Chronic Diseases Surge Past Infections as India's Leading Killers, Lancet Warns

A groundbreaking Global Burden of Disease (GBD) study published in The Lancet and launched at the World Health Summit in Berlin has revealed a seismic shift in India’s health landscape. By 2023, non-communicable diseases (NCDs) such as ischaemic heart disease, chronic obstructive pulmonary disease (COPD), and stroke have overtaken infectious diseases like tuberculosis and diarrhoea as the leading causes of death in India. This epidemiological transition, driven by rising lifestyle-related illnesses, signals an urgent need for a reorientation of India’s health policies to address the growing burden of chronic diseases.

The GBD report, compiled by over 16,500 researchers worldwide, highlights that NCDs now account for nearly two-thirds of deaths globally, with India mirroring this trend. In 1990, diarrhoeal diseases topped mortality charts with an age-standardised mortality rate (ASMR) of 300.53 per lakh. By 2023, ischaemic heart disease had taken the lead with an ASMR of 127.82 per lakh, followed by COPD (99.25 per lakh) and stroke (92.88 per lakh). Infectious diseases, including lower respiratory infections and neonatal disorders, have significantly declined in rank, while COVID-19, a major killer in 2021, dropped to the 20th position by 2023.

The study also notes a decline in India’s overall all-cause mortality rate, from 1,513 per lakh in 1990 to 871 per lakh in 2023, alongside a 13-year increase in life expectancy, from 58.5 to 71.6 years. However, unlike many countries that saw declines in NCD mortality between 2010 and 2019, India experienced a rise in deaths from chronic diseases. Notably, the risk of dying from NCDs before age 80 increased for both men and women, with women facing a sharper rise.

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This shift from acute infections to chronic, lifestyle-related illnesses demands a comprehensive overhaul of India’s health agenda. The report underscores the need for strengthened primary health systems to enable early detection of conditions like hypertension, diabetes, and cancers. Preventive measures, including tobacco cessation, improved diets, increased physical activity, and air pollution control, must be scaled up. Additionally, integrating chronic care models with long-term patient follow-up, ensuring equitable access to NCD care for rural and marginalized groups, and enhancing data systems for better cause-of-death tracking are critical steps.

As India progresses toward its health goals for 2047, addressing the NCD epidemic will be pivotal to reducing avoidable mortality and extending healthy lifespans. The rise of chronic diseases marks a new era of health challenges, requiring a shift from reactive disease control to proactive prevention and from fragmented programs to integrated health systems. With heart disease, COPD, and stroke now the chief killers, India must act swiftly to combat these silent threats to its population’s health.

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