MEDICAL EXPERTS WELCOME INCREASED HEALTHCARE BUDGET, FUND ALLOCATION FOR VACCINE AND RESEARCH - The Daily Guardian
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MEDICAL EXPERTS WELCOME INCREASED HEALTHCARE BUDGET, FUND ALLOCATION FOR VACCINE AND RESEARCH

How successful has the government been in addressing the needs of the health sector? Medical experts share their take on Union Budget 2021 and what it means for the healthcare sector.

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Medical experts were hoping for a substantial increase in budget allocation to the healthcare sector. Thus, 137% increase in budget allocation as compared to last year has provided some respite, especially after the way the pandemic exposed the weaknesses in the country’s healthcare system. This was hailed as a welcome step by doctors and medical experts.

The government placed the healthcare sector in the first section of the budget speech which shows their dedication to strengthen healthcare facilities. The total budget outlay for the health and wellbeing sector is Rs 2.23 lakh crore whereas last year it was Rs 94,452 crore. PM Atmanirbhar Swasth Bharat Yojana has announced with a total outlay of Rs 64,180 crore over six years.

The government has allocated Rs 35,000 crore for Covid-19 vaccines, will provide further funds if required and Rs 2,663 crore for the department in health research. Around INR 60,030 crore has been earmarked for the department of drinking water and sanitisation. Reactions of doctors and medical experts on the budget are as follows:

Enhancing access to healthcare is a great move

The budget 2021 has certainly focused more on healthcare than the previous budget. With an objective to improve healthcare infrastructure, the government allocated Rs 64,180 crore which will be invested over six years to improve primary, secondary and tertiary healthcare in addition to National Health Digital Mission. This can lead to bringing in more hospitals under Ayushman Bharat in Tier 2 and Tier 3 cities for the benefit of the poor in these areas. One of the key initiatives proposed in this year’s budget is the addition of 17,000 rural and 11,000 urban health and wellness centres which is a great move towards enhancing access to healthcare. Also, the government has proposed to set up integrated public health labs in each district with 3,382 block public health units across 11 states. The outlay of Rs 1.41 crore for the Swach Bharat 2.0 mission which will further help in the enhancement of sanitisation standards across the country. To effectively curb the Covid-19 pandemic, the government has also planned to set aside Rs 35,000 crore for Covid-19 Vaccine in FY22. Overall, it’s been an encouraging move from the government to promote healthcare in India with a holistic vision.

-Dr Dharminder Nagar, Managing Director, Paras Healthcare

A much-needed step in a direction of strengthening healthcare and promoting preventive healthcare has been taken

The budget does recognise the immediate needs for the Covid-19 pandemic and the vaccine requirements for the nation. The focus on spending on Covid measures and the vaccines will bring the much-needed stability to the public healthcare setup. The increase in budget outlay for health and welfare by 137% as compared to the previous year will boost the public health and pharmaceuticals sector. The PM Aatmanirbhar Swasth Bharat Yojana to develop capacities of health care systems, develop institutions for detection and cure of new and emerging disease is the first step to boost rural health and keep the country ready for emergency handling of pandemic situations. The government will need to continue to invest in the development of human resources and infrastructure in the years to come. The decision to include the pneumococcal vaccine is also a welcome decision along with the announcement of Mission Poshan to improve nutritional outcomes for children. With Budget 2021, the government has taken a much-needed step in a direction of strengthening healthcare and promoting preventive healthcare. Robust monitoring and implementation plan in place will see the initiatives achieve great success.

-Dr Minnie Bodhanwala, CEO, Wadia Hospitals, Mumbai

Enhanced allocation along with holistic approach to healthcare will certainly augur well for the country

The Finance Minister has accorded special attention to the healthcare sector, increasing the overall outlay to health and wellbeing to nearly Rs 2.25 lakh crore. The enhanced allocation, along with the plan to look at healthcare holistically, including nutrition, sanitation, clean drinking water and pollution control, certainly augur well for the country. Significant focus also has been brought to scaling up infrastructure, like critical care capabilities as well as primary and secondary care facilities through the PM Atmanirbhar Swasth Bharat programme. It is also very heartening that the FM promised higher allocations as required, as institutions absorb the funds committed at the first instance. All in all, it is a great beginning in the journey to take our healthcare system to world-class standards.

Further, the augmented government spend planned for capital expenditure by over 35% would aid job creation and growth in incomes, which would in turn enable people to spend on healthcare when required.

-Dilip Jose, Managing Director & CEO, Manipal Hospitals

Government is serious about the steps needed to reach a level of health preparedness

The health allocation in the first digital Union Budget reflects that the government is serious about the steps needed to reach a level of health preparedness. The budget outlay in health and welfare shows that our budget is focused on preventive, curative and holistic healthcare. The allotment of Rs 35,000 crore for Covid-19 vaccine research shows that more vaccines will be rolled out for the common masses and soon we will have a corona-free nation.

-Dr Shuchin Bajaj, Founder & Director, Ujala Cygnus Group of Hospitals

The budget will facilitate the creation of new and advanced institutions for emerging diseases.

The budget will strengthen the vision of Atma Nirbhar Bharat.It will provide a big boost to the healthcare industry working on the development of modalities for preventive healthcare, curative healthcare, and general wellness. Undoubtedly, it will help to expand the capacity of primary, secondary, and tertiary care health systems and strengthen national healthcare infrastructure. Also, it will facilitate the creation of new and advanced institutions for emerging diseases. We welcome these steps as we remain committed to building the nation’s healthcare infrastructure to fulfil the government’s mission.

-Dr GSK Velu, Chairman & Managing Director, Trivitron Healthcare

Government intends to be future-ready to address any healthcare crises

This year’s budget is pragmatic, positive and committed to the healthcare sector which needed a deliberate boost post unprecedented virus outbreak last year. Setting up of 15 Health Emergency Centres shows the government’s intent to be future-ready to address any healthcare crises. The proposals would make quality healthcare accessible and affordable, besides standardising healthcare infrastructure across the country.

-Harshit Jain, MD, CEO and Founder, Doceree

Emphasis on clean air, safe drinking water and nutrition critical for better maternal and child health

At the outset, I congratulate the Government of India for undertaking this arduous task in these unprecedentedly challenging times. The emphasis on clean air, safe drinking water and nutrition are critical factors for better maternal and child health and will go a long way in reducing both maternal mortality rate and infant mortality rate (IMR). This will improve the quality of life in the lowest strata of our society. Besides, the announced rollout of pneumococcal vaccine outside the existing five states to the entire country will also play a critical role in helping India contain infectious diseases as well as complement the Covid-19 vaccines in the process of building immunity as well as herd immunity.

-Dr Gauri Agarwal, Fertility expert

and Founder of Seeds of Innocence

A step to boost the medical device manufacturing

The government’s inclusion of preventive medicine, curative medicine and well being implies that it is taking a comprehensive view of health and not adopting an ad-hoc policy stance. The expansion of the PLI scheme with an allocation of Rs 1.97 lakh crore for the next five years will also impart a boost to the medical device manufacturing in the country.

– Ashok Patel, Founder & CEO, Max Ventilator

Government should aggressively initiate reforms in medical education

We have been saying that emphasis on promotive, preventive and primary care only can help in making a healthy India. One rupee spent on these 3 Ps can save five on curative care. Sanitation, drinking water, and nutrition have a similar impact. We are happy to note that the Union Budget is focused on these issues. Simultaneously, the government should aggressively initiate reforms in medical education including nursing and allied health workforce. In terms of resource allocation and policy support amid a once-in-a-century pandemic Union Budget 2021-22 looks progressive.

-Dr Girdhar Gyani, Director General, Association of Healthcare Providers- India ( AHPI)

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Health & Wellness

HEAR ME OUT: A CHILD’S UN-ATTENDED MENTAL HEALTH NEEDS CAN CAUSE LONG-TERM CONSEQUENCES

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Balanced mental health helps a child achieve good mental, emotional and physical growth. If the required emotional support is missing, it can harm the child’s overall wellbeing with long-lasting effects. Since one can’t point out exactly where and when the damage occurred, the signs of this unintentional act can be challenging to identify and overcome. At times, parents are unable to comprehend their child’s emotions and feelings which makes it difficult for them to retort to their cognitive needs. For instance, a child has been complaining that he or she is upset about a friend at school but the parent brushes it off as a childhood game instead of attending and helping the child cope with the issue. As a result of this behaviour, over time, the child begins to feel that his or her problems are not as important for their parents and stops seeking support. 

As a responsible guardian, one must take the time to understand the role played by mental health in your child’s overall well-being. Untreated emotional needs can lead to more grave health problems having long-term consequences. 

Below mentioned are some of the jeopardies of disregarding a child’s mental health needs:

Deteriorating of mental health problems: Mental health needs in children like unconditional love from family, the urge to be raised in a secure environment or ample opportunity to socially interact do not get better on their own. In order to fasten the process of recovery, it is important to address their need on a timely basis. For instance, unattended anxiety-like low-self-esteem may intensify to panic attacks, and failing to address the same can lead to post-traumatic stress disorder.

Enduring physical health challenges: A healthy and balanced lifestyle can be achieved only by a fine amalgamation of one’s emotional and physical requirements. One needs to be mentally fit to be physically fit. Intertwining our physical and mental health lends us with a recipe for balanced health care. To maintain that stability, love, security, and acceptance should be at the core of family life. For parents, it is extremely important to make their child understand that their love is boundless and does not depend on his/her success or any accomplishments. Parents who do not notice the child’s emotional needs tend to indirectly abandon their physical health too causing them to fall prey to multiple ailments in the long run. 

Instability in your daily life: Being unable to meet the child’s emotional needs can make it challenging to cope with everyday life. It can hinder the child’s ability to study, sleep, eat and play. Anxiety in children can make communication tougher, making it even more difficult to treat mental ailments and address the issue.

Inability to nurture emotions: Never having understood the importance of their own emotions, these kids will grow up into adults who too will fail to nurture emotions in their children. Hence, effective treatment is necessary to help people of all ages to overcome the effects of emotional neglect in the short term and avert future complications.

A child’s emotional state of mind must never be unnoticed since their mental wellbeing is just as essential as their physical health. Mental health in kids is crucial since it tends to impact how your child thinks, feels, acts, learns, and the way they handle stress, and relate to others. Hearing out about the child’s innate emotional needs will help them to follow good mental hygiene and develop resilience. This will further help them cope with whatever life has in store for them and turn out to be mature and stable adults.

The writer is Mental & Emotional Wellbeing Coach, Founder – Let Us Talk.

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5 TYPES OF TESTS FOR ALZHEIMER’S DIAGNOSIS

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Alzheimer’s disease is an age-related neurological disease that occurs due to the progressive shrinking, damage and death (atrophy) of brain cells. Dementia too is an age-related disorder that occurs due to the damage and death of brain cells (atrophy). However, both diseases are not a part of normal ageing.

In India, an estimated 11% of people above the age of 65 years develop Alzheimer’s disease. Over 50 million people the world over have Alzheimer’s disease, of which 5.3 million are in India alone, and it is expected that the number of Alzheimer-related dementia is expected to go up to 10 million by 2040 (1 of every 27 people), as per a 2020 study on dementia.

Alzheimer’s is the most common cause leading up to dementia.

SYMPTOMS

• Deterioration in brain function manifests gradually in the manner given below. However, interestingly, the part of the brain which deals with skills like reading, appreciation of music, dancing or drawing, may deteriorate at a much later stage:

 increasing absent-mindedness,

 decreased ability to remember conversations and recent happenings,

 memory lapse, memory loss and difficulty remembering or recognising previously familiar places, people and objects,

 lack of concentration,

 difficulty in organising and articulating thoughts,

– inability to multitask,

– increasing inability to recognise numbers and dealing with bills and other such;

– graduallyfinding it increasingly challenging to accomplish daily routine tasks such as eating, bathing, and dressing. 

• Social withdrawal,

• Mood disorders, apathy and depression,

• Disturbed sleep pattern,

• Delusionary behaviour

BLOOD TESTS

The progression of Alzheimer’s disease is gradual. Recent path-breaking studies indicate that the following tests can predict its onset long before the symptoms begin to appear:

Thyroid profile (T3, T4, TSH) – to assess thyroid dysfunction: Both Hyper and Hypothyroidism have been recognised as risk factors for dementia. Both high and low levels of TSH (thyroid-stimulating hormone) are linked to AD and dementia among women, but not men. 

Vitamin B12 test (methylmalonic acid (MMA) blood test) –Low levels are associated with brain shrinkage and brain cell atrophy. 

Vitamin D test (25-hydroxyvitamin D) – Vitamin D is essential for the absorption of calcium, magnesium, phosphate, zinc and iron in the body and acts as a hormone on its own while encouraging healthy hormone secretion. Low Vitamin D levels increase the risk of AD by 50%, while severe deficiency increases the risk by 125%.  

IRS-1 protein – (IRS-1 proteinis critical in insulin signalling in the brain and is found to be defective in Alzheimer’s patients). Insulin resistance is the most vital factor for Type 2 Diabetes, and research studies are afoot to prove the strong link between T2DM and AD with absolute certainty. AD has been termed as Type 3 Diabetes by many experts.

APOE4 protein – DNA evaluation ascertains the presence of APOE4 protein in AD patients, especially where genetics is a major cause (as in young-onset AD). It is found to be absent in patients who are not afflicted by AD.

Testing of microRNAs – Testing of microRNAs in the blood and brain, which has an 87% accuracy in predicting dementia.  

NEUROLOGICAL HEALTH EVALUATION 

The doctor may ask the patient to carry out some physical activity (e.g. walking from one point to another, draw a chair, sit down, stand up, respond to sounds, solve a quiz or solve mathematical questions requiring dealing with numbers, logic, etc.) to assess the following:

Tests involving physical movement

– Muscle tone, strength, coordination and reflexes

– Hearing and vision evaluation

– Physical balance

Tests to assess cognitive decline and mental health 

– Level of memory skills: remembering recent conversations, recognising people, places and objects, etc.

– Coherence and flow of thought

– Articulation and decision-making skills

– Depression and mood swings

– Social interaction levels

BRAIN FUNCTION TESTS

MRI (magnetic resonance imaging) of the brain to detect brain shrinkage. 

CT (computerised tomography) scan of the brain to detect abnormalities caused by a previous trauma due to brain injury, stroke, or tumour.

PET (positron emission tomography) scan helps indetermining the pattern of brain degeneration and poor nutrient metabolisation, beta-amyloid clusters and tau tangles. However, many times, the full picture of beta-amyloid plaques and tau tangles in the brain, which are a major cause of Alzheimer’s can be fully ascertained as the definite cause, only after the patient’s death.

The writer is Lab Director at Lifeline Laboratory.

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ALL YOU MUST KNOW ABOUT ALZHEIMER’S DISEASE

Dr Sreekanta Swamy

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Alzheimer’s disease (AD) is a slow and progressive brain disorder that results in the gradual worsening of memory and thinking skills, eventually resulting in an inability to do even simple things over time. Every year, 21 September is celebrated as World Alzheimer’s Day to create awareness about the disease. Alzheimer’s is the most common type of dementia (a group of diseases that results in memory impairment). It amounts to nearly 70% of all causes of dementia. Why people develop this disorder is not yet known so far. The sufferer experiences symptoms because the nerves present in the brain that carry out the function of thinking, memory, learning (called cognitive functions), are damaged or impaired. 

There are nearly 55 million people affected with dementia all over the world and nearly 70% to 80% of them have been diagnosed with Alzheimer’s disease. This number is projected to increase to 155 million in 2050. As the healthcare system is improving all over the world, the number of aged population is also increasing which results in more elderly people being diagnosed with dementia.

Sufferers of AD experience loss of productive abilities, increased dependence on family for care, and create a huge economic impact on society. Nearly 50% of Alzheimer patients are living in resource-poor countries. It is commonly seen in people over the age of 60 to 65 years of age and increases in number with the increase in age. 

AD is caused due to the accumulation of a protein called beta-amyloid outside the nerve cells and an abnormal protein called tau inside the nerve cells. These accumulations result in the impairment of the supply of nutrients to nerve cells in the brain and finally death of the nerve, which then progresses and results in shrinkage of the brain. These changes initially involve the nerve cells in the brain which are responsible for memory and learning, but as the disease progresses, it will involve other parts of the brain. The average life span after diagnosing AD is about four to eight years, but some can live up to 15-20 years. The progression of AD can be divided into three stages. 

STAGE 1. MILD OR EARLY STAGE

In this stage, most people can function independently in many areas and may need assistance with some activities. They are able to drive and take part in most activities. An important feature in this stage is the impairment of recent memory which may show slow worsening over time. This stage usually lasts for two to four years.

STAGE 2. MODERATE 

In this stage, most people show impaired memory, difficulty in remembering names, places, confusion, inability to recognise familiar places, mood changes, aggression, sleep disturbances, hallucinations and delusions. Many people show uninhibited and improper behaviour. They may have a stiffness of the limbs, limitation of movements. Most people required assistance for their day to day activities. This stage is usually long duration spanning from 2 to 10 years

STAGE 3- SEVERE STAGE

In this stage, all the affected people need total assistance for all the day to day activities round the clock. They may be incontinent, feeding may be difficult and mobility may be significantly restricted, with poor recognition of self and surroundings. This stage may last for one to three years.

All those people who are around the age of 60to 65 years, who show impairment of their recent memory- like forgetting familiar names, forgetting places of objects, difficulty in finding familiar ways and places should be evaluated by a neurologist. This is important because while dementia could be the reason, the root cause can be another treatable condition if evaluated correctly and with treatment, a patient can significantly improve.

Currently, there is no permanent cure for AD anywhere in the world. Some of the medications which can delay the progression of the disease are used in all the affected patients.

Many studies suggest that the following helps in slowing the progression

• Getting regular exercise. It helps to stimulate your brain’s ability to maintain good brain health

• Stay socially engaged. Connecting face-to-face with others can help improve your cognitive function

•  Eat a brain-healthy diet. The right foods can help reduce inflammation and promote better communication between brain cells.

• Get quality sleep to flush out brain toxins and avoid the build-up of damaging molecules.

Most importantly, a person affected with this disease has to be supported by a multi-disciplinary team which is supervised by neurologist, psychiatrist, psychologist, physiotherapist, and most importantly expert nursing care. The caregiver plays an important role in the management of a person with Alzheimer’s disease along with the help of other family members.

The writer is Head of Neurology, Aster RV Hospital, JP Nagar, Bengaluru.

A person affected with  Alzheimer’s has to be supported by a multi-disciplinary team which is supervised by neurologist, psychiatrist, psychologist, physiotherapist, and most importantly expert nursing care. The caregiver plays an important role in the management of a person with Alzheimer’s disease along with the help of other family members.

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IMPORTANCE OF EATING HEALTHY AND NUTRITIOUS FOOD FROM CHILDHOOD

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Nutrition plays a crucial role in the wholesome growth of a child—both physically and mentally. A balanced diet is recommended for children so that they do not suffer from cognition and immunity-based health hazards.

Children’s brains are capable of developing at a very fast cadence. Interestingly, by the time children reach a stage where they begin to attend primary school, their brains already progress at a very high pace compared to any other point in their life cycle. We frequently make use of the terms “growth” and “development” synonymously while discussing children growing up, but in fact, these are two very different qualities. Growth implies a quantifiable enlargement in dimensions of the body, such as height and weight; on the other hand, development implies the acquisition of perceptions towards surroundings, attitude, behaviour patterns, and socialising skills. Apart from growth and development, the third most crucial dimension is maturation, which refers to the progression of a child into adulthood at a certain time, depending on the sex of the child, and other biochemical factors. All three aforementioned dimensions of progress in children are facilitated by good nutrition.

When children are deprived of essential nutrients in food, they get malnourished or undernourished. Malnutrition is a state when an individual’s diet is not capable enough to make available sufficient nutrients required for optimal health. It can be due to a variety of underlying socio-economic reasons—low-income sources, difficulty in obtaining food, and other physical and mental health circumstances. Malnutrition severely affects growth, development, and maturity amongst children. In the 2020 Global Hunger Index report, India was ranked 94th out of 107 countries. India harbours more than one-third of the world’s malnourished children. 50% of children, below 5 years of age die because of sheer undernourishment. Most of these children belong to underprivileged and destitute families.

The Government of India considers the health of children an important concern. Hence, various central and state schemes are being executed in full swing, to eradicate hunger. They consist of Integrated Child Development Services (ICDS), National Children Fund (NCF), National Health Mission, Midday Meals Scheme, amongst many others. Under the government’s supervision, various steps have been taken in the direction of nutritional security amongst children and vulnerable citizens. These include setting up community kitchens, adding protein-rich supplements to the Public Distribution System, which includes pulses and millets, etc. Various Non Profit Organisations are also executing hunger annihilation projects in the same direction. It requires a partnership between all the entities involved in hunger annihilation in order to actually help the country progress.   

The children of today become the powerful and progressive youth of tomorrow. They must be protected and nourished adequately. Our efforts as individuals must never fell short when it comes to the children of our country, and hence it is important to join forces and work together for a brighter future for our children. Food must always remain a fundamental necessity and not a luxury!  

The writer is the Founder and President, Wishes and Blessings NGO.

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WHAT ARE THE CAUSES AND TREATMENTS OF ACNE AND PORES?

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Acne or pimples as it is commonly known is not just a teenage problem. It can happen to anybody at any time! Men and women included. The zit that you have been itching to pop happens when the skin pores become blocked with oil, dead skin cells, debris and even bacteria.

This is why it is important to keep the skin pores clean. When clogged, the skin can not breathe and oil and bacteria find a merry ground to cultivate and cause different kinds of acne. There are millions of pores on the skin and they keep the skin healthy, ensure even distribution of sebum (aka keeps its moisturised) and keeps the skin cool.

The cause of acne and enlarged pores

The pores open outwards to a follicle that has hair and a sebaceous gland. Any disturbance in its function can cause the pores to become enlarged, clogged and turn into blackheads, whiteheads, pimples and other kinds of acne. The common well-known causes of acne and enlarged pores includes

• High level of sebum production

• Loss of elasticity of the skin around the pores

• Hormonal imbalance

• Dirt and pollution

• Sun damage

• Reduction of collagen

• Genetics

• Medications

• Stress

• Diet high in processed food and refined carbs

Of course, we all know or have heard about period pimples but there are some little known reasons that also might be causing those unsightly zits. Some of these are:

• Hair products coming in contact with the skin

• Not removing makeup or using the incorrect makeup remover

• Facial hair removal using topical products

• Too many skincare products and switching products too often

• Heavy sunscreens

• Your cell phone. The surface can transfer bacterial on the skin

Not treating acne or relying solely on home treatments will not bring in the much-needed relief. Acne and large pores are not a threat to your life but can be a bit of a downer for self-esteem and sometimes physically painful too.

Most of the time if you are careful in not popping the zit, it will go away in some time but if there is a pattern to the appearance then your dermatologist is the go-to person for long time relief.

The good news is that simple home care and some professional treatments can help get clean the pores and remove the acne without leaving any scars behind. Treatment depends on the type of acne, your age, the severity of acne and type of acne. Here are some popular treatments recommended by skin specialists worldwide to control acne:

• Medications – There are two types of acne medications one that is applied topically and the other that you have to take orally. Topical medications include:

Benzoyl peroxide cream and gel. This helps in killing the bacteria and drying out the pimple. Use it only on the pimple.

Salicylic acid is a common name for over-the-counter acne medications. This helps by removing the dead skin cells and keeping the pores clean.

Azelaic acid kills the microorganism and reduces swelling and inflammation

Vitamin A derivatives include retinol products that not only prevent clogged pores but also get rid of the signs of ageing. These can be used on the entire face safely.

Glycolic acid works by exfoliating the skin and improving collagen production and thus keeping the pore size in check.

Niacinamide is a popular vitamin B derivative it controls inflammation and reduces excess oil production and thus keeps moderate acne in control.

Oral medications include antibiotics, oral contraceptives and isotretinoin. Contraceptives are commonly given to women and contain a combination of estrogen and progesterone and they target the underlying cause of acne, that is, hormonal imbalance.

• Dermabrasion and microdermabrasion – these professional techniques remove the top layer of the skin using a rotating tip. These are mostly used to remove the dead skin cells (preventive measure) and treat acne scars.

• Photodynamic therapy – Using lasers and lights to reduce oil production in the follicles and preventing bacterial development

• Chemical peels – Specially formulated chemicals are applied to the skin to exfoliate the top layer. This treatment is not a permanent solution.

• Removing blackheads and whiteheads – the blackhead and whiteheads are removed using a special tool to keep the skin pores clean and breathing.

• Cystic acne – For Cystic acne, Cortisone steroid injections are used to bring immediate relief and improve acne healing.

● • Micro-needling – This treatment is specifically used to make the pores appear smaller and improved collagen production. This indirectly helps in controlling acne.

At home, you can do simple things like using skin suitable cleanser morning and night, protecting your skin from the sun, avoid contact with friction such as phones, hats, helmets etc., avoid using greasy products, drinking an adequate amount of water and avoiding ‘breakout’ food to keep the acne and enlarged pores at bay.

The writer is a Consultant Dermatologist, Cosmetic Dermatologist & Dermato-Surgeon, The Esthetic Clinics.

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FROM PROMISE TO FULFILMENT: HEALTHCARE STARTUPS WILL BUILD INTERNET OF MEDICAL THINGS IN INDIA

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Even before the Covid-19 pandemic, healthcare was one of the most critical issues in India, from both access and cost viewpoints. Having limited resources means doing more with less, and nothing enables that better than technology. In the last 18 months, the emergence of healthcare and health-tech startups has demonstrated that admirably.

Here is the scale of the challenge in healthcare: India’s allopathic doctor-to-patient ratio is 1:1596, compared to the WHO standard of 1:1000. India is ranked 145 out of 195 countries on the Health Access and Quality (HAQ) index, a global metric created by the Institute for Health Metrics and Evaluation (IMHE) at the University of Washington in Seattle, USA.  

At the same time, in June 2021, India had 5,705 startups that focus on healthcare, according to Traxcn, a research firm that tracks technology investments. According to the same firm, investment in India’s health-tech sector from 2014 amounts to roughly $3.4 billion.

As our 2020 report “Igniting Startups with Investor Insights”–that we wrote in partnership with KPMG–said, health and technology would be the fastest growing sectors that startups and private equity investors would be betting on.

SURVEYING THE LANDSCAPE

India’s health-tech universe is a widely varying one, and experts identify several areas. Most, however, are concentrated in a limited group: telemedicine, online pharmacies, homecare, and diagnostics. In other words, they focus on improving access and care.

Telemedicine was one of the areas where the impact of health-tech was most visibly felt during the pandemic. A report by IAMAI-PRAXIS found that telephonic and video consultations with doctors went up by 300% during the pandemic (still ongoing). Orders from e-pharmacies went up 200%, mostly from patients with chronic conditions.

Apollo Health, a healthcare player with a large presence, has set up teleclinic centres in rural locations; video chat technologies allow patients to consult doctors directly. But several health-tech companies offer more than just teleconsultations. Consider Practo, that helped to create scale in direct-to-patient, app-based solutions. This startup offers a whole package of services that includes insurance claims filing, electronic health records, and even links patients to a network of doctors and hospitals.

Other health-tech startups that enable more efficient doctor-patient consultations include Lybrate, DocsApp, and MFine. A report by the McKinsey Global Institute estimates that by 2025, telemedicine will account for half of all patient-doctor consultations in India. There’s a bonus: it will save $4 to $5 billion in costs since telemedicine visits are 30% cheaper.

Access to medicines has been another challenge. According to a 2018 report from Research and Markets, a market intelligence provider, India’s 850,000 retail pharmacies are still only able to meet 60% of total demand. Firms like 1mg, PharmEasy, Netmeds, Medlife, etc., have emerged to address that gap. 

FROM HEALTH-TECH TO DEEPTECH

In recent years, people have started paying greater and more regular attention to personal health management. Health tracking apps like Maya and PregBuddy, for example, help women monitor their periods and their conditions during pregnancy.

Many fitness and nutrition startups have emerged as wellness gained importance. Fitternity, Cure.fit, HealthifyMe, GoQii, and HealthKart are among the prominent ones. There are several business models, for example, GoQii has a wearable device with remote trainers. Yourdost and InnerHour focus on mental wellbeing.

The home healthcare segment continues to evolve, from simple testing, taking care of the elderly, cancer support, pathology sample collection–many remember the flurry of RT-PCR testing at home during the pandemic–to physiotherapy and home nursing.

More than 75% of all clinical decisions depend on diagnostics, so it is only natural that health-tech goes there too.

This is where artificial intelligence and data analytic—the high-tech end of health-tech—come in. Qure.ai, NIRAMAI Health Analytix, and SigTuple enable faster, better diagnosis, using deeptech to analyse radiology, pathology, and medical imaging reports. 

Some innovations address indirect health issues. The BabyLabel LLP, for example, makes CO2Care, which are small canisters to be placed in any masks to protect against airborne virus infections like Covid-19. These canisters have the material in them that absorbs CO2. It addresses concerns over CO2 buildup in masks worn for extended periods. Research indicates that increased CO2 concentration could result in people suffering from fatigue, headaches, and a loss of concentration. 

There are other areas in which health-tech startups become deeptech or IP-driven, innovator firms: medical devices, biotech R&D, biopharma, healthcare IT services, even genomics. The possibilities seem almost endless, integrating healthcare and technology to make the extraordinary possible. 

FUTURE OF HEALTH-TECH IN INDIA

Viewed in terms of size, the market for healthcare technology does not seem impressive, at an estimated $2 billion or roughly Rs 15,000 crore. That’s less than 1% of the overall healthcare market which according to many analysts, will be $372 billion in 2025.

But it’s the impact that healthcare startups and health-tech will create that matters. Health-tech is expected to grow at 39% on a compounded annual growth rate and create 40 million new jobs by 2030. The government has introduced several elements of a national digital health ecosystem that, when it all comes together, will have exponential network effects. 

In July 2015, while launching the Digital India Initiative, Prime Minister Narendra Modi said, “I dream of a Digital India where quality healthcare percolates right up to the remotest regions powered by e-healthcare.” Health-tech startups will reshape how healthcare is delivered in the next decade and make the realisation of that vision possible.

Aman Gupta is Co-founder & Managing Partner at SPAG and Christina A. D’souza is the Healthcare Practice Lead at SPAG.

Health-tech is expected to grow at 39% on a compounded annual growth rate and create 40 million new jobs by 2030. The government has introduced several elements of a national digital health ecosystem that, when it all comes together, will have exponential network effects.

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