India's Race Against Time: Tackling the NCD Epidemic by 2047

As India approaches its 100th anniversary in 2047, policymakers envision a prosperous, equitable, and resilient nation - a "Viksit Bharat." However, a major threat looms: non-communicable diseases (NCDs), which already account for almost two-thirds of all deaths in the country.

The NCD crisis in India is particularly alarming, as over half of the NCD mortality strikes people before the age of 70, unlike many high-income nations where most NCD deaths occur after 70. In fact, in recent years, there has been increasing concern over people in their 30s and 40s passing away from sudden cardiac arrest. These untimely deaths not only cause immense grief but also coincide with prime earning and caregiving periods, eroding household income, shrinking the skilled workforce, and hiking healthcare costs.

Global evidence, echoed in India's own studies, shows that five NCDs - cardiovascular disease, cancers, diabetes, chronic respiratory disease, and mental health disorders - are largely driven by five modifiable risk factors: tobacco use, unhealthy diet, physical inactivity, harmful alcohol use, and air pollution. This "5x5" framework provides India with a clear battle plan to tackle the NCD epidemic.

While the government has taken commendable steps, such as increasing taxation on cigarettes and launching initiatives like the POSHAN Abhiyan to promote nutrition, there is still more work to be done. Certain forms of tobacco remain under-regulated, public awareness on salt intake and trans fats needs strengthening, and air pollution continues to pose a significant public health risk. Innovative solutions, such as nurse-led hypertension clinics and smartphone decision-support tools, are emerging, but more must be done to ensure every citizen has access to preventive care and treatment.

Ultimately, India has shown its ability to tackle complex health challenges, from eradicating smallpox to rapidly scaling up COVID-19 vaccinations. By applying similar lessons of task-shifting, preventive focus, and health system integration, the country can work towards its vision of a "Viksit Bharat" - a nation where every citizen can live a long, healthy, and productive life, free from the burden of preventable diseases.