Friday, March 4, 2016

Indian government finally wakes up to the ESRD epidemic



When the Union Budget mentions the words "dialysis" and "ESRD", it definitely means good news. Probably for the first time in the history of this country have these two words been mentioned in this important speech of the country's Finance Minister.

With India being the Diabetes Capital of the world, it should hardly come as a surprise that a large number of Indians are falling prey to the epidemic of kidney disease. Arun Jaitley, the Finance Minister said in his speech, "Almost 2.2 lakh new patients of end-stage renal diseases get added in India every year, resulting in an additional demand for 3.4 crore dialysis sessions". It is clear that the healthcare infrastructure in the country is nowhere near equipped to cater to a need of this magnitude.

The budget speech consisted of two important parts pertaining to dialysis:

1. The National Dialysis Program which aims to have a dialysis centre in each district using the Public-Private-Partnership (PPP) model

2. Duty waiver for certain parts of dialysis equipment

For a sector that has suffered neglect and additional burden, any first step is welcome - at least they have us on the radar! In actual terms, these are baby steps in the long path to providing succour to the thousands of dialysis patients in the country.

And here's why. Let's take the second one first. Duty waiver for certain parts of dialysis equipment. No dialysis machines are made in India. So, the duty waiver would apply only for when parts are to be replaced. How would this reduce costs for patients in a significant way?

The National Dialysis Program has the potential to become like the US Medicare ESRD program. Of course, there are 'miles to go before I sleep'. The first step of course, is to provide the necessary infrastructure in the hospitals in each district to be able to run a dialysis centre. This itself is a massive exercise. You need to have trained staff for this purpose. You need dialysis machines, water treatment plants, personnel to maintain this equipment. You need nephrologists to be able to prescribe and manage the patients. You need to also ensure that the centres are run at good quality standards. You need professionals to define the standards and ensure that they are followed in a continuous manner.

By no means is this going to be an easy exercise. Rome, of course wasn't built in a day. The National Dialysis Program is a fantastic thought. As of now, it remains just that - a thought. I suspect that the effort to take it to fruition would be more than that to build Rome!

That said, I wholeheartedly welcome this move. As I pointed out, at least they have us on the radar! That itself is huge. Step by step, with the help of ethical professionals who genuinely want to enable the Indian population to get access to quality dialysis services, the Government should make this scheme successful. It must keep in mind that the eventual goal should be to provide a scheme that not merely provides dialysis but provides better quality of lives for patients with ESRD in India. focus on quality and not quantity. Start with a pilot city. Then gradually expand it to cover a state, a region and then the entire country. We are with you!

3 comments:

Unknown said...

I believe this is a similar process to what happened in the USA years ago with Medicare. Congratulations! I will eagerly be watching for additional"baby steps".

shrey saswat said...

I just wanted to add few lines...."woods are lovely..dark and deep; we have promises to keep....miles to go before WE sleep...miles to go before WE sleep"....such dreams will never give us lullaby sleep.....WE are with you Sir.

shrey saswat said...

High five sir...I cannot resist myself saying..."we shall overcome...we shall overcome...we shall overcome one day....O peace in the heart, we do believe...we shall overcome one day"