India faces a significant challenge with the "triple burden" of diseases, encompassing malnutrition, communicable diseases, and a rapidly growing prevalence of non-communicable diseases (NCDs) such as diabetes and hypertension. These chronic conditions are central to India's epidemiological transition, often emerging earlier in life, with many individuals developing type 2 diabetes as young as their 30s and 40s. As people live longer, the complications associated with prolonged diabetes and hypertension, such as heart disease, chronic kidney disease, stroke, blindness, and amputations, further increase the overall burden on the healthcare system.

The Tree: Trunk and Branches Model

The analogy of diabetes and hypertension as the “trunk” of a tree, with organs like the heart, kidneys, eyes, brain, and feet as its “branches,” captures how critical it is to maintain control over these root conditions. A healthy “trunk” supports the overall well-being of the “branches,” whereas unmanaged diabetes and hypertension lead to severe complications affecting multiple organs.

Addressing Systemic Challenges

One of the primary barriers to controlling NCDs in India is the weak control cascade, which spans from screening to the long-term management of conditions. Resource limitations, particularly in rural and underserved areas, hinder the consistent and effective management of hypertension and diabetes. While government spending on healthcare has increased, it still falls short of meeting the needs of the population, especially in the prevention and management of lifestyle-related disorders.

Policy Recommendations and Technological Interventions

To maximize the impact of healthcare spending, India could benefit from prioritizing prevention and targeted interventions for NCDs like diabetes and hypertension. Proactive prevention could reduce costs associated with related complications, like cardiovascular and kidney diseases, blindness, and amputations.

The Government of India and various state governments are making strides with population-based screening initiatives. Accredited Social Health Activists (ASHAs) are conducting early detection assessments through Community-Based Assessment Checklist (CBAC) forms. Additionally, digital solutions, such as the NCD portal, are being implemented to streamline and improve patient records and facilitate evidence-based decision-making through tools like electronic case record forms (eCRF) and Clinical Decision Support Systems (CDSS). These systems help healthcare providers make more informed, customized treatment plans.

The Path Forward

Through these technology-enabled approaches, India can move closer to achieving accessible diabetes care for all. With coordinated efforts in screening, targeted treatment, and leveraging technology, India can better manage the NCD crisis, particularly diabetes and hypertension, ultimately reducing their impact on the broader healthcare system.