Noncommunicable diseases (NCDs)

Overview

Keyfacts

Digital Interventions

Additional Resources

Quiz

  • Overview

    Noncommunicable diseases (NCDs), commonly called chronic diseases, are long-lasting conditions influenced by genetic, physiological, environmental, and behavioral factors. The diseases pose a significant global health challenge, responsible for the majority of deaths worldwide and impacting people across both high-income and low-income settings. The most common NCDs include cardiovascular diseases (CVDs), cancers, chronic respiratory disorders, and diabetes mellitus.

    There are three risk factors for NCDs: modifiable behavioral, metabolic, and environmental. The modifiable behavioral factors consist of tobacco consumption (including second-hand smoking), physical inactivity, unhealthy diet, and harmful use of alcohol. Raised blood pressure, overweight obesity, hyperglycemia, and hyperlipidemia are the key metabolic factors. Environmental risk factors largely include air pollution.

  • At the Global Level (World Health Organization, 2024)

    • About three-quarters of all global deaths (74.0%) occur due to NCDs, amounting to 41 million people.
    • Of all these deaths, 77.0% are from low- and middle-income group countries.
    • Among all NCDs, cardiovascular diseases hold the weight of most NCD deaths (17.9 million) annually. While cancers are responsible for 9.3 million deaths, followed by chronic respiratory diseases (4.1 million), and diabetes (2.0 million).
    • Regarding risk factors, tobacco consumption, including second-hand smoke, accounts for 8 million deaths worldwide, followed by air pollution caused 6.7 million deaths, of which NCDs contributed to 5.7 million deaths.
    • Of all the deaths attributable to alcohol use, more than half are from NCDs, 1.8 million deaths are attributed to excess salt/sodium intake, and 830,000 can be attributed to physical inactivity annually.

  • At National Level

    • Approximately 64% of all deaths are due to NCDs in India, which also impacts the economic growth of the country. It is estimated that the financial loss attributed to NCDs (including mental health) would reach US dollar 3.55 trillion between 2012 and 2023.
    • According to the Indian Council of Medical Research, the changes in Daily Adjusted Life Years (DALYs) proportions between 1990 and 2016, as posted in 2022, are 2.9% to 6.6% for CVDs, 2.9% to 4.4% for CRDs, 0.7% to 2.2% for Diabetes, and 0.7% to 0.9% for breast cancer.
    • According to the National Family Health Survey-5, 2019-21, the prevalence of hypertension (elevated blood pressure (Systolic ≥140 mm of Hg and/or Diastolic ≥90 mm of Hg) or taking medicine to control blood pressure) among adult women was 23.6% and 26.6% among males.
    • The prevalence was reportedly higher among urban populations, by 3.4% for women and 3.9% for men than among the rural population.
    • Sikkim has the highest prevalence of hypertension, i.e., 35% among women and 42% among men.
    • The survey also concluded that 17.9% and 16.3% of men and women had blood glucose levels >140 mg/dl or were taking medicine to control their blood sugar levels, respectively.

  • Global Level Interventions

    Be He@lthy, Be Mobile (BHBM): This is a global mobile health (mHealth) effort spearheaded by the World Health Organisation (WHO) and the International Telecommunication Union (ITU). The program helps governments use mobile technology to address priority health issues and strengthen existing national health programs for preventing, managing, and treating health problems and diseases. Since its inception in 2013, BHBM has reached 3.7 million people through 16 programs in 12 countries. It offers evidence-based behavior change information and assists governments in designing and integrating digital health services into existing health systems. The mobile technology was used to create awareness (through SMS messages), train health workers, provide remote consultation services, and prevent and treat NCDs. The types of mHealth tools used were one-way or two-way text messaging, IP messaging services (such as WhatsApp and Facebook Messenger), unstructured supplementary service data (USSD), interactive voice response systems (IVRS), and mobile applications.

  • National Level Interventions

    The India Hypertension Control Initiative (IHCI): The Indian Hypertension Control Initiative (IHCI) is a five-year collaboration between the Ministry of Health and Family Welfare, the Indian Council of Medical Research, the state governments, and WHO-India. Addressing India’s rising hypertension epidemic, where 20 crore adults are affected and just 2 crore have it under control, IHCI supports the government’s “25 by 25” objective. This goal is to reduce early NCD mortality and high blood pressure prevalence by 25% by 2025. IHCI aims to improve hypertension management by focusing on five components: 1. Treatment protocol, 2. medical supply, 3. task sharing and team-based care, 4. information systems, and 5. patient-centered care.

    The states implying the initiative use a ‘Simple app’ to support large-scale hypertension and diabetes programs. The healthcare workers use the app to record blood pressure, blood sugar, and medicines at every patient visit. The key features of the app are:

    Personalized SMS/WhatsApp reminders, Simple telemedicine, overdue patient lists, Patient line lists, Secure calling, Offline first design, patient ID cards, patient reports, automatic report update and translation to 16 languages, and risk analysis.

Digital health interventions to address non-communicable diseases in low- and middle-income group countries are presented below.

Table 1: Types of Digital Health Interventions used globally

S. No.  Digital Health Interventions WHO classification of digital health interventions
A. For beneficiaries 
1. Short message services Targeted client communication
2. Multimedia message services Targeted client communication
3. Interactive voice response or phone calls Targeted client communication
4. Web-based/online telecare platforms Targeted client communication, untargeted client communication, on-demand information services to clients
5. Smartphone applications Targeted client communication, untargeted client communication, personal health tracking, on-demand information services to clients, client-to-client communication
B. For healthcare providers
1. Electronic health/medical record Client health records, client identification, and registration
2. Decisions support systems Healthcare provider decision support
3. Digital-based provider training sessions Healthcare provider training
4. Telemonitoring devices, including point-of-care systems Telemedicine, laboratory, and diagnostics Imaging management
5. Digital-based health examination report, screening, and diagnosis Laboratory and diagnostics imaging management
6. Electronic prescriptions Prescription and medication management
7. Web-based/online telecare platforms Telemedicine
8. Smartphone applications Targeted client communication, untargeted client communication, healthcare provider communication, telemedicine, client health records, healthcare provider decision support
C. For data services
1. Electronic health/medical record Data collection, management, and use

Source: Xiong, S., Lu, H., Peoples, N., Duman, E. K., Najarro, A., Ni, Z., Gong, E., Yin, R., Ostbye, T., Palileo-Villanueva, L. M., Doma, R., Kafle, S., Tian, M., & Yan, L. L. (2023). Digital health interventions for non-communicable disease management in primary health care in low-and middle-income countries. NPJ digital medicine, 6(1), 12. https://doi.org/10.1038/s41746-023-00764-4

Global Programs and Policies

  • WHO Global Action Plan for the Prevention and Control of NCDs 2013-2020

    The WHO Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2020 outlines a comprehensive strategy for treating noncommunicable diseases (NCDs), which include cardiovascular disease, cancer, chronic respiratory disease, and diabetes. This plan, approved by the World Health Assembly in May 2013, offers several policy alternatives and tactics that Member States, international partners, and WHO may all work together to execute. Key goals include lowering early death from NCDs by 25% by 2025 through focused interventions and global collaboration. The strategy is consistent with the 2030 Agenda for Sustainable Development, including Sustainable Development Goal 3: ensuring healthy lives and promoting well-being for all ages.

    Read more about WHO Global Action Plan for the Prevention and Control of NCDs 2013-2020

  • The Global Non-Communicable Disease Compact 2020–2030

    The purpose of the NCD Compact is to speed up progress toward achieving the Sustainable Development Goals (SDGs) related to non-communicable diseases (NCDs) while taking into account the commitments outlined in the relevant resolutions passed by the United Nations General Assembly and the guidance from resolutions adopted by the World Health Assembly.

    Read more about The Global Non-Communicable Disease Compact 2020–2030

  • WHO Cervical Cancer Elimination Initiative: From Call to Action to Global Movement

    WHO launched its global strategy to expedite the elimination of cervical cancer as a public health issue on November 17, 2020, along with its associated goals and targets for 2020–2030. The strategy and accompanying resolution set specific targets to be achieved by 2030: 90% coverage for Human Papillomavirus (HPV) vaccination, 70% coverage for screening, and 90% access to treatment.

    Read more about WHO Cervical Cancer Elimination Initiative

National Programs

  • National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS)

    The Government of India has been implementing NPCDCS since 2010 to address significant NCDs at the district level as part of the National Health Mission. The key strategies and activities of the program are:

    • Generating health awareness and promoting healthy habits for early detection.
    • Implemented population-based screenings for diabetes, hypertension, and cancer in over 400 areas to promote early detection.
    • Ensuring prompt and cost-effective healthcare services through affordable diagnosis and treatment options.
    • Rehabilitation and follow-up services include psychosocial counseling, home-based care, and palliative care.

    Read more about National Programme for Prevention and Control of NPCDCS

  • Kerala’s Non-Communicable Disease Control Program

    The Non-Communicable Diseases (NCD) Control Programme in Kerala, piloted in Neyyattinkara Taluk and Wayanad district in 2008-09, improves NCD care by involving ASHA workers and collaborating with NRHM and state health services. It was expanded to Trivandrum in 2010-2011 to address Kerala’s high NCD prevalence due to urbanization and lifestyle changes. Amrutham Arogyam is an initiative focusing on risk factor reduction, health education, screening and free medicine for people over 30, and early management of complications. This holistic approach positions Kerala as India’s leader in NCD management.

    Read more about Kerala’s Non-Communicable Disease Control Program

Take the Quiz

Name(Required)
What are noncommunicable diseases (NCDs) often referred to as?
What percentage of all deaths worldwide are caused by NCDs?
Which of the following is NOT a common type of NCD?
What percentage of NCD deaths occur in low- and middle-income countries?
What are the four major types of NCDs mentioned?
What initiative helps governments use mobile technology to address health conditions globally?
Which program in India aims to control hypertension using digital tools?
Which state in India has the highest prevalence of hypertension?
In which year the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS) was implemented in India?
What is the primary goal of the WHO Global Action Plan for the Prevention and Control of NCDs 2013-2020?