India is experiencing a public health crisis, a "triple burden" of chronic respiratory disorders, COPD (Chronic Obstructive Pulmonary Disease), Asthma, and Tuberculosis (TB).
Each condition poses unique risk factors that are very dangerous alone; however, they each contribute to a huge and often unrecognised menace to the nation's health, impacting millions of individuals and health care systems across India.
While each respiratory disease has its own salient, underlying origins, we can observe concurrent characteristic risk factors and impact upon vulnerable populations experiencing these chronic respiratory disorders.
A closer look at the threat
● Tuberculosis (TB): Currently, India has the highest burden of TB in the entire world. TB is a transmitted bacterial infection that is an airborne disease, and if not treated, it can be fatal. A prior history of TB can predispose individuals to develop chronic lung diseases.
● Asthma: A chronic respiratory condition that causes airway inflammation, which leads to wheezing and a feeling of being unable to catch their breath. The prevalence of asthma is high in India, and a significant proportion of global deaths from asthma occur in India.
● Chronic Obstructive Pulmonary Disease (COPD): This progressive disorder, which is also known as chronic lung disease, causes difficulties in breathing in relation to the impact of chronic or repeated irritants on the lungs.
COPD is the leading cause of death in India, and while the disease is frequently attributed to smoking, non-smoking conditions actually account for a large burden of COPD cases.
Shared Causes and the Path Forward
The combined burden of NCDs, infectious diseases and risk factors for ill health in India results from commonly shared social, environmental and lifestyle determinants.
Air pollution, both associated with mobility as well as industrial emissions from outdoors, and indoor air pollution from the use of biomass fuels for cooking, seriously contributes to all three areas of the burden.
Cigarette smoking, active or passive, presents a major risk factor for non-communicable diseases (NCDs), particularly COPD, and is certainly a risk factor associated with TB. In addition to smoking, overcrowding and poverty also contribute to the risk factors associated with the increase of infectious diseases such as TB and other respiratory infections.
This complex crisis will need to be dealt with on many levels.
The government of India has already initiated some key strategies, such as the National TB Elimination Programme and the National Clean Air Programme. For change to be sustainable, and to really reduce the burden of respiratory health, we must move from thinking of combinations of sickness just as a means of treating the sick to one of preventing sickness.
That would mean partnering for social change; increasing awareness of risk, improving and protecting the environment, investing in and improving health and health access.
This is extremely important in rural areas, if we consider that this is where poorer health outcomes may occur for people in India. Improved awareness, education, research and health outcomes cannot happen without coming together in action by government, health professionals and people, so that all people in India can breathe freely again.
Disclaimer: The views expressed in this article are of the author and not of Health Dialogues. The Editorial/Content team of Health Dialogues has not contributed to the writing/editing/packaging of this article.
