The noncommunicable diseases challenge that will shape Fixit Bharat 2047

in Dhammapada Athakatha In Buddhist literature, Kissa Gautami asks Buddha to revive her dead child. Buddha asks Gautami to find a family that has never known death and get a few mustard seeds to bring their son back to life. She moved from house to house but found that each family had suffered loss. The lesson was that death, no matter how painful, is part of every human being’s life.

Today, another reality is affecting a growing number of Indian families: cardiovascular diseases. A heart attack or stroke can change not just one person’s life, but the health, finances and future of an entire family. In addition, it also affects the country’s economy as most people get heart attacks or strokes at an early age.

This is why India’s approach to healthcare must evolve. As the country works to become a developed nation by 2047, economic growth, digital transformation and world-class infrastructure will be important measures of progress. But so is the health of its people. India has made great strides in diagnosing and treating disease, but much of healthcare still focuses on managing disease after it occurs. Chronic diseases often develop silently over many years, making prevention and early detection equally important. For India, the next step should be to make maintaining health as important as treating disease.

Non-communicable diseases, including hypertension, diabetes, obesity, heart and lung diseases, cancer and mental health disorders, contribute to more than two-thirds of deaths and disabilities in India. These conditions are often seen as problems later in life, but this is increasingly not the case. Take, for example, a 40-year-old professional who was diagnosed with heart disease while supporting his family. Regular medications, medical expenses, and time away from work can affect not only their health but also their family’s finances. When NCDs affect people during their working years, the consequences extend beyond the individual to include families, workplaces, and the economy more broadly.

The latest ICMR-INDIAB study estimates that 101 million Indians have diabetes and 136 million have prediabetes. Nearly 315 million people suffer from high blood pressure, while 254 million people suffer from general obesity. These numbers indicate a growing metabolic health burden. The urban-rural gradient is also worrying, as the prevalence in urban areas is twice that of the rural population. Rapid urbanization, sedentary lifestyles, unhealthy diets, stress, and inadequate sleep can increase this burden and jeopardize India’s demographic dividend. The demographic dividend refers to the potential for economic growth resulting from having a large working-age population. Therefore, maintaining the health of this population is as important as creating jobs and expanding economic opportunities.

The encouraging news is that many of these conditions can be prevented. According to the World Health Organization, up to 80% of premature heart disease, stroke and type 2 diabetes can be prevented by addressing risk factors such as unhealthy diets, physical inactivity, tobacco use, harmful alcohol consumption, air pollution, treating high blood pressure and diabetes, and maintaining optimal body weight. Therefore, prevention must be a public health priority. It can reduce the financial and emotional burden of chronic disease on families, help people stay productive, and relieve pressure on health care systems. These benefits extend beyond the health sector and are fundamental to building a healthier and more resilient India.

The preventive healthcare ecosystem needs to operate at multiple levels. Regular health screenings, monitoring blood pressure and blood glucose, improving health literacy, healthier workplaces, improved nutrition, and opportunities for physical activity can all help identify and control disease early to prevent future disaster. This also means enhancing the continuity of care, starting with primary prevention, through treating risk factors before the disease develops, through to early diagnosis, treatment and rehabilitation. India already has platforms that can support this approach.

Examples include the Ayushman Arogya Mandirs, which brings preventive and primary healthcare closer to communities, while the Pradhan Mantri Ujjwala Yojana reduces household exposure to smoke by enabling access to LPG connections. Strengthening such programs, along with reliable drug supply chains and longer prescriptions, can make preventive and ongoing care more accessible.

Technology can further support this transformation, but only if it is designed at scale. Artificial intelligence, connected diagnostics, predictive analytics, and digital health platforms can help identify risks early, monitor patients remotely, and expand care beyond hospital walls. However, expensive devices and smartphone-based solutions will only reach a small portion of India’s population.

The focus should therefore be on affordable technologies that can work through existing primary health care networks and community health workers. The measure of success should not be how advanced technology is, but rather how many people it can help reach and stay healthy.

Creating a healthier India cannot be the responsibility of the healthcare sector alone. Employers can promote healthier workplaces. Schools can help children develop healthy habits early. Urban planners can design neighborhoods that make walking and physical activity easier.

Policymakers can promote access to preventive services, while communities can help build awareness and encourage healthy behaviors. Health must become a cross-sector consideration, not an issue addressed only when someone is admitted to hospital.

A developed India is ultimately built by healthy people. For Vixit Bharat 2047 to be more than just an economic ambition, prevention must become a defining part of India’s healthcare strategy. It should not simply be the goal Add years to life But to add Life to years.

Professor Durairaj Prabhakaran, Executive Director, Center for Chronic Disease Control (CCDC)