Longevity with well-being is modern medicine’s challenge

Modern medicine has progressed and so has pathology. The number of diseases hasn’t reduced, nor has the distress related to them. We have increased longevity and made advanced years liveable. We are yet to find a cure for many diseases while we have found cures for many infectious ones, and we have remarkable successes in emergency care. In cases where there is no cure yet, it is about effective management and enhancing quality of life.

India is yet to overcome the issues of malnutrition and communicable diseases. The country is witnessing a rising burden of non-communicable diseases. India has the highest number of people suffering from chronic health issues.

Some factors contributing to health issues among the youth

Consumption of processed food

Excessive use of tobacco and alcohol

Sedentary lifestyle

Stress

Pollution

Changing health profile

With the burden of both communicable and non-communicable diseases, India’s health profile has undergone a significant transformation over the past few decades. Ischemic heart disease is one of the highest-ranked causes of premature deaths in India. While communicable diseases such as tuberculosis once dominated public health concerns, non-communicable diseases now account for over 60 per cent of deaths nationwide.

It represents a fundamental shift in the patterns of mortality, disease and primary health challenges across the population. Around 15 years ago, communicable diseases, maternal and neonatal disorders, and nutritional deficiencies accounted for approximately 61 per cent of the total burden. By 2024, this figure had declined to about 33 per cent, while non-communicable diseases rose from 30 per cent to nearly 65 per cent.

Several interrelated factors have contributed to this shifting profile. India’s improving life expectancy means more people live long enough to develop chronic conditions. By 2017, over 34 per cent of Indians lived in urban areas, associated with more sedentary lifestyles and processed food consumption. Rising incomes have altered dietary patterns and lifestyle choices. Increasing air pollution in urban areas has contributed to respiratory and cardiovascular disease rates.

Drug-resistant TB is a threat

India bears the world’s largest tuberculosis (TB) burden, accounting for about 27 per cent of global cases. The period between 2003 and 2017 saw both challenges and progress in TB control. Multi-drug resistant TB and extensively drug-resistant TB emerged as serious threats, with approximately 1.30 lakh such cases reported annually by 2024.

TB-HIV co-infection continued to complicate treatment approaches, with approximately 92,000 patients requiring dual management annually. The HIV landscape in India transformed dramatically between 2003 and 2017, shifting from emergency response to chronic disease management.

Diabetes on the rise

Diabetes prevalence among adults has increased from estimated 73 million to about the 109 million people between the ages 20 and 79. Indians typically developed diabetes 5-10 years earlier than the Western populations, with significant onset in the 30-45 age group. Diabetes-related complications including retinopathy, nephropathy and neuropathy affect approximately 30-40 per cent of long-term diabetes patients. The economic burden of diabetes care is estimated at 1.50 per cent of GDP.

CVD, cancer: Early detection for better treatment outcome

Cardiovascular diseases (CVD) accounted for 28 per cent of all deaths by 2024, up from about 19 per cent in 2003. About 52 per cent of CVD deaths occurred before the age of 70. Hypertension affected approximately 33 per cent of adult urban population and 25 percent of adults in rural areas. Incidence of stroke increased by about 40 per cent.

New cancer cases rose from approximately eight lakhs annually in 2003 to over 1.30 million by 2024. Cancer-related deaths increased from about 4.50 lakhs to nearly eight lakhs annually in the same period. Contributing factors included tobacco use - responsible for approximately 30-40 per cent of cancers, changing reproductive patterns - later childbearing and fewer children (increasing breast cancer risk), dietary changes, physical inactivity, environmental exposures and longer lifespans that is a risk factor for cancer.

Late-stage diagnosis remains common, with approximately 75-80 per cent of cancers detected at advanced stages, limiting treatment efficacy and increasing mortality.

Modern medicine has done much in the fields of infectious diseases and emergencies to aid cure. The thrust, both of clinicians and research, must now turn decisively towards prevention and cure. Also, longevity with well-being is modern medicine’s other big challenge. Advances in vaccines, better treatment for hypertension, diabetes, cancers etc, deserve attention as also, the role of meditation, yoga, spirituality etc in preventing disease at various levels.

(The author is former director, Sri Jayadeva Institute of Cardiovascular Sciences and Research)