Debating the ‘Healthy Longevity Initiative’ Report

Syllabus: GS2/ Health

In Context

• The World Bank’s 2024 report, Unlocking the Power of Healthy Longevity, highlights a rapidly aging population and the rise of NCDs in Low-and Middle-Income Countries (LMICs).

About

• The report highlights that addressing NCDs, such as heart disease, diabetes, and cancer, is essential for achieving healthy longevity and sustaining human capital in rapidly aging populations.
• And, reduced health funding in India and other LICs/LMICs may hinder achieving SDG targets, especially as general government spending rises faster than health allocations.

Key Points of Report

• Impact of NCDs: NCDs now account for over 70% of global deaths annually, and this trend is set to continue. By 2050, the total number of deaths is projected to rise from 61 million in 2023 to 92 million, further highlighting the need for urgent interventions.
• Health Spending:Between 2019 and 2023, per capita health spending grew modestly—0.4% in LICs and 0.9% in LMICs—compared to pre-pandemic growth rates of 4.2% and 2.4%, respectively.
  • In India, the share of health in the total budget dropped below 2% post-pandemic, reaching around 1.75–1.85%.
• Challenges for India
  • Aging Population: India has around 140 million elderly, with a growth rate three times the overall population, placing strain on health and social systems.
  • Risk Factors: Tobacco, alcohol, sedentary lifestyles, and poor diets increase NCD risks, especially in rural areas with limited healthcare access.
  • Economic and Social Impact: Rising NCD rates lead to impoverishment, reduced investments, and economic slowdown.
  • Gender and Social Equity: Women, who often serve as caregivers and experience longer lives with NCDs, need targeted health protections.
  • Inconsistencies in Ayushman Bharat: Designed to provide health insurance to the bottom 40% but hindered by corruption, low funding, and eligibility challenges.
  • Higher Out-of-Pocket Medical Expenditure: India’s healthcare costs are often out-of-pocket, with travel costs forming a significant portion, especially for rural populations seeking care.

Government Initiatives

• National Programme for Health Care of the Elderly (NPHCE): Provides specialized healthcare services for older adults.
• National Social Assistance Programme (NSAP): Offers financial assistance to elderly individuals below the poverty line.
• Ayushman Bharat: A health insurance scheme aiming to cover the bottom 40% of households; however, coverage remains limited.
• Atal Vayo Abhyuday Yojana (AVYAY): Promotes welfare services for senior citizens.
• Elderline: A helpline to assist elderly individuals in accessing necessary services.

Way Forward

• Life-Course Approach to NCDs: The report advocates a life-course approach to managing NCDs, emphasizing prevention, early diagnosis, and continuous management across all ages. This approach requires reforms across health, labor, and social protection sectors to support long-term care and reduce NCD burdens.
• Leveraging Fiscal Tools: Raising taxes on harmful products such as tobacco and alcohol can reduce health risks and generate funds to improve healthcare services.
• Expanding Social Security Coverage: Strengthening Ayushman Bharat to ensure broader coverage for elderly and low-income populations can reduce financial strain from healthcare costs, particularly in rural and underserved areas.
• Investing in Geriatric Healthcare Infrastructure: India needs improved healthcare facilities for chronic disease management, particularly in rural regions. Training healthcare workers in geriatric care and making affordable long-term care options accessible is essential.
• Addressing Gender and Social Equity: Targeted health and social protections for women are necessary to address the challenges they face as caregivers and as individuals who experience a greater burden of NCDs in older age.
• Regulating Healthcare Costs: The Supreme Court of India has urged the government to regulate prices in private hospitals, which remain high and inaccessible for many. Ensuring consistent enforcement of these regulations is key to reducing out-of-pocket expenses for vulnerable groups.

Source: TH