1. Trends & Projections of NCDs in India
Diabetes
2000: 32 million (WHO)
2010: 51 million (International Diabetes Federation)
2030: 80 million (WHO)
Cardio-vascular Diseases
1998: 19 million (ICMR)
2005: 38 million (Nat. Com. Macroeconomics & Health)
2015: 64 million (Nat. Com. Macroeconomics & Health)
Cancer
Estimated number of persons with cancer: 2.8 million
Annual Incidence: 1.1 million
NCD Deaths 5.2 million (50.5%) of all cause deaths

2. Structure & Organisation
Union Govt. Ministry of Health & Family Welfare – NCD cell; still evolving
35 States (provinces) - NCD cells at State & District planned (each distt. Is about 1.5 million)
About a dozen vertical NCD programs including National Program for prevention and control of Cancer, Diabetes, CVD & Stroke and National Rural Health Mission
NCD programs plan 10,000 US$ for
(increase of nearly five times than last plan)
Many activities in NCD field, yet un-coordinated

3. NRHM flow chart health care delivery in India
State Project Management Unit
State Health Mission
State Health Society
District Project Management Unit
District Health Mission
District Health Society
Block Health & Sanitation committee
CHC
RKS
PHC
RKS
Village Health & Sanitation committee
Untied
Fund
Sub Centre
ASHA PW

4. Key Interventions of National Program for prevention and control of Cancer, Diabetes CVD & Stroke
Key Area
Activities
Health Promotion
Public awareness through multi-media
Counseling for healthy lifestyle (Balanced diet, regular exercise, avoid alcohol and tobacco)
Early Diagnosis
Screening of persons above 30 years for diabetes and hypertension at all levels; facilities up to Sub-centre level
Case Management
Facilities for diagnosis and treatment (NCD Clinic) at Comm. Health Centre level & above
CCU at District Hospital and above
Treatment of cancer at District Hospital & above
Capacity Building
Infrastructure Development & Equipment
Training of human resources at all levels
Management & Monitoring
NCD Cell at National, State & District level
Surveillance, monitoring & evaluation
Regular review meetings

5. Activities in NCD Prev. & control
National NCD summit Aug 2011 at N. Delhi
Food labeling for nutritional information by FSSAI food authority
Indian International Trade fair health ministry’s pavilion with NCD theme Nov 2011
NCD theme painting competition and ministry’s calendar for 2012
Awareness through National TV network in states.
Health promotion courses
Increase in the Post Graduate seats across India
Central Drug standard control organization (CDSCO)
AYUSH department for Yoga and others
School Health and School Health Policy
Tobacco Control & Increase in taxation on Tobacco

6. Challenges Large Population Diversity in culture, belief and systems
Inaccessibility; difficult terrains
Individual & Institutional affordability
Private sector catering to 80% healthcare
Uniform model cannot work uniformly
Provision of lifelong care to NCD patients
Unwillingness of experts to go to villages
Medicare by quacks and chemists

7. Lessons learnt
Shortage of Specialist (e.g. Medical Oncologist /Endocrinologist/Cardiologist/Medical Physicist/ Cyto-pathologist/Cyto-pathology technician
Need of intensive clinical training
Delay in procurement of equipment
Availability of space
Health Management Information System
Poor Record Management
Proper linkages/network with Tertiary centres and Medical colleges is absent
NCD management cannot replace the healthcare delivery system

8. Next steps
The NCD Program needs to be taken into mission mode ( like NRHM - another program)
A dedicated male health worker in addition to Female Health Worker needs to be employed at sub-centre (lowest level) exclusively for NCD
Strengthening / development of health care delivery system at different levels
Screening needs to be sustained and be integrated with health care delivery system
Human Resource capacity building to be done
Provision of drugs for poor and needy at all levels

9. Trade fair 2011 Ministry’s Pavilion - NCD Theme
Thank You