Health and medicine related postage stamps from India are mostly about personalities (See a previous blog), or about institutions (Another blog here). Some other A handful of others celebrate progress in medicine, and feature in this blog.
1. Change in Health metrics since independence
At the time of Indian Independence, India’s health situation reflected decades of poverty, colonial neglect, epidemics, and weak public health infrastructure. Average life expectancy was 32 years, and premature deaths were a commonplace. Of a thousands births, 160 would die before their first birthday. There were only 60,000 doctors in India, and a mere 2700 hospitals.
Yet, enthusiasm was high, and in 1951, we had first stamps with a slogan “Healthy India”, issued to raise funds rather than for postage.
In contrast to health metrics at the time of independence, today average life expectancy is about 70 years. Of 1000 births, only 24 die before their first birthday. Health infrastructure has exponentially increased, with about 22 Lakh doctors who work in over 70,000 health facilities across the country.
2. Eradicating diseases – Polio
While, small-pox eradication was achieved in 1981, polio was the next target. About 150,000 children contracted polio every year, disabling them for life. In 1985 Rotary international initiated PolioPlus aimed at immunizing children with polio. Two years later, this initiative was launched in India, and hence the 1987 postage stamp.
Next year, in 1988 Rotary partnered with WHO, UNICEF and CDC for Global polio eradication. These efforts were intensified in 1995 with Indian Governments “Pulse polio” initiative, that saw more than 10 billion polio vaccinations done till 2010. This was achieved by observing National polio vaccination days / weeks, with as many as 160 million vaccines administered on a single day. With these efforts, India saw its last case of Polio in 2011, and since 2014 we are declared as polio-free.
3. Eye donation and Blindness prevention
In 1948, first eye-bank was established in Chennai in India. This was also a first in Asia. Eye banks store a layer of the eye (cornea) which is collected from voluntary donors after death. This is then transplanted individuals with a damaged cornea. India launched its National program for control of blindness in 1976. We also expanded eye-banks, to more than 700 today and about half of 80,000 corneas collected each year, are transplanted to treat blindness each year.
Commonest cause of blindness is cataract. In India we perform about 7 million cataract surgeries every year, a number highest in the world. In 1970, 1.4% population had blindness, a number which has sharply dropped to 0.35% in 2020s. This decline is due to cataract surgery programs, improved eye care access, and various public health initiatives.
4. Overcoming hunger and malnutrition
At the time of Independence, malnutrition rates were high in children, as well as in adults. This was fulled by widespread food insecurity, low agricultural productivity, poverty, and limited healthcare facilities.
In 1950, about 65% of all children were underweight, a number which is halved to 32% today. Further, 45% of all adults were underweight at the time of independence, as compared to about 15% now. This has been achieved through various food security and health initiatives, such as Green-revolution (increased production), Mid-day meals in schools (greater availability), Nutritional campaigns and Integrated child development services or ICDS (better advocacy and care) and improved package of services.
In fact the situation has reversed to such a degree, that from a negligible proportion in 1950s, about 20% of all adults are overweight and obese. More challenges still remain, pertaining to nutritional anemias and other micronutrient (Vitamin A, Iodine) deficiencies.
5. Expanding ability to perform complex procedures
The year 1996 marked 150 years of Anesthesiology and 100 years of cardiac surgery. India issued postage stamps on both events, also exhibiting our ability by this time to do complex surgical procedures.
Prior to 1980s tertiary care in India was limited, and multi-specialty corporate health sector was non-existent. Public investment in tertiary care was limited to only a few apex institutions.
The decade of 80s marked a change as more and more specialists, who were trained abroad started returning back to the country. In 1983 Apollo Hospitals at Chennai started with first corporate facility.
With economic liberalization, more investment in the sector in 1990s, expansion of facilities that could perform complex surgeries, India started its journey as a hub for medical tourism. Further expansion, and international accreditation led to enhanced capacity as well as capability. Today India’s private sector is worth 150 billion USD, with about a million health-care providers and 1.2 million hospital beds.
6. Organ transplant
First successful kidney transplant was done in 1954 in US. In India it happened in 1971, at CMC Vellore. First Liver and Heart transplants in the world happened in US and South Africa respectively in 1967. India framed its organ transplant policy in 1994, paving way for first Liver transplant in 1998, and Heart in the year 2000.
While the expertise in performing organ transplantation in India has grown in last 25 years, numbers remain limited. About 20,000 organ transplants happen every year, and 70% of these being Kidneys, 25% Liver, remaining heart, lung, or other organs. T
India is in top ten countries in terms of volume of organ transplant. We also do highest number of live donor procedures, than any other country. While growing, the numbers are small, mostly due to limited donor pool and handful of transplant enabled centers.
7. Research, Production capacity and Covid vaccine
The COVID pandemic that started in 2019-20, began to decline in 2021, with advent of vaccination. Indian vaccine came soon after one of the first global vaccines were launched. The success story however lies elsewhere.
India became global leader in vaccine production capacity. Serum Institute of India, Pune became World’s largest vaccine manufacturer by volume. Its production capacity exceeded 250 million doses per month. Indigenous Covaxin was produced at about 50 million doses a month. India also had largest vaccine administration program, totaling about 2.2 billion dosages (first, second and third dose put together) from 2021 to 2023. We also provide vaccine doses to over a 100 countries across the world.
India is the largest supplier of generic medicines globally, and we contribute to about 20% of global production. India supplies over 60% of global vaccine demand of all vaccines put together. India pharma-exports total about 30 billion USD per year.
Global health rankings
India’s health story is asymmetric. Large population, and imbalances place it poorly in the rankings. We rank 121 in Global health system rankings, 120 in universal health coverage, and 66 in global health security. Long way to go, as we are in the middle tier, ven amongst large countries. So more success stories are yet to be written !!