Abstract
BackgroundThe Sustainable Development Goals (SDGs) are seen in most corners as the embodiment of a more inclusive and holistic development approach, key to addressing the numerous and urgent challenges the world faces. In the health realm, a true SDG approach will require a five-fold paradigm shift according to Buse and Hawkes. This article explores whether early traces of this paradigm shift can already be witnessed in the Indian context, focusing on Non-Communicable Diseases (NCDs) more in particular.DiscussionBy now, NCDs make up a large health burden in India, both individually and on the health system. Inspired by an SDG vision, tackling NCDs will require a comprehensive approach rooted in preventive, curative and rehabilitative services. In India, some early momentum in this respect can already be witnessed, certainly in addressing the first two challenges identified by Buse and Hawkes, leadership and intersectoral coherence, and a shift from treatment to prevention. A central plan addressing health through an inter-sectoral approach has shaped the trajectory so far, moving away from silos to engagement with sectors beyond health. New guidelines addressing comprehensive primary healthcare propose a community outreach and preventive approach for NCDs. At a broader level, NCD prevention is also closely linked to tackling the so called “commercial determinants of health” and will require among others strong (central and state level) regulation, teaming up with global advocacy networks and capitalizing on global frameworks, where they exist. Strong political leadership will be indispensable for this, and is according to Buse and Hawkes closely linked to seeing health as a right and the government as accountable when it comes to providing for the right to health through its policies and actions.ConclusionNational stewardship will thus be key, via a more adaptive network governance structure with the central level coordinating with the state level to ensure implementation, while also engaging with other stakeholders, sectors, the private sector and civil society. As one can expect, networked governance, necessary for the battle against NCDs, is a work in progress in India. In sum, some of the early (paradigm shift) signs are encouraging, but by and large it is still too early to assess whether a real paradigm shift has taken place.
Highlights
The Sustainable Development Goals (SDGs) are seen in most corners as the embodiment of a more inclusive and holistic development approach, key to addressing the numerous and urgent challenges the world faces
The example of Non-Communicable Diseases (NCD) in the Indian context is uniquely suited to explore whether a national policy shift in paradigm is already starting to happen, in line with the abovementioned Sustainable Developmental Goals (SDGs) paradigm, policy & governance changes required for the new era
Buse & Hawkes do not use the term in their paper, given the complex nature of institutions and partnerships required to achieve SDG health goals, we argue that a networked governance model, fit for the SDG era, will be needed
Summary
We will describe how India addresses the NCD burden at the start of the SDG era. In addition to the ‘rights’ gap already identified by Buse & Hawkes in the SDG health goal, Gruskin et al describe the lack of a human rights approach in the ‘Global Action Plan for the Prevention and Control of NCDs 2013-2020’ They suggest that a real human rights framework provides robust norms and directives, describes legal responsibilities of government and mechanisms to enhance accountability to guide the policy agenda and priority setting for NCD prevention and control [44]. Suffice to say, this will be one of the most challenging paradigm shifts to achieve, not just in India, but all around the globe
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
