Screening project success in India may help UK patients

Indian nurses to be recruited by the NHS
Indian nurses to be recruited by the NHS

By Sairah Masud

RESEARCHERS from Britain and India have collaborated on a £6 million project to tackle the growing rate of diabetic blindness among India’s working class population over the next four years.
Led by Professor Sobha Sivaprasad from Moorfields Eye Hospital, Ornate India, with funding from the UK Research Council, plans to develop innovative screening technology for the early detection of diabetic retinopathy to reduce the rate of blindness among the 70 million people in India suffering from diabetes, and its associated healthcare costs.
If the project is a success, the NHS could adopt a similar strategy in this country.
Researchers propose to study the efficacy of mobile phone cameras for retinal screening as well as new blood and urine tests that will detect risks of complications from the disease.
Prof Sivaprasad said: “If we screen every person with diabetes every year, we are likely to reduce the risk of blindness as a nation.
“We’re going to train health workers at primary care centres to screen the irises and develop a holistic approach, rather than an elaborate screening process, to make sure that we have an impact on blindness.”

Innovative technology to detect blindness from diabetic retinopathy in
India could be adopted by the NHS

Current annual screening procedures in the UK involve the use of expensive equipment that can only be operated by trained professionals. There is currently no such systematic screening procedure for diabetes in India.
The new protocols are aimed at addressing the issue of retinal screening which researchers say at present is “physically impossible” to do with the vast population in India.
Lord Kamlesh Patel of Bradford OBE, chair of the International Advisory Committee for the project, said: “This involves some of the best academics and scientists working with the Kerala government to look at different ways of identifying early screening for people who might have diabetes.”

Lord Kamlesh Patel

For the estimated 70 million people in India diagnosed as diabetic, there are a further 70 million who are either pre-diabetic or undiagnosed due to lack of complete data and rudimentary primary care infrastructures.
“In this country [Britain] we do it extremely well, but it’s expensive and we’re a population of 60 million. In India, there’s a population of 140 million who might need it and there’s no way we can afford to do it that way.
“We have developed different techniques using a specialist camera phone and urine and
blood tests. If it works, it will not only save lives and the eyesight of millions in India, but we’ll be able to bring it to the UK and innovate here,” Lord Patel added.
Evidence shows that diabetes is the leading cause of blindness in working-age adults in India and across the world. Early detection and timely treatment can reduce this number and can also make timely referrals for other complications such as stroke, heart attacks
and kidney disease.
Those involved in the project hope that if the tests in India are successful, the lessons learnt from that ground-breaking technology can be translated into the NHS to
significantly reduce costs.
Professor of Public Health, Mala Rao OBE, said: “If we could successfully predict and identify those people at risk of complications in the developing world, clearly there is scope to introduce that technology to the NHS.
“At the moment we have a fabulous eye screening programme but it’s very expensive. Perhaps there are less expensive ways: we may be able to do it in the future if some of our attempts to bring in screening programmes are shown to be feasible in this country.”
An estimated £14 billion is spent a year on treating diabetes and its complications in the UK, with the cost of treating complications representing a much higher cost.
With the prevalence of diabetes in the UK estimated to rise to four million by 2025, the project aims to use the UK-India collaboration to make affordable, universal healthcare a reality.
Lord Patel said: “This is not the UK going to India and saying ‘we’ll tell you how to do it’. It’s about shared partnership and learning from each other. This is going to be an example of how we share data across continents and how we make that work in policy and practice.”