On the occasion of World Health Day, the Apollo Hospitals Group, Asia’s largest and most trusted healthcare group, unveiled a report on the Health of the Nation that puts a spotlight on how the last two decades have seen a steady rise in non-communicable diseases (NCDs).  The contribution of NCDs as the top causes of death in India has risen to a staggering 64.9% as compared to communicable diseases, maternal and other causes that dropped to 25%. The study provides a unique perspective drawn from Apollo Hospitals’ 37 years of experience and its vast footprint across the country and underlines how Artificial Intelligence and Big data analytics can help to predict risk and prevent NCDs. Given the pandemic, this is also important as individuals with NCDs such as diabetes, heart disease, hypertension, chronic kidney disease, and chronic liver disease have a greater mortality risk from COVID-19.

Dr Prathap C Reddy, Chairman, Apollo Hospitals Group said, “Even before the pandemic began, we have been facing an unacceptable loss of lives due to non-communicable diseases (NCDs). The silent epidemic of NCDs was evident with NCDs behind 40% of all hospital stays. However, in dealing with the COVID-19 pandemic, the data from our Health of the Nation report made it clear that we have let another epidemic slip, the epidemic of NCDs – the impact of which we are already beginning to see around us. We can overcome NCDs together as a country, only if each and every one of us take our health seriously.

“At Apollo, we have been working on preventive health for over 37 years. From the very first Master Health Check in the country, we have been constantly evolving our programs for early detection and better clinical outcomes. Apollo ProHealth is a proactive personalized health management program backed by cutting-edge technology – advanced diagnostics, artificial intelligence and predictive algorithms – to help identify your health risk. It coaches you to stay on the path to wellness until your health goals are achieved. With Apollo ProHealth, we hope to change the health check paradigm from a long checklist of tests to a meaningful conversation with the doctor on the status of your health, with a comprehensive plan to make you healthier tomorrow than you are today. Today, on World Health Day, on behalf of the Apollo Hospitals Group, I dedicate Apollo ProHealth to the health of our nation!”

NCDs affect not just health, but also productivity and economic growth. The 2030 Agenda for Sustainable Development adopted by the United Nations recognises NCDs as a major challenge for sustainable development with the target to reduce premature mortality from NCDs by one-third by 2030. The pandemic last year has exacerbated the risks and impact of NCDs manifold, as also shown in the Health of the Nation report.

Dr Sangita Reddy, Joint Managing Director, Apollo Hospitals Group said, “Apollo Hospitals’ commitment is to the health of the nation, with a vision to make our nation healthier. With the urgent need to respond to the challenge of non-communicable diseases, we cannot afford a pure treatment and curative approach to health. We believe that a focus on prevention will be transformative for the health of the nation. We are harnessing the power of technology to develop new methodologies for screening, detection, and patient risk profiling. We are using our pioneering experience of over 37 years and countrywide network to create and innovate new models of care to improve clinical outcomes. We have been the first to adopt Artificial Intelligence and Big data analytics to predict risk and personalize care.

“Today, we are showcasing our insights into a vast amount of health data that will form the foundation of a healthcare model for our future. Many arms of Apollo Hospitals have worked together, collating their knowledge, data on the incidence of disease, and put that into one holistic report that is a representative study of the Health of the Nation.”

NCDs account for 65% of all deaths in India. There is a need to look at new norms of preventive health management that allow us to detect and tackle risks from NCDs before they manifest, even more so in the context of the COVID-19 pandemic. The Health of the Nation report offers a unique perspective of the healthy and unhealthy – across occupations, economic segments, and demographics, and trends of non-communicable diseases across the country. The study will help put in place approaches to improve disease prevention, increase the accuracy of early diagnoses that will, in turn, lead to a more personalized and patient-centric treatment approach.

Dr Anupam Sibal, Group Medical Director, Apollo Hospitals Group said, “The Health of the Nation study highlights the need to direct our efforts efficiently towards controlling NCDs through optimal use of our healthcare infrastructure. The highest prevalence of pre-diabetes and diabetes is seen in 45-60 year olds and is almost as high as the 60+ age group. Amongst the diabetics, around 50% also have hypertension and are above the recommended weight. Around 60% of these diabetics are also leading a sedentary lifestyle. The data also indicates that while women have lower incidence of NCDs, the difference is marginal. Hence, they must stay vigilant. The economically disadvantaged are also not spared, although with lower prevalence.”

There is a significant diabetes population in the major metros and suburbs of India, especially the Delhi NCR – Punjab & Haryana Belt, Kolkata, entire Mumbai-Ahmedabad belt, Hyderabad and Chennai, Kerala and Tamil Nadu, as well as in the predominantly rural areas of MP, Maharashtra, UP, Bihar, parts of Orissa and Gujarat. There is a significant hypertensive population in major metros such as Delhi, Punjab & Haryana, Kolkata, Mumbai, Goa, Trivandrum and Hyderabad and in the predominantly rural areas in Tamil Nadu, Karnataka, UP, Bihar, Orissa and Gujarat.

Prof. Nirmal Kumar Ganguly. Former Director-General, Indian Council of Medical Research and President, Apollo Hospitals Educational and Research Foundation said, “Our pilot community health model, Total Health, to reduce premature NCD-related deaths in rural areas was launched in 2013 in Aragonda, Chittoor district. The program saw 31,350 people classified as low risk, moderate risk and high risk, according to their ten-year risk of developing NCDs, and proactively managed with regular follow up, investigations, medication, clinical interventions, counselling and lifestyle modifications for diabetes, hypertension and cancer. In addition, the program also addresses all other social determinants of health in the country (e.g., drinking water, nutrition, kitchen gardening, livelihood generation) to beyond just health to ‘Total Care’ for ‘Total Health’.”

Under this program 1,980 diabetic and hypertensive patients have been put under regular follow up, who are under now control with proper investigations, medication, counseling and life style modifications. Also 5,391 rural women were screened for cancer and 17 early cancer cases (cervix and breast) were diagnosed and managed with appropriate health intervention services which were free of cost

Around 80% of mortality from NCDs is preventable with early detection and proper management. It is critical to continue to focus on regular health check-ups to detect NCDs along with AI-enabled tools that allow premature health events to be identified early.

Dr Sujoy Kar, Chief Medical Information Officer said, “The study gives us the data that will allow the effective use of technology to predict risks and guide our actions to prevent and rein in the NCD epidemic. One such example is to evaluate and manage the High Sensitive Troponin-I (hsTnI) categorical CVD risk in subjects undergoing preventive health checks (PHC).

“AI and predictive algorithms can predict risk, prevent premature health events, and overcome chronic lifestyle diseases, when caught early. For example, we have developed a Cardiovascular Risk Score (AICVD) in the Indian population and it is now prospectively used and followed up on 33000 individuals as part of ProHealth to predict the risk of developing cardiovascular disease.”

There are various clinical tools using AI and data analytics ready for deployment as well as under research for various NCDs. These include tools and algorithms to identify medical issues early in CT scans, predict various risks including the risk of developing cardiovascular disease, asthma, liver fibrosis in NAFLD, breast cancer, pre-diabetes and stroke.

Dr Sathya Sriram, CEO, Preventive Health, Apollo Hospitals Chennai said, “The Health of the Nation study has shown us the importance of shifting the paradigm in India from a curative to a preventive mindset. Apollo ProHealth, empowered by AI and predictive algorithms, is a personalized proactive health management program based on 22 million health checks, building on Apollo’s pioneering efforts in preventive care and led by medical experts committed to making individuals healthier. Apollo ProHealth includes personalized health risk assessment to predict health risks and diagnostics tailored to your profile, physician-led evaluation for a personalized treatment plan and wellness goals, and Health Mentors to regularly monitor your health parameters and help individuals stay on the path to wellness. Over the last 12 months, a cohort of ProHealth guests with diabetes have shown 33%-60% target achievement across multiple health parameters, such as blood pressure, cholesterol, physical activity and HbA1c.”