Source: Hindu

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Context

• India is experiencing a significant epidemiological transition characterized by a rise in non-communicable diseases (NCDs) alongside persistent infectious diseases.
• This dual burden presents unique challenges to the healthcare system, requiring integrated strategies for prevention and management
  

Details

Non-Communicable Diseases (NCDs)

• Non-communicable diseases are chronic conditions that are not transmitted from person to person.
• They include cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes.
• NCDs account for a significant portion of morbidity and mortality in India.

Prevalence and Statistics

• Cardiovascular Diseases: The leading cause of death, accounting for 28.1% of total deaths in 2016​​.
• Diabetes: India has the second-highest number of diabetes cases in the world, with an estimated 77 million adults affected in 2019​.
• Cancer: The incidence of cancer is rising, with an estimated 1.3 million new cases diagnosed annually​.
• Chronic Respiratory Diseases: Conditions like chronic obstructive pulmonary disease (COPD) and asthma are prevalent, with COPD alone affecting over 55 million people​​.

Risk Factors

• Lifestyle Choices: Poor diet, physical inactivity, tobacco use, and excessive alcohol consumption.
• Environmental Factors: Air pollution is a significant risk factor, especially for respiratory diseases.
• Genetics: Family history can increase the risk of certain NCDs.

Government Initiatives

• National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS): Launched in 2010, this program aims to prevent and control NCDs through awareness, early diagnosis, and management​​.
• Ayushman Bharat: A comprehensive healthcare initiative that includes health promotion and preventive measures for NCDs​​.

Infectious Diseases

• Infectious diseases remain a major public health concern in India.
• These diseases are caused by pathogenic microorganisms such as bacteria, viruses, parasites, or fungi and can spread directly or indirectly from one person to another.

Prevalence and Statistics

• Tuberculosis (TB): India has the highest burden of TB in the world, with an estimated 2.7 million cases in 2018.
• HIV/AIDS: Around 2.1 million people are living with HIV in India as of 2017​​.
• Malaria: India reported around 338,000 malaria cases in 2018, although the actual number may be higher due to underreporting​​.
• Dengue: Seasonal outbreaks are common, with several thousand cases reported annually​.

Challenges

• Drug Resistance: Rising cases of drug-resistant TB and antimicrobial resistance are major challenges.
• Infrastructure: Inadequate healthcare infrastructure, particularly in rural areas, hampers effective disease management.
• Awareness and Education: Lack of awareness and education about preventive measures contributes to the spread of infectious diseases.

Government Initiatives

• National Tuberculosis Elimination Programme (NTEP): Aims to eliminate TB by 2025 through comprehensive strategies including early detection and treatment​​.
• National AIDS Control Programme (NACP): Focuses on prevention, testing, and treatment of HIV/AIDS​ ​.
• National Vector Borne Disease Control Programme (NVBDCP): Manages diseases like malaria, dengue, and chikungunya through vector control measures and public awareness campaigns​​.

Morbidity Trends

A study published in PLOS ONE analyzed morbidity data from the National Sample Survey Organisation (NSSO) for the years 1995, 2004, 2014, and 2018. Key findings include:

• Overall Morbidity: Doubled from 56 per thousand in 1995 to 106 per thousand in 2014, but dropped to 79 per thousand in 2018.
• NCDs: Prevalence increased more than three times from 8.6 per thousand in 1995 to 30 per thousand in 2018.
• Infectious Diseases: Prevalence almost doubled from 8 per thousand in 1995 to 15 per thousand in 2018 .

State-Wise Disparities

• High Prevalence States: Kerala, Andhra Pradesh, Karnataka, West Bengal, and Punjab have higher prevalence rates for NCDs.
• Low Prevalence States: Northeastern states like Manipur, Meghalaya, and Nagaland report lower prevalence rates .

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NCD in India

Sources:

Hindu

PRACTICE QUESTION Q: India faces a complex health landscape with the dual burden of NCDs and infectious diseases. Effective management requires a multifaceted approach. Comment. (250 Words)