India won’t meet UN targets to reduce premature mortality from major non-communicable diseases: ICMR-NCDIR

NCDs account for 66 per cent of all deaths in India, of which 22 per cent were premature deaths in 2019

By Seema Prasad
Published: Wednesday 25 October 2023
The four major non-communicable diseases are cancer, cardiovascular disease, chronic respiratory diseases, and diabetes. Photo: iStock__

India will likely miss reaching targets set by the World Health Organization (WHO) and the United Nations-mandated Sustainable Development Goals (SDG) to reduce premature deaths from four major Non-Communicable Diseases (NCD), according to an analysis by the Indian Council of Medical Research (ICMR).

The premature mortality rate for four major non-communicable diseases (NCD) namely cancer, cardiovascular disease (CVD), chronic respiratory diseases (CRD), and diabetes, is projected to decrease by 13.9 per cent from 2010 to 2025 in India.

Therefore, the country’s progress toward the WHO target of a 25 per cent reduction in premature mortality for the four NCDs by 2025, compared to 2010, will likely be missed by a considerable margin.

The “25 by  25  target” was outlined when the WHO adopted a global NCD monitoring framework in 2013. 

The SDG target to reduce premature deaths from the four major NCDs by a third from 2015 to 2030 will also likely be missed by India as the researchers projected a decline of 15.6 per cent from 2015 to 2030.

The assessment was conducted by the ICMR’s National Centre for Disease Informatics and Research (NCDIR) in Bengaluru.

“The publicly available data from the census for population and the Sample Registration System (SRS) for cause of death by 5-year-age groups were extracted. Age-standardised premature mortality rates, unconditional probability of dying, and annual percent change (APC) were computed,” the researchers explain their methods in the paper.

“The percentage changes in premature mortality from 2010 to 2025 were 33.9 per cent, 17.4 per cent, 9.3 per cent, and 6.9 per cent for CRD, cancer, CVD, and diabetes respectively. For 2015–2030, these changes were 21.7 per cent, 11.5 per cent, 15.4 per cent, and 15.1 per cent,” the results said.

The WHO has defined the unconditional probability of dying (UPoD) from the four NCDs between the ages of 30 and 69 as the progress indicator for monitoring the reduction in premature mortality.

“The UPoD from the 4NCDs was 24.4 per cent in 2010 and is projected to be 21.0 per cent and 20.0 per cent in 2025 and 2030, indicating a relative reduction of 13.9 per cent by 2025 from 2010 and 15.6 per cent by 2030 from 2015,” the report said.

The study found that UPoD was higher among males, particularly around the age of 44, owing to risk factors such as tobacco use and alcohol consumption. The reduction in UPoD depends on other risk factors, such as physical inactivity, overweight/obesity, inappropriate diet (including high salt intake), and high systolic blood pressure.

In comparison, lower and middle-income countries are reducing NCDs at a higher rate at 25.1 per cent. Other countries previous reduction rates include Moldova (25 per cent), Peru (23.2 per cent among women), China (38.7 per cent), and Sweden (26.6 per cent).

Furthermore, based on the current analysis, the target of 25 per cent (WHO) and 33 per cent (SDG) could possibly be reached by 2039 and 2053 in India, the researchers calculated.

Four of 10 NCD deaths are premature and occur before the age of 70. The majority of these premature deaths occur in low- and middle-income countries, resulting in productivity loss and economic impact, the WHO said. NCDs account for 66 per cent of all deaths in India, of which 22 per cent were premature deaths in 2019, according to the WHO’s NCD data portal.

Some of the surveillance programmes include the National Program for Noncommunicable Diseases, the National Tobacco Control Program, the Eat Right India movement, the National Health Policy of 2017, and the National multi-sectoral action plan for prevention and control of Common NCDs 2017-2022.

The impact of the implementation of such programmes should be monitored, and their impact can be evaluated by studying the premature mortality due to NCDs, the researchers said.

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