UPSC EDITORIAL ANALYSIS : Health advice to take with no pinch of salt
Kartavya Desk Staff
Source: The Hindu
• Prelims: Current events of national importance, WHO, NCDs, Salt, ICHI, ICMR, age tax, mortality, fertility rate, AI, robotic surgery etc
• Mains GS Paper I & II: Development and management of social sectors/services related to Health and education etc
ARTICLE HIGHLIGHTS
• World Health Organization (WHO)(2023) released a report, the first ever on hypertension, titled “Global report on hypertension: the race against a silent killer”.
INSIGHTS ON THE ISSUE
Context
Health:(WHO)
• A certain totality of health to the realms of mental and social well-being and happiness beyond physical fitness, and an absence of disease and disability.
• We cannot achieve health in its wider definition without addressing health determinants.
Non-communicable Diseases(NCD’s):
Hypertension (high blood pressure):
• It is a condition when the pressure in your blood vessels is too high (140/90 mmHg or higher). It is common but can be serious if not treated.
• Blood pressure is written as two numbers. The first (systolic) number represents the pressure in blood vessels when the heart contracts or beats. The second (diastolic) number represents the pressure in the vessels when the heart rests between beats.
• The first (systolic) number represents the pressure in blood vessels when the heart contracts or beats.
• The second (diastolic) number represents the pressure in the vessels when the heart rests between beats.
• World Hypertension Day is celebrated on May 17 every year to promote awareness about hypertension and encourage people to prevent and control this silent killer.
Hypertension in India:
• High blood pressure is the single most important risk factor for early deaths
• It leads to an estimated 10.8 million preventable deaths every year, globally.
• The number of adults with hypertension nearly doubled in the last three decades (since 1990) to reach 3 billion.
• Globally, an estimated 46% of adults with hypertension are unaware that they have the condition less than half (42%) with hypertension are diagnosed and treated. Only one in five adults (21%) with hypertension has it under control.
• less than half (42%) with hypertension are diagnosed and treated.
• Only one in five adults (21%) with hypertension has it under control.
• The Indian Council of Medical Research-INdia DIABetes (ICMR-INDIAB) study has estimated that in India, 311 million people (or one in every three adults) have hypertension. Adults with hypertension are threefold of the estimated 101 million people living with diabetes.
• Adults with hypertension are threefold of the estimated 101 million people living with diabetes.
#### Salt and Hypertension:
#### ● Excess dietary salt intake (five grams or more per day)
#### ● It is one of the key risk factors to hypertension
#### ○ Contributing to two million cardiovascular disease deaths in 2019.
#### ● Research studies have shown that by reducing salt
#### ○ cardiovascular disease risks can be reduced by 30% and mortality by 20%.
#### ● Indian adults consume on average 8-11 grams of salt per day
#### ○ It is approximately twice that of the WHO recommended daily salt intake.
#### ○ High salt intake is responsible for an estimated 1,75,000 deaths in India.
Survey by Foundation for People-centric Health Systems:
• It conducted 50 health camps in five localities of Delhi and Gurugram, from October 2023 to March 2024, and screened and treated around 12,000 people.
• Most of the people were women, migrant workers, and rickshaw and taxi drivers, nearly all from low income groups.
• A large number of them were found to have diabetes and hypertension
• Outcome: Majority of cases detected for the first time in these camps, indicating the gaps in terms of awareness, detection and treatment.
Hypertension and India:
• Government has set a target of putting 75 million people with hypertension and/or diabetes on standard care by 2025.
• The India Hypertension Control Initiative (IHCI): It is collaborative project of the ICMR, Ministry of Health and Family Welfare/Directorate General of Health Services, WHO India and other partners It was initiated in 2017 in 25 districts in five States of India.
• It was initiated in 2017 in 25 districts in five States of India.
• The IHCI won the ‘2022 UN Interagency Task Force, and WHO Special Programme on Primary Health Care Award’.
• The IHCI was expanded to 140-plus districts of India, in 2023
Strategies followed by IHCI:
• The IHCI rolled out simplified drug and dose-specific treatment protocols for primary-care settings.
• It focused on strengthening the drug supply chain By including protocol-based drugs in the State essential drug list the forecasting of drugs based on morbidity ensuring adequate budget allocation in annual plans to purchase hypertension medication.
• By including protocol-based drugs in the State essential drug list
• the forecasting of drugs based on morbidity
• ensuring adequate budget allocation in annual plans to purchase hypertension medication.
• The IHCI has followed team-based and decentralized care.
• Components to make health services patient-centric by measures such as the dispensing of 30 days of medicine in every patient visit are part of the initiative.
• It has used information systems for programme monitoring.
Results of IHCI implementation:
• The development of simple treatment protocols with fewer drugs, ensuring reliable drug supply
• Linking patients to facilities closer to home for follow-up and engaging teams increases access and utilization of health services from government facilities By bringing people to health services.
• By bringing people to health services.
• Simplified programme monitoring makes programme performance assessment both quantifiable and actionable.
What steps need to be taken to control Hypertension?
• 76 million cardiovascular deaths and 450 million disability adjusted life years (DALYs) would be avoided If countries, with proven interventions, mobilize to achieve the goal of 50% population hypertension control by 2050.
• If countries, with proven interventions, mobilize to achieve the goal of 50% population hypertension control by 2050.
• An estimated 4.6 million deaths can be prevented in India by 2040 if half the hypertensive population has its blood pressure under control. This will help countries achieve the targets under their National Health Policy along with global targets and commitments such as universal health coverage.
• This will help countries achieve the targets under their National Health Policy along with global targets and commitments such as universal health coverage.
• Raise awareness about the risk of and long-term adverse impact of untreated hypertension. High blood pressure can affect the entire vascular system (multiple organs including the heart, kidneys, brain and eyes).
• High blood pressure can affect the entire vascular system (multiple organs including the heart, kidneys, brain and eyes).
• Scale up evidence-based public health interventions such as the IHCI. Strategies and lessons from such experiences should be used to design and implement interventions To prevent and control other lifestyle diseases such as diabetes mellitus and chronic kidney diseases. The interventions in health programmes are often targeted on modifiable risk factors. However, there are non-modifiable risk factors such as family history. Hypertension control initiatives in India need to focus on the healthy adults as well, who may have known non-modifiable risk factors. Intensify efforts to reduce dietary salt consumption using strategies such as ‘SHAKE the salt habit’ under the WHO’s HEARTS strategy. Approaches under SHAKE: Surveillance to measure and monitor salt use Harness industry to promote and reformulate foods and meals that contain less salt Adapt to standard labeling and marketing Knowledge, educate and communicate to empower individuals to eat less salt Environment — support settings that promote healthy eating. Lifestyle diseases demand multi-sectoral actions. In 2017, India developed and approved a multi-sectoral plan for the prevention and the control of non-communicable diseases. These plans must be revisited and more concrete actions done by key sectors. Raise awareness about salt in food. There is invisible salt in the form of pickles, breads, namkeen and papad. Food packages need to have better labeling of items/packets in terms of low, medium and high salt content. People need to be sensitized to read food package labels and make informed decisions.
• Strategies and lessons from such experiences should be used to design and implement interventions To prevent and control other lifestyle diseases such as diabetes mellitus and chronic kidney diseases.
• To prevent and control other lifestyle diseases such as diabetes mellitus and chronic kidney diseases.
• The interventions in health programmes are often targeted on modifiable risk factors. However, there are non-modifiable risk factors such as family history. Hypertension control initiatives in India need to focus on the healthy adults as well, who may have known non-modifiable risk factors.
• However, there are non-modifiable risk factors such as family history.
• Hypertension control initiatives in India need to focus on the healthy adults as well, who may have known non-modifiable risk factors.
• Intensify efforts to reduce dietary salt consumption using strategies such as ‘SHAKE the salt habit’ under the WHO’s HEARTS strategy. Approaches under SHAKE: Surveillance to measure and monitor salt use Harness industry to promote and reformulate foods and meals that contain less salt Adapt to standard labeling and marketing Knowledge, educate and communicate to empower individuals to eat less salt Environment — support settings that promote healthy eating. Lifestyle diseases demand multi-sectoral actions. In 2017, India developed and approved a multi-sectoral plan for the prevention and the control of non-communicable diseases. These plans must be revisited and more concrete actions done by key sectors. Raise awareness about salt in food. There is invisible salt in the form of pickles, breads, namkeen and papad. Food packages need to have better labeling of items/packets in terms of low, medium and high salt content. People need to be sensitized to read food package labels and make informed decisions.
• Approaches under SHAKE: Surveillance to measure and monitor salt use Harness industry to promote and reformulate foods and meals that contain less salt Adapt to standard labeling and marketing Knowledge, educate and communicate to empower individuals to eat less salt Environment — support settings that promote healthy eating.
• Surveillance to measure and monitor salt use
• Harness industry to promote and reformulate foods and meals that contain less salt
• Adapt to standard labeling and marketing
• Knowledge, educate and communicate to empower individuals to eat less salt
• Environment — support settings that promote healthy eating.
• Lifestyle diseases demand multi-sectoral actions. In 2017, India developed and approved a multi-sectoral plan for the prevention and the control of non-communicable diseases. These plans must be revisited and more concrete actions done by key sectors.
• In 2017, India developed and approved a multi-sectoral plan for the prevention and the control of non-communicable diseases.
• These plans must be revisited and more concrete actions done by key sectors.
• Raise awareness about salt in food. There is invisible salt in the form of pickles, breads, namkeen and papad. Food packages need to have better labeling of items/packets in terms of low, medium and high salt content. People need to be sensitized to read food package labels and make informed decisions.
• There is invisible salt in the form of pickles, breads, namkeen and papad.
• Food packages need to have better labeling of items/packets in terms of low, medium and high salt content.
• People need to be sensitized to read food package labels and make informed decisions.
Way Forward
• Stronger enforcement of food regulation in India has the potential to prevent many diseases and reduce the burden on health services. There needs to be higher taxation on high salt (and also high sugar, high fat) food and other packaged products.
• There needs to be higher taxation on high salt (and also high sugar, high fat) food and other packaged products.
• Regular checking of one’s blood pressure should become an integral part of lifestyle. Access to BP apparatus needs to be increased in public places such as malls, shops and pharmacies, where people can have their BP measured either free or at nominal and affordable charges.
• Access to BP apparatus needs to be increased in public places such as malls, shops and pharmacies, where people can have their BP measured either free or at nominal and affordable charges.
• Every office and workplace needs to have a functional BP apparatus and employees should be encouraged to check their BP regularly.
• Every single visit to health-care providers should be used to measure one’s BP.
• Physicians should advise/sensitize people to measure and monitor their BP.
QUESTION FOR PRACTICE
Besides being a moral imperative of the Welfare State, primary health structure is a necessary precondition for sustainable development.” Analyze.(UPSC 2021) (200 WORDS, 10 MARKS)
Editorial Analysis – 18 May 2024