Non-communicable diseases (NCDs) are no longer silent threats on the periphery of India’s health agenda—they have become a defining challenge of our time, shaping both the nation’s demographic future and economic stability. With cardiovascular diseases, diabetes, cancers, and chronic respiratory ailments now accounting for nearly two-thirds of all deaths, the scale of the crisis is staggering. A recent Indian Council of Medical Research study highlights a sobering reality: 71% of Indian adults are metabolically unhealthy, even when they appear outwardly well. Coupled with the fact that one in three Indians is pre-diabetic, two in three are pre-hypertensive, and one in ten suffers from depression, the picture reveals both medical and societal vulnerabilities.
In this guest column, Sunish Jauhari, India President of Arogya World, argues that what makes the problem even more concerning is its intergenerational impact—overweight and obesity now affect one in five households, including children, reflecting deeply ingrained lifestyle patterns. Rising sales of cardiac medicines further point to a system overly reliant on treatment. Jauhari underscores the urgent need to move from policy intent to lived practice, championing a prevention-first approach that brings schools, workplaces, communities, and urban design into India’s roadmap for better health.
From Policy to Practice: Charting India’s Roadmap to Beat the Growing NCD Crisis
Looking at the pace at which non-communicable diseases are growing in India, it has the potential to destabilise the country’s demographics and economy. On the other hand, if addressed mindfully, it could put avert an impending crisis and put India on a track of more sound development, as the country prepares for 2047.
A recent study led by the Indian Council of Medical Research (ICMR) presents a serious narrative: 71% of Indian adults are metabolically unhealthy, even while appearing healthy, raising health concerns. Among the significant NCDs are cardiovascular diseases and diabetes, cancers and chronic respiratory disease are accounting for 63% of deaths in India. Everyday data indicate that lifestyle changes are all too obvious - 1 in 3 Indians are pre-diabetic, 2 in 3 are pre-hypertensive, and 1 in 10 Asian Indians are affected by depression, to a greater extent than can be explained or understood through health conditions.
The burden of unhealthy living is not borne by individuals alone but by the entire healthcare system. In India, one in five households is overweight or obese. This includes children as well as adults. This highlights the fact that unhealthy living is not just widespread in today’s generation butcarries on across generations as a result ofnormalized family behavior.
According to the Pharmarack report published in June 2025, sales of cardiac medicines rose sharply from ₹1,761 crores to ₹2,645 crores, reflecting both the rising incidence of lifestyle diseases and an over-reliance on medication. What is still absent is an equal degree of attention given to preventative and early intervention measures in the public health system. The data underscores India’s push towards a healthcare system that seeks to prevent diseases instead of merely treating them; thus, recognizing that India's struggle with non-communicable diseases represents an equal challenge in social determinants as it is in the medical.
Policy Foundations: India's Framework for NCD Control
Over the past two decades, India has established a robust policy framework to respond to its burden from NCDs. Investments in nationally backed programs such as the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) and Ayushman Bharat Health and Wellness Centres, have highlighted three main aspects of NCD practice: screening, early detection and management. Additionally, the National Health Policy 2017 stated an overarching aim to reduce premature mortality from NCDs by 25% by the year 2025, as in alignment with the WHO "25x25" Global Goal.
There have been regulatory efforts aimed at reducing risk exposure. For instance, the Food Safety and Standards Authority of India (FSSAI) has led various campaigns to raise awareness around the importance of mandatory nutrition labelling on packaged foods. Additionally, it has led public awareness drives for tobacco control legislation and restriction on advertisement of unhealthy foods.
Yet, while policy frameworks are widely available, upward trends in obesity, diabetes, and cardiovascular disease data call attention to the need for a collaborative effort. The challenge is the translation of policy from ideas and language into our everyday actions.
A Roadmap for Action: From Policy to Practice
Effective tackling the NCD crisis will require a whole-of-society approach definitive in success and transformative to our approach to health from "treatment to prevention" and "policy to lived practice".
Reimagining Schools as Health Hubs
Schools must be a primary site of transformational behavioural change. This can include mandates for daily physical activity, while also introducing health literacy into their curricula. Tools such as Sugar and Oil Boards can educate children about hidden sugars and fats to encode new healthy habits early in life. School meals through mid-day meal schemes should focus on balanced nutrition, limiting processed foods and focusing on healthy, whole foods.
Building High-Functioning, Community-Based Preventive Care
Primary health workers and community wellness centres must be able to conduct regular NCD risk screening for blood pressure, blood sugars, BMI and waist-to-hip ratio. Digital health tools and mobile applications can incorporate screening into the ecosystem, follow up on check lists and maintain local health dashboards for future state planning.
Establishing Healthy Places
Workplaces can be a major player in support of preventive health - either through annual health check-ups, annual health risk assessment, or by offer wellness programs or healthy cafeteria options. Workplaces also build aspiration and hence influence private spaces. On the other hand,urban planning could promote physical activity by design -include bicycle tracks, safe walkinginfrastructure and pedestrian zones, and public gym facilities - moving it from being an exception to being a norm. This also includes addressing all forms of pollution, affecting air quality, which has been a struggle for all the major cities in India in the recent years.
Active Use of Behavioural Science
Public health campaigns must also move from being informative towards nudging behaviour. Techniques include using labels with “high sugar” or “high salt” messages and limits on portion size in restaurants as well as taxes on sugary drinks and warnings on dangerous fads. Behavioural science can help to better structure and inform groups to make it easy, cheaper, and socially desirable for citizens to choose the healthier option where possible.
Multi-sectoralapproach
It is critical for governments, NGOs, schools, businesses, and media to align their messaging and actions. The only option for countering the multifactorial drivers of NCDs requires government, civil society, businesses and media to act as “whole-of-government, whole-of-society”.
Towards a healthier future
India is facing a serious NCD crisis that has evolved from a health issue that many people couldn’t access to a major challenge that’s vital for the country’s progress. Given that 60-85% of the population is suffering from metabolic health issues, the demographic advantage of the country stands at a risk. Thus, this needs to be tackled as if it continues then the productivity is expected to suffer significantly; this will in turn increase health costs for future generations.
Our health system needs to prioritize prevention above all. This is the key to making policies effective in the long run, especially when we integrate healthy habits into schools, workplaces, and communities. One non-negotiable to doing this effectively is for different sectors and departments to work together. Education, health, work, play etc are different functions of the same life! Often times, the reason why we do not move forward, or go two steps back, is disintegrated and siloed functioning. By joining up efforts, and adopting systematic approaches, we can transform India’s healthcare model from one focused on treatment to one centered on care. Not only will this lead to healthier citizens, but it will also foster a more reliable and resilient economy, which is the one thing we all want.
