In News:

Obesity has emerged as a critical public health issue in India, with rising prevalence across age groups and socio-economic strata. It is a key risk factor for non-communicable diseases (NCDs) like diabetes, cardiovascular diseases, and hypertension. Recognizing its growing burden, the Government of India has adopted a multi-ministerial, community-driven, and policy-integrated strategy to promote healthier lifestyles.

What is Obesity?

• Definition (WHO): Abnormal or excessive fat accumulation that presents a risk to health.
• Measurement: Body Mass Index (BMI = kg/m²)
  • Body Mass Index (BMI), previously known as the Quetelet index, is a simple way to check if an adult has a healthy weight. It is calculated by dividing a person's weight in kilograms by their height in meters squared (kg/m²). To find BMI, take a person’s weight (kg) and divide it by their height (m) squared.
  • WHO Standard:
    • Overweight: BMI ≥ 25
    • Obese: BMI ≥ 30
  • Indian Criteria (lower threshold):
    • Overweight: BMI 23–24.9 kg/m²
    • Obese: BMI ≥ 25 kg/m²
    • Morbid Obesity: BMI ≥ 35

Prevalence of Obesity

Global Trends (1990–2022):

• Children (5–19 yrs) with obesity: ↑ from 2% to 8%
• Adults with obesity: ↑ from 7% to 16%

India-Specific Data (NFHS-5, 2019–21):

• Overweight/obese: 24% women, 23% men
• Obese (15–49 yrs): 6.4% women, 4.0% men
• Children under 5 (overweight): ↑ from 2.1% (NFHS-4) to 3.4%

Causes of Obesity

• Increased consumption of processed, calorie-dense foods
• Sedentary lifestyle and urbanization
• Reduced physical activity
• Environmental and socio-economic factors
• Excessive use of edible oil, salt, and sugar in Indian diets

Key Government Initiatives to Combat Obesity

1. Ministry of Health and Family Welfare

• NP-NCD (National Programme for Prevention and Control of Non-Communicable Diseases):
  • Integrated under Ayushman Bharat Health & Wellness Centres
  • Focus: Screening, early diagnosis, IEC/BCC awareness, and NCD clinics
  • Facilities: 682 District NCD Clinics, 191 Cardiac Units, 5408 CHC Clinics

2. Ministry of AYUSH

• All India Institute of Ayurveda (AIIA): Specialized treatments (Panchakarma, diet, yoga)
• Ayurswasthya Yojana (2021–22): Funds projects tackling obesity, diabetes, and NCDs
• Research by CCRAS: Validating Ayurvedic lifestyle interventions (Dincharya, Ahara, Yoga)
• Collaboration with CSIR for integrating Ayurveda with modern science

3. Ministry of Women and Child Development

• POSHAN Abhiyaan (2018):
  • Focus: Nutrition for children, adolescent girls, pregnant/lactating women
  • Mission Saksham Anganwadi &Poshan 2.0 (2021): Combines nutrition, health, wellness
  • Use of PoshanVatikas, millet promotion, and fortified food
  • Jan Andolan for community-level awareness

4. Ministry of Youth Affairs and Sports

• Fit India Movement (2019):
  • Fitness pledges, Fit India School certification, community fitness programs
• Khelo India Programme (2016–17):
  • Sports infrastructure and talent development
  • Promotes sports culture and active lifestyles in youth

5. Food Safety and Standards Authority of India (FSSAI)

• Eat Right India Movement:
  • Supply-Side Reforms:FoSTaC, hygiene ratings, food fortification
  • Demand-Side Awareness: Eat Right Schools/Campus, DART Book, Magic Box
• Aaj Se Thoda Kam Campaign: Reduce fat, salt, and sugar intake
• RUCO Initiative: Repurposing Used Cooking Oil into biodiesel
• HFSS Food Labelling: Front-of-pack labels for High Fat, Salt, Sugar foods

Innovative Tools

Tool                                                           Description

DART Book                                          Simple home tests for food adulteration

Magic Box                                           102 school-level food safety experiments

Food Safety on Wheels              Mobile food testing & awareness vans

Fit India App                                       Daily fitness tracking and motivation

India’s Way Forward: Towards Amrit Kaal

• Whole-of-government and whole-of-society approach
• Emphasis on lifestyle change, preventive healthcare, and regulation
• Stronger public health infrastructure and education
• Leveraging traditional wellness systems (Ayurveda & Yoga)
• Community empowerment via awareness drives and behavior change

In News:

Patient advocacy groups across India have raised serious concerns over delays in implementing the National Policy for Rare Diseases (NPRD) 2021, which has left many rare disease patients — especially children — in life-threatening situations. They have urged the government for immediate intervention to resume life-saving treatments and release stalled funds under the policy.

Rare Diseases:

• Rare diseases are severe, often genetic, life-threatening disorders that impact a small percentage of the population.
• They disproportionately affect children, with 30% of diagnosed patients not surviving beyond age five without timely treatment.
• Examples include Lysosomal Storage Disorders (LSDs) such as Gaucher, Pompe, Fabry, and MPS I & II.

About NPRD 2021

The Ministry of Health & Family Welfare launched the National Policy for Rare Diseases in March 2021 to streamline the diagnosis, research, and treatment of rare diseases in India.

Key Features of NPRD 2021:

• 63 rare diseases currently included under the policy (as recommended by the Central Technical Committee for Rare Diseases (CTCRD)).
• Categorization of diseases into three groups:
  • Group 1: Diseases amenable to one-time curative treatment.
  • Group 2: Diseases requiring long-term/lifelong treatment with relatively lower cost.
  • Group 3: Diseases requiring very high-cost lifelong therapy where patient selection is critical.

Institutional Support:

• 12 Centres of Excellence (CoEs) identified at premier government hospitals to provide diagnosis and treatment.
• Nidan Kendras established to provide genetic testing and counselling services.
• National Consortium for Research and Development on Therapeutics for Rare Diseases (NCRDTRD) set up to coordinate R&D and promote indigenous drug manufacturing.
• Tax exemptions (on GST and Customs Duty) granted for imported drugs for individual and institutional use.

Financial Provisions:

• Financial assistance of up to ?50 lakh per patient for treatment at CoEs.
• Patients must register at CoEs to receive diagnosis and initiate treatment.

Challenges and Crisis

Despite policy provisions, implementation has been stalled, leading to a healthcare emergency for rare disease patients.

Key Issues Raised:      

• Insufficient funding: The ?50 lakh cap is inadequate for chronic and ultra-rare diseases that need lifelong therapy.
• Administrative delays: Fund disbursement to CoEs has been slow, disrupting continuity of treatment.
• Impact on Patients:
  • Patients like Alishba Khan, Ashok Kumar, Imran Ghoshi, and Adrija Mudy with Gaucher or MPS I have exhausted their funding.
  • Patients who had previously stabilized are now regressing due to interrupted therapy at leading hospitals like AIIMS Delhi, IGICH Bangalore, and IPGMER Kolkata.

Legal Developments:

• On October 4, 2024, the Delhi High Court directed the Ministry of Health and Family Welfare to:
  • Release additional funds beyond the ?50 lakh limit.
  • Create a ?974 crore National Fund for FY 2024–25 and 2025–26.
• Months later, no concrete action has been taken, further eroding trust in the policy's effectiveness.

Demands by Advocacy Groups

• Sustainable, long-term funding model for lifelong treatment of rare and ultra-rare diseases.
• Immediate fund release to CoEs and simplification of administrative processes.
• Ensure uninterrupted access to essential therapies and expand the scope of financial support.