Rajesh Kesari | Non-communicable diseases behind increasing burden of diseases in India

Human beings are in constant battle with other organisms that have been fine-tuned by evolution. Historically, health of human beings was largely affected by fatal epidemic diseases, famines, injury and other complications. As communities evolved, new age health problems like diabetes, hypertension, cardiovascular, respiratory, and kidney diseases, along with mental health issues became more significant. Increasing life expectancy, growing population, urbanisation, climate change and changing lifestyle acted as major drivers of such chronic diseases which are grouped under an umbrella term of non-communicable diseases (NCDs).

The NCD burden is rising globally and is expected to reach alarming proportions. The World Health Organisation (WHO) projects that the total annual number of deaths from NCDs will increase to 55 million by 2030, if timely interventions are not done for its prevention and control. For India, its vast population combined with rapidly changing lifestyle makes the problem acute. Moreover, the recent onslaught of the Covid-19 virus which has caused extreme health issues and distress has brought a sharper focus on preventive health care. Over the past two years, Covid management across the country has indicated that people with co-morbidities of non-communicable diseases have a higher mortality rate than those who do not and thus, if India wants to successfully navigate more such pandemics in the future, it must address NCDs is an inclusive manner.

Despite challenging circumstances, several laudable steps have been taken by the Government of India to not only address this mounting concern but also promote healthy living.  A population-based initiative for prevention, control and screening for common non-communicable diseases, i.e. diabetes, hypertension and common cancers has been rolled out in the country under National Health Mission and also as a part of Comprehensive Primary Health Care.

Preventive aspect of NCDs is also strengthened under Comprehensive Primary Health Care through Ayushman Bharat Health Wellness Centre scheme, by promotion of wellness activities and targeted communication at the community level. Other initiatives for increasing public awareness about NCDs and for promotion of healthy lifestyle includes observation of National and International Health Days and use of print, electronic and social media for continued community awareness. Fit India movement implemented by Ministry of Youth Affairs and Sports, and various Yoga related activities carried out by Ministry of AYUSH along with Swachh Bharat Abhiyan are examples of unique initiatives which not only aim to improve the overall health of the citizens but also their quality of life.

Given that India is a vast country with varied socio-economic challenges, continued and sustained interventions to strengthen our healthcare systems will remain critical. A 2021 report by ASSOCHAM on the rising burden on non-communicable diseases in India suggested that the prevalence of having any NCDs among the population is 116 per 1000 population. It identified hypertension, digestive disease, and diabetes as the top three NCDs followed by respiratory diseases, brain/neurological disorders, heart diseases/CVD, kidney disorders, and cancer in the order of prevalence.

It makes an alarming observation that non-communicable diseases increase after 18 years and show a quantum leap when an individual cross the age of 35 years. It was found that more than two-thirds of individuals suffering from non-communicable diseases are in the most productive life age group – between 26 and 50s. Given that we are one of the youngest nations in the world, unflinching and concerted efforts for a ‘Swasth Bharat’ is imperative.

The age group (26-50 years) is particularly important as people make several lifestyle choices which they carry into their 40s and 50s and therefore, maintaining a healthy lifestyle from young adulthood is key to one’s overall health and well- being. A more holistic awareness campaign on a healthy lifestyle needs to be built so that we create a healthy youth for the nation. Here, it is important to state that instead of deflecting from the real issue by focusing on some of the small components which may have some unhealthy characteristics will not deliver the desired results. Such myopic outlook would indeed be counterproductive and will not benefit either the current or the future generations.

Our lifestyle choices play an important part in contributing to health conditions and, therefore, sensitisation on this issue is important.

However, equal emphasis needs to be also given to better management of issues such as air pollution, low physical activity, a low diet in legumes, high stress levels etc, which have been proved to have a much larger role and greater risks in contributing to NCDs.In our efforts towards public health initiatives, raising awareness levels, not moral policing will prove to be a more effective for holistic and preventive healthcare.  

Owing to the advances across the spectrum of health and development, India has entered a new era in public health during the past ten years; that said, we must continue to build on this progress. Apart from NCDs, India is making progress in managing larger issues such as providing nutritious diet, clean water, hygiene and sanitation which is playing a pivotal role in mitigating our health risks and positively contributing to India’s challenge of preventing diseases and better health outcomes.