Pre-emptive care – A new model of care

Rajendra Pratap Gupta

President & Member

Board of Directors

Shri Ghulam Nabi Azad

Union Minister of Health & Family Welfare                                                                                                                                                                                                                                                                               October 10th, 2012

Government of India.

Nirman Bhawan, New Delhi – 110108.

Reference: Empowering people , ‘Pre-emptive care’ model & update on the Government Industry Dialogue

Dear Shri Azad ji,

Hope this finds you doing good.

I attended a workshop for health ministers of NDA two days ago . During the workshop , we also visited a village in Gadhchiroli ( A naxalite area in Maharashtra ).  Here, I came across a 7th class failed lady who has been delivering healthcare information and advice in the village for many years on mother and child health, and out of the past five years , the village has been ‘Child death free’ for four years .

This service of the 7th class failed lady makes me believe that time has come to move from, ‘Health for All’ to ‘All for Health’ and under this ,

• Move to a system for self care
• We must come out with a healthcare booklet for all the citizens in regional languages
• Give generic names with prices for medicines ( OTC – Over the country or non-prescription pharma or non-pharma products ) , for common seasonal and acute ailments
• Also, the Government must make this booklet available to all the citizens on its website & as an application in Android / Nokia and other phone operating systems. It is time to empower people to take to primary and preventive care . Healthcare indications with OTC products application must be made mandatory in all languages for cell phones sold in India . May be, MOCIT ( Ministry of Communications & IT ) can take the lead in doing this .

More than 3 years back , I had written in the document titled ‘Healthcare  reforms agenda’ (http://www.dmai.org.in/Healthcare_Reforms_Agenda.pdf ) , about ‘mass screenings’ for people,  and I am glad that your ministry has accepted it , and has already done over 10 million screenings in the past 10 months , which is really commendable .  Now , it is time for India to move from ‘Preventive’ care to ‘Pre-emptive’ care ( till now, I haven’t heard this word used for health ! ).

‘Pre-emptive healthcare’ ( Before teen age ) ,  starts before the age ( late twenties ), when ‘Preventive care’ starts . It would include ;

• Starting with health screening for children when they turn the age of 10  . Earlier the better !  So that children grow up healthy .
• The screenings will include obesity , blood pressure and diabetes screenings, every 6 months . These checks would not cost more than Rs. 10 a year , but can help in making India the healthiest nation !
• Also, major healthcare problems arise due to deficiency of vitamins A, D & B & Omega 3. We must recommend guidelines for all children to undergo tests for deficiency of these vitamins and Omega 3, and also tie up with national level labs for offering these tests at rates mutually agreed by the Government . I understand that currently , it is difficult to have a test for Omega 3 in India, even if one needs to get it done !
• Also, dental examination and eye check – ups must be made mandatory from the age of 6 years

We should, therefore, focus on drafting the child health guidelines and ensure that these become the basic requirement for school admissions and thus, are enforced nationally.

Lastly , on the Government Industry Dialogue (GID) for Healthcare that was organized by the Disease Management Association of India (DMAI) . I understand that you could not attend due to your pre-occupation, but I did receive the note conveying your good wishes for this initiative. This dialogue was a massive success with 60 CEO’s from the Healthcare sector companies attending the dialogue and was addressed by ;

• Dr.Sam Pitroda , Advisor to the Prime-Minister
• Shri Keshav Desiraju, Spl. Secretary , MOHFW
• Dr.Ashok Kumar – representing the DGHS , Dr.Jagdish Prasad
• Shri. Anil Swarup, Addl. Secretary, Ministry of Labour & Employment
• Dr.K.Srinath Reddy, President , PHFI & Chairman, High Level Expert Group on Universal Coverage
• Dr.Prathap C. Reddy, Chairman, Apollo Hospitals Group;
• Besides CEO’s & Managing Directors of leadings healthcare corporations

Besides , the dialogue was well attended by the media . Details of the deliberations are available on http://governmentindustrydialogue.org

This dialogue showed the keenness from both the sides ( Industry & the Government ) to work shoulder to shoulder to address the key healthcare challenges facing the nation .

Three areas of cooperation have emerged; i.e. adoption of districts under mass screening programs , companies willing to work on secondary prevention program in addition to the mass screening program , IT & mHealth companies willing to provide innovative solutions for managing chronic diseases and program evaluation tools, training front line health workers & Rural health . It would be good if the MOHFW now moves to focused meetings under the Government Industry Dialogue to decide the scope of collaboration specific to each program. I am sure that this will lead to more effective implementation of existing programs . I look forward to your guidance on the same.

Over the next couple of weeks, I will be attending meetings in USA – ‘International Wellness and Chronic Care Symposium’,  and in Manila – ‘The Asia Pacific Leadership & Policy Dialogue’, hosted by WHO and the World Economic Forum for digital health . Will update you on the developments

With best regards ,

Rajendra Pratap Gupta

CC.

Dr.Manmohan Singh, Prime Minster, Govt. of India.

Dr.Sam Pitroda ,Advisor to the Prime Minister of India .

Shri Keshav Desiraju, Special Secretary, Health & Family Welfare, GOI.

Shri Anil Swarup, Addl Secretary, Ministry of Labour & Employment , GOI

Dr.K.Srinaty Reddy, President , PHFI & Chairman, HLEG- Universal Coverage

Dr.Jagdish Prasad, DGHS, Min. of Health & Family Welfare, GOI.