Stronger together: a new pandemic agenda for South Asia

The global increase in COVID-19 cases in 2021 has primarily been due to an uncontrolled surge in South Asia. It is estimated that by 1 September 2021, approximately 1.4 million in South Asians will die due to COVID-19 alone. The total number of excess deaths will be much higher—including non-COVID causes, as health systems are on the brink of collapse. With 33.4% of South Asians being extremely poor and the large-scale loss of livelihood being reported, the region faces a potentially catastrophic future for the ongoing decade. However, countries in South Asia continue to remain divisive. This differs from other geographic ‘blocs’ that frequently cooperate on mutual interest issues. Tensions in South Asia are shaped by complex domestic, bilateral, intra-regional and international geopolitical factors, despite the region’s obvious geographic, economic and cultural interdependence. A key lesson from the current pandemic is that countries need to share lessons and actively coordinate, complement and supplement each other’s public health responses, especially between neighbours.

Read the Editorial published in BMJ Global Health with Dr Soumyadeep and his colleagues which presents a pragmatic ‘Stronger Together’ agenda on critical areas of concern for political, social, medical and public health leaders in South Asia to consider and build on here (open access)

Photo by Min An on

Cost-effectiveness of interventions to control cardiovascular diseases and type 2 diabetes mellitus in South Asia:

Cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) together contribute to the largest burden of morbidity (14% of disability-adjusted life years) and mortality (over 30% of all deaths) in South Asia.T2DM doubles the risk of developing CVD, and approximately half of patients with T2DM are known to be hypertensive.By 2030, it is projected that there will be 120.9 million people with diabetes in South Asia (90–95% of these will have T2DM), more than double the number affected in North America or Europe.

South Asians experience higher case fatality rates and rates of premature death due to CVD (deaths occurring at least 10–15 years younger) than the rest of the Western world.A report in 2010 suggested that the total annual income loss to households affected by CVDs in India was 144–158 billion INR. The WHO estimates that India will lose US$237 billion due to heart disease, stroke and diabetes, which will slow the growth in India’s GDP (gross domestic product) by 1% over the next 10 years, thereby contributing to poverty. The mortality and morbidity due to CVD/T2DM thus impose a huge economic burden on individuals, families and society, the health system, and the economy as a whole.

CVD and T2DM share various common risk factors (unhealthy diet, physical inactivity, tobacco use, high blood pressure, dyslipidaemia and stress), and hence there is considerable overlap in strategies used to control these diseases.

While the efficacy and safety of various interventions have been tested by several randomised controlled clinical trials and subsequent systematic reviews and meta-analyses, little is known about the cost-effectiveness of these interventions from the perspective of either the patient or the healthcare system.

Full Systematic Review Protocol on the issue was published by Singh K , Sekaran AMC , Bhaumik S et al  recently in BMJ Open and is available here (Click) (Open Access )

The Cochrane Colloquium comes to India

Chowmahalla Palace,Hyderabad
Picture from Chowmahalla Palace,Hyderabad, royal seat of the Asaf Jahi dynasty where the Nizams entertained their official guests and royal visitors.

Cochrane, the global leader in evidence-informed health is for the first time in its more than 20 year history (the first Cochrane Centre opened in Oxford,UK in October 1992 ) is for the first time holding its annual colloquium in India, or for that matter in South Asia.

The 22nd Cochrane Colloquium takes place in Hyderabad, India from 21-26 September, 2014 with the theme ‘Evidence-informed public health: opportunities and challenges’. The event is landmark especially when seen in the background of the impending evidence based medicine as well as universal health coverage in South Asia.The event will see Professor Gordon Guyatt delivering the Annual Cochrane Lecture and plenaries conducted and chaired by global leaders on EBM,public health and policies with the following themes :
1. East meets West: Evidence-Informed Public Health; Concepts, Context, Opportunities, Challenges,
2.Public Health: the context, the vision, the opportunities
3.Capacity Development: Challenges and Innovations
4.Cochrane Reviews: Assuring Quality and Relevance
5.Advocating for Evidence: Improving Health Decision-Making through Advocacy, Partnerships and Better Communication

Five Special themed session which will highlight important issues on the following theme are also scnheduled and their are inumerable workshops held.There are about 88 oral presentations and more than hundred posters.

Keep looking at this page for daily on the spot  updates on the event.

Health and beyond… strategies for a better India: Concept paper on primary health care in India

India is one of the fastest growing economies of the world, and is posed to overtake China in terms of being the most populous nation of the world. The very essential components of primary health care – promotion of food supply, proper nutrition, safe water and basic sanitation and provision for quality health information concerning the prevailing health problems – is largely ignored. Access to healthcare services, provision of essential medicines and scarcity of doctors are other bottlenecks in the primary health care scenario. Complete absence of evidence-based guidelines on clinical scenarios and treatment plans in the primary health care sector, together with overburdening of the secondary and tertiary care sectors, has substantially lowered the quality of care in the nation.
The paper by Dr. Soumyadeep B published in the Journal of Family Medicine and Primary Care , of the Academy of Family Physicians of India is a concept note that suggests a triad of strategies (technology, accountability and ink-blot strategy) that can be adapted to various problems in the primary healthcare scenario . Read the full paper here (Open Access ):