13/09/2026
The Missing Stitch: Why India Must Prioritize Early Detection Over End-Stage Interventions
India’s healthcare priority is upside down: high-margin intervention is getting all the money, while low-cost prevention gets the crumbs. Cardiovascular disease (CVD) is the commonest cause of death in India, accounting for approximately 27% to 28.1% of all total mortality. What we need is preventive medicine and focus on reducing Diabetes, Hypertension and allied issues like the central problem of the Fatty liver. New measures like aggressive cholesterol lowering, intensive blood pressure and diabetes control by a life style measures coupled with judicious use of affordable medicines need a pro active propagation. Prevention is like the proverbial ‘A stitch in time saves nine”. Early detection is the need of the hour. Detecting high cholesterol, high blood pressure and diabetes including pre-diabetes which have assumed epidemic proportions. The figures are alarming and mind boggling - Diabetes 11.4%, pre-diabetes 15.3%. Hypertension 33.5%, generalized obesity 28.6%, Abdominal obesity 39.5% and bad lipids (dyslipidaemias) in 81.2%.
One would have expected the medical pharmaceutical and device industry to contribute generously towards promotion of meetings to propagate measures on prevention rather than spend bulk of their educational grants for treatment of diseased individuals. The overwhelming majority of pharma and medical device commercial budgets—estimated at 90% to 95% or higher—is spent on treating established or end-stage diseases rather than propagating disease prevention. Industry research data shows that the highest profit margins and largest market returns come from specialized treatments, such as oncology drugs, orphan biologicals, and late-stage medical devices (e.g., cardiac implants, dialysis equipment). True primary prevention (such as lifestyle modification, vaccine drives, or early metabolic management) often relies on generic medicines or low-cost interventions. Because there is significantly less profit to be made in preventing a disease compared to managing a chronic or end-stage one, commercial budgets for meetings (like Continuing Medical Education, or CME) naturally track toward high-cost therapeutic areas. Aren’t these priorities very sad in a country of our magnitude where cardio vascular, metabolic, liver diseases and kidney related issues are increasing by leaps and bounds all around including the rural India which used to have substantially reduced figures till recently. Today, the traditional rural-urban divide has evolved. While urban areas still maintain high exposure to specific metabolic risks, modern data show that rural areas often match or exceed urban areas in actual CVD mortality and specific risk factors.
Meetings supporting paediatric preventive healthcare systems globally tend to spend vastly more on treating chronic diseases after they develop rather than investing in preventing them early in life. The vast majority of healthcare financing goes toward managing advanced illnesses (like adult heart disease, type 2 diabetes, and cancer) or acute emergency care. Preventive measures—such as early childhood nutrition programs, vaccinations., routine screenings, and lifestyle interventions—receive a tiny fraction of total healthcare spending.
It may sound ridiculous that meetings promoting treating end stage diseases like non-surgical aortic and mitral valve serious issues getting huge financial support from pharma industries making high blood pressure, cholesterol lowering drugs and diabetes treating drugs which improve the life span and the quality of life would rather go to spend their budgets on treatments which prolong the life by a few months to at the most a few years of agony, because of ageing and co-morbidities.
It is time to have such National debates to give sense to the promoters of meetings of non-surgical techniques, Robotic surgery and other basically palliative procedures in contrast to funding meetings on preventive measures which are much more cost effective and productive in the National interests. A healthy young man any day needs priority over a demented individual with agonizing co-morbidities especially in a cost conscious country like ours.
