Disease Control Priorities

Despite its economic growth, India trails behind other developing nations in several measures of health; some recent health gains have actually been reversed. And even as old nemeses like malaria, TB, and other infectious diseases continue to afflict Indians, the chronic, noncommunicable diseases characteristic of industrial nations—cardiovascular conditions, respiratory disorders, diabetes, cancers—are increasing. The country must make rational, evidence-based choices about health spending. Following an approach developed by the Disease Control Priorities Project, an international initiative of the World Health Organization and several collaborators, CDDEP researchers conducted a rigorous analysis of preventable diseases in India and the best ways to tackle them. Researchers identified the most cost-effective interventions against major causes of death and disability, and then determined which of these interventions could be feasibly scaled up and practicably deployed. The result, a major report titled Choosing Health: An Entitlement for All Indians, points the way to a more equitable and effective health system with a package of basic health care interventions that would save millions of lives. In fact, India could greatly improve the health of its people at relatively low cost. Like all CDDEP research, the report integrates multiple perspectives—from economics, epidemiology, and disease modeling to risk analysis and statistics. CDDEP researchers are also exploring novel strategies for combating vitamin A deficiency, which causes severe morbidity and mortality in India. Mustard (Brassica juncea) can be genetically modified to express high levels of beta-carotene, a precursor to vitamin A, and the seed is widely consumed in the form of cooking oil. Researchers have compared the costs and benefits of alternative approaches to delivering vitamin A supplementation and find that genetically modified “golden mustard” seed is an attractive alternative.