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Of all the major health threats, none have challenged the foundation of public health system as the rise of NCDs that are costing human life and depleting the exchequer

Let’s just quickly analyse the threat of NCDs from India’s perspective. We are the third most obese nation after the United States of America and China, and second only to China in the number of type-2 diabetes cases. Diabesity is obesity and diabetes clubbed together, and it has emerged as a considerable threat by spreading like a slow poison.

Also, NCDs are no longer restricted to the urban areas as was the case until a few years ago. Obesity and type-2 diabetes cases are soaring even in rural areas. During our visits to health camps in rural areas, we have witnessed a sharp rise in the number of Type-2 diabetes cases. So, as a state, we need to cater to the patients at the grassroots and guide them so that such diseases can be prevented. The state should target the prevention of obesity and diabetes, rather than trying to cure them.

‘Schools should be prohibited from allowing the students to eat foods that are too high on salt, sugar and other unhealthy ingredients. One more thing that policymakers should seriously deliberate on is enforcing a ban on advertisements that lure children to fast food.’

We can manage NCDs better if we design a multi-pronged strategy aiming solely at the prevention aspect. For this, we have to target at the right time, which is just after a baby is born. Our programmes should be designed so well that they can become part of education. At the school level, food supplied to the children must be supervised, and we should keep them away from fast food.

Salt and sugar are the two widely available substances that are killing the new generation. We need to take measures to control their rampant misuse. Schools should be prohibited from allowing the students to eat foods that are too high on salt, sugar and other unhealthy ingredients. One more thing that policymakers should seriously deliberate on is enforcing a ban on advertisements that lure children to fast food.

Coming to healthcare services in Maharashtra, and Mumbai in particular, the nation’s financial capital is one of the top-most destinations for healthcare services across the world. The city has the world’s best doctors and resources. If we want to transform the healthcare model, we must translate this on improving our overall healthcare services – take the best of urban healthcare and translate it into rural healthcare. The success of Healthy Maharashtra lies in the integration and alleviating of rural healthcare.

However, this is unfortunately not happening even today. Getting basic medical care is still a huge challenge in rural areas. We need a more effective outreach programme to deal with the disparity between urban and rural healthcare. Targeted training will produce the best doctors, who can deliver their best under any circumstances. I would like to present this proposal to the Maharashtra government to help build a Healthy Maharashtra.

As a prosperous state, we have got such a wealth of talent at our disposal with which we can reach to the remotest village with state-of-the-art healthcare services. In my opinion, Maharashtra should become the hub for medical education. Senior doctors should help produce a skilled workforce so that the poor and needy patients also can avail state-of-the-art medical care.

Here, I would like to suggest a broad strategy of using live cases for study. We have to study the pattern of the disease like whether we can treat diabetes earlier. Who are the more serious patients, and can they benefit from surgery? Can surgery be a long-term cost-effective option for diabetics, who are facing complications? All this needs to be ascertained and thoroughly studied. If we do this, we can surely build a Healthy Maharashtra.

One cannot doubt the prowess of Maharashtra, and the pool of talent it has. The state must bring more brilliant minds to work on the ground. If there is an implementation of effective ideas, an advisory board of experienced doctors, action-oriented plan for the next two to five years, we will definitely be a much healthier nation.

The author is a Bariatric Surgeon and Founder, Digestive Health Institute

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