Global Nephrology: Dialysis in India

Source: rediff news

The market for dialysis is growing exponentially in India. Business magazines and analysts are abuzz at the business opportunity, but it isn't all about making money. Here are some quotes from a recent article by Adi Narayan in BusinessWeek:

"About 52,000 patients in India are on kidney dialysis. It’s only 4 percent to 33 percent of the cost in the U.S., but too rich for most Indians." 

Georgi Abraham one of India's most respected and senior nephrologist talks about the situation:  “There’s a huge demand for dialysis centers, but only those who can afford it get it” ....Often I find that patients just disappear. They get one or two sessions when they have some money and then stop. Within a week or two of stopping dialysis, they may just collapse and die.”

"More than 90 percent of the 230,000 people who develop chronic kidney failure each year in India die within months because of lack of treatment, according to a 2009 study by the All India Institute of Medical Sciences and the Health Ministry....[yet] the Indian market for kidney care may grow to $152 million next year from $97 million in 2007, forecasts researcher Global Markets Direct. "

Surprisingly, until now, there has been no attempt to develop minimum standards. Companies claim that they are the best with little to support the claim. Some sketchy operators dialyze without even any attempt at purifying the water. Mohan Rajapurkar a senior nephrologist and pioneer in dialysis at MPUH in Nadiad Gujurat has, along with other nephrologists and the endorsement of the Indian Society of Nephrology, developed some guidelines for dialysis facilities. These guidelines have been presented to the Indian Government and people are waiting to hear whether these guidelines will be adopted by the government. 


The bottom-line is that while dialysis in India is a small sliver of the global dialysis market (see figure), it is growing rapidly. However, like many developing countries India needs to go on two tracks - on the one hand regulate facilities to ensure that minimum standards are met and second increase the availability and access to dialysis for everyone - especially the poor who currently die because they cannot afford treatment. Currently, it's doing neither very well.