Burden of non communicable diseases in India: Setting priority for action.

ABSTRACT

Non-communicable diseases (NCDs) are defined as diseases of long duration, and are generally slow in progression. NCDs are replacing communicable diseases, maternal and child health as well as malnutrition as the leading cause of death. Non-communicable diseases are the leading cause of death in the world, responsible for 63% deaths worldwide in 2008. NCDs accounts for 53 percent of deaths in India. Based on available evidence cardiovascular diseases (24 percent), chronic respiratory diseases (11 percent), cancer (6 percent) and diabetes (2 percent) are the leading cause of mortality in India. Treatment cost is almost double for NCDs as compared to other conditions and illnesses. Burden of non-communicable diseases and resultants mortality is expected to increase unless massive efforts are made to prevent and control NCDs and their risk factors. India could develop a strategy for reducing out of pocket expenditure. Underlying determinants of NCDs mainly exist in non-health sectors, such as agriculture, urban development, education and trade. Inter-sectoral collaboration is therefore essential to create an enabling environment. Government of India had launched various vertical programmes such as National Cancer Control Programmes, National Tobacco Control Programme, National Programme for Prevention and Control of Cancer, Diabetes, CVD and Stroke (NPCDCS) etc. Strong surveillance, monitoring and evaluation system is required for successful implementation of the programmes. Public health facilities should be strengthened for providing services of screening; early diagnosis and treatment within the public health care delivery system. Efforts need to be done on implementing the clinical standards and guidelines developed under the Indian Public Health Standards (IPHS), and integrating NCD training into training curricula of health workforce.