June 2016

Make Health Budget 5% of Annual GDP to Ensure Universal Care

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KK-Aggarwal

Dr K K Aggarwal, Hon’ble Secretary General, Indian Medical Association and President, Heart Care Foundation of India

With India facing a heart disease epidemic and soon to acquire the title of the ‘Heart Disease Capital of the World’, there is an urgent need of a ‘National Cardiovascular Control’ programme, shares Padma Shri Awardee Dr K K Aggarwal, Hon’ble Secretary General, Indian Medical Association and President, Heart Care Foundation of India with Elets News Network (ENN)

Sir, it’s quite interesting to see your involvement with different platforms and stakeholders of Indian healthcare. In the light of this, do you think enough measures and communication campaigns are being undertaken to address the growing demand of cardiac diseases.

The medical fraternity faces several issues and threats in today’s day and age and is often misunderstood. My role as the Honorary Secretary General of the Indian Medical Association, which is the largest representative organisation of doctors of modern scientific medicine, has been to ensure that the voice of Indian doctors is heard both within the country and outside. We have been fighting tirelessly to safeguard the interests of the doctors with respect to the increasing incidence of violence against them, misrepresentation, especially in the National Council of Educational Research and Training (NCERT) books as being corrupt, inclusion in the consumer protection act and the unjust rules of the Pre- Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act.

As the president of Heart Care Foundation of India, a non-government organisation (NGO) I founded in 1987 with the sole aim of working towards a healthier India, I have been working towards the cause of preventive health and helping those who are in need of medical intervention, but are unable to afford treatment. A few activities, which are running successfully today, include:

  • Perfect Health Mela: A preventive health fair that has been taking place in the national capital for over 21 years in collaboration with the Government of India. The five-day event sees participation of over 5,000 school and college students, 4,000 nurses and medical students and is visited by 1 to 2 lakh people on a year-on-year basis. All competitions, activities and events at the Perfect Health Mela are centred around health themes.
  • Hands-Only Cardiopulmonary Resuscitation (CPR) 10 Training Campaign: In the past two years, we have trained over 1.5 lakh people on the essential life-saving technique of hands-only CPR 10 for revival after sudden cardiac arrest. We also hold three Limca Book of World Records in this regard for the maximum number of people trained in one day, one location and one hour.
  • Sameer Malik Heart Care Foundation Fund: Through this initiative, we provide technical and financial assistance to anyone belonging to economically weaker sections of the society in the need of cardiac intervention. We believe that no person should die of heart disease just because they cannot afford treatment.

With India facing a heart disease epidemic and soon to acquire the title of the ‘Heart Disease Capital of the World’, I believe that our country is in urgent need of a ‘National Cardiovascular Control’ programme. Presently, the focus of the government is only on the prevention and management of communicable diseases. A public-private partnership in this regard can go a long way.

Sir, the average age of a person suffering with heart diseases has come down drastically and the rate of coronary heart disease in the Indian community is almost twice as high as their western counterpoints. What will be your recommendations for our youngsters to tackle this problem?

Indians are 17 times more prone to suffering from heart attacks than their western counterparts. I have developed an easy-to-learn formula of 80 to live up till the age of 80 without a heart attack:

Dr KK formula of 80 for living up to 80 without a heart attack

  • Women must keep their abdominal circumference lower than 80 cm and men 90 cm
  • Keep your fasting sugar lower than 80 mg%
  • Keep your blood pressure lower than 80 mm Hg
  • Keep your heart rate lower than 80 per minute
  • Keep your bad low-density lipoprotein (LDL) cholesterol lower than 80 mg%
  • Do not consume more than 80 grams of caloric solid or liquid food at once
  • Observe a carbohydrate fast 80 days a year
  • Do not consume alcohol and if you do, restrict it to not more than 80 ml in a day or 80 grams in a week
  • Do not consume more than 80 ml of alcohol in less than 80 minutes
  • Restrict your soft drink consumption to 80 ml in one go. The tip is to add soda and dilute it to make it 200 ml
  • Do not consume more than 80 eggs in a month
  • Consume at least 80 fruits and vegetables servings in a week
  • Do not consume tobacco otherwise you will end up with a surgery bill of Rs 80,000
  • Do not consume more than 80 ml/gram of ghee, oil and butter in a week
  • People at high risk should consult their doctor and consume 80 mg of aspirin for prevention of cardiac disease
  • People at high risk should consult their doctor and consume 80 mg of statins for prevention of cardiac disease
  • Ensure to sit out in the sun for at least 80 days in a year to fulfil the body’s requirement of vitamin D
  • Walk for 80 minutes in a day
  • Brisk walk for 80 minutes in a week
  • Brisk walking is defined as taking a minimum of 80 steps in a minute
  • Walk for 80 steps after every 80 minutes
  • Reach 80 per cent of your target heart rate when doing heartconditioning exercises
  • Do aerobic exercises for 80 minutes a week
  • Do stretching exercises for 80 minutes in a week
  • Keep noise pollution less than 80 db
  • Avoid areas where the particulate matter (PM) 2.5 and PM 10 levels are higher than 80
  • Do not use your mobile phone for more than 80 minutes in a day
  • Whenever you clap, clap 80 times
  • Do yoga for 80 minutes in a week
  • Do 80 cycles of pranayama in a day
  • Spend 80 minutes in a week close to nature
  • Practice 80 minutes of non-violent communication every Monday
  • Call 80 people and practice 80 seconds of free writing every Tuesday
  • Distribute non-materialistic gifts to 80 people every Wednesday
  • Think differently on 80 occasions every Thursday
  • Spend time in the natural environment for 80 minutes every Friday
  • Help 80 people every Saturday
  • Wash your hands fora minimum of 80 seconds
  • Get 80 per cent immunity to flu and pneumonia through vaccination
  • Article 80: You cannot be punished twice for the same offence
  • Ensure that your peak expiratory flow rate (PEFR) lung function is more than 80 per cent
  • Keep your epidermal growth factor receptor (EGFR), kidney function more than 80
  • Learn hands-only CPR, since it can help revive 80 per cent of sudden cardiac arrest patients within 10 minutes of their death
  • Children should not watch more than 80 minutes of television in a day
  • Sleep for 8 hours a day to live up to 80 years
  • Spend 80 minutes reading everyday for an active and healthy brain
  • Plant 80 saplings every year
  • Learn 80 new words in a month
  • Meet 80 new people in a year
  • Make 80 people smile in a year
Perfect-Health-Mela

Dr KK Aggarwal during one of the activities at ‘Perfect Health Mela’

As an advocator of preventive and universal healthcare, what measures do you think need to be undertaken to take care of critical areas, such as health financing, health infrastructure, skilled human resources, etc., particularly in cardiology segment where cost of treatment continues to be exorbitant and the incidence of cardiovascular diseases (CVDs) being higher in both rich and poor population.

The following steps will ensure universal healthcare in the long run:

  • Primordial cardiac care
  • Health budget should be 5 per cent of the annual gross domestic product (GDP)
  • Reducing the cardiac disease burden through a preventive cardiac care programme
  • Wellness parameters, such as more jogging tracks, reducing blood pressure of the community, and reducing salt and trans fat intake of the society
Universal Healthcare
  • Ensure primordial cardiac care
  • Public-private partnership
  • Increasing the share of healthcare in health budget
  • Cost-effective medical devices
  • Preventive cardiac care programme
  • Ensure wellness parameters

Please enumerate innovations that have taken place across the cardiac value chain and collaboration among various stakeholders, including the government, providers, pharmaceutical companies, medical technology firms and health insurers to enable cardiac care interventions.

  • Now costly device are available on an equated monthly installment (EMI)
  • Leadless pace makers have come up
  • Beating bypass is a reality
  • After stenting, the patient can be discharged the same day
  • Cardiac transplant is becoming a routine
  • Aortic valve is now replaced without surgery
  • Stents have become affordable
  • Absorbable stents are now available
  • Hybrid catha labs are now a routine
  • Congenital heart surgeries are saving lives

Most of the stakeholders in the Indian medical sector know that you have been the pioneer in the field of clot-dissolving therapy for heart attacks and bringing the technique of colour Doppler echo cardiography. Could you please highlight the infrastructural challenges that you have encountered as a cardiologist?

  • In 1987, when I brought 2D colour Doppler echo technology to the country, there were no cardiac hospitals in Delhi. Now, we have advanced to three-dimensional (3D) echo.
  • Today India is as developed in terms of healthcare technology and treatment as any other country in the world.
  • I have been witness to patients dying due to the lack of angiography facilities in the past, which is not the case today and indicates how far we have come.
  • Clot-dissolving therapy today has become the gold standard in situations where emergency stenting cannot be done in acute heart attack cases.

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