Major Non-Communicable Diseases (Ncds) and Their National Programmes in India

India experiences a rapid epidemiological transition, moving from communicable diseases to non-communicable diseases (NCDs) as the primary cause of morbidity and mortality. NCDs account for nearly 63% of all annual deaths in the country, with cardiovascular diseases, cancers, chronic respiratory conditions, and diabetes driving the majority of this burden. These chronic conditions arise from a combination of genetic factors and modifiable behavioral risks, including tobacco consumption, alcohol use, unhealthy diets, and physical inactivity. To address this public health challenge, the Government of India implements targeted national healthcare initiatives focusing on early screening, primary prevention, and decentralized treatment access across all levels of healthcare delivery.

Epidemiological Profile of Major Non-Communicable Diseases

Non-communicable diseases are long-term conditions that develop slowly and do not spread from person to person. Four main disease groups represent the largest share of NCD deaths and disability-adjusted life years (DALYs) in the country.

Cardiovascular Diseases (CVDs)

Cardiovascular diseases are the leading cause of mortality in India, accounting for over a quarter of all deaths. Ischemic heart disease and stroke form the bulk of CVD-related fatalities. Uncontrolled hypertension serves as the single largest preventable risk factor for heart attacks and stroke.

Diabetes Mellitus

India hosts one of the largest populations of individuals living with diabetes globally. Type-2 diabetes dominates cases due to increasing insulin resistance, urban sedentary lifestyles, and dietary changes. Unmanaged diabetes leads to secondary complications including diabetic retinopathy, neuropathy, and end-stage renal disease.

Oncological Disorders (Cancers)

Cancer incidence shows a steady rise across rural and urban populations. Oral cancer, lung cancer, and stomach cancer represent the most common malignancies among men. Breast cancer and cervical cancer account for the highest disease burden among women. Tobacco usage directly links to over 80% of oral and head-neck cancer cases.

Chronic Respiratory Diseases

Chronic Obstructive Pulmonary Disease (COPD) and asthma create a heavy health burden due to indoor air pollution from biomass fuel combustion and ambient outdoor air pollution. India accounts for a disproportionate share of global COPD mortality.

National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD)

The Ministry of Health and Family Welfare launched the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) in 2010. The government revised operational guidelines and expanded the mandate, renaming it the National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD).

• Administrative Structure: The scheme operates under the National Health Mission (NHM) NCD Flexi-pool. Funding is shared between the Centre and States in a 60:40 ratio, except for North-Eastern and Hilly States where the ratio is 90:10.
• Core Interventions: Focuses on health promotion, opportunistic screening, population-based screening, infrastructure strengthening, human resource training, and supply of essential drugs and diagnostic tools.
• Expanded Disease Scope: Beyond the original core diseases, NP-NCD now integrates care for Chronic Obstructive Pulmonary Disease (COPD), Asthma, Chronic Kidney Disease (CKD), Non-Alcoholic Fatty Liver Disease (NAFLD), and ST-Elevation Myocardial Infarction (STEMI).

Strategic Initiatives and Primary Healthcare Integration

The national strategy relies on shifting NCD care from tertiary hospitals to primary health centers, bringing screening and management directly to local communities.

Population-Based Screening (PBS) Initiative

Population-based screening targets all individuals aged 30 years and above for five common NCDs: hypertension, diabetes, oral cancer, breast cancer, and cervical cancer. Frontline health workers, including Accredited Social Health Activists (ASHAs) and Auxiliary Nurse Midwives (ANMs), use the Community-Based Assessment Checklist (CBAC) to identify at-risk individuals during home visits.

Ayushman Arogya Mandirs

Primary Health Centres (PHCs) and Sub-Centres upgraded into Ayushman Arogya Mandirs serve as the primary operational hubs for NCD screening, routine check-ups, free drug dispensing, and lifestyle counseling. These centers ensure continuum of care and follow-up.

The “75/25” Initiative

Unveiled by the Union Health Ministry, this initiative aims to place 75 million individuals diagnosed with hypertension and diabetes under standardized care protocols by December 2025. It represents a large expansion of NCD management in primary healthcare settings.

National NCD Portal and IT Architecture

A dedicated web application and mobile software track individual health records, screening outcomes, treatment adherence, and referral networks across healthcare facilities nationwide. It enables real-time monitoring of screening progress.

STEMI Care Model

The ST-Elevation Myocardial Infarction (STEMI) project establishes hub-and-spoke networks connecting rural health centers with tertiary cardiology facilities. It enables rapid administration of clot-dissolving drugs at peripheral centers before patient transport.

Specialized National Health Programmes for Chronic Conditions

In addition to the overarching NP-NCD framework, specialized central programs target specific chronic health issues.

• National Programme for Palliative Care (NPPC): Integrated into the health system to relieve suffering for patients with end-stage chronic illnesses and advanced cancers.
• National Programme for Prevention and Control of Deafness (NPPCD): Focuses on early identification, treatment, and rehabilitation of hearing impairment caused by age-related degeneration, infections, and chronic acoustic trauma.
• National Tobacco Control Programme (NTCP): Operates under the COTPA Act (Cigarettes and Other Tobacco Products Act, 2003) to reduce tobacco demand through public bans, graphic warnings, cessation centers, and taxation.

Overview of Key NCD Interventions in India

Core NCD Facts

• Mortality Contribution: Non-communicable diseases account for approximately 63% of total deaths in India.
• Universal Screening Age: Population-based screening under NP-NCD targets all citizens aged 30 years and above.
• Covered Common Cancers: The primary screening mandate under primary healthcare covers oral, breast, and cervical cancers.
• Funding Structure: NP-NCD operates on a 60:40 Centre-State cost-sharing model, and a 90:10 ratio for North-Eastern and Himalayan States.
• Programme Renaming: The former NPCDCS programme was expanded and officially renamed as NP-NCD in 2023.
• Global SDG Alignment: Sustainable Development Goal (SDG) Target 3.4 aims to reduce premature mortality from NCDs by one-third by 2030.
• Primary Healthcare Hubs: Upgraded Sub-Centres and PHCs functioning as Ayushman Arogya Mandirs serve as the primary delivery points for NCD screening and medication.