marriages, and childbearing by women above 30 years of age.
All these are completely avoidable - by MMR vaccination,
marriage counseling, and public education on risks of marrying
relatives and late childbearing. And yet, annually about
200,000 children are born with CHD in India. The case of
RHD is even more pathetic. It is caused by a simple streptococcal
sore throat, a common childhood infection, between the ages
of 5 and 15. While sore throat is gone in a couple of days,
the child may develop Rheumatic fever, resulting in RHD.
Even most educated middle-class parents are unaware of this.
RHD is fully preventable, and all it needs is immediate
treatment of strepthroat in children with simple, relatively
inexpensive, antibiotics. And yet, over 150,000 children
get RHD every year. There are probably 5 to 10 million Indians
suffering from CHD and RHD.
let us look at our health infrastructure and need for allocations
to meet this challenge after the disease strikes children.
In the entire country, a total of 42,000 heart surgeries
take place. A typical surgery costs Rs 100,000. 90% of these
surgeries are for coronary artery disease, and not even
10% on CHD and RHD. If today's government is willing to
make allocations to surgically treat all cases of CHD and
RHD - it will have to allocate Rs 50,000 crores to just
take care of the existing patients - and at the current
rate it will take over a 1000 years! It would cost Rs 4000
crores to take care of the 350,000 new patients who are
added each year. Even after all that expense and effort,
about half the patients cannot be helped much and the life
span of the rest is prolonged for only limited periods.
Meanwhile human misery keeps mounting as more unborn, and
young children are afflicted by these preventable diseases.
misplaced compassion and political grandstanding are no
substitutes to sensible policy when it comes to promoting
human welfare. What we need is a campaign of mass immunization
(MMR), public education (consanguineous marriages, late
pregnancies and strepthroat), and immediate treatment of
strepthroat in all children in 5 - 15 age group. Such a
programme costs no more than Rs.100 crores per annum for
the whole country. Many diseases can be tackled through
an effective delivery system to spread health education,
administer vaccines and early treatment. For this, an army
of million health volunteers needs to be raised at a low
cost (about Rs. 600 crores per annum) to be the interface
between the community and primary health centres, and they
will address all the health needs, including heart diseases.
We definitely need to help the unfortunate victims of CHD
and RHD with available resources, but the priority should
be clearly to prevent millions from becoming victims tomorrow.
Let us not make the same mistake we made in the initial
stages of fighting Polio - through our misplaced compassion
and not so sensible policies, governments spent scarce money
on calipers for Polio victims instead of focusing on immunization.
The near eradication of Polio now has proved that we are
capable of overcoming our mistakes and taking on such successful
are lucky to live in an age when most problems have simple,
effective, relatively low-cost, high-impact solutions. Very
few of our problems are intractable. A bit of wisdom, sensible
policies, well-directed and modest allocations, and effective
delivery systems can accomplish a great deal to promote
growth and human happiness.