First WHO report details devastating impact of hypertension and ways to stop it
Author: BI Bureau
New York: The World Health Organization (WHO) released its first-ever report on the devastating global impact of high blood pressure, along with recommendations on the ways to win the race against this silent killer. The report shows approximately 4 out of every 5 people with hypertension are not adequately treated, but if countries can scale up coverage, 76 million deaths could be averted between 2023 and 2050.
Hypertension affects 1 in 3 adults worldwide. This common, deadly condition leads to stroke, heart attack, heart failure, kidney damage and many other health problems, according to a release by the WHO.
The number of people living with hypertension (blood pressure of 140/90 mmHg or higher or taking medication for hypertension) doubled between 1990 and 2019, from 650 million to 1.3 billion. Nearly half of people with hypertension globally are currently unaware of their condition. More than three-quarters of adults with hypertension live in low- and middle-income countries.
Older age and genetics can increase the risk of having high blood pressure, but modifiable risk factors such as eating high-salt diet, not being physically active and drinking too much alcohol can also increase the risk of hypertension.
Lifestyle changes like eating a healthier diet, quitting tobacco and being more active can help lower blood pressure. Some people may need medicines that can control hypertension effectively and prevent related complications.
The prevention, early detection and effective management of hypertension are among the most cost-effective interventions in health care and should be prioritized by countries as part of their national health benefit package offered at a primary care level. The economic benefits of improved hypertension treatment programmes outweigh the costs by about 18 to 1.
“Hypertension can be controlled effectively with simple, low-cost medication regimens, and yet only about one in five people with hypertension have controlled it.” Said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. “Hypertension control programmes remain neglected, under-prioritized and vastly underfunded. Strengthening hypertension control must be part of every country’s journey towards universal health coverage, based on well-functioning, equitable and resilient health systems, built on a foundation of primary health care.”
The report is being launched during the 78th Session of the United Nations General Assembly which addresses progress for the Sustainable Development Goals including health goals on pandemic preparedness and response, ending tuberculosis and attaining Universal Health Coverage. Better prevention and control of hypertension will be essential to progress in all of these.
An increase in the number of patients effectively treated for hypertension to levels observed in high-performing countries could prevent 76 million deaths, 120 million strokes, 79 million heart attacks, and 17 million cases of heart failure between now and 2050.
“Most heart attacks and strokes in the world today can be prevented with affordable, safe, accessible medicines and other interventions, such as sodium reduction,” said Michael R. Bloomberg, WHO Global Ambassador for Noncommunicable Diseases and Injuries. “Treating hypertension through primary health care will save lives, while also saving billions of dollars a year.”
Hypertension can easily be treated with safe, widely available, low-cost generic medications using programmes such as HEARTS. WHO's HEARTS technical package for cardiovascular disease management in primary health care and the Guideline for the pharmacological treatment of hypertension in adults provide proven and practical steps to deliver effective hypertension care in primary health care settings.
Effective community- and country-wide blood pressure management can be achieved in countries of all income levels. More than 40 low- and middle-income countries, including Bangladesh, Cuba, India and Sri Lanka, have strengthened their hypertension care with the HEARTS package, enrolling more than 17 million people into treatment programmes. Countries such as Canada and South Korea delivered comprehensive national hypertension treatment programmes, and both countries surpassed the 50% mark for blood pressure control in adults living with hypertension. Sustained, systematic national hypertension control programmes can succeed—and a high level of blood pressure control translates into fewer strokes and heart attacks, and longer, healthier lives.
The report underscores the importance of implementing WHO-recommended effective hypertension care to save lives, which include the following five components:
Protocol: practical dose- and drug-specific treatment protocols with specific action steps for managing uncontrolled blood pressure can streamline care and improve adherence.
Medication and equipment supply: regular, uninterrupted access to affordable medication is necessary for effective hypertension treatment; currently, prices for essential anti-hypertensive medicines vary by more than ten-fold between countries.
Team-based care: patient outcomes improve when a team collaborates to adjust and intensify blood pressure medication regimens per doctor orders and protocols.
Patient-centred services: to reduce barriers to care by providing easy-to-take medication regimens, free medications and close-to-home follow-up visits, and making blood pressure monitoring readily available.
Information systems: user-centred, simple information systems facilitate rapid recording of essential patient-level data, reduce health care worker data entry burden, and support rapid scale-up while maintaining or improving the quality of care.
“Every hour, more than 1 000 people die from strokes and heart attacks. Most of these deaths are caused by high blood pressure, and most could have been prevented,” said Dr Tom Frieden, President & CEO, Resolve to Save Lives. “Good hypertension care is affordable, within reach, and strengthens primary health care. The challenge now is to go from “within reach” to “reached.” This will require commitment of governments around the world.” /BI/
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NEP-2020 aspires for inclusive excellence in school education
Rajeev Ranjan Roy
The New Education Policy-2020 (NEP-2020), unveiled recently, aims at achieving excellence in school learning by imparting quality, affordable and inclusive education to all, with an extra emphasis on those children coming from socially and educationally disadvantaged groups of the society. It is a futuristic endeavour towards building Ek Bharat, Shrestha Bharat. The previous education policies largely focussed on the issues of access and equity in giving school education, while the NEP-2020 commits to laying the foundation of a vibrant Bharat where no one is devoid of a kind of school education, which helps every student become an asset for the nation in a true sense. The unfinished agenda of the National Policy on Education 1986, which was modified in 1992, has been effectively dealt with in the NEP-2020 along with the vision behind the Right to the Free and Compulsory Education Act, 2009, which “laid down legal underpinnings for achieving universal elementary education.”
Given the undisputed role of education in nation building, the NEP-2020 rightly lays the stress on standardization and accreditation of school infrastructure and teachers as well, since education with accountability, transparency and affordability is the need of the hour, and hence the need to “empower schools, teachers with trust, enabling them to strive for excellence and perform at their very best, while ensuring the integrity of the system through the enforcement of complete transparency and full public disclosure of all finances, procedures and outcomes.” Since private sector is significantly present in the field of school education, the idea to promote ‘not-for-profit’ entities is a unique feature of NEP-2020, which at the same time intends to promote private philanthropic efforts for quality education, thereby affirming the public-good nature of education, while protecting parents and communities from arbitrary increase in tuition fees.
An equally important area, which has got due attention in the NEP-2020 is the need for efficient resourcing and effective governance through school complexes and clusters, a significant initiative in view of the fact that nearly 28 per cent of India’s public primary schools and 14.8 per cent of upper primary schools have less than 30 students. The average number of students per grade in the elementary schooling system – Grades 1 to 8 – is about 14, with a notable proportion having below six students during 2016-17, the year which also had 1,08,017 single-teacher schools, and majority of them – 85,743 – being primary schools taking care of Grades 1-5 children. It was, therefore, a pressing need to evolve a mechanism for establishing a grouping structure, say, school complexes, consisting of one secondary school together with all other schools, which lead to greater resource efficiency and more effective functioning, coordination, leadership, governance, and management of schools in the cluster. This will not only ensure optimum utilisation of resources, but will also foster the sense of oneness and togetherness among the school children, who are the future of the nation.
What further makes the New Education Policy-2020 uniquely special is its pledge for equitable and inclusive education for all, one of the great dreams of our founding fathers. Education, as the NEP-2020 rightly envisions, is “the single greatest tool for achieving social justice and quality.” Inclusive and equitable education, indeed an essential goal in its own right, is also critical to achieving a social order where every citizen has “the opportunity to dream, thrive, and contribute to the nation.” Quality, affordable and ethical education to all is the first move to break multiple social and economic barriers, which sow the seeds of exclusion, discrimination and exploitation against our own people on different parochial considerations.
Needless to say efforts were made in the past as well to bridge the educational chasm between socially and educationally disadvantaged groups (SEDGs) and the children of top social strata, but the desired results remained elusive. SEDGs account for the country’s overwhelming population, but their children’s share in quality school educational institutions has been minimal over the years. Early childhood care and education (ECCE) needs to be handled more comprehensively. According to the Unified-District Information System for Education (U-DISE) 2016-17 data, about 19.6 per cent of students belonged to Scheduled Castes (SCs) at the primary level, but this fraction fell to 17.3 per cent at the higher secondary level. These enrollment drop-outs were more severe for ST students (10.6 per cent to 6.8 per cent), and differently-abled children (1.1 per cent to 0.25 per cent), with even greater declines for female students within each of these categories. Thus, there is no scope for any complacency on the part of the government. A series of interventions including better facilities, more and more hostels, scholarships and other enabling support have been provisioned in the NEP-2020 so that the idea of ‘learning for all’ is realised in a more comprehensive manner.
Teachers are not only an integral part of an education system, but the most important stakeholder in the entire gamut of things. Their quality and ability to teach school students, when they are in their formative age, become something of paramount importance. From their recruitment to training, every precaution needs to be taken to ensure that school education is not rendered to a mere formality, but becomes a game changer. The New Education Policy-2020 comes with a basket full of tools and parameters to ensure holistic training and upgradation of teachers and their teaching skills in a sustainable manner. From continuous professional development (CPD) to career management and progression (CMP), the NEP-2020 vouches for a set of common guidelines – National Professional Standards for Teachers (NPST), which will be put in place by the National Council for Teacher Education (NCTE) in its restructured new form as the Professional Standard Setting Body (PSSB) under the General Education Council. This exercise will be carried out in consultation with National Council Educational Research and Training (NCERT), SCERTs, teachers from across levels and regions.
The teacher education will also undergo a sea-change. By 2030, the minimum degree qualification for teaching will be a 4-year integrated B.Ed. that teaches a range of knowledge content. Today B.Ed. teaching is most poorly regulated in our country ever since the standalone B.Ed. colleges were allowed to be opened up in the private sector. It is high time to take B.Ed. teaching more than seriously. The NEP-2020 stipulates that by 2021, a new and comprehensive National Curriculum Framework for Teacher Education (NCFTE-2021) will be formulated by the NCTE. NCFTE, which will also factor in the requirements of teacher education curricula for vocational education, will be revised once every 5-10 years.
In conclusion, the NEP-2020 visualizes to impart a school education which lays the foundation of a self-reliant India and also to help our country emerge as a knowledge hub. From the foundation of learning to foundational literacy and numeracy to checking drop outs and ensuring universal access to education for all and at all levels to the restructuring of school curriculum, India is in for a metamorphosis in the field of school education, recognizing, identifying and fostering the unique capabilities of each student. Tools such as multi disciplinarity, emphasis on conceptual understanding, creativity and critical thinking, ethics and human and constitutional values, full equity and inclusion, and light but tight regulatory framework are bound to do wonders. Education is a public service, a rare pursuit in nation building, which should be holistic and inclusive and must make one take pride in India and its rich, diverse, ancient and modern culture and knowledge systems and tradition. The NEP-2020 aspires so, indeed!
( The writer is a senior journalist and author. The views expressed are strictly personal.)
NEP-2020 aspires for inclusive excellence in school education
Rajeev Ranjan Roy
The New Education Policy-2020 (NEP-2020), unveiled recently, aims at achieving excellence in school learning by imparting quality, affordable and inclusive education to all, with an extra emphasis on those children coming from socially and educationally disadvantaged groups of the society. It is a futuristic endeavour towards building Ek Bharat, Shrestha Bharat. The previous education policies largely focussed on the issues of access and equity in giving school education, while the NEP-2020 commits to laying the foundation of a vibrant Bharat where no one is devoid of a kind of school education, which helps every student become an asset for the nation in a true sense. The unfinished agenda of the National Policy on Education 1986, which was modified in 1992, has been effectively dealt with in the NEP-2020 along with the vision behind the Right to the Free and Compulsory Education Act, 2009, which “laid down legal underpinnings for achieving universal elementary education.”
Given the undisputed role of education in nation building, the NEP-2020 rightly lays the stress on standardization and accreditation of school infrastructure and teachers as well, since education with accountability, transparency and affordability is the need of the hour, and hence the need to “empower schools, teachers with trust, enabling them to strive for excellence and perform at their very best, while ensuring the integrity of the system through the enforcement of complete transparency and full public disclosure of all finances, procedures and outcomes.” Since private sector is significantly present in the field of school education, the idea to promote ‘not-for-profit’ entities is a unique feature of NEP-2020, which at the same time intends to promote private philanthropic efforts for quality education, thereby affirming the public-good nature of education, while protecting parents and communities from arbitrary increase in tuition fees.
An equally important area, which has got due attention in the NEP-2020 is the need for efficient resourcing and effective governance through school complexes and clusters, a significant initiative in view of the fact that nearly 28 per cent of India’s public primary schools and 14.8 per cent of upper primary schools have less than 30 students. The average number of students per grade in the elementary schooling system – Grades 1 to 8 – is about 14, with a notable proportion having below six students during 2016-17, the year which also had 1,08,017 single-teacher schools, and majority of them – 85,743 – being primary schools taking care of Grades 1-5 children. It was, therefore, a pressing need to evolve a mechanism for establishing a grouping structure, say, school complexes, consisting of one secondary school together with all other schools, which lead to greater resource efficiency and more effective functioning, coordination, leadership, governance, and management of schools in the cluster. This will not only ensure optimum utilisation of resources, but will also foster the sense of oneness and togetherness among the school children, who are the future of the nation.
What further makes the New Education Policy-2020 uniquely special is its pledge for equitable and inclusive education for all, one of the great dreams of our founding fathers. Education, as the NEP-2020 rightly envisions, is “the single greatest tool for achieving social justice and quality.” Inclusive and equitable education, indeed an essential goal in its own right, is also critical to achieving a social order where every citizen has “the opportunity to dream, thrive, and contribute to the nation.” Quality, affordable and ethical education to all is the first move to break multiple social and economic barriers, which sow the seeds of exclusion, discrimination and exploitation against our own people on different parochial considerations.
Needless to say efforts were made in the past as well to bridge the educational chasm between socially and educationally disadvantaged groups (SEDGs) and the children of top social strata, but the desired results remained elusive. SEDGs account for the country’s overwhelming population, but their children’s share in quality school educational institutions has been minimal over the years. Early childhood care and education (ECCE) needs to be handled more comprehensively. According to the Unified-District Information System for Education (U-DISE) 2016-17 data, about 19.6 per cent of students belonged to Scheduled Castes (SCs) at the primary level, but this fraction fell to 17.3 per cent at the higher secondary level. These enrollment drop-outs were more severe for ST students (10.6 per cent to 6.8 per cent), and differently-abled children (1.1 per cent to 0.25 per cent), with even greater declines for female students within each of these categories. Thus, there is no scope for any complacency on the part of the government. A series of interventions including better facilities, more and more hostels, scholarships and other enabling support have been provisioned in the NEP-2020 so that the idea of ‘learning for all’ is realised in a more comprehensive manner.
Teachers are not only an integral part of an education system, but the most important stakeholder in the entire gamut of things. Their quality and ability to teach school students, when they are in their formative age, become something of paramount importance. From their recruitment to training, every precaution needs to be taken to ensure that school education is not rendered to a mere formality, but becomes a game changer. The New Education Policy-2020 comes with a basket full of tools and parameters to ensure holistic training and upgradation of teachers and their teaching skills in a sustainable manner. From continuous professional development (CPD) to career management and progression (CMP), the NEP-2020 vouches for a set of common guidelines – National Professional Standards for Teachers (NPST), which will be put in place by the National Council for Teacher Education (NCTE) in its restructured new form as the Professional Standard Setting Body (PSSB) under the General Education Council. This exercise will be carried out in consultation with National Council Educational Research and Training (NCERT), SCERTs, teachers from across levels and regions.
The teacher education will also undergo a sea-change. By 2030, the minimum degree qualification for teaching will be a 4-year integrated B.Ed. that teaches a range of knowledge content. Today B.Ed. teaching is most poorly regulated in our country ever since the standalone B.Ed. colleges were allowed to be opened up in the private sector. It is high time to take B.Ed. teaching more than seriously. The NEP-2020 stipulates that by 2021, a new and comprehensive National Curriculum Framework for Teacher Education (NCFTE-2021) will be formulated by the NCTE. NCFTE, which will also factor in the requirements of teacher education curricula for vocational education, will be revised once every 5-10 years.
In conclusion, the NEP-2020 visualizes to impart a school education which lays the foundation of a self-reliant India and also to help our country emerge as a knowledge hub. From the foundation of learning to foundational literacy and numeracy to checking drop outs and ensuring universal access to education for all and at all levels to the restructuring of school curriculum, India is in for a metamorphosis in the field of school education, recognizing, identifying and fostering the unique capabilities of each student. Tools such as multi disciplinarity, emphasis on conceptual understanding, creativity and critical thinking, ethics and human and constitutional values, full equity and inclusion, and light but tight regulatory framework are bound to do wonders. Education is a public service, a rare pursuit in nation building, which should be holistic and inclusive and must make one take pride in India and its rich, diverse, ancient and modern culture and knowledge systems and tradition. The NEP-2020 aspires so, indeed!
( The writer is a senior journalist and author. The views expressed are strictly personal.)
