The leading life threatening chronic disease segments in India are cardiovascular (CVD), diabetes, respiratory and kidney disease. These five account for nearly 25% of total sales by the top 10 pharmaceutical companies in India. Of these, CVD, diabetes and kidney disease are strongly linked and have a large overlapping population.

Diabetes: With over 30% of the world's population suffering from diabetes mellitus in India, the problem is reaching epidemic proportions. A significant proportion of those inflicted are not even aware of the condition or of treatment options. Less than 5% of patients with diabetes take insulin as a form of treatment.

Cardiovascular Disease: India accounts for nearly 20% of the world's population suffering from heart diseases. The CVD care market is expected to grow to nearly 12% of the total healthcare market by 2012, up from about 8% currently*.

End-Stage Renal Disease (ESRD): The recent article published by Dr V Jha in Kidney International shows age adjusted ESRD incidence of around 232 per million. Extrapolated to  the population of the country, it would mean an annual incidence rate of around 230,000 to 250,000 new ESRD cases. It is estimated that less than 50% of these get to see a doctor and about 14-15% in total are on any form of long-term therapy. Over 70% of patients, who start therapy, drop out in the first year itself, overwhelmingly due to lack of funds. Less than 10% of all Indian ESRD patients get any meaningful Renal Replacement Therapy (RRT). Some succumb to co-morbid conditions which could have been prevented by early detection; the rest because of the low quality of clinical care.

Chronic Care is typically perceived to be expensive, largely in urban centres and does not do a good job of reaching out to the poor, with low literacy and awareness levels. Apathy, misinformation and geographic distance from medical facilities results in late/ no detection, low treatment rates and poor outcomes.

In recent times, the Government has laid stress on healthcare and the need to be more proactive in ensuring healthcare for its citizens. However, for some time now, the stress will be on infectious diseases and epidemics leaving very little for chronic diseases. There is, thereby, the need to supplement Government activity through foundations - specifically in driving awareness and preventive health programs in chronic disease care.

* Data Source: National Sample Survey Organization, WHO and CII -IHF - McKinsey Study (2002)