Cancer, diabetes, hypertension largest cause of death

Lifestyle-related diseases are now killing more Indians than the infectious ones. India’s disease pattern has undergone a major shift over the past decade, says the World Health Organisation (WHO).

The latest WHO data paints a worrying picture. At present, out of every 10 deaths in India, eight are caused by non-communicable diseases (NCDs) such as cardiovascular diseases, cancers, chronic respiratory diseases and diabetes in urban India. In rural India, six out of every 10 deaths is caused by NCDs.

Similar is the trend in the Southeast Asian region. While NCD deaths have seen a 21% jump, infectious diseases deaths have fallen by 17%. The projection is that the South-east Asian region will have the greatest total number of NCD deaths in 2020: 10.4 million.

Speaking to TOI, Dr Nata Menabde, WHO representative to India, said: “Globally, 60% of the deaths are now caused by NCDs. Similar are the numbers in India. NCDs are affecting the entire globe. If not controlled, they will become a tsunami that will not only kill people but impair development and crash economies.”

Shocked by the alarming spike in NCDs, India is launching a comprehensive national programme to prevent and control these. Union health minister Ghulam Nabi Azad on Tuesday said: “The programme will be rolled out during the 12th Plan period starting 2012. It will cover all 640 districts. The programme will focus on health promotion, prevention of exposure to risk factors, early diagnosis, treatment of NCDs and rehabilitation.”

Calling for urgent action to check the rise in NCDs, mental health issues and injuries which account for twothird of the country’s total disease burden, Azad said: “India with an estimated 5.1 crore diabetics has the world’s second largest diabetic population following China. Unless effective measures are taken, India may have 8 crore diabetics by 2030. Similarly, the number of people affected by cardio-vascular diseases which was about 3.8 crore in 2005 may go up to 6.4 crore by 2015.”

The UN has taken note of the NCD menace. After the 2001 UN summit on HIV that made the world come together to fight the deadly AIDS virus, this September, NCDs are set to receive a similar push in New York.

To be attended by the who’s who, including PM Manmohan Singh, the historic UN General Assembly on the Prevention and Control of NCDs on September 19 and 20 will decide how to better prevent, diagnose and treat cancer, cardiovascular disease, chronic respiratory disease and diabetes, which together cause 8 million deaths worldwide, annually.

A ministry official said: “Till now, programmes to combat NCDs which cause 60% of all deaths were tremendously under funded. NCDs also remained a low priority and not included in the Millennium Development Goals. The high-level meetings running up to the UN NCD summit should change that.”

Cardiovascular diseases will be the largest cause of death and disability in India by 2020, WHO says. It is estimated that the overall prevalence of diabetes, hypertension, ischemic heart diseases (IHD) and stroke is 62.47, 159.46, 37.00 and 1.54 respectively per 1,000 population of India. Additionally, there are around 25 lakh cancer cases in India.

Calling it “an impending disaster for many countries – a disaster for health, for society and national economies,” WHO director-general Dr Margaret Chan said: “Chronic NCDs deliver a two-punch blow to development . They cause billions of dollars in losses of national income, and push millions of people below the poverty line, each and every year.”

According to a recent report, each year NCDs cause more than 9 million deaths before the age of 60 years. They also kill at a younger age in countries like India where 29% of NCD deaths occur among people under 60, compared to 13% in high-income countries.

Dr Ala Alwan, WHO’s assistant director-general for NCDs said: “About 30% of people dying from NCDs are under 60 and in their most productive period of life. These premature deaths are largely preventable.” Without action, the NCD epidemic is projected to kill 52 million people annually by 2030, Dr Alwan added.

Approximately 44% of all NCD deaths occur before 70. In countries like India, a higher proportion (48%) of all NCD deaths occur in people under the age of 70, compared with high-income countries (26%). Cardiovascular diseases were responsible for the largest proportion of NCD deaths under 70 (39%), followed by cancers (27%). Chronic respiratory diseases and digestive diseases were together responsible for 30% of deaths while diabetes was responsible for 4% of deaths.