WHO report reveals 5.8 million patients are under hypertension treatment in India; drug availability remains biggest issue, ET HealthWorld

by Rahul Devi

The World Health Organization (WHO) recently reported that around 5.8 million hypertension patients across 27 states in India are being treated under the Indian Hypertension Control Initiative (IHCI) as of June 2023. The main challenge identified in the report is the availability of medicines for these patients. The IHCI aims to reduce premature mortality from non-communicable diseases by 25% by 2025 through evidence-based strategies for hypertension management and control.

Launched in 2017, the IHCI is a collaborative effort involving the Ministry of Health & Family Welfare, Indian Council of Medical Research, State Governments, and WHO-India. The initiative has made significant progress in strengthening hypertension care in India, with more than 17 million people enrolled in treatment programs across low- and middle-income countries (LMICs) like Bangladesh, Cuba, and Sri Lanka.

Under the IHCI, 27 Indian states and union territories have developed a standard treatment protocol for hypertension based on the WHO HEARTS technical package. This package provides cost-effective strategies to control blood pressure and prevent heart attacks, strokes, and other complications. It includes standardized drug and dose-specific treatment protocols, uninterrupted access to quality medications, and a monitoring system to track patient progress and health system performance.

However, the report highlights the availability of medicines as the biggest challenge for the IHCI. In some areas, the lack of availability discourages patients from returning to facilities for follow-up visits. To address this issue, WHO-recruited consultants and the Union Ministry of Health and Family Welfare have strengthened the medicine supply chain. They have facilitated the development of state-specific hypertension treatment protocols and included protocol drugs in the list of essential medicines in each state.

The IHCI has also decentralized its program to more than 18,000 Ayushman Bharat Health and Wellness Centres (HWCs) to improve access to care. These HWCs are part of India’s primary health care system, delivering community-level services. By 2020, more than 70% of health care facilities involved in the IHCI had ensured one month’s stock of protocol medicines, with fewer than 10% experiencing stock-outs.

During the first wave of the COVID-19 pandemic, drug refills at these decentralised health care centres helped more than 38% of patients continue their hypertension treatment. The report acknowledges the role of the partnership between WHO and the Union Ministry of Health and Family Welfare in scaling up the IHCI. What initially started in selected districts in five states has now expanded to include 155 districts.

Hypertension affects roughly one-third of adults aged 30-79 worldwide, according to the WHO report. However, only 54% of those affected have been diagnosed, 42% are receiving treatment, and only 21% are considered to have controlled their hypertension. Treating hypertension is crucial in achieving the United Nations’ Sustainable Development Goal of reducing premature mortality from noncommunicable diseases.

In conclusion, the Indian Hypertension Control Initiative has made significant progress in treating hypertension patients across 27 states in India. However, the availability of medicines remains a significant challenge. With the collaboration of various stakeholders and the strengthening of the medicine supply chain, the IHCI aims to achieve its objective of reducing premature mortality from non-communicable diseases by 25% by 2025. Treating hypertension is essential in meeting global health goals and improving the overall health outcomes of individuals.

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