CSB IAS ACADEMY
THE ROAD MAP TO MUSSORRIE…
MAINS Impact- 2025 – 22/02/2025
NON-COMMUNICABLE DISEASES (NCDS)
SYLLABUS:
GS 2 > Social justice > Health > Health
IN NEWS:
o Recently, the Union Ministry of Health & Family Welfare has launched an Intensified Special
Non-Communicable Disease (NCD) Screening Campaign to ensure 100% coverage of
individuals aged 30 years and above. This initiative, running from 20th February to 31st
March 2025, aims to enhance early detection, timely intervention, and improved healthcare
linkages for major NCDs, including Diabetes, Hypertension, and three common cancers—
Oral, Breast, and Cervical.
KEY FEATURES OF THE SCREENING DRIVE
o Door-to-Door Screening: ASHAs (Accredited Social Health Activists), ANMs (Auxiliary Nurse
Midwives), and frontline workers ensure coverage, focusing on remote areas.
o Healthcare Integration: Screening conducted at Ayushman Arogya Mandirs (AAMs) and
health centers, with free follow-ups.
o Essential Supplies: BP monitors, glucometers, diagnostic kits, and medicines ensured at all
centers.
o Real-Time Monitoring: Daily data tracking via NP-NCD Portal for efficient intervention.
o Multi-Agency Coordination: Nodal officers at facility, district, and state levels oversee
execution.
o Daily Review: States/UTs submit reports by 6 PM, with central government support.
NON-COMMUNICABLE DISEASES:
o Non-communicable diseases (NCDs) are medical conditions or diseases that are not caused by
infectious agents. These are chronic diseases of long duration, and generally slow progression.
o The main types of NCD are cardiovascular diseases (such as heart attacks and stroke), cancers,
chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma)
and diabetes.
WHAT CAUSES NCDs:
NCDs are the result of a combination of genetic, physiological, environmental and behavioural
factors.
CSB IAS ACADEMY 22-02-2025
o Tobacco use: chewing, smoking,
second-hand smoke, and smokeless
tobacco
o Unhealthy diet: diets low in fruit,
vegetables, and whole grains, but high
in salt and fat
o Harmful use of alcohol
o Physical inactivity
o Air pollution: both outdoor air
pollution and household air pollution
o Genetics: Eg: Type 2 diabetes can be
inherited
o Epidemiological transition: The epidemiologic transition describes changing patterns of
population distributions in relation to changing patterns of mortality, fertility, life expectancy,
and leading causes of death.
STATISTICS:
o Over 60.46 lakh people died due to NCDs in India in 2019, which accounts for 66 per cent of
total deaths, according to the World Health Organization's (WHO) Global Health Estimates
2020.
o The report further revealed that there was a 22% probability of death between the age of 30
and 70 due to any type of non-communicable disease.
CSB IAS ACADEMY 22-02-2025
o India is known as the “Diabetes Capital of the World,” with over 77 million people living with
diabetes as of 2020, according to the International Diabetes Federation.
o At least 4.6 million deaths in India can be averted by 2040 if half of the people with
hypertension manage to keep their blood pressure under control, says the first-ever report
(2023) by the World Health Organisation on the devastating global impact of high blood
pressure. The report also said that 34% of adults are physically inactive in the country, 4%
are obese, and 28% smoke or chew tobacco
o Also, the report found that uncontrolled hypertension is the reason for 52% of the deaths
from cardiovascular diseases (one of the major types of non-communicable diseases)
like heart attacks and strokes in India.
CHALLENGES:
o Ageing population:
o The incidence of NCD and mortality increased with age. The elderly population (aged
60 years or above) in India accounted for 8.6% of the total population in 2011. This
number is expected to increase by 40% to 195 million in 2031.
o Limited political attention:
o NCDs are recognised as a public health emergency in slow motion. However, the
agenda for health continues to be dominated by maternal and child health priorities
and infectious diseases.
o Deficiencies in the health system:
o Prevention, treatment and care that can prevent or delay the class of diseases are out
of bounds for millions of people.
o Excessive consumerism:
o Driven by unchallenged aggressive marketing strategies, the lifestyle of people has
changed. This has resulted in tobacco use, alcohol abuse, excessive consumption of
trans, sugar, salt and high-fat foods, especially saturated fats.
o Economic challenges:
o Due to absence of social security net and high out of pocket expenditures, NCDs
severely affect the poor and vulnerable people of the society, forcing them into the
abyss of poverty.
o Poor urban planning:
o Improperly or poorly managed urban planning has brought a significant increase in air
pollution and sedentary living, thereby aggravating NCDs.
o Eg: a recent health report by ASSOCHAM states that 76% of the population with NCDs
is exposed to high air pollution.
o Pandemic induced disruptions:
o Covid-19 highlighted the link between NCDs and infectious disease, with serious
impacts on NCD care. In the early months of the pandemic, 75 per cent of countries
reported disruption to essential NCD services.
CSB IAS ACADEMY 22-02-2025
GOVERNMENT EFFORTS:
I. INTERNATIONAL
o SDG Target 3.4:
o The Sustainable Development Goal target to reduce early deaths from NCDs by a
third by 2030.
o WHO Global Action Plan for the Prevention and Control of NCDs 2013-2020:
o The Global Action Plan provides Member States, international partners and WHO with
a road map and menu of policy options which, when implemented collectively
between 2013 and 2020, will contribute to progress on 9 global NCD targets to be
attained in 2025, including a 25% relative reduction in premature mortality from NCDs
by 2025.
o India was the first country to adopt the National Action Plan
o WHO Framework Convention on Tobacco Control (WHO FCTC)
o The WHO FCTC is the first ever international public health treaty focusing on the global
public health issue of tobacco control.
o WHO-FCTC provides for various measures to reduce the demand as well as supply of
tobacco
o India ratified the treaty in 2004
II. NATIONAL INITIATIVES
o National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Disease,
and Stroke (NPCDCS) (2010):
o Part of National Health Mission (NHM) to prevent and manage common NCDs.
o Objectives:
▪ Promote lifestyle changes to prevent NCDs.
▪ Enable early diagnosis and treatment at various healthcare levels.
▪ Train healthcare personnel to manage NCDs.
▪ Strengthen palliative and rehabilitative care.
o NCD cells at different levels ensure implementation.
o Pilot project integrating AYUSH with NPCDCS in six districts.
o India added a 10th global target to address household air pollution.
o National Multisectoral Action Plan for Prevention and Control of Common NCDs (2017-2022)
o Blueprint for tackling NCDs in India's socio-economic and cultural context.
o 3. Indian Hypertension Control Initiative (IHCI) (2017)
o 5-year initiative involving MoHFW, ICMR, State Governments, and WHO-India.
o "25 by 25" goal: Reduce premature NCD mortality by 25% by 2025.
o Aims to reduce hypertension prevalence by 25% through strengthened management.
o Expanded to 130+ districts across 23 states.
CSB IAS ACADEMY 22-02-2025
o Other efforts:
o National Tobacco Control Programme: It was launched in 2007-08 with the aim
to create awareness about the harmful effects of tobacco consumption, reduce the
production and supply of tobacco products, ensure effective implementation of the
Cigarettes and Other Tobacco Products Act, 2003.
o Ujjwala yojana: It was launched in May 2016 and aims to provide LPG (liquefied
petroleum gas) connections to poor households. One of its intended objectives is to
reduce indoor air pollution.
o Eat right campaign: FSSAI launched the Eat Right campaign to curb consumption of
sugar, salt and fat. The objective is to combat negative nutritional trends and fight
lifestyle diseases.
o Fit India Movement: It was launched in August 2019 under Ministry of Youth Affairs
and Sports, to make fitness an integral part of our daily lives.
CHALLENGES ASSOCIATED WITH NCDS IN INDIA:
o Economic Burden and Healthcare Costs:
o NCDs impose a substantial financial strain on India's healthcare system due to high
costs of long-term treatments, hospitalizations, medications, and diagnostics.
o WHO estimates that NCDs could cost India around $4.58 trillion in economic output
by 2030 due to healthcare costs and reduced labor productivity.
o PHFI (Public Health Foundation of India) reports that NCDs account for 25% of all
hospital admissions and nearly 50% of all healthcare expenditures, highlighting the
significant economic burden.
o Loss of Productivity and Workforce Decline
o NCDs primarily affect the working-age population, leading to absenteeism, reduced
productivity, and early retirements, thus hampering economic growth.
CSB IAS ACADEMY 22-02-2025
o The Indian Council of Medical Research (ICMR) suggests that adults between 30 and
60 years are increasingly affected by NCDs, reducing labor force participation.
o Increased rates of hypertension, diabetes, and cardiovascular diseases among the
workforce contribute to lower productivity and economic slowdown.
o High Out-of-Pocket Expenditure (OOPE) and Poverty
o The high cost of managing chronic conditions often leads to significant out-of-pocket
expenses for Indian households, pushing many into poverty.
o National Sample Survey Office (NSSO) Report (2018) states that over 70% of
healthcare costs in India are borne by households, with a major portion attributed to
NCD treatment.
o Low insurance penetration and inadequate social security schemes worsen the
financial distress for NCD patients.
o Increased Morbidity and Mortality
o NCDs account for 66% of all deaths in India, as per WHO Global Health Estimates
2020.
o The first-ever WHO Global Report on Hypertension (2023) found that 52% of
cardiovascular deaths (heart attacks and strokes) in India are due to uncontrolled
hypertension.
o ICMR reports that 60% of premature deaths in India occur due to NCDs, affecting
individuals aged 30-69 years, significantly reducing life expectancy.
o Demographic Shift and Ageing Population
o As India's elderly population grows, the prevalence of NCDs will rise, leading to
increased demand for geriatric care and long-term medical support.
o The Census of India (2011) projected that the number of elderly (60+ years) will rise
from 104 million (2011) to 340 million (2050).
o This demographic shift will place immense pressure on the healthcare system and
social security infrastructure.
o Lifestyle and Behavioral Risk Factors
o Unhealthy dietary habits (high intake of processed food, sugar, salt, and trans fats)
contribute to obesity, diabetes, and hypertension.
o Physical inactivity (34% of adults) and obesity (4%) are leading contributors to NCD
prevalence.
o Tobacco and alcohol consumption remain high, with 28% of adults smoking or
chewing tobacco.
o The WHO Framework Convention on Tobacco Control (WHO-FCTC) has recognized
India’s efforts, but aggressive marketing and poor regulation of alcohol and tobacco
products persist.
o Air Pollution and Environmental Factors
o Air pollution (both indoor and outdoor) is a major driver of respiratory diseases like
COPD, lung cancer, and asthma.
o The Global Burden of Disease (GBD) Study (2020) found that India has one of the
highest rates of deaths due to air pollution-related diseases.
CSB IAS ACADEMY 22-02-2025
o ASSOCHAM’s Health Report revealed that 76% of NCD patients in India are exposed
to high levels of air pollution, worsening their condition.
o Epidemiological Transition and Changing Disease Patterns
o India is undergoing an epidemiological transition, where NCDs have overtaken
communicable diseases as the leading cause of death.
o This transition requires a shift in public health priorities, from a focus on infectious
diseases to chronic disease management and prevention.
o Strain on Healthcare Infrastructure
o Overcrowding in hospitals, lack of NCD specialists, and inadequate screening and
follow-up care hinder effective disease management.
o Rural areas lack specialized care, making early detection and treatment difficult.
o Health workforce shortages make it challenging to manage chronic diseases at
primary healthcare levels.
o Social and Family Impact
o The financial burden and long-term care required for NCD patients create emotional
and economic stress on families.
o NSSO data reports that 18% of household income is spent on healthcare, with severe
cases leading to higher financial distress.
WAY FORWARD:
o Strengthening Preventive Healthcare and Early Screening
o Expansion of NPCDCS and Ayushman Bharat programs to improve early screening, diagnosis,
and treatment.
o Mass awareness campaigns on healthy lifestyle choices, tobacco and alcohol reduction, and
importance of physical activity.
o Integration of AYUSH with modern medicine for holistic care.
o Financial Protection and Universal Health Coverage
o Increase public health spending on NCD management.
o Reduce out-of-pocket expenditure (OOPE) by expanding health insurance coverage for
chronic diseases.
o Ensure free or subsidized essential medicines and diagnostics for low-income groups.
o Addressing Lifestyle and Environmental Risk Factors
o Stronger regulations on tobacco, alcohol, and unhealthy foods through higher taxation and
marketing restrictions.
o Expansion of the Eat Right Campaign and implementation of front-of-pack labeling on
unhealthy food products.
o Promotion of fitness initiatives like the Fit India Movement to combat physical inactivity.
o Tackling air pollution by enforcing stricter emission norms and promoting clean energy
solutions.
o Strengthening Primary Healthcare Infrastructure
o Train frontline healthcare workers (ASHAs, ANMs, PHCs) in NCD detection and management.
CSB IAS ACADEMY 22-02-2025
oExpand digital health and telemedicine services to improve access to specialist care in rural
areas.
o Improve research and surveillance on NCD trends to guide policy decisions.
o Multi-Sectoral and Policy Interventions
o Enforce pollution control measures to reduce respiratory illnesses linked to environmental
factors.
o Strengthen urban planning to promote walkable cities, green spaces, and active transport
options.
o Expand research funding to develop cost-effective and indigenous solutions for NCD
management.
CONCLUSION:
India’s growing NCD crisis threatens health, economy, and workforce productivity. A multi-sectoral
approach with early detection, preventive care, financial protection, and lifestyle changes is crucial.
Strengthening public health policies and universal healthcare will be key to reducing the burden and
ensuring a healthier, more productive nation.
PRACTICE QUESTION:
Q. Discuss why India is vulnerable to Non-Communicable Diseases (NCDs) and the measures taken
by the government to address them. (10 marks, 150 words)
APPROACH
Define NCDs, cite WHO (2020) – 66%
Introduction deaths, mention rising burden & NCD
Screening Campaign (2025).
Q. Discuss why India
is vulnerable to Non- Discuss factors making India
vulnerable to NCDs
Communicable
Diseases (NCDs) and
MODEL ANSWER: taken Body
the measures
by the government to List government measures to
address them. (10 address NCDs
marks, 150 words)
Conclusion Provide way forward and conclude.
MODEL ANSWER:
Non-Communicable Diseases (NCDs) are chronic, non-infectious conditions like diabetes,
hypertension, and cancer, causing 66% of deaths in India (WHO 2020). With a rising burden, the NCD
CSB IAS ACADEMY 22-02-2025
Screening Campaign (2025) aims for 100% screening of individuals aged 30+ for early detection.
Despite efforts, India remains highly vulnerable to NCDs.
FACTORS MAKING INDIA VULNERABLE TO NCDS:
1. Lifestyle and Behavioral Risks
o Rising cases of diabetes, hypertension, obesity, and cardiovascular diseases are linked
to unhealthy diets, physical inactivity (34% of adults), tobacco use (28%), and
excessive alcohol consumption (WHO 2023).
o Increased consumption of processed foods high in sugar, salt, and trans fats has led
to a surge in lifestyle-related diseases.
o Sedentary lifestyles due to urbanization and work culture contribute to physical
inactivity, worsening metabolic disorders.
2. Environmental Challenges
o Air pollution is a leading cause of chronic respiratory diseases, lung cancer, and
cardiovascular conditions.
o According to the ASSOCHAM Health Report, 76% of NCD patients in India are exposed
to high levels of air pollution, worsening their health conditions.
o Household air pollution from biomass fuel use further increases the risk of respiratory
disorders, especially in rural areas.
3. Ageing Population
o NCD risk increases with age, and India’s elderly population (60+ years) is projected to
grow by 40% by 2031 (Census 2011).
o Age-related diseases such as hypertension, diabetes, stroke, and neurodegenerative
disorders are expected to rise.
o Increased life expectancy means longer exposure to NCD risk factors, requiring better
geriatric care and long-term disease management.
4. Weak Healthcare Infrastructure & High Treatment Costs
o Limited access to preventive healthcare leads to late-stage diagnosis and higher
mortality.
o Out-of-pocket expenditure (OOPE) is 70% (NSSO 2018), making treatment
unaffordable for many, especially the poor.
o Shortage of NCD specialists, diagnostic centers, and primary healthcare services in
rural areas results in inadequate disease management.
o High treatment costs (50% of healthcare spending on NCDs – PHFI) create a financial
strain on families and healthcare providers.
5. Lack of Preventive Health Measures & Awareness
o Low awareness of early screening and lifestyle modifications leads to late-stage
diagnosis of NCDs.
o Preventive healthcare remains underfunded, with more focus on curative rather than
preventive strategies.
o Limited health literacy results in poor disease management, especially in rural and
underserved populations.
CSB IAS ACADEMY 22-02-2025
GOVERNMENT MEASURES TO ADDRESS NCDS:
1. NPCDCS (2010) – Under National Health Mission, it provides screening, treatment, and
preventive healthcare for NCDs.
2. Indian Hypertension Control Initiative (IHCI) (2017) – Targets 25% reduction in premature
NCD mortality by 2025.
3. Ayushman Bharat & AAMs – Expands primary healthcare access for NCD screening and
treatment.
4. National Tobacco Control Programme (2007) – Regulates tobacco use and raises awareness.
5. Eat Right Campaign & Fit India Movement – Focuses on healthy eating and active lifestyles.
Way Forward
o Preventive Healthcare & Screening – Expand NPCDCS & Ayushman Bharat, promote
awareness on lifestyle risks.
o Strengthening Healthcare Access – Improve PHCs, telemedicine, and specialist availability.
o Financial Protection – Reduce OOPE, expand insurance & subsidized NCD treatment.
o Tackling Risk Factors – Enforce regulations on tobacco, alcohol, junk food, and pollution
control.
o Policy & Research – Promote walkable cities, green spaces, and invest in NCD research & data
collection.
India's rising NCD burden threatens public health, economy, and workforce productivity. A multi-
sectoral approach with preventive care, healthcare strengthening, and lifestyle interventions is
essential to reduce mortality and improve health outcomes. Early screening initiatives like the
Intensified NCD Screening Campaign (2025) are key steps toward a healthier India.
