India’s Mortality Landscape: The Growing Burden of NCDs and Persistent Communicable Diseases

Published on :- October 1st, 2026

India is in the midst of an epidemiological transition: non-communicable conditions like cardiovascular disease and diabetes now account for a growing share of deaths, causing nearly six in every ten deaths today. Communicable diseases, meanwhile, have fallen sharply as a share of mortality over the same period but still account for roughly two in ten deaths nationally.

NCDs also account for four of the five leading causes of DALYs (Disability-Adjusted Life Years—a measure of the total years of healthy life lost due to illness, disability, or premature death) in 2023, led by cardiovascular (CVD), respiratory diseases and diabetes, making it India’s largest disease burden. But this transition is far from uniform. Mortality and burden of disease varies significantly across states, regions and rural-urban populations, revealing a more complex picture than the national trend alone suggests. Understanding where disease burden and mortality are concentrated across diverse geographies and demographic groups—and where detection and treatment remain limited—is critical to ensuring that healthcare infrastructure, services, and funding are tailored to specific local needs rather than applied as a one-size-fits-all model.

UNDERSTANDING DRIVERS OF MORTALITY

For decades, India’s health challenges were closely associated with infectious and communicable diseases. But the country’s mortality profile is changing. Between 2005 and 2023, the share of deaths from communicable diseases nearly halved, falling from 36.5% to 19.7%, while non-communicable diseases (NCDs) emerged as the dominant cause of death in 2023, rising from 45.2% to 60.1% in 2023.

This burden is driven in large part by cardiovascular disease (CVD), which stands as a leading cause of mortality in India, contributing to one-third of all deaths and more than half of all NCD-related deaths.WHO highlights that the growing burden of chronic non-communicable diseases (NCDs) in India is driven by interconnected demographic and lifestyle shifts, including population ageing, rapid urbanization, and changing dietary and physical-activity patterns.

THE BURDEN OF MORTALITY VARIES ACROSS GEOGRAPHIES

This epidemiological transition of India is closely associated with economic development, but its pace and trajectory vary considerably across states. Recognising these disparities, the Government of India established the Empowered Action Group (EAG) in 2001 under the Ministry of Health and Family Welfare to focus on states that faced persistent challenges in population stabilisation and key health outcomes. The EAG comprises eight states—Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Odisha, Rajasthan, Uttar Pradesh, and Uttarakhand—which were identified for targeted public health attention given their socio-economic and health vulnerabilities. / In EAG states and Assam, communicable diseases still account for 27.6% of deaths—nearly twice the 15.4% recorded in Non-EAG states. In contrast, more economically developed states transitioned to NCD-led mortality nearly two decades earlier with 51.5% of the deaths attributed to NCDs in 2005.

India’s NCD transition is far from uniform. While NCDs account for 60.1% of deaths nationally, their share ranges from 43.3% in Central to 63.1% in the North East. The divide is even sharper for communicable diseases—from just 4.9% of deaths in the South to 20.2% in Central.

India may be entering an NCD-dominated era nationally, but the transition is unfolding at very different speeds across states—with communicable diseases still accounting for a substantial share of deaths in less economically developed regions. India’s cities are emerging as a major centre of the country’s NCD mortality burden, particularly among men. Urban men experience a 6.7 percentage-point higher share of deaths from NCDs than their rural counterparts, with this urban–rural gap widening across recent reporting periods. This points to a growing concentration of NCD mortality in urban areas, even as the broader epidemiological transition continues to unfold unevenly across the country. The picture is more complex beyond India’s cities. While communicable disease mortality has fallen to historic lows nationally between 2022 and 2024, rural areas continue to report a higher share of deaths from communicable diseases than urban areas, with a persistent 3 percentage-point gap across both sexes. India’s mortality profile therefore reflects a dual pattern: a growing concentration of NCD mortality in urban areas alongside a continuing communicable disease burden in rural regions.

RISK FACTORS DRIVING THIS BURDEN

The growing NCD burden is accompanied by rising levels of several major risk factors, including obesity, elevated blood pressure and high blood sugar, as observed between NFHS-4 and NFHS-6. Often associated with changing lifestyles and diets, these risk factors increase the risk of cardiovascular diseases and other chronic conditions.

Between 2013 and 2023, the contribution of risk factors such as high blood pressure, including hypertension, and high blood sugar increased by 105 and 565 per 100,000 population, respectively, to Disability-Adjusted Life Years (DALYs). NCD mortality has also been rising by approximately 2% annually, alongside a worsening risk-factor profile. Against this trajectory, India’s National NCD Monitoring Framework sets a target of a 25% relative reduction in the prevalence of raised blood pressure. Applying this target to the current prevalence estimates of 19.4% (F) and 22.1% (M) implies target prevalence levels of approximately 14.6% and 16.6%, respectively. For obesity and diabetes, the framework calls for halting the rise in prevalence, implying a target of 0% increase from the current baseline. At the current pace of change, it could take an estimated 8–9 years for hypertension prevalence to reach the target level, while the share of the population with elevated blood sugar has continued to increase over the past three years.

THE STATE RESPONSE

As NCD risk factors continue to rise, timely screening and early detection are increasingly important. NCD clinic data provide insights into the utilisation of NCD services and the detection of major conditions, including cancer, diabetes, cardiovascular diseases and stroke. However, as these data capture only individuals who attended NCD clinics, they should not be interpreted as estimates of NCD prevalence in the general population. The data also reveal substantial variation across states in both clinic attendance and the detection of NCDs. In 2022, 9.91 crore people attended NCD clinics across India, equivalent to around 7,220 attendances per lakh population. Attendance varied widely—from 29,849 per lakh in Tamil Nadu to 501 in Assam and 2,774 in Bihar. Nationally, 60.6 lakh people were diagnosed with diabetes and 74.8 lakh with hypertension among clinic attendees. Around 17.2% of attendees were diagnosed with an NCD, although this reflects clinic attendees and should not be interpreted as population prevalence. Diagnosis rates also varied sharply—from 5.5% in Tamil Nadu to 58.2% in Assam and 53.1% in Bihar. These differences may reflect variations in who accesses clinics, screening and follow-up practices, and health-system capacity. Overall, the data point to significant variation across states in access to NCD screening and detection. This is particularly important given India’s growing NCD risk burden, with an estimated 20–30% of the population exposed to risk factors such as high blood sugar and/or overweight or obesity. Expanding preventive screening and routine health checks could enable earlier detection and management, while helping ensure that NCD services reach a broader share of the population across states.

HOW CSR CAN HELP?

Corporate health CSR is one potential source of funding to address India’s changing disease burden, but allocations do not fully reflect the country’s shifting mortality profile. In FY23–25, companies reported ₹22,845 crore in health CSR spending, of which ₹4,693 crore could be analysed based on project descriptions to identify what areas are attracting funding within healthcare. NCDs accounted for ~41% (₹1,934 crore) of this identifiable funding, making them a meaningful corporate health priority. However, funding is heavily concentrated in cancer, which received ₹1,202 crore (~25% of identifiable health CSR), while all other NCDs combined received ₹732 crore—around 40% less. Overall, corporate engagement with NCDs is growing, but remains concentrated in cancer rather than across the broader NCD burden.

NCD funding is growing, but the increase is being driven largely by cancer. Between FY23 and FY25, NCD funding grew at a 34.5% CAGR, rising from ₹491 crore to ₹888 crore. Cancer accounted for nearly 80% of this increase, growing at a 44.9% CAGR compared with 18.2% for non-cancer NCDs. This concentration is particularly notable given the broader NCD burden. Cardiovascular diseases (CVDs), among the largest contributors to NCD burden, received approximately ₹223.6 crore—11.6% of NCD funding and less than 1.1% of total analysed Health CSR funding over FY23–25. Diabetes received ₹57.2 crore, while respiratory diseases received just ₹1.2 crore. CKD was the only NCD category to experience a decline in funding, falling at an 11.1% CAGR. The concentration extends to the scale of individual projects. The two largest identified cancer projects were each worth around ₹30 crore and focused on advanced cancer radiotherapy, compared with approximately ₹14 crore for the largest identified cardiovascular health project and ₹5 crore for the largest diabetes project. Funding is also concentrated among a relatively small group of companies. Only 7.7% of companies (97) funded NCDs consistently across all three years, yet these companies accounted for 46% of identifiable NCD funding. This suggests that the growth in NCD-focused CSR is being sustained by a relatively concentrated set of corporate funders, with cancer receiving a disproportionate share of the increase.

THE CARE CONTINUUM

India’s NCD burden is rising faster than funding is responding. NCDs receive 1934 crores (as of FY23-25) of identifiable health funding, despite cardiovascular diseases alone accounting for nearly one third of deaths and much of its risk being preventable. The need also varies sharply across states, making geographically responsive funding critical. As India expands screening through NCD clinics and Ayushman Arogya Mandirs, the focus must extend beyond detection to treatment, adherence and follow-up. Ultimately, NCDs require a whole-of-society response—spanning health, nutrition, agriculture, education and healthier food environments—to prevent risk and sustain long-term care.

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