The World Health Day 2024, highlights a basic human right: that of health. The right to health is clearly mentioned in the World Health Organization’s Constitution¹, which states that the highest attainable standard of physical and mental health should be aimed for.

GOVERNMENTAL RESPONSE

Governments across the world try to ensure that their citizens attain this right. India’s national health programs cover all phases of life, from childhood and adolescence, to pregnancy, adulthood and old age².

Specific diseases of public health importance, such as vaccine-preventable diseases, malnutrition, chronic diseases, and cancers are included. There is special focus on minority and marginalized sections of society, such as the transgender community.

The services listed in these national health programs are offered through an extensive structure of primary, secondary, and tertiary health care centers³. These are administered by public and private health care system, and governed by standards such as the Indian Public Health Standards⁴. Essential lists of medicines, devices and diagnostics ensure availability of important medical and surgical interventions at affordable rates⁵.

PUBLIC RESPONSE

This has led to a situation where the average citizen feels, and rightfully so, that health is their right⁶. Services such as vaccination, maternal care and medical care, are accepted passively, as their utilization does not require active participation on part of the recipient. In fact, vaccine hesitancy⁷ is reported in spite of the fact that it is offered free of cost.

CHANGING TRENDS

As these aspects of health care became more and more effective, the incidence of acute and infectious diseases has also come down markedly. Unfortunately, the prevalence of chronic diseases, such as diabetes and obesity, has increased dramatically. These pandemics pose an important challenge to well-being, at both individual and public health levels. It is certainly one’s right, therefore, to access good quality metabolic and endocrine care, and achieve optimal outcomes. Exercising this right is part and parcel of the welcome trend towards person-centered care⁸.

RESPONSIBILITY AND RIGHTS

Along with rights, however, come responsibilities. The nature of chronic disease is such that their control and management depend predominantly on self-care and self-management. While it is the duty of the health care system to explain skills needed to live with a chronic disease, it is the responsibility of the individual to put this education in practice. Persons living with any chronic disease, or disability, need to own up to this responsibility. Doing so does not in any way mean that they should abnegate their rights. At the same time, requesting a person living with chronic illness to take charge of their management certainly does not indicate that health care professionals can abdicate their own responsibility⁹.

ALL ARE EQUAL

Family members, friends, colleagues, and other caregivers are equally important members of the health care ecosystem. These stakeholders need to be integrated in chronic care, as they fulfill essential responsibilities of support and succor¹⁰. They also enjoy rights, as caring for a person with chronic disease may lead to compassion fatigue, financial stress, and other hazards. Appreciating this, considering the high prevalence of these conditions, and understanding the need for teamwork in chronic disease, it makes sense to use plural “our” instead of the self-centered “my” in our action statement.

REALITY

Rights and responsibility should be accepted in the right manner, with a view to improving satisfaction and outcomes of health care. The best results are obtained if rights and responsibilities, as well as dues and duties are shared equitably, in the spirit of cooperation and consociation. This is termed as responsible person-centered care⁹.

From a chronic disease perspective, therefore, our clarion call should be “Our health, our right, our responsibility”.

REFERENCES

1. WHO Constitution. Available at: https://www.who.int/about/accountability/governance/constitution. Last accessed March 20, 2024.
2. List of national health programmes. Available at: https://ihatepsm.com/blog/national-programs-related-health-india-december-2023-brief-description-each. Last accessed March 20, 2024.
3. Chokshi M, Patil B, Khanna R, Neogi SB, Sharma J, Paul VK, et al. Health systems in India. J Perinatol. 2016;36(s3):S9-12.
4. Indian Public Health Standards. Available at: https://nhm.gov.in/index1.php?lang=1&level=2&sublinkid=971&lid=154. Last accessed March 20, 2024.
5. National List of Essential Medicines (2022). Available at: https://main.mohfw.gov.in/?q=newshighlights-104. Last accessed March 20, 2024.
6. Kalra S, Megallaa MH, Jawad F. Patient-centered care in diabetology: from eminence-based, to evidence-based, to end user-based medicine. Indian J Endocrinol Metab. 2012;16(6):871-2.
7. Kalra S, Verma M, Agrawal N. Vaccine hesitancy in primary care: building bridges by understanding barriers. J Pak Med Assoc. 2022;72(12):2565-6.
8. Kalra S. The history of person-centred medicine: a South Asian perspective. Int J Person Centered Med. 2022;12(1):41-6.
9. Kalra S, Baruah MP, Unnikrishnan AG. Responsible patient-centered care. Indian J Endocrinol Metab. 2017;21(3):365-6.
10. Stuckey HL, Mullan-Jensen C, Kalra S, Reading J, Wens J, Vallis M, et al. Living with an adult who has diabetes: qualitative insights from the second Diabetes Attitudes, Wishes and Needs (DAWN2) study. Diabetes Res Clin Pract. 2016;116:270-8.