Ncmh Background Papers—Burden of Disease in India

NCMH Background Papers—Burden of Disease in India
Disease burden in India: Estimations and causal analysis
Disease burden in India
Estimations and causal analysis*
Disease burden estimations based on sound epidemiological
research provide the foundation for public policy. Which
diseases and what interventions does public policy need to
focus upon are normally derived from such evidence. Well
researched, longitudinal data can enable judicious targeting
and help decide what needs to be done where, for whom,
and when. Conversely, the absence of such good quality
empirical data can affect programme designing and consequently
outcomes. India has ample evidence of such
impacts, often due to the mismatch between disease burden
and its causal factors, and the interventions adopted and
priorities in resource allocation.
Besides the need to avert disease for enhancing the quality
of life, neglect can have adverse consequences on the wellbeing
of affected families—social, psychological as well as
economic. Diseases that are heavily concentrated among
working age adults or the poor, as is the case with HIV/
AIDS, cardiovascular disease (CVD), tuberculosis (TB), etc.,
can have a ruinous impact as such diseases are extremely
expensive to treat, especially due to lack of insurance
mechanisms. For example, in the case of HIV/AIDS, the
out-of-pocket expenditure on treatment and services was
reportedly Rs 6000 per HIV-positive person over a six-month
reference period, while for clients on antiretroviral treatment
(ART), the expenditures were markedly higher, nearly
Rs 18,150 per person over a six-month period. Roughly
40%–70% of these expenditures are financed by borrowing.
The devastating impact of TB, asthma, chronic obstructive
pulmonary disease (COPD), heart diseases, etc. on individual
household is similar, with children having to discontinue
schooling and/or take up employment to provide an additional
source of income. Analysis of data...