysis and treatment protocols for sexually transmitted infections, HIV/AIDS andopportunistic 74 NATIONAL AIDS RESEARCH INSTITUTE, PUNEM aternal and Child HealthReview of women and children s Health in India : Focus on safe 85 RAJANI R.

5 VED, AV TA R SINGH DUAC ausal analysis and treatment protocols for maternal 112 SARALA GOPALAN, SHALINI GAINDERviNCMH Background Papers Burden of Disease in IndiaComponents of under-five mortality trends, current stagnation and future forecasting 152 ARVIND PANDEY, BHATTACHARYA, D. SAHU, REHENA SULTANAN ewborn and child Health in India : Problems and interventions .. 179 SIDDARTH RAMJIE stimation of the Burden of diarrhoeal diseases in India .. 182 NATIONAL INSTITUTE OF CHOLERA AND ENTERIC DISEASES, KOLKATAC ausal analysis and treatment protocols for childhood diseases .. 188 SIDDARTH RAMJISECTION II: NON-COMMUNICABLE DISEASESV ascular DiseasesForecasting vascular Disease cases and associated mortality in India .

6 197A. INDRAYANS uggested treatment for selected cardiac disorders at secondary-level Health care facilities in low-resourcecountries .. 216 CENTRE FOR CHRONIC Disease CONTROL, NEW DELHIC ancersCancer: Current scenario, intervention strategies and projections for 2015 .. 219M. KRISHNAN NAIR, CHERIAN VARGHESE, R. SWAMINATHANM ental HealthMental, neurological and substance abuse disorders: Strategies towards a systems approach .. 226 GURURAJ G., GIRISH N., ISAAC and COPDE conomic Burden of asthma .. MURTHY, SASTRYE conomic Burden of chronic obstructive pulmonary Disease .. MURTHY, SASTRYOral and Dental DiseasesOral and dental diseases: Causes, prevention and treatment strategies.

7 275 NASEEM SHAHB lindnessNational Programme for Control of Blindness .. 299AV TA R SINGH DUAB lindness estimations, projections and service delivery .. 305 MURALIKRISHNAN R., PRAVEEN KRISHNA R., THULASIRAJ , DAMODAR BACHANI, SANJEEV GUPTA, MURTHYC ontentsviiNCMH Background Papers Burden of Disease in IndiaAppendix to Section IIServices, equipment, personnel and drugs required at different levels of Health care for non-communicablediseases .. 318 BARIDALYNE NONGKYNRIH, CHERIAN VARGHESESECTION III: INJURYI njuries in India : A national perspective .. 325 GURURAJ A: Causes of various diseases/ Health conditions ..351 NATIONAL COMMISSION ON MACROECONOMICS AND Health , NEW DELHIA nnexure B: Interventions for the management of diseases/ Health conditions at different levels of care.

8 362 NATIONAL COMMISSION ON MACROECONOMICS AND Health , NEW DELHIC ontentsviiiNCMH Background Papers Burden of Disease in IndiaixNCMH Background Papers Burden of Disease in IndiaPrefaceIn pursuance of the recommendations made by theCommission on Macroeconomics and Health , Indiaestablished the National Commission on Macroeconomicsand Health (NCMH) in March 2004. The main objectiveof the NCMH was to establish the centrality of Health todevelopment and make an evidence-based argument toincrease investment in Health . The Terms of Reference ofthe NMCH were mainly centred on identifying a packageof essential Health interventions that ought to be madeavailable to all citizens and also list systemic constraintsthat need to be addressed for ensuring universal access tothis package of services.

9 The NCMH was also to indicatethe resources required and targets that ought to be achievedby of the Terms of Reference of the NCMH was to comeup with a baseline of the estimated prevalence of diseasesin India , particularly those that disproportionately affectthe poor now or have the potential to do so in the on such estimations, the Commission was to indicatetargets that could be achieved within a specific , the NCMH invited leading experts in thecountry to assist in identifying those diseases/conditionsthat were responsible for high levels of mortality andmorbidity and, if unchecked, could have ruinous implicationsfor a majority of households in India .

10 The experts were alsogiven three other tasks: (i) to project the Disease Burden ina decade from now, assuming the current status quo in termsof policy attention and investment levels; (ii) identify theproximate, direct and indirect causal factors that, if tackledadequately, could substantially reduce Disease incidenceand thereby enhance welfare; and (iii) provide a minimalstandard treatment protocol listing the interventions thatought to be undertaken at different levels of care to avertdeath and reduce progression of Disease . This informationwas to enable us to cost the interventions and arrive at thequantum of investment required to achieve the aspiration ofuniversal access to essential Health experts identified 17 diseases /conditions that publicpolicy needed to take note of on priority.