India is grappling wit a rising neurological disease burden

Neurological diseases and mental disorders have become major public health crises and are emerging as major challenges to health care systems globally. India’s population, in particular, is going through an epidemiological and demographic transition, which has led to an increasing burden of non-communicable diseases, including of the brain and mind. This is also attributed to increasing longevity and changing lifestyles.

According to the Global Burden of Disease Study 1990-2019 published recently in Lancet Global Health, non-communicable and injury-related neurological disorders in India have more than doubled in the last three decades, with substantial state-level variations. As health is a state subject, state-specific measures are urgently needed to address gaps.

Stroke, a major neurological disorder, occurs among younger people in India compared to the West, contributing to 37.9% of the total neurological disease burden. While stroke incidence and mortality have been declining in high-income countries, these rates have doubled in India in the last three decades. Additionally, nearly 600,000 stroke survivors with disabilities are added to the population every year.

India is also home to 10 to 12 million people with epilepsy. It has nearly 800,000 patients with Parkinson’s Disease. Due to an increase in life expectancy to nearly 70 years, the ageing population is seeing a steep rise in the number of patients with dementia. The annual cost of dementia-related health care is estimated to be above ₹150 billion. The geriatric population is likely to increase from 7.1% in 2001 to 17% of the population by 2050. This will result in more than 300 million senior citizens by 2050, with a consequent increase in ailments such as dementia.

While neurological disorders associated with poverty and under-development are declining, there is an epidemic of non-communicable neurological disorders. While incorporating neurological care within the ambit of primary care is urgent and necessary, this must be complemented by access to specialised neurological services. There are billion people. This amounts to two neur gists for one million people, a dismal do patient ratio. Moreover, most neurologist concentrated in cities.

With Covid-19, neurological services received a further hit. Patients with chr neurological illnesses such as epilepsy, kinson’s Disease, and multiple scleros well as stroke, have suffered due to the disruption/modification of routine care. lic health measures such as social distan and social isolation have also had har effects on the elderly who need care. spectrum of neurological invo ment in Sars-cov-2 is still evolv as long-term neurological eff remain to be seen.

The National Programme for vention and Control of Cancer, betes, Cardiovascular Diseases Stroke, which was launched in 2 is a step in the right direction. M national policies and program specifically targeting epilepsy, n infections, dementia and neuro-degener diseases need to be planned. District ho tals are a weak link in the public health system. The fragile district health sys needs to be well-equipped with CT scan trained manpower and infrastructure.

The neurological disease burden warr urgent prioritisation of programmes foc on targeted prevention and treatment. U preparation, planning, and urgent step treatment and long-term care of an increa population of neurologically affected pe are instituted, this grim situation will st the health care system in the coming ye

Although the number of specialist trai positions in neurology has increased fro in 1990 to 500 in 2020, we need more tra manpower. The medical community, sc tists, researchers and civil society must cr awareness about brain health, and assist ernment agencies and non-governme organisations in providing treatment and vention of neurological disorders.