World Kidney Day 2023: Kidney Health for All – Preparing for the Unexpected, Supporting the Vulnerable: Are We Well Prepared?

The menace of kidney diseases including chronic kidney disease (CKD) has taken more than 850 million people worldwide¹ in its grip. In India, the prevalence of CKD cannot be accessed accurately but it has been reported to be 17.2% by Screening and Early Evaluation of Kidney Disease study.² The recent pandemic has proved that CKD patients are more vulnerable to the deadly coronavirus disease 2019 (COVID-19).³ The third world and other developing countries are even more vulnerable⁴ because of risk factors like poverty, poor sanitation, pollutants, water contamination, overcrowding and increasing incidence of hypertension and diabetes. The burden of diabetes is high and increasing globally, particularly in developing economies like India. The estimates in 2019 showed that 77 million individuals had diabetes in India, which is expected to rise to over 134 million by 2045.⁵

World Kidney Day is an annual global campaign that aims to raise awareness about the importance of kidney health and the role of kidneys in our overall health.⁶ The theme for World Kidney Day 2023 (9th March, 2023) is “Preparing for the unexpected, support the vulnerable!”, which emphasizes the need to support people who are at risk of kidney disease and those who have already been diagnosed. In India, the campaign is more critical than ever, given the high burden of kidney disease in the country.² It is expected that most people in India are not aware that they have kidney disease, and the disease often goes undiagnosed until it has reached an advanced stage. In this article, we share our views on different policy changes which are needed to fulfil the theme of World Kidney Day 2023.

HOW TO BE PREPARED FOR THE NEXT PANDEMIC?

The COVID-19 pandemic has highlighted the importance of preparedness and proactive measures in managing a global public health crisis. While the world is still grappling with the current pandemic, it is essential to learn from this experience and prepare for future pandemics. Figure 1 depicts various strategies needed to be prepared for next unexpected health disaster.

Figure 1. Preparing for the unexpected: we need to be well prepared for the next unexpected health disaster.

• Strengthen health care systems: A strong health care system is crucial in managing a pandemic. Governments should invest in health care infra­structure, such as hospitals, clinics and medical supplies, to ensure adequate capacity to respond to a pandemic. This includes increasing the number of health care workers and ensuring that they have the necessary training and resources to manage the crisis effectively.
• Develop and maintain pandemic preparedness plans: Governments, health care organizations and businesses should have a plan in place for managing a pandemic. This plan should include strategies for testing, contact tracing and quarantine, as well as procedures for obtaining and distributing medical supplies and equipment. The plan should be regularly updated and tested to ensure its effectiveness.
• Invest in research and development: One of the critical aspects of managing a pandemic is the availability of effective treatments and vaccines. Governments and private organizations should invest in research and development of new treat­ments and vaccines that can be quickly deployed in the event of a pandemic. This will require sustained investment in the scientific community to ensure that researchers have the necessary resources to develop effective treatments and vaccines.
• Promote public health education: Public health education and awareness are essential in managing a pandemic. Governments and health care organiza­tions should invest in public health education campaigns to educate people about the risks and symptoms of a pandemic, as well as measures they can take to protect themselves and others. This includes basic hygiene practices, such as hand washing, social distancing and wearing masks.
• Increase international cooperation: Pandemics are a global issue, and international cooperation is essential in managing them effectively. Governments, international organizations and the private sector should work together to share information, resources and expertise. This includes increasing cooperation in vaccine distribution, sharing scientific research and improving coordination in managing the global supply chain for medical supplies and equipment.

HOW CAN WE SUPPORT THE VULNERABLE?

We propose “EACH” concept for supporting the vulnerable in India (Fig. 2). “EACH” stands for- Education, Alliance, Collaboration and Health Equity.

Figure 2. “EACH” concept for supporting the vulnerable.

To support these vulnerable groups, it is essential to raise awareness about kidney disease and its risk factors. This can include educating the public about the importance of a healthy lifestyle, regular kidney function testing, and early detection and management of chronic illnesses.

Interdepartmental alliances are necessary for better understanding of illness and early detection of kidney disease. Public-private partnership (PPP) will also bolster the capacity of health care facilities and help in the early diagnosis and prompt treatment of such illnesses. Kidney-noncommunicable disease (NCD) collaboration will help support the vulnerable patients. National standards should be framed for NCD care and reporting. Also, research and finance would be the integral part of NCD care.

Health equity is necessary for accessible health care facilities and better service delivery. Training health care professionals at primary health care centers and community health care centers would help in achieving this goal. Financing the underprivileged will help in maintaining equity and should be promoted by PPP models.

In addition, there is a need to increase access to health care, particularly in rural areas where the burden of kidney disease is higher. This can include the expansion of telemedicine services and the training of health care professionals to provide specialized care for kidney disease.

In conclusion, we should be well prepared for the next pandemic and strengthen our health care system, develop and maintain pandemic preparedness plans, invest in research and focus on international collabo­ration. To support the vulnerable, the “EACH” concept is worth implementing.

REFERENCES

1. Jager KJ, Kovesdy C, Langham R, Rosenberg M, Jha V, Zoccali C, et al. A single number for advocacy and communication—worldwide more than 850 million individuals have kidney diseases. Kidney Int. 2019;96(5):1048-50.
2. Singh AK, Farag YM, Mittal BV, Subramanian KK, Reddy SR, Acharya VN, et al. Epidemiology and risk factors of chronic kidney disease in India - results from the SEEK (Screening and Early Evaluation of Kidney Disease) study. BMC Nephrol. 2013;14:114.
3. Pecly IMD, Azevedo RB, Muxfeldt ES, Botelho BG, Albuquerque GG, Diniz PHP, et al. COVID-19 and chronic kidney disease: a comprehensive review. J Bras Nefrol. 2021;43(3):383-99.
4. Levin AT, Owusu-Boaitey N, Pugh S, Fosdick BK, Zwi AB, Malani A, et al. Assessing the burden of COVID-19 in developing countries: systematic review, meta-analysis and public policy implications. BMJ Glob Health. 2022;7(5):e008477.
5. Pradeepa R, Mohan V. Epidemiology of type 2 diabetes in India. Indian J Ophthalmol. 2021;69(11):2932-8.
6. IFKF-WKA. World Kidney Day: Kidney Health for All. Available from: https://www.worldkidneyday.org/2023-campaign/2023-wkd-theme/. Accessed Feb. 23, 2023.