The Rising Debt Of NCDs In India

Noncommunicable diseases are one of the main challenges to public health worldwide in the modern era, as per WHO globally NCDs kill 41 million people every year which accounts for 71 per cent of all deaths in the world and 77 per cent of these fatalities happen in low to middle income economies. 

NCDs are also termed as chronic diseases, the diseases of longer durations which are a result of genetic, behavioural, physiological and environmental factors. 

The major part of the NCDs include heart diseases which is the number one killer followed by cancers, chronic respiratory diseases like asthma, and diabetes.

As per the inputs by NFHS-5, NCDs account for more than two thirds of all deaths in India (65 per cent) and according to a report by WHO in 2015, in India nearly 5.8 million people die of NCDs each year, the experts believe these numbers to be quite high now as significant lifestyle changes are occurring due to the modern lifestyle which is also leading to a rise in the burden of NCDs in India.

The majority of metabolic risk factors for NCDs subsume obesity, raised blood pressure, raised blood glucose levels and raised cholesterol levels in blood.

“The rise of NCDs has been driven primarily by four major risk factors: tobacco use, physical inactivity, the harmful use of alcohol and unhealthy diets. The epidemic of NCDs poses devastating health consequences for individuals, families and communities, and threatens to overwhelm health systems,” Dr Mahesh Kumar, Consultant, Internal Medicine,  Narayana Health City.

India is also called the diabetic capital of the world and is home to 77 million diabetic patients, second most in the world after China and closely one in every fourth person is also overweight in India, with the western lifestyle seeping well within the Indian culture.

Nalini Saligram, founder & CEO, Arogya World explained that diabetes and other NCDs, once diagnosed at age say 30 becomes truly chronic and the patient lives with diseases for decades. This puts more drain on the healthcare system. “And diabetes doesn’t stay static, complications of uncontrolled diabetes are severe which are heart disease and stroke and foot amputations, kidney disease, blindness and even oral decay,” she added.

Rapid urbanisation coupled with globalisation of unhealthy lifestyles and ageing populations are some of the major drivers of NCD. Unhealthy diets, lack of physical exercises and tobacco consumption are leading to the rising debt of NCDs in India and around the world.

Another major challenge in dealing with NCDs is its penetration in the younger population, each year over 15 million people die globally in the age group of 30 to 69 years from NCDs, and 85 per cent of these deaths occur in low and middle level income countries.  

Ms Saligram informed that Indians get diabetes one or two decades earlier than the people in the west, so at the peak of their productive years, Indians are getting diagnosed with diabetes. In their 30s and sometimes in even 20s and teens they are getting type two diabetes. 

The Ministry of Health and Family Welfare launched the National Multisectoral Action Plan for Prevention and Control of Common NCDs in 2019, the government is making amends and is alive to the rising challenge of NCDs. But medical experts believe there are still challenges that hamper the efforts to detect and treat NCDs at the right time.

Dr Kumar enumerates that NCDs face many challenges in India including infrastructure, economic spending, demographic challenges and management. “Further, lack of adequate preventive infrastructure and access to medicine, primary health care and technology are also aspects affecting late identification and management of NCDs,” he added.

“To reduce risk of NCDs, there is a need to create concentrated and continuous awareness through multi-media encouraging the adoption of healthy lifestyle by the public. Government needs to facilitate an enabling environment to give options to the public to adopt healthy lifestyle such as facilities for physical activity in educational establishments, workplaces and residential areas and providing healthy food in schools and work places. There is also need to scale up the ‘NCD Clinics’ establish clinics at the primary healthcare level to promote integrated chronic disease management, said Dr Kumar.