The World Health Organization and India's Ministry of Health and Family Welfare join forces to ensure access to care for 75 million people with diabetes and hypertension by 2025, with the first national-level project funded by WDF in India.
17 October 2024 Andreea Enea
In the heart of South Asia, a significant healthcare shift is underway. India, home to a fifth of the world’s population, bears a substantial share of the global non-communicable diseases (NCDs) burden. A new project aims to alleviate this burden and change the narrative for those living with diabetes and hypertension.
A 12-year study by the Indian Council of Medical Research – India Diabetes has provided new data, estimating 101 million people with diabetes and 136 million with prediabetes in 2021. These numbers highlight the critical need for effective health strategies. Data from India’s NCD Monitoring Survey (2017-2018) shows that only 16.3% of individuals aged 30-69 have their blood glucose levels managed, and just 12.3% have their blood pressure regulated, pointing to a significant gap in effective diabetes management.
The Ministry of Health and Family Welfare (MoHFW), with support from the World Health Organization (WHO) Country Office in India, launched a project of unprecedented scale to ensure timely access to care for 75 million people with diabetes and hypertension by 2025.
The Strengthening NCD Management in Primary Care in India project marks a significant development, being the first time WDF supports a project at the national level in India and the first collaboration with MoHFW and WHO.
'This partnership serves as an ideal platform to advocate for systemic changes, particularly in integrating NCD management with critical areas like maternal health. It allows us to bring about change on a scale we have not seen before', says Leif Fenger Jensen, WDF’s Managing Director.
India has been the largest recipient of WDF funding, with multiple projects focused on gestational diabetes care, community-level type 2 diabetes care and awareness, comprehensive eye care and diabetic retinopathy.
In September 2024, WDF’s programme managers Mette Skar and Dr Radha Valaulikar visited different locations in the Madhya Pradesh State, India, to discuss the large-scale project.
They met with the partnering organisations as well as with many of the local healthcare professionals, as well as with patients and other key stakeholders in the WDF-supported projects in India.This direct engagement with the people provided a better understanding of the vital work and role that community-level health workers play on the ground.
Mr Motilal Jadhav (left), living with hypertension and diabetes for 17 years, regularly visits the Community Health Centre Kolar for treatment per the state protocol developed by the Government of Madya Pradesh and WHO. The arm-in blood pressure monitor in the picture enhances the efficiency of NCD nurses.
This project is not just about numbers; it's about people. It aims to serve both rural and urban areas, including tribal peoples and underserved communities such as residents of low-income urban areas and marginalised settings and people living below the poverty line.
By strengthening the capacity of primary-level health facilities in every state to bring care closer to home, the project seeks to reduce out-of-pocket costs due to delayed detection and complications and ensure equitable access to care for those who need it most.
Marking a new milestone in NCD treatment programmes, WHO India will extend its expertise and resources to MoHFW and state governments, overseeing coordination, planning, and monitoring.
'WDF’s support for our work in India has arrived at a critical time, allowing us to sustain the momentum of our efforts over the past five years. It also empowers us to strive towards, and hopefully exceed, the targets we've set in alignment with the Government of India's plans', explains WHO representative to India Dr Roderico Ofrin.
WHO's network of NCD consultants on the ground will facilitate this process, ensuring the program's successful implementation and significant impact.
'Our on-ground teams are adapting strategies for each state, with a focus on strengthening primary care. We aim to bring a systemic shift in NCD management, not just in the 400 districts selected for this project, but nationwide. It is a substantial task, but a necessary one. We're confident that, together, we can effect a lasting change in NCD care.'
Key components of the project:
The WDF project was launched to support the implementation of the '75 by 25' Roadmap – an ambitious plan announced by the Indian Government at the 2023 G20 New Delhi summit to reach 75 million people with diabetes and hypertension under care by 2025.
WHO
With a strong presence in over 150 countries, WHO collaborates with governments and health ministries to implement programs. The WHO India Office, one of the largest, works closely with the government to develop health policies and control NCDs. With over 200 field offices, WHO India implements its programs at the grassroots level, aiding MoHFW in coordination and planning.
MoHFW
MoHFW is dedicated to large-scale detection, treatment, and management of diabetes and hypertension, and for the project implementation will provide leadership, coordinate policy setting and implementation, allocate funds, and monitor the development. It is also responsible of hiring NCD consultants at national and state levels for effective management.
The '75 by 25' Roadmap builds on key country initiatives like the health reform (Ayushman Bharat), the National Programme for Prevention and Control of NCD, and the Indian Hypertension Control Initiative (IHCI).
IHCI was started in 2018 by MoHFW, WHO India and partners to empower primary care to manage hypertension and diabetes. After five years, it successfully scaled up to 155 districts in 27 states, improving blood pressure control rates from 16% to 46%. Over 26,500 Health and Wellness Centers (HWCs) provide follow-up care, 26 million people are on protocol-based treatment, and the national NCD portal is being used in most HWCs.
The new project will support MoHFW with the '75 by 25' Roadmap by scaling up IHCI’s effective model. It will be rolled out across 400 districts out of 785, covering all 28 states and 8 Union Territories of India ensuring availability, usability, and quality of care, and setting a new standard for healthcare delivery.
The comprehensive nature of the WDF project sets forth clear goals to tackle the challenges of the health system:
Firstly, it strives to ensure at least 75% of target districts have access to essential diagnostics and medicines for diabetes and hypertension. This involves equipping at least 50% of all primary care clinics in the target districts with trained healthcare professionals and community health workers (CHWs) who can deliver protocol-based care.
Secondly, it will enhance the use of health information systems. This includes addressing gaps in diabetes treatment protocols and improving the capacity of healthcare workers at the primary healthcare level.
Lastly, the project will increase community awareness by involving Auxiliary Nurse Midwives (ANMs), Accredited Social Health Activists (ASHAs), and Community Health Officers (CHOs) in outreach efforts.
It also aims to increase the annual use of government funds for NCDs at the state level, showing a keen commitment to improving healthcare infrastructure and services.
By addressing critical areas and leveraging a strong collaboration, this national project is ready to catalyse a major shift in India's healthcare system, backing up the '75 by 25' initiative.
This is the culmination of the ambitions of our partnerships in India. The model addresses WHO health system building blocks and leverages a mature digital health landscape and we see it as a blueprint for future large-scale, high-quality care interventions.', shares WDF’s Sr Programme manager Mette Skar.
Its goals reflect a commitment to improving the lives of millions and setting a new standard for NCD care.
'It's about immediate impact and long-term systemic change'.