India is experiencing a rapid health transition with a rising burden of Non-Communicable Diseases (NCD) surpassing the burden of Communicable diseases like water-borne or vectorborne diseases, TB, HIV, etc. The Non-Communicable Diseases like Cardiovascular diseases, Cancer, Chronic Respiratory Diseases, Diabetes, etc. are estimated to account for around 60% of all deaths. NCDs cause considerable loss in potentially productive years of life. Losses due to premature deaths related to heart diseases, stroke and Diabetes are also projected to increase over the years.
In order to prevent and control major NCDs, the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) was launched in 2010 with focus on strengthening infrastructure, human resource development, health promotion, early diagnosis, management and referral.
Under NPCDCS, NCD Cells are being established at National, State and District levels for programme management, and NCD Clinics are being set up at District and CHC levels, to provide services for early diagnosis, treatment and follow-up for common NCDs. Provision has been made under the programme to provide free diagnostic facilities and drugs for patients attending the NCD clinics. Cardiac Care Units (CCU) are also being set up in identified districts for providing facilities for emergency Cardiac Care. Day Care Centres at the identified districts are setup to provide facilities for Cancer care.
During the period 2010-2012, the programme was implemented in 100 districts across 21 States. Review of the initial phase of programme implementation helped to identify the bottlenecks and accordingly the programme was re-strategised and scaled-up. The programme aims to cover the entire country by March 2017.
The modified strategies are as follows:
Total cost of the programme for period 2012-2017 is Rs. 8,096 crore (share of Government of India is Rs. 6,535 crore and that of State Governments is Rs. 1,561 crore). The funds are being provided to the States under NCD Flexi-Pool through State PIPs of respective States/UTs, with the Centre to State share in ratio of 60:40 (except for NE and Hilly States, where the share is 90:10).
For the Cancer component, there is the Tertiary Care Cancer Centers (TCCC) scheme, which aims at setting up/strengthening of 20 State Cancer Institutes (SCI) and 50 TCCCs for providing comprehensive cancer care in the country. Under the scheme there is provision for giving a ‘one time grant’ of Rs. 120 crore per SCI and Rs. 45 crore per TCCC, to be used for building construction and procurement of equipment, with the Centre to State share in the ratio of 60:40 (except for North-Eastern and Hilly States, where the share is 90:10).
As on March 2016, the programme is under implementation in all 36 States/UTs. A total of 298 District NCD Cells and 293 District NCD Clinics have been established in the country. Also, there are 103 functional Cardiac Care Units for emergency cardiac care and 64 Day-Care Centres for Cancer care at the District levels in the country.
During 2015-2016, more than 1.29 crore persons have been screened in the designated NCD Clinics. Among these NCD Clinic attendees, around 8% were diagnosed to be Diabetics and 12% were Hypertensives. Also, around 90,000 persons were diagnosed to be suffering from Cardiovascular diseases and over 13,000 persons were detected to be having common Cancers (including Oral, Cervical and Breast Cancers) among them. During 2015-2016, around 96 lakh persons were screened under various outreach activities for common NCDs (in Camps and PHC/SC), and they were referred to higher Centres for diagnosis and management.
RECENT INITIATIVES UNDER NPCDCS