BMI View: India will continue to battle a heavy burden of communicable and non-communicable diseases. This is the result of low expenditure on healthcare, coupled with many people being on low incomes (especially in rural areas). We highlight that over the long term, lifestyle changes resulting from increases in affluence will cause a rise in non-communicable diseases due to the growth of obesity. Pharmaceutical companies can therefore leverage on the commercial opportunities presented by a shift in disease trends.
India-based Bharat Biotech has launched Typbar-TCV, a vaccine against typhoid disease for adults and infants aged six months and older. According to the firm, the current forms of typhoid vaccines are unable to provide long-term protection, or to protect children aged two years and under. Much of Bharat Biotech's research focuses on tropical communicable diseases such as chikungunya, malaria and Japanese encephalitis.
The company's focus on such infectious diseases is unsurprising, given the high burden of these conditions in the India. According to BMI's Burden of Disease Database (BoDD), disability-adjusted life years (DALYs) lost to communicable diseases in the country reached 89,722,987 in 2012, representing 42% of total DALYs lost to both communicable and non-communicable diseases. By 2030, this proportion will decline to 32%. Despite the decrease, the burdens of both communicable and non-communicable disease are still fairly balanced, which is unlike the case in developed countries where the burden of non-communicable disease is significantly higher than communicable diseases.
|High Disease Burden|
|DALYs Lost To Communicable & Non-Communicable Diseases In India|
A key factor contributing to the high burden of communicable diseases is the lack of access to treatments and prevention. This lack of access can be attributed to the low per capita expenditure on healthcare (US$57.70 in 2012), which renders many people barely able to afford even very basic medical services. In addition to low expenditure, a high proportion of the population in India is still living in rural areas (68% in 2012), where healthcare facilities are often inadequate. This lowers diagnosis and detection rates of diseases in general. According to India's Annual Health Survey 2010-2011, only 62% of the children in India are considered fully immunised (against tuberculosis, three doses of DPT (diphtheria, pertussis and tetanus), polio and measles), highlighting the low vaccination rate in the country. Due to these factors, it will be difficult to eradicate communicable diseases in the country. The situation is worsened by the emergence of multi-drug resistant strains of tuberculosis and malaria.
While India continues to battle the high burden of communicable diseases, economic development has let to rising incomes and improved nutrition in certain parts of the country. Increasingly, people will adopt a more 'Westernised' sedentary lifestyle. In August 2013, Dr Anoop Misra, head of department of diabetes and metabolic diseases at Fortis, stated that approximately 22% of Indian children (aged five to 19) are obese, increasing the risk of them developing other non-communicable diseases later in life such as heart disease, cancer, diabetes and high cholesterol.
According to the International Diabetes Federation, India has approximately 63mn diabetic patients, the second-highest prevalence in Asia Pacific after China (92mn). In addition, the World Health Organization (WHO) estimates that by 2020, a staggering 60% of the world's cardiac patients will be found in India. In the past 50 years, rates of coronary disease among India's city dwellers have increased from 4% to 11%. As a result, the commercial potential for manufacturers of therapeutics for chronic diseases is enormous.
|Major Cause Group||Number Of Deaths||Number Of Deaths As Percentage Of Total|
|Source: Census India|
|Disease of the circulatory system||243,377||27.7|
|Certain infectious and parasitic diseases||122,595||14.0|
|Injury, poisoning and certain other consequences of external causes||77,763||8.9|
|Disease of respiratory system||75,027||8.5|
|Certain conditions originating in the perinatal period||61,674||7.0|
|Endocrine, nutritional and metabolic diseases||35,355||4.0|
|Symptom signs and abnormal clinical findings||114,646||13.1|