Context
Back 30 years ago, non-communicable diseases (NCDs) were rarely known in the villages; but, today, low- and middle-income countries are suffering with an NCD burden that has sprawled from cities to villages.
Non-communicable Diseases (NCDs)
(a) They are chronic diseases of long duration and are the consequences of a combination of genetic, physiological, environmental, and behavioural factors.
(b) The main types of NCDs are cardiovascular diseases (such as heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma), and diabetes.
(c) The causes for NCDs are: unhealthy diet, sedentary lifestyle, and consumption of tobacco and alcohol.
(d) NCDs, including heart ailments, stroke, cancer, diabetes, and chronic lung disease, are cumulatively responsible for 74% of all deaths worldwide.
(e) They significantly affect people in low- and middle-income countries, where around 75% of global NCD deaths occur.
NCDs in India
(i) In India, more than 60% of all deaths occur due to NCDs..
(ii) Cardiovascular diseases (coronary heart disease, stroke, and hypertension) have a share of 45% of all NCD deaths, followed by chronic respiratory disease (22 %), cancers (12 %), and diabetes (3%).
(iii) One of the main reasons for this rise of non-communicable diseases is the consumption of tobacco.
(iv) Around one in four Indians suffer the risk of death from such diseases before reaching the age of 70.
Why are they on the rise?
(i) Unhealthy Diets: Increased consumption of processed, fat-loaded, high-sugar, and low-fibre foods.
(ii) Lack of physical activity: Sedentary lifestyle due to urbanisation and digitalisation added further woes.
(iii) Substance Use: Increased tobacco and alcohol consumption, especially among youth, makes them more vulnerable.
(iv) Environmental Factors: Respiratory and heart diseases mostly occur due to polluted air.
(v) Lack of Preventive Healthcare: Inadequate focus on preventive care in the public health system—lack of required awareness, diagnosis, and early-stage detection of such diseases.
(vi) Double Burden of Disease: Coupled with communicable diseases, NCDs are straining already burdened health infrastructure.
(vii) Socioeconomic Inequality: Poor and marginalised populations have inadequate access to quality healthcare, healthy food, and education. They are rising rapidly even among the low-income communities due to nutrition deficiency and inadequate awareness.
Concerns of High NCD Burden
(i) Epidemiological Transition: India is moving towards non-communicable diseases from communicable diseases, even in rural areas. Many regions suffer from the onslaught of both diseases.
(ii) Economic and Social Impact: High out-of-pocket expenditure (OOPE) for long-term treatment affects productivity, especially among the working-age population. Nudges many households into poverty due to long-lasting healthcare costs.
(iii) Health System Challenges: Primary healthcare is conventionally focused on maternal-child and communicable diseases. There is a lack of adequate screening, awareness, and trained workforce for chronic disease management.
Governments Initiatives
(i) National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) 2010: The Government of India provides technical and financial support to the States/UTs under the programme as part of the National Health Mission (NHM).
(ii) Screening under NHM: A population-based initiative for prevention, control, and screening for common NCDs. People of 30+ years of age are screened for the three most common cancers, i.e, oral, breast, and cervical.
(iii) Awareness Programmes: Other initiatives for increasing public awareness about Cancer and for promotion of a healthy lifestyle include observation of National Cancer Awareness Day & World Cancer Day.
(iv) Fit India Movement: It is implemented by the Ministry of Youth Affairs and Sports, and various yoga-related activities are carried out by the Ministry of AYUSH.
(v) Eat Right India Movement: Led by the Food Safety and Standards Authority of India (FSSAI). Promotes healthy eating habits, reduction in trans fats, salt, and sugar intake.
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Way Forward
(i) Robust primary healthcare for early diagnosis and continuous monitoring, and management of the disease.
(ii) Encouragement to lifestyle interventions like Physical activity(exercise), healthy and balanced diet, and no-tobacco campaigns will bear fruitful results.
(iii) Use digital health tools and telemedicine to expand reach. As it will require more funds, the dispensation must increase financial stimulus to NCDs.
(iv) A multi-segmental approach involving urban planning, food systems, education, and environment is the need of the hour to eliminate them.
(v) Policy Efforts: Encouraging private sector investments to address the issue of regional imbalance in availability of human resources & infrastructure for treatment of chronic NCDs.
Conclusion
NCDs are a serious public health threat in India. The solution for this challenge lies in a multi-faceted strategy encompassing prevention, early detection, quality treatment, and NCD management, coupled with the control of the underlying risk factors.