Lok Sabha Question No. 321 (STARRED), answered on 2022-03-25
Subject: Kidney and Heart Diseases
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Ashok Kumar Rawat

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

## LOK SABHA STARRED QUESTION NO.321 TO BE ANSWERED ON THE 25 TH  MARCH, 2022

## KIDNEY AND HEART DISEASES

## †*321. SHRI ASHOK KUMAR RAWAT:

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

- (a) whether the Government is aware of the increase in the number of kidney, heart and poverty-borne diseases along with diseases like Hepatitis-B, HIV and Tuberculosis in the country;
- (b) if so, the details thereof and the reasons therefor; and
- (c)  the  steps/measures  being  taken  by  the  Government  to  provide  timely  medical facilities to the people suffering from the above diseases and prevent the spread of the bacterial and viral diseases?

## THE MINISTER OF HEALTH AND FAMILY WELFARE

## ANSWER (DR MANSUKH MANDAVIYA)

- (a) to (c) A Statement is laid on the Table of the House.

## STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO. 321* FOR 25 TH  MARCH, 2022

(a) to (c): Non-Communicable Diseases (NCDs) are estimated to account for 63% of all  deaths  in  India.  A  study  'The  changing  patterns  of  cardiovascular  diseases  and their risk factors in the States of India: The Global Burden of Disease Study 19902016'  was  published  in  Lancet  Global  Health  2018  by  Indian  Council  of  Medical Research  (ICMR).  As  per  the  study,  heart  diseases  contributed  28.1%  of  the  total deaths in India, in 2016 compared to 15.2% in 1990. Another study 'Global, regional and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017' was published in Lancet 2020 by ICMR. As per the study, the age standardized prevalence of chronic kidney disease (CKD) in India has increased by 5.6% between 1990 and 2017.

The Department of Health & Family Welfare, Government of India provides technical and financial support to the States/UTs under the National Programme for Prevention  and  Control  of  Cancer,  Diabetes,  Cardiovascular  Diseases  and  Stroke (NPCDCS),  as  part  of  National  Health  Mission  (NHM).  Under  NPCDCS,  682 District NCD Clinics, 191 District Cardiac Care Units, and 5408 Community Health Center NCD Clinics has been set up.

A  population-based initiative for prevention, control and screening for common  Non-Communicable  Diseases  (NCDs)  i.e.  diabetes,  hypertension  and common cancers has been rolled out in the country under NHM and also as a part of Comprehensive  Primary  Health  Care.  Under  the  initiative,  persons  more  than  30 years of age are targeted for their screening for common NCDs. Screening of these common  NCDs  is  an  integral  part  of  service  delivery  under  Ayushman  Bharat  Health and Wellness Centres.

Government of India is supporting free of cost dialysis services to all patients Below Poverty Line (BPL) at district hospitals in the country under Pradhan Mantri National  Dialysis  Programme  (PMNDP)  launched  in  2016.  Under  PMNDP,  State Governments  are  supported  under  the  umbrella  of  the  National  Health  Mission (NHM). PMNDP has been implemented in total 35 States/UT in 571 Districts at 1054 centres by deploying 7207 hemo-dialysis machines. Total 13.16 lakh patient availed dialysis services and 137.34 Lakhs Hemo-dialysis sessions held- as on 31st January 2022.

Cardiovascular Diseases & Kidney Diseases patients are getting treatment at various  health  facilities  in  the  health  care  delivery  system  including  Medical Colleges,  Central  Institutes  like  AIIMS,  Central  Government  hospitals,  and  private sector hospitals. There is also focus on cardiovascular diseases & kidney diseases in its  various  aspects  in  case  of  new  AIIMS  and  many  upgraded  institutions  under Pradhan  Mantri  Swasthya  Suraksha  Yojna  (PMSSY).  Under  Pradhan  Mantri  Jan Arogya Yojana (PMJAY), health insurance cover of Rs. 5 lakhs per family per year for  secondary  or  tertiary  care  hospitalization  to  over  10.74  cr.  beneficiary  families identified  from  Socio  Economic  and  Caste  Census  2011  (SECC  2011)  database  is provided. AB-PMJAY  provides  treatment corresponding to a total of 1,669 procedures under 26 different specialties for NCDs  including Cardiovascular Diseases  &  Kidney  Diseases.  The  treatment  packages  under  AB-PMJAY  are  very comprehensive  covering various treatment related aspects such as drugs and diagnostic services.

Preventive  aspect  of  Cardiovascular  Diseases  &  Kidney  Diseases  is  being strengthened under Comprehensive Primary Health Care through Ayushman Bharat Health  Wellness  Centre  scheme,  by  promotion  of  wellness  activities  and  targeted communication  at  the  community  level.  Other  initiatives  for  increasing  public awareness about Cardiovascular Diseases & Kidney Diseases and for promotion of healthy lifestyle  includes observation of National and International Day and use of print, electronic and social media for continued community awareness. Furthermore, healthy  eating  is  also  promoted  through  FSSAI.  Fit  India  movement  is  being implemented  by  Ministry  of  Youth  Affairs  and  Sports,  and  various  Yoga  related activities are being carried out by Ministry of AYUSH. In addition, NPCDCS gives financial support under NHM  for awareness generation (IEC) activities for Cardiovascular Diseases & Kidney Diseases to be undertaken by the States/UTs as per their Programme Implementation Plans (PIPs).

National Viral Hepatitis Control Program under the National Health Mission has been launched by Ministry of Health and Family Welfare, Government of India in  July  2018  and  services  expanded  to  include  management  of  Hepatitis  B  in February  2019.  The  key  strategies  adopted  under  the  program  include  awareness generation, promoting diagnosis and providing treatment for viral hepatitis. Under the program,  free  diagnostics  and  drugs  are  being  made  available  for  management  of viral  hepatitis.  Around  1.51  crore  people  have  been  screened  for  hepatitis  B  and approx., 13,379 patients have been put on treatment for hepatitis B.

The prevalence of HIV in India continues to be low with an adult prevalence rate  of  0.22%  as per  the latest  HIV  Estimations  2020  report of  the  Government of India.  The national adult prevalence has declined from an estimated peak prevalence of 0.54% in 2000-2001 through 0.33% in 2010 to 0.22% in 2020.

The  Government  of  India  is implementing  the  National  AIDS  Control Programme (NACP) to respond to the HIV disease in the country. Currently, phase-V of the NACP is under implementation as a Central Sector Scheme fully funded by the Government  of  India  to  prevent  the  spread  of  HIV  infections  keeping  more  than 99.5% of the adult population HIV free. Under the Programme, more than 4 crore HIV tests are being done annually at 34,500 facilities and around 14.20 lakh people living with HIV/AIDS (PLHIV) are taking free, life-saving, high-quality antiretroviral medicines from 657 centres. More than 9 lakh viral load tests are being done among PLHIV who are on treatment to monitor the effectiveness of treatment towards the attainment of viral load suppression.

As  per  the  Global  TB  Report,  2021  by  the  World  Health  Organization,  the incidence of TB in India has reduced from 217/lakh population in 2015 to 188/lakh population in 2020.

The steps taken by the Government to address Tuberculosis are as under:

- i. Integration with Ayushman Bharat - Health & Wellness Centres to decentralize screening and treatment services closer to the community
- ii. Scale up of private sector engagement to increase the notification
- iii. Scale  up  of  Rapid  molecular  diagnostics  (CBNAAT  /  Truenat)  for  TB diagnosis & early detection of drug resistant TB
- iv. Active  Case  Finding  (ACF)  among  vulnerable/key  populations  under  the programme to find the additional TB cases
- v. Nutritional  support  under  Nikshay  Poshan  Yojana  (NPY)  to  all  eligible  TB patients
- vi. To strengthen the  community  involvement,  identification  of  TB  survivors  as TB Champions and trained them using the standardized training curriculum on empowering TB survivors to TB champions
- vii. Expansion of TB preventive treatment