Chronic non-communicable diseases (NCDs) such as heart disease, stroke, and lung ailments have overtaken infections as India’s leading killers, according to the Global Burden of Disease 2023 study published in The Lancet.
For decades, infectious diseases like tuberculosis and diarrhoea dominated India’s mortality landscape. But as lifestyles, diets, and air quality have changed, chronic illnesses now account for most deaths.
The study found that by 2023, ischaemic heart disease had become the top cause of death, with an age-standardised mortality rate (ASMR) of 127.82 per lakh, followed by chronic obstructive pulmonary disease (COPD) at 99.25 and stroke at 92.88. In 1990, diarrhoeal diseases had led with an ASMR of 300.53.
COVID-19, which dominated in 2021, has now dropped to the 20th position.
Globally, NCDs now cause nearly two-thirds of all deaths — a pattern mirrored in India.
The country’s overall death rate declined from 1,513 per lakh in 1990 to 871 in 2023, and life expectancy rose from 58.5 to 71.6 years. Yet, between 2010 and 2019, deaths from NCDs in India continued to rise, with women showing a sharper increase in risk than men.
Experts said the findings demand a major health policy shift — from controlling infections to preventing and managing chronic conditions.
The report urged stronger primary care systems for early detection of hypertension, diabetes, and cancers, along with preventive efforts such as tobacco control, healthier diets, and air pollution reduction.