International Society of Nephrology (ISN) and International Federation of Kidney Foundation (IFKF) have earmarked second Thursday of March each year for World Kidney Day. Last year the day was observed in Pakistan on 9th March 2007 to create awareness for this global calamity.
The social services like health and education are neglected in developing countries. Major portions of financial resources are utilised in areas of conflicts and debt financing resulting in Aid Prone economy.
Third world spending on health varies from 0.8 percent to 5.3 percent GDP and per capita income is less than US% 1000/ annum in most of the countries. Media has created much awareness among the people and their needs are turning into demands. In such situation a rational approach would be to educate the masses and practice preventive medicine. This approach will have a far-reaching and positive impact on our limited financial resources.
Communicable disease like TB, Malaria, Smallpox, Polio, Dysentery and Hepatitis have largely been contained in developing countries by various measures like safe water, sanitation, locally and economical medicines and mass vaccination.
Now the non-communicable diseases Diabetes, Hypertension and Chronic Kidney Disease have become a challenge. Dr S.A. Jaffar Naqvi, Chief Executive of the Kidney Foundation call them the silent killer. National Kidney Foundation K/DOQI clinical practice guidelines have redefined Chronic Kidney Disease into five stages and the emphasis is on delaying the progression of chronic kidney disease to End Stage Kidney disease. End Stage Kidney Disease has now become a global calamity. Even developed countries like USA, Europe and Japan are feeling the financial burden of managing End Stage Kidney Disease and are devising preventive strategy.
In developing world the situation is worse because in addition to the brunt of communicable disease now the non-communicable disease are also spreading like wild fire. The magnitude of the problem can only be estimated as date on actual incidence is not available. Even at a very conservative assumption of 100 / million renal failure population the financial projection are phenomenal. Imaging 96,620 End Stage kidney Disease patient in India and 15,000 patients in Pakistan needing dialysis or transplant each year.
By conservative estimate Rs 200,000 per patient per year is needed. Thus to look after all End Stage Kidney Disease patients in Pakistan huge budget allocation of Rs 288 million / year is required. This amount is not available. In Pakistan hardly 20 percent of such patient are fortunate enough to have dialysis and only 5 percent are able to get kidney transplant. It appears that most of the patients with End Stage Kidney Disease in less privileged countries have only one option.
We must emphasise and publicise prevention. We should avoid over publicising dialysis transplant. Our aim should be to prevent Diabetes and Hypertension, thus delaying the onset and avoid progression of Chronic Kidney Disease to End Stage Kidney Disease, rational dialysis and transplant is the developing country's perspective.
The Kidney Foundation of Pakistan is organising a walk on 4 March, to educate the people and create awareness about the kidney diseases. The Foundation is also organising a lecture meeting and medical camp on this occasion on 4 and 8 March.