Health on the Brink

Dear Readers,

Double Helical, a comprehensive national health magazine, serves as a platform to celebrate innovations, individuals, products, and services transforming India’s healthcare sector, paving the way for affordable, high-quality, and inclusive healthcare.

In the March 2025 issue, we feature a special story on the Annual Health Budget. The financial outlays reveal a piecemeal, populist approach, lacking the heft to address the deep-seated issues plaguing our healthcare system. While the allocation to the Ministry of Health and Family Welfare and AYUSH has increased from INR 94,671 crore to INR 1,03,851 crore compared to last year’s budget, the increase lacks impact. Adjusted for inflation, the real rise is a mere 3 percent—hardly a game-changer. More alarmingly, this figure is 4.7 percent less than the actual expenditure in 2020–21. Are we regressing in our commitment to health resources? The numbers suggest so. Paradoxically, this means the healthcare available to citizens in 2021 was, in real terms, superior to what’s on offer now. With costs soaring, the budget has failed to keep pace. The health sector’s share in the total Union Government Budget has slipped from 2.26 percent in 2020–21 to 2.05 percent today.

Another story tackles referral commissions in healthcare, a complex issue that demands scrutiny to separate outright unethical behaviour from systemic financial pressures. There’s a clear divide: recommending unnecessary tests or procedures is a flagrant breach of ethics and illegal, deserving outright condemnation. In contrast, referral payments to attract patients, while ethically murky, warrant a deeper look. Are they driven by profiteering or survival in a cutthroat, underfunded healthcare landscape? The assumption that banning referral fees would slash hospital bills ignores the economic realities hospitals face—skyrocketing operational costs, inadequate reimbursements, and relentless financial strain. Why do hospitals pay these commissions? Often, it’s not greed but a desperate bid to stay afloat in a broken system.

Gender-Based Violence (GBV) takes centre stage in another feature. Defined as intentional physical, psychological, or sexual harm—or threats thereof—directed at individuals based on gender, GBV is a pervasive scourge. Dr Vinay Agarwal notes that while it affects both men and women, it predominantly targets women at the hands of men, rooted in patriarchal power imbalances. The United Nations estimates that one in three women globally has faced physical or sexual violence from an intimate partner in their lifetime, making GBV the most widespread violation of women’s human rights.

GBV spans physical violence (hitting, slapping, stabbing), with 23–53 percent of abused pregnant women reporting kicks or punches to the abdomen; sexual violence (coerced sex, marital rape, attacks on sexual organs); verbal violence (withholding communication or mobility, mental harassment, false accusations); emotional violence (belittling self-worth, public ridicule, threats to child custody); and economic violence (controlling finances, denying employment, withholding money). Globally, nearly 30 percent of women in relationships report experiencing violence. Risk factors for perpetrators include low education, exposure to family violence, attitudes endorsing gender inequality, and substance abuse. For victims, similar factors—plus acceptance of violence—heighten vulnerability.

Prostate health is the subject of another story. As men age, an enlarged prostate—Benign Prostatic Hyperplasia (BPH)—becomes nearly inevitable. Though non-cancerous, BPH brings disruptive symptoms: frequent urination, painful bladder emptying, and sleep disturbances.

Another story presents new insights: With chronic respiratory diseases claiming 4 million lives yearly and affecting 550 million people globally, a drug-free therapy—rooted in WHO-endorsed integrative principles and India’s AYUSH systems—offers hope, reversing asthma, COPD, and lung fibrosis while curbing addictions like tobacco and alcohol.

The edition also focuses on gynaecological cancer treatment, which has leapt forward, shifting from radical surgeries to precision-driven, minimally invasive techniques. Genomic profiling, targeted therapies, robotic surgery, immunotherapy, and molecular diagnostics promise faster recovery, better survival, and enhanced quality of life.

The WHO predicts 2.5 billion people—one in four—will face hearing loss by 2050, costing nearly US$1 trillion annually, which is the focus of another comprehensive story. With 1 billion young adults at risk from unsafe listening, a US$1.40-per-person investment could yield a 16-fold return, making ear care a global priority.
This issue brims with many more intriguing, mind-blowing, and thought-provoking stories.

Happy reading!

Thanks and regards

Amresh K Tiwary,
Editor-in-Chief