Model Answer

Introduction

India is undergoing an epidemiological transition — a shift from infectious diseases to chronic Non-Communicable Diseases (NCDs) — which now account for roughly 65% of deaths in the country, with nearly one-quarter of these deaths occurring below the age of 70. This changing disease profile demands a reorientation of public health priorities from episodic curative care to long-term prevention, early detection and management.

Body

• Causes: The transition is multi-factorial. Rapid urbanisation, sedentary lifestyles, unhealthy diets and rising obesity have increased metabolic disorders such as diabetes and cardiovascular disease. Environmental degradation and air pollution have amplified respiratory diseases — COPD alone contributes to over 75% of India's respiratory disease burden. Demographic ageing increases the population at risk of chronic conditions. Health-system factors — limited diagnostic capacity at PHC/CHC level, late presentation and low community awareness — further worsen outcomes.
• Consequences: Early deaths from NCDs reduce productive life years, strain household finances and increase catastrophic health expenditure. For older adults, multimorbidity lowers quality of life and increases dependency, challenging social support systems and public finances.
• Measures: A comprehensive response should be preventive, promotive and curative:
  1. Primary-level strengthening: Equip PHCs/CHCs with simple diagnostic tools (glucometers, spirometers), training for guideline-based diagnosis and referral protocols.
  2. Health promotion & school programmes: National campaigns and school curricula to instil healthy eating, physical activity and tobacco-free norms from childhood.
  3. Environmental synergy: Integrate health objectives with environmental policies — reduce air pollution, promote active transport and healthy urban planning.
  4. Policy & fiscal tools: Tax unhealthy products, regulate advertising of junk food, expand health insurance coverage for chronic care and subsidise essential NCD medicines.
  5. Research & surveillance: Strengthen NCD surveillance, invest in translational research linking nutrition, ecology and chronic disease, and monitor outcomes.

Conclusion/Way Forward

Managing the NCD challenge requires a whole-of-government and whole-of-society approach that prioritises prevention, strengthens primary care diagnostics and aligns environmental and nutritional policy with health goals to safeguard India's demographic dividend.