Lok Sabha Question No. 655 (UNSTARRED), answered on 2016-11-18
Subject: Non-Communicable Diseases
Ministry: HEALTH AND FAMILY WELFARE
Asked by: SUMEDHANAND SARASWATI, HUKUM SINGH, SHIVKUMAR CHANABASAPPA UDASI, NARANBHAI KACHHADIA, RANJANBEN BHATT

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 655 TO BE ANSWERED ON 18 TH NOVEMBER, 2016

## NON - COMMUNICABLE DISEASE S

## 655. SHRI SUMEDHANAND SARSWATI:

SHRI HUKUM SINGH:

SHRI SHIVKUMAR UDASI:

SHRI NARANBHAI KACHHADIYA:

SHRIMATI RANJANBEN BHATT:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) whether the number of cases of various Non -Communicable Diseases (NCDs) such as heart disease, diabetes, blood - pressure, hypertension and other lifestyle diseases are on the rise in the country, if so, the details thereof, State/ UT - wise;
- (b) the number of people suffering from and those died therefrom during each of the last three years and the current year , State/ UT - wise;
- (c) the steps taken by the Government for prevention and control of such diseases along with the number of hospitals, Primary Health Centres (PHCs) equipped to treat such patients, State/UT -wise;
- (d) the steps taken/proposed to be taken by the Government to increase public health spending and create a national health fund for free and affordable treatment of poor patients; and
- (e)  the  other  measures  taken/proposed to  be  taken  by  the  Government  for prevention  and affordable treatment of suchdiseases and spread awareness in this regard?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SMT. ANUPRIYA PATEL )

- (a)& (b) : Indian Council of Medical Research (ICMR) has undertaken a survey on diabetes v ICMR  India  Diabetes  (ICMR -INDAB)  Study  on  the  prevalence  of  diabetes.  It  is  an  ongoing study and current results available from 15 States/UTs indicate overall prevalence o f Diabetes which varies from 4% to 13%.

ICMR  has  informed  that  according  to  the  Report  of  National  Commission  on Macroeconomics and Health, there were 380 lakh cases of Cardiovascular Diseases (CVDs) the year 2005 and these were estimated to rise to 6 41 lakh cases in the year 2015.  The number of deaths from CVDs was estimated to more than double during this period.

The  data  available  from  the  Indian  Council  of  Medical  Research -India  Diabetes (INDIAB) Study Phase I done in the rural and urban settings in 3 States and 1 Union Ter viz., Tamil Nadu, Maharashtra, Jharkhand and Chandigarh for hypertension indicates t he range of prevalence of hypertension from 19.8% to 31.5 %.

State wise data for prevalence and mortality of Non - Communicable Diseases (NCDs) is not maintained centrally.

State/UT wise estimates of incidence and death due to cancer, as furnished by ICMR , for last three years and current year are at Annexure -I & II.

(c): Government of India is implementing National Programme for Prevention and Control o Cancer,  Diabetes,  Cardiovascular  Diseases  and  Stroke  (NPCDCS)  under  National  Health Mission (NHM) tosupplement the efforts of the State Governments for the interventions up District level.  The objective of the programme includes setting up of NCD Clinics at and  Community  Health  Centre  (CHC),  Cardiac  Care  Units,  Day  Care  Centres,  awareness generation for behavior  and life - style  changes,  screening  and  early  diagnosis  of  persons  with high  level  of  risk  factors  and  their  treatment  and  referral  (if  required)  to  higher  f appropriate management for Non - communicable Diseases. The program me includes intervention at  the  level  of  Primary  Health  Centres  (PHCs)  and  Sub - Centres  also.    A  Statement  showing State/UT - wise list of NCD clinics and Cardiac Care Units (CCUs) established under NPCDCS i at Annexure -III.

(d) & (e) : The draft National He alth Policy 2015 envisages raising public health expenditure progressively to 2.5% of the Gross Domestic Product (GDP).

While health is a State subject, the Central Government supplements the efforts o State Governments for improving the healthcare.

Steps taken to improve public health and to provide affordable health car e, inter alia, include : -

#  Initiatives  under  the  National  Health  Mission  (NHM)  with  a  view  to  provide  access affordable,  effective  and  quality healthcare  services  especially  to  the  poor  and  vulnerable sections of the population. Primary health care in India is provided free of cost in health facilities through a nationwide network of Community Health Centres (CHCs), Prim Health Cent res (PHCs) and Sub Centres (SCs).

# Janani Shishu Suraksha Karyakaram (JSSK) envisages free drugs, diagnostics, blood and besides free transport from home to institution, between facilities in case of a referra back home, for all pregnan t women delivering in public health institutions.

# Initiatives under National Urban Health Mission (NUHM) with focus on primary health c needs of urban population particularly slum dwellers and other marginalized groups.

# Providing free medicines u nder the various national health programmes for diseases such as Malaria, TB and Leprosy.

# Making available tertiary health care services in the public sector through strength hospitals, establishment of AIIMS institutions and up - gradation of ex isting Government medical colleges across the country.

# Rashtriya Swasthya Bima Yojana (RSBY) which provides for smart card based cashless heal insurance including maternity benefit cover of up to Rs. 30,000/ - per annum on family floater basis to Below Poverty Line (BPL) families (a unit of five) in the unorganized sector.

# Rashtriya Arogya Nidhi set up under the Ministry of Health & Family Welfare provides financial assistance to patients, living below poverty line suffering from major life t tening diseases, to receive medical treatment.

#  The  Central  Government,  through  its  hospitals  including  All  India  Institute  of  M Sciences (AIIMS), Dr. Ram Manohar Lohia Hospital, Delhi, Safdarjung Hospital, Delhi, La Hardinge Medical College and Associated Hospitals, Delhi, Jawaharlal Institute of Post Gradua Medical Education and Research (JIPMER), Puducherry and Post Graduate Institute of Medic Education and Research (PGIMER), Chandigarh, North Eastern Indira Gandhi Regional Institu of  Hea lth  and  Medical  Sciences  (NEIGRIHMS),  Shillong,  Regional  Institute  of  Medical Sciences (RIMS), Imphal augments the efforts of the State Governments for providing he services in the country.

# The Ministry of Health and Family Welfare has started AMRIT (Affordable Medicines and Reasonable Implants for Treatment) stores where essential life saving medicines and imp including stents are being provided at a substantial discount vis - à- vis the Maximum Retail Price.

| Estimated Incidence of cancer cases in India by different State/UT - All sites - (2013 to 2016)* - Both sexes   |   Estimated Incidence of cancer cases in India by different State/UT - All sites - (2013 to 2016)* - Both sexes |   Estimated Incidence of cancer cases in India by different State/UT - All sites - (2013 to 2016)* - Both sexes |   Estimated Incidence of cancer cases in India by different State/UT - All sites - (2013 to 2016)* - Both sexes |   Estimated Incidence of cancer cases in India by different State/UT - All sites - (2013 to 2016)* - Both sexes |
|-----------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------|
| States                                                                                                          |                                                                                                            2013 |                                                                                                            2014 |                                                                                                            2015 |                                                                                                            2016 |
| Jammu &Kashmir                                                                                                  |                                                                                                           13404 |                                                                                                           14115 |                                                                                                           14864 |                                                                                                           15652 |
| Himachal Pradesh                                                                                                |                                                                                                            7140 |                                                                                                            7425 |                                                                                                            7722 |                                                                                                            8029 |
| Punjab                                                                                                          |                                                                                                           28835 |                                                                                                           30002 |                                                                                                           31214 |                                                                                                           32474 |
| Chandigarh                                                                                                      |                                                                                                            1110 |                                                                                                            1162 |                                                                                                            1217 |                                                                                                            1274 |
| Uttaranchal                                                                                                     |                                                                                                           10709 |                                                                                                           11240 |                                                                                                           11796 |                                                                                                           12381 |
| Haryana                                                                                                         |                                                                                                           26688 |                                                                                                           27933 |                                                                                                           29240 |                                                                                                           30611 |
| Delhi                                                                                                           |                                                                                                           17578 |                                                                                                           18356 |                                                                                                           19168 |                                                                                                           20015 |
| Rajasthan                                                                                                       |                                                                                                           72275 |                                                                                                           75642 |                                                                                                           79160 |                                                                                                           82836 |
| Uttar Pradesh                                                                                                   |                                                                                                          212075 |                                                                                                          222615 |                                                                                                          233659 |                                                                                                          245231 |
| Bihar                                                                                                           |                                                                                                          111572 |                                                                                                          117603 |                                                                                                          123949 |                                                                                                          130628 |
| Sikkim                                                                                                          |                                                                                                             462 |                                                                                                             467 |                                                                                                             473 |                                                                                                             479 |
| Arunachal Pradesh                                                                                               |                                                                                                            1212 |                                                                                                            1231 |                                                                                                            1252 |                                                                                                            1272 |
| Nagaland                                                                                                        |                                                                                                            1284 |                                                                                                            1288 |                                                                                                            1294 |                                                                                                            1300 |
| Manipur                                                                                                         |                                                                                                            2759 |                                                                                                            2836 |                                                                                                            2916 |                                                                                                            2998 |
| Mizoram                                                                                                         |                                                                                                            1552 |                                                                                                            1585 |                                                                                                            1618 |                                                                                                            1652 |
| Tripura                                                                                                         |                                                                                                            2110 |                                                                                                            2139 |                                                                                                            2169 |                                                                                                            2199 |
| Meghalaya                                                                                                       |                                                                                                            3121 |                                                                                                            3184 |                                                                                                            3246 |                                                                                                            3311 |
| Assam                                                                                                           |                                                                                                           30775 |                                                                                                           31124 |                                                                                                           31474 |                                                                                                           31825 |
| West Bengal                                                                                                     |                                                                                                           95316 |                                                                                                           99339 |                                                                                                          103532 |                                                                                                          107906 |
| Jharkhand                                                                                                       |                                                                                                           35206 |                                                                                                           37031 |                                                                                                           38947 |                                                                                                           40959 |
| Orissa                                                                                                          |                                                                                                           43882 |                                                                                                           45736 |                                                                                                           47666 |                                                                                                           49674 |
| Chhattisgarh                                                                                                    |                                                                                                           27310 |                                                                                                           28738 |                                                                                                           30239 |                                                                                                           31817 |
| Madhya Pradesh                                                                                                  |                                                                                                           77175 |                                                                                                           81034 |                                                                                                           85078 |                                                                                                           89315 |
| Gujarat                                                                                                         |                                                                                                           63884 |                                                                                                           66952 |                                                                                                           70171 |                                                                                                           73551 |
| Daman &Diu                                                                                                      |                                                                                                             299 |                                                                                                             339 |                                                                                                             385 |                                                                                                             440 |
| Dadra &Nagar Haveli                                                                                             |                                                                                                             389 |                                                                                                             421 |                                                                                                             457 |                                                                                                             497 |
| Maharashtra                                                                                                     |                                                                                                          117317 |                                                                                                          122256 |                                                                                                          127390 |                                                                                                          132726 |
| Telangana                                                                                                       |                                                                                                           36885 |                                                                                                           38494 |                                                                                                           40177 |                                                                                                           41939 |
| Andhra Pradesh                                                                                                  |                                                                                                           51462 |                                                                                                           53570 |                                                                                                           55776 |                                                                                                           58072 |
| Karnataka                                                                                                       |                                                                                                           64306 |                                                                                                           67237 |                                                                                                           70302 |                                                                                                           73511 |
| Goa                                                                                                             |                                                                                                            1522 |                                                                                                            1587 |                                                                                                            1655 |                                                                                                            1726 |
| Lakshadweep                                                                                                     |                                                                                                              71 |                                                                                                              77 |                                                                                                              82 |                                                                                                              89 |
| Kerala                                                                                                          |                                                                                                           35620 |                                                                                                           37550 |                                                                                                           39672 |                                                                                                           42004 |
| Tamil Nadu                                                                                                      |                                                                                                           73736 |                                                                                                           76091 |                                                                                                           78512 |                                                                                                           80999 |
| Pondicherry                                                                                                     |                                                                                                            1351 |                                                                                                            1428 |                                                                                                            1510 |                                                                                                            1596 |
| Andaman & Nicobar Islands                                                                                       |                                                                                                             389 |                                                                                                             402 |                                                                                                             415 |                                                                                                             429 |
| Total                                                                                                           |                                                                                                         1270781 |                                                                                                         1328229 |                                                                                                         1388397 |                                                                                                         1451417 |

Ref: Three-year Report of the PBCRs: 2012-2014, Bengaluru, 2016

*Projected cancer cases for India were computed using a projected incidence rates and the population (person-years)

| States                    |   2013 |   2014 |   2015 |   2016 |
|---------------------------|--------|--------|--------|--------|
| Jammu &Kashmir            |   6782 |   7144 |   7525 |   7925 |
| Himachal Pradesh          |   3598 |   3742 |   3893 |   4048 |
| Punjab                    |  14580 |  15171 |  15784 |  16423 |
| Chandigarh                |    563 |    590 |    618 |    646 |
| Uttaranchal               |   5399 |   5667 |   5949 |   6245 |
| Haryana                   |  13505 |  14135 |  14797 |  15491 |
| Delhi                     |   8897 |   9290 |   9699 |  10127 |
| Rajasthan                 |  36495 |  38202 |  39985 |  41848 |
| Uttar Pradesh             | 107170 | 112514 | 118115 | 123985 |
| Bihar                     |  56372 |  59431 |  62651 |  66040 |
| Sikkim                    |    234 |    236 |    240 |    242 |
| Arunachal Pradesh         |    619 |    628 |    638 |    649 |
| Nagaland                  |    659 |    662 |    665 |    667 |
| Manipur                   |   1381 |   1419 |   1460 |   1500 |
| Mizoram                   |    791 |    808 |    824 |    841 |
| Tripura                   |   1079 |   1094 |   1109 |   1125 |
| Meghalaya                 |   1612 |   1644 |   1676 |   1710 |
| Assam                     |  15677 |  15853 |  16029 |  16206 |
| West Bengal               |  48075 |  50110 |  52231 |  54443 |
| Jharkhand                 |  17760 |  18683 |  19653 |  20671 |
| Orissa                    |  22105 |  23043 |  24019 |  25035 |
| Chhattisgarh              |  13751 |  14472 |  15231 |  16030 |
| Madhya Pradesh            |  38962 |  40917 |  42964 |  45110 |
| Gujarat                   |  32275 |  33832 |  35466 |  37182 |
| Daman &Diu                |    154 |    176 |    200 |    229 |
| Dadra &Nagar Haveli       |    198 |    215 |    233 |    254 |
| Maharashtra               |  59231 |  61732 |  64332 |  67035 |
| Telangana                 |  18573 |  19385 |  20235 |  21126 |
| Andhra Pradesh            |  25904 |  26970 |  28082 |  29244 |
| Karnataka                 |  32401 |  33881 |  35430 |  37052 |
| Goa                       |    767 |    799 |    834 |    870 |
| Lakshadweep               |     36 |     39 |     42 |     45 |
| Kerala                    |  17858 |  18827 |  19892 |  21062 |
| Tamil Nadu                |  37118 |  38310 |  39537 |  40796 |
| Pondicherry               |    678 |    717 |    759 |    802 |
| Andaman & Nicobar Islands |    196 |    203 |    210 |    217 |
| Total                     | 641455 | 670541 | 701007 | 732921 |

## National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS)

## Infrastructure Details ( As on 30th September 2016)

| S. No.   | State               | State NCD Cell   |   District NCD Cell |   District NCD Clinic |   CCU |   CHC NCD Clinic |   Day Care Center |
|----------|---------------------|------------------|---------------------|-----------------------|-------|------------------|-------------------|
| 1        | Andhra Pradesh      | 1                |                   9 |                     9 |     7 |               62 |                 0 |
| 2        | Arunachal Pradesh   | 1                |                  17 |                    17 |     0 |               20 |                 0 |
| 3        | Assam               | 1                |                  14 |                    14 |     5 |               43 |                 5 |
| 4        | Bihar               | 1                |                   6 |                     6 |     3 |                0 |                 0 |
| 5        | Chhattisgarh        | 1                |                   9 |                     9 |     1 |               53 |                 2 |
| 6        | Goa                 | 1                |                   1 |                     1 |     1 |                2 |                 0 |
| 7        | Gujarat             | 1                |                  19 |                    19 |     5 |               68 |                 2 |
| 8        | Haryana             | 1                |                   9 |                     9 |     4 |                2 |                 6 |
| 9        | Himachal Pradesh    | 1                |                  12 |                    12 |     2 |              140 |                 0 |
| 10       | Jammu               | 1                |                   2 |                     2 |     2 |                5 |                 2 |
|          | Kashmir             |                  |                  10 |                    10 |     4 |               19 |                 4 |
| 11       | Jharkhand           | 1                |                  12 |                    12 |     1 |               56 |                 0 |
| 12       | Karnataka           | 1                |                  15 |                    15 |     5 |               48 |                 5 |
| 13       | Kerala              | 1                |                   5 |                     5 |     4 |               85 |                 4 |
| 14       | Madhya Pradesh      | 1                |                  15 |                    15 |     5 |               46 |                15 |
| 15       | Maharashtra         | 1                |                  17 |                    17 |    10 |              127 |                 5 |
| 16       | Manipur             | 1                |                   9 |                     8 |     0 |                5 |                 1 |
| 17       | Meghalaya           | 1                |                   3 |                     3 |     1 |                6 |                 2 |
| 18       | Mizoram             | 1                |                   6 |                     6 |     2 |               10 |                 2 |
| 19       | Nagaland            | 1                |                  11 |                    11 |     1 |                0 |                 2 |
| 20       | Odisha              | 1                |                  19 |                    17 |     5 |               62 |                 1 |
| 21       | Punjab              | 1                |                  22 |                    22 |     2 |              192 |                 3 |
| 22       | Rajasthan           | 1                |                  24 |                    24 |     7 |               75 |                 8 |
| 23       | Sikkim              | 1                |                   2 |                     2 |     2 |                0 |                 1 |
| 24       | Tamil Nadu          | 1                |                  32 |                    32 |    15 |              621 |                 0 |
| 25       | Telangana           | 1                |                   2 |                     2 |     0 |                0 |                 0 |
| 26       | Tripura             | 1                |                   2 |                     2 |     0 |                0 |                 0 |
| 27       | Uttar Pradesh       | 1                |                  38 |                    38 |     0 |               77 |                 0 |
| 28       | Uttarakhand         | 1                |                   2 |                     2 |     0 |                8 |                 0 |
| 29       | West Bengal         | 1                |                  10 |                    10 |     8 |               38 |                 1 |
| 30       | Andaman & Nicobar   | 1                |                   0 |                     0 |     0 |                0 |                 0 |
| 31       | Chandigarh          | 1                |                   0 |                     1 |     0 |                0 |                 0 |
| 32       | Dadar &Nagar Haveli | 1                |                   0 |                     1 |     0 |                0 |                 0 |
| 33       | Daman &Diu          | 1                |                   0 |                     0 |     0 |                0 |                 0 |
| 34       | Lakshadweep         | 1                |                   0 |                     0 |     0 |                0 |                 0 |
| 35       | Delhi               | 1                |                   0 |                     0 |     0 |                0 |                 0 |
| 36       | Puducherry          | 1                |                   2 |                     3 |     1 |                1 |                 0 |
|          | Grand Total         | 36               |                 356 |                   356 |   103 |             1871 |                71 |