On declining fertility, population ageing, GST implacation for healthcare, antibiotic resistance, emerging infectious diseases and more
In 2023, India made headlines, after a United Nations report said it was projected to overtake China and become the world's most populous country. And this did happen. What also happened in 2023 however, was something that only came to light this week: the country's Total Fertility Rate (TFR) fell for the first time in two years to 1.9, reports Abhinay Lakshman, on data from the latest Sample Registration Survey Statistical Report.
In 2021 and 2022, India's TFR had remained constant at 2.0. What does this mean? The TFR denotes the average number of children expected to be born per woman, during her entire span of reproductive period. A replacement level TFR, which is the average number of children each woman needs to give birth for one generation to replace the other, is 2.1. According to this latest data, released by the Office of the Registrar General of India, 18 States and UTs in India have now reported a TFR of below the replacement level. India's Crude Birth Rate, defined as the number of annual live births in a population per 1,000 people, has also declined to 18.4, a drop from 19.1 in 2022.
What all of this points to, as our editorial on the subject notes, is clear: our population is slowly declining and ageing, albeit with vast regional differences. And on that note, we have a series of stories for you to dive into, exploring issues to do with geriatrics, senior living and care. First published in our e-book, Shades of Grey: Geriatric Care and its Social and Economic Facets, these stories offer a glimpse into what lies ahead and how the country must prepare.
Serena Josephine M. does a deep dive into a subject that causes anxiety in most households: mounting healthcare expenses for senior citizens, while Afshan Yasmeen addresses an oft-neglected issue: prioritising the mental health of our elderly population. Geetha Srimathi offers an overview of assistive technology and developments in this field, while Dr. Karthik Narayan R. details an emerging trend: ageing within the care of joint families is giving way to more structured, professional models via senior living facilities. And finally in another story not part of the e-book but very relevant, V. Krishnakumar tells us how physiotherapy can help achieve healthy, active ageing.
Another issue that hit the headlines this week was, of course, GST. While the healthcare industry has welcomed the move to reduce GST on medicines and medical devices and said it will be benefit patients, alongside the zero GST on individual health and life insurance policies reports Bindu Shajan Perappadan, a closer look at the policies has revealed a disturbing aspect. The GST revamp moves a bevy of sugar-based, calorically dense and nutritionally poor foods to the 5% bracket, says Vasudevan Mukunth. These price cuts, without warning labels, may expand access to products but do not help shoppers tell healthy and unhealthy foods apart. This assumes importance in light of the fact that India's front-of-pack labelling debate has been stalled since a 2022 draft. Another alarming aspect is the decision to reduce the GST on beedis from 28% to 18%, while other tobacco products remain in the highest 40% slab. Health experts have warned that cheaper beedis could increase their use, particularly among poor and vulnerable communities, worsening India's tobacco-related health burden.
Two other stories that you may want to look into this week on that looming public health threat, antimicrobial resistance: Rashikkha Ra Iyer writes on how India's unbridled use of antibiotics has dangerous consequences for the mental health of its citizens, and Athira Elssa Johnson tracks a disturbing rise of antibiotic-resistant sexually transmitted infections in the country.
Here's a quick wrap-up of the amoebic meningoencephalitis situation in Kerala: two children, siblings of a child who died of the infection, have been treated and discharged from hospital. The State has reported five deaths in less than a month, while the number of people currently under treatment, is nine. C. Maya reports that Acanthamoeba, the ubiquitous free-living amoeba found widely in the environment, could be much more widely present in the State's waterbodies than was thought before. Ipodcast with Dr. Aravind Reghukumar, head of department of infectious diseases, Government Medical College Thiruvananthapuram, on why Kerala is seeing a spike in these infections.
Our tailpiece for the week is on paving the way for more women in urology, a field where women are grossly under-represented. Do give it a read!
National Nutrition Week has drawn to a close, but if you missed our webinar on 'What, when and how we eat matter', you can read about it here, and watch it here.
As per usual, here's our list of explainers for when you want an all-round view on a subject:
Our All you need to know series this week is on ADHD
Dr. Karthik Madesh Ratnavelu writes on the transformational power of cochlear and middle ear implants
Vilasini Raman explains the importance of speech and swallowing rehabilitation in cancer care
R. Sujatha decodes a study on advanced air filters in operation theatres and if there is a benefit to using them
Dr. C. Aravinda chronicles Kenya's elimination of sleeping sickness
Dr. K. Ganapathy explores the rise of gamification in healthcare
Sahana Venugopal delves into a subject of increasing concern: Do generative AI chatbots encourage risky behaviour?
Lila Shriram, Sarojini Nadimpally, Gargi Mishra and Ragini De write on the battle for disability justice for people with sickle cell disease
This story is about an online tool that can calculate the extent to which blood pressure medicines prescribed by a doctor will be effective.
And finally, this podcast explains how the entry of unqualified practitioners and a lack of regulatory oversight is impacting patient safety when it comes to skin and hair procedures being performed in India.
For many more health stories, head to our health page and subscribe to the health newsletter here.