“In our 60 hospitals, an average of 20 per cent of heart attacks we attend to are in the 25-35 age group. Heart attacks have always been there, but at age 60 or 70 years, not for a person who is 25,” says Apollo Hospitals Chairman Prathap C Reddy.

And that has the octogenarian medical practitioner worried. Having been a forerunner in setting up large corporate hospitals in the country starting with Chennai (1983), Reddy says India needs to pull out all the stops to fight an epidemic of non-communicable diseases (NCDs) that stares it in the face.

NCDs are long-term diseases such as diabetes, hypertension, cardiovascular diseases, stroke and cancers; they account for nearly 90 per cent of preventable, premature deaths in middle-income countries such as India, says Reddy. And they can be prevented through screening, medical intervention and disease management, in addition to lifestyle modification. In fact, he quips, “diabetes is like a house dog: if you look after it well, it will not bite you."

Citing his own example, Reddy says, “Every three years, I have been getting an angiogram done on me. Everytime I get it done, my doctor tells me, ‘Your angiogram is like that of a 30-year-old’. How did I achieve that? I exercise regularly, offer my prayers and take out about two hours a day to do things that I enjoy, be it watching movies or spending time with my grandchildren”.

An epidemic of pre-diabetics

“India must prepare itself to face the NCD threat,” he says, particularly concerned about the increasing number of pre-diabetics who show no symptoms.

Apollo doctors screened some 1.59 lakh people in urban and rural areas across India and found that seemingly healthy people were on the brink of developing diabetes, says Reddy ( in picture below ). His recommendation: that everyone over age 30 check for diabetes.

A 2011 study jointly done by the Harvard School of Public Health and the World Economic Forum projected that the global GDP loss due to diabetes between 2011 and 2030 would be $1.7 trillion.

Reddy says that all stakeholders, from health authorities to private healthcare providers and doctors, need to step up their efforts if India is to dodge the dubious distinction of being home to the world’s largest number of diabetics.

“Having conducted over 12 million health checks (over 20 years), we have been able to advise patients on impending health concerns and provide timely treatment and remedies,” he says.

The Aragonda experiment

In 2013, the Group launched an integrated rural healthcare service delivery network. It started in Reddy’s hometown of Aragonda (Chittoor District of Andhra Pradesh) as a door-to-door survey commissioned to study the health indicators of the community.

Till date, Apollo has reached 35,000 people, of whom 3,000 are under treatment for various diseases. A key feature of the programme was to tackle diabetes, hypertension, coronary artery disease, cancer, and COPD, along with monitoring risk factors like smoking, chewing tobacco, nutrition, sedentary lifestyle, and so on, Reddy explains.

The project has a scalable hub-and-spoke model where people from Aragonda who require advanced treatment are referred from rural health centres and satellite clinics to Apollo’s Chittoor Medical College and Hospital. About 30,000 people have been screened for NCDs, and 972 patients are under management for diabetes and hypertension.

But the other interesting feature of the programme is that it ended up playing a pivotal role in combating fatalities from communicable (or infectious) diseases like tuberculosis and addressing maternal and child health as well, explains Reddy, giving a snapshot to policy planners on how one healthcare programme can benefit many.