Noncommunicable diseases (NCDs) like heart attack, diabetes and stroke— often brushed aside as the cost of modern living — have emerged as the primary cause of death and disability worldwide, overtaking infectious diseases by a staggering margin, a study published in The Lancet has said.
Unveiled at the World Health Summit in Berlin this week, the comprehensive analysis, based on the Global Burden of Disease (GBD) 2023 study, reveals that NCDs such as ischemic heart disease, stroke, and diabetes are now responsible for nearly two-thirds of all global mortality and morbidity.
This shift in the landscape of global health is compounded by a demographic time bomb — an ageing population living longer but sicker lives, weighed down by chronic conditions.
“The evidence presented in the Global Burden of Disease study is a wake-up call,” said Dr. Christopher Murray, Director of the Institute for Health Metrics and Evaluation (IHME), University of Washington. “Government and healthcare leaders must respond swiftly and strategically to the disturbing trends that are reshaping public health needs.”
While diarrhoeal diseases dominated the mortality charts in 1990, today it is ischemic heart disease that claims the highest number of lives, with an age-standardised mortality rate (ASMR) of 127.82 per one lakh population. In contrast, diarrhoeal diseases — with an ASMR of 300.53 in 1990 — have seen significant decline, reflecting improvements in sanitation and infectious disease control.
The study also confirms a sharp descent of Covid-19, which, after peaking as the leading cause of death in 2021, dropped to the 20th position by 2023. However, the vacuum left behind by the virus has only underscored the growing dominance of lifestyle and environment-linked illnesses.
Other significant contributors to the global disease burden include chronic obstructive pulmonary disease (COPD), lower respiratory infections, and neonatal disorders, highlighting the persistent challenge of maternal and child health in lower-income countries.
In India, the trend mirrors the global pattern. Ischaemic heart disease, stroke, and diabetes are now the leading causes of both mortality and disability, posing a grave challenge to a public health system still calibrated for managing infectious diseases.
With nearly half of all deaths and disability attributable to modifiable risk factors such as high blood sugar, elevated body mass index (BMI), and uncontrolled hypertension, experts suggest a national reckoning is overdue.
“These are not unavoidable outcomes. They are largely preventable with the right public health policies and individual behavioural changes,” said a senior epidemiologist from AIIMS, speaking on condition of anonymity.
While global life expectancy has rebounded to pre-pandemic levels — 76.3 years for females and 71.5 years for males — thanks to medical and nutritional advances, the quality of those extended years remains a matter of concern.
Despite a 67 per cent decline in global ASMR since 1950, the world’s ageing population is experiencing longer lives with sustained periods of disability and chronic illness. Alarmingly, mental health disorders have surged during this period, with anxiety disorders increasing by 63 per cent and depressive disorders by 26 per cent, according to the GBD analysis.
Contrary to general belief, the study finds that adolescents and young adults are facing increasing health threats. Suicide, drug overdose, and excessive alcohol consumption are now among the top causes of mortality in this age group — a trend attributed to social instability, economic stress, and lack of mental health infrastructure.
Beyond individual behaviours, lead exposure, air pollution, and rising ambient heat continue to pose serious threats to public health. The data also connects sexual abuse and intimate partner violence with long-term mental health consequences, including depression and anxiety, urging a broader social policy response.
“These are not just health issues — they are reflections of systemic inequalities and policy gaps,” said a public health expert from the Indian Council of Medical Research (ICMR).
As the global health community digests the findings of this pivotal report, one message is clear: a curative model is no longer sufficient. The scale and complexity of NCDs demand a preventive, policy-driven approach that targets root causes — from dietary reform and urban design to healthcare access and gender equity.
The GBD study draws upon data from 204 countries, covering 375 diseases and injuries and 88 risk factors, making it the most comprehensive such assessment to date.
If governments, particularly in developing nations like India, fail to recalibrate their health priorities, the current “disease of affluence” may soon become a disease of neglect — one that burdens future generations with prolonged suffering, preventable deaths, and irreversible health system strain, warned the study.
