Mumbai: The year 2023 saw the World Health Organization (WHO) announce the end of the Covid-19 pandemic, with WHO president Tedros Adhanom Ghebreyessus declaring that the virus was no longer a global health emergency. India detected its first case of the JN.1 variant, which led the Union government to ask states to monitor influenza cases, increase testing for the virus and send positive samples for genome sequencing.

Meanwhile, the WHO attributed a mystery illness in China, which caused pneumonia in children, to mycoplasma pneumoniae, a common respiratory pathogen. The WHO advised against any travel or trade restrictions.

While there are few reasons to worry about large outbreaks or pandemics at the moment, in India people continue to fall ill and are unable to get treated for communicable and noncommunicable diseases.

With the worst of the pandemic behind us, here is a look at the issues plaguing the health of Indians in 2023:

Lifestyle diseases in the spotlight

Before the pandemic, ischaemic heart disease was the leading cause of death in India, followed by chronic obstructive pulmonary disorder and stroke, according to the WHO. Together, these three non-communicable diseases (NCDs) caused an estimated 226 deaths per 100,000 population in India in 2019. Diarrhoeal diseases, TB and neonatal conditions caused 112 deaths per 100,000 population.

The National Programme for Prevention and Control of Non-communicable Diseases (NP-NCD) replaced the National Program for Prevention and Control of Cancer, Diabetes and Stroke. Sedentary lifestyles and a lack of space for physical activity are responsible for the surge in cases of diabetes, we reported in August 2023. In 2021, diabetes affected 101 million Indians. Cancer affected 1.46 million people in 2022, said Bharati Pravin Pawar in response to a question raised in Parliament in July 2023.

To get treatment, patients and their families sold their assets and amassed debts, as we reported in March 2023. The Cachar Cancer Hospital and Research Centre, an affordable cancer care centre manned by Magsaysay awardee Ravi Kannan to seek treatment for cancer, is a godsend for patients in and near Silchar in Assam, as we reported in November 2023.

TB lingers

As the NCD burden increased, communicable diseases continued to draw attention from health policymakers. India had the highest incidence of TB in the world, accounting for 27% of new cases worldwide in 2022.

In 2023, India hosted the One World TB Summit, where it reiterated its 2025 deadline for TB elimination. To meet that deadline, India needs to identify new cases proactively and ensure that they complete their treatment, as we reported in May 2023.

Children’s routine immunisation picked up pace in 2023 worldwide as well as in India, as the WHO reported in July 2023. The last round of the Intensified Mission Indradhanush 5.0 came to an end in October 2023.

Manipur crisis exposed gaps in healthcare

A team of doctors was dispatched to strife-stricken Manipur in May 2023 to aid the healthcare efforts in the strife-stricken state. The ongoing violence made it difficult for patients to navigate the internal borders and get treatment, as we reported in September 2023. With schools serving as relief camps, children were at home four months after the crisis first erupted, we reported in September 2023.

Malnutrition prevalent, but extent unclear

India ranked 111 out of 125 countries on the Global Hunger Index, as per the Concern Worldwide and Welthungerhilfe group’s statistical measure of hunger and undernutrition. The Union government rebutted these figures, claiming that the measure of ‘underweight’ among children is overestimated by the international humanitarian aid agencies.

Prevalence of low weight among children decreased, but the triple burden of undernutrition, hidden hunger and overweight threaten the survival, development and growth of children, as we reported in August 2023.

A novel effort by the Pune Zilla Parishad reduced the prevalence of malnutrition among children in the area, bringing down the number of malnourished children from 2,118 in 2022 to 346 in 2023, as we reported in August 2023.

Climate change makes its presence felt

The year 2023 is the hottest recorded. The WHO has declared climate change as the single biggest threat facing humanity. Climate change resulted in air pollution, affected the food systems, and resulted in increasing the geographical limit in which malaria is found, etc.

Of the 216 cities for which air quality data are reported, 53 had poor, very poor or hazardous air on December 4, 2023. Our analysis of November 2023 data from Delhi’s air quality monitors revealed that the concentration of particulate matter in the air was over eight times the limit set by the National Ambient Air Quality Standards.

The Conference of Parties 28 (COP28) this year had a dedicated health day for the first time. (Read our explainer on its significance). In India too, 28 states have devised action plans on Climate Change and Human Health, Minister of State for Health and Family Welfare S.P. Baghel declared in Parliament in August 2023.

Extreme temperatures take a toll on human health, as our data visualisation from March 2023 explains. Increasing nighttime temperatures do not allow the body to cool down, which poses several health risks, as we reported in May 2023. Heat-related mortality will increase by more than 2.5 times by 2050, we reported in September 2023.

Livelihoods were also affected by climate change, as our May 2023 report from Kutch shows.

More quality hospitals, universal health insurance coverage needed

Ayushman Bharat, the Union government’s flagship health insurance scheme, completed five years in September 2023. To achieve its goal of health for all, the scheme needs more hospitals and to expand its coverage, as we reported in October 2023.

The first WHO Traditional Medicine Global Summit was held in Gandhinagar in Gujarat in August 2023. IndiaSpend reported on doctors of the Ayurveda, Yoga, Unani, Siddha and Homeopathy systems of medicine practising allopathic medicine to fill gaps in public healthcare, in September 2023.

Less than 1% of India’s public hospitals undergo the quality checks that are part of the National Accreditation Board for Hospitals and Healthcare Providers’ accreditation and certification process, as we reported in Aug 2023.

About one in five Indians will be aged 60 years or more by 2050, predicts the India Ageing Report. As India’s population ages, the burden of disease will increase, underscoring the need for universal healthcare, said Rama Baru, a professor and researcher at the Centre for Social Medicine and Community Health at Jawaharlal Nehru University in New Delhi, in an October 2023 interview with IndiaSpend.

To improve healthcare provisioning, especially in rural areas and aspirational districts, the government of India added more medical seats, as Pawar told parliament in August 2023. India needs more specialist doctors to treat NCDs, but adding more seats without hiring faculty to teach in medical colleges will not improve the ratio of doctors to patients, as we reported in December 2023.

Finally, 2023 was not a good year for Indian pharmaceutical manufacturers. In 2022, Indian-made cough syrups were held responsible for the deaths of children in Uzbekistan, Gambia and Cameroon. Following WHO’s alerts on Indian-made cough syrups, Central Drugs Standard Control Organisation and state drug control agencies investigated the firms involved, and three firms lost their manufacturing licence in consequence.

Generic medicines were being provided in Jan Aushadhi Kendras throughout the country, but a move to make it compulsory for doctors to prescribe generic medicine was scrapped. The generic drug industry may also have to deal with amendments to the patent law that will make it more difficult to manufacture generic versions of life-saving drugs for TB and cancer, as we explained in September

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