Non-communicable diseases (NCDs) are responsible for maximum out-of-pocket expenditure on health, and economic output lost due to them, excluding mental conditions, is estimated to be USD 3.55 trillion for the country for 2012-2030, the government said on Wednesday. In view of the growing burden of non-communicable diseases, associated morbidities and mortalities, the government has also widened the ambit of the prevention and control programme for NCDs by including chronic obstructive pulmonary diseases and asthma, chronic kidney diseases and non-alcoholic fatty liver diseases.

With the inclusions, the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) has now been renamed as the National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD), the government said.

NCDs are estimated to account for 63 per cent of all deaths in the country of which cardiovascular diseases lead with 27 per cent overall mortality cause followed by chronic respiratory diseases (11 per cent), cancers (nine per cent), diabetes (three per cent) and others (13 per cent), according to the World Health Organisation‘s NCD-India profile for 2018.

In the revised operational guidelines for the NP-NCD, released on Wednesday, the government also said, “Non-communicable diseases (NCDs) are responsible for maximum out-of-pocket expenditure on health, and economic output lost due to them, excluding mental conditions, is estimated to be USD 3.55 trillion for the country for 2012-2030.”

The document of the Union health ministry that focuses on comprehensive primary health care stated that “comprehensive primary health care (CPHC) has an important role in the primary and secondary prevention of several disease conditions, including NCDs which today contribute to 63 per cent of the mortality in India”.

The provision of primary health care reduces morbidity, disability and mortality at much lower costs and significantly reduces the need for secondary and tertiary care, it said.

The document noted that as a step towards ensuring promotive, preventive, curative, palliative and rehabilitative aspects of universal healthcare, the government launched the Ayushman Bharat scheme in 2018. It has two components to ensure universal health coverage — Ayushman Bharat Health and Wellness Centres and Ayushman Bharat-Pradhan Mantri Jan Aarogya Yojana (PM-JAY).

This ensures CPHC at the primary level and provision of financial protection for accessing curative care at secondary and tertiary levels through engagement with both public and private sector.

The operational guidelines for the NP-NCD has been developed for policymakers of different levels, government officials, NGOs, peripheral health care providers and other stakeholders with the purpose of providing an understanding of promotive, preventive and curative approach to reduce morbidity and mortality due to NCDs.

The incidence of cancer in India is 13.92 lakhs, according to the the report of National Cancer Registry Program (2020), and among males, cancers of lung, mouth, oesophagus and stomach are the leading sites across most of registries. Breast cancer is the commonest cancer followed by cervical cancer among females.

The document provides guidance to programme managers for effective implementation of NCDs strategies with purpose of significant improvement of various NCDs indicators in the next seven years by 2030.

The guidelines have been shared with states and Union territories for implementation to strengthen health care services for the NCDs across all levels of care, and to enable a continuum of care approach.