A major shift has been observed in India’s health profile, with chronic lifestyle-related diseases now surpassing infectious diseases as the leading cause of death in the country, according to new findings published in The Lancet’s Global Burden of Disease (GBD) Study 2023.

The study reveals that illnesses such as heart disease, stroke, and chronic lung disease have become the primary causes of mortality, replacing infectious diseases like diarrhoea, tuberculosis, and respiratory infections that once dominated India’s health landscape.

Heart Disease Tops the List

The report indicates that by 2023, ischaemic heart disease emerged as the single largest cause of death in India, with an age-standardised mortality rate (ASMR) of approximately 127.8 per lakh population. Chronic obstructive pulmonary disease (COPD) followed closely with 99.2 per lakh, while stroke accounted for 92.8 per lakh deaths.

In comparison, diarrhoeal diseases — which were among the leading killers in 1990 with an ASMR of 300.5 per lakh — have drastically declined, reflecting the country’s success in combating infectious illnesses.

Life Expectancy Rises, But New Health Risks Emerge

India’s overall mortality rate has dropped significantly over the past three decades — from about 1,513 per lakh in 1990 to 871 per lakh in 2023. During the same period, the average life expectancy rose from 58.5 years to 71.6 years.

However, experts caution that longer life expectancy has brought with it a growing burden of chronic illnesses. Between 2010 and 2019, the probability of dying from a non-communicable disease before the age of 80 increased for both men and women, with women experiencing a sharper rise.

Changing Disease Landscape

Public health experts attribute this transition to several factors: improved control of infections through vaccination, sanitation, and medical advancements, alongside lifestyle changes associated with urbanisation, such as unhealthy diets, physical inactivity, and increased stress.

Environmental issues — particularly air pollution — have further contributed to the surge in cardiovascular and respiratory diseases. With more people living longer, India’s population is also more exposed to chronic conditions that develop over time.

Health System Faces New Challenges

The shift from infectious to lifestyle-related diseases presents complex challenges for India’s healthcare system. While infections often require short-term treatment, chronic conditions demand lifelong management, regular follow-ups, and lifestyle interventions.

Experts have emphasised the need to:

• Strengthen primary healthcare for early screening and management of hypertension, diabetes, and other NCDs.
• Promote preventive care and awareness campaigns focusing on diet, exercise, and smoking cessation.
• Improve surveillance systems to monitor disease patterns and risk factors at regional and national levels.
• Reorient healthcare spending to allocate adequate resources for NCD prevention and long-term care.

Warning Signs for the Future

Doctors warn that unless urgent measures are taken, India could face a dual health crisis — managing both the residual threat of infections and the rising wave of lifestyle diseases. The growing prevalence of obesity, diabetes, and hypertension among younger populations is particularly concerning, indicating an early onset of chronic conditions.

“India has made tremendous progress in controlling communicable diseases. But we are now entering a stage where lifestyle-related illnesses threaten to reverse those gains,” said a senior health researcher involved in the study.

Policy Implications

Public health officials are calling for an integrated approach that combines preventive healthcare, policy reform, and behavioural change. Stronger tobacco control, improved air quality, and nutrition education are considered essential steps.

Investments in community health centres, digital health monitoring, and chronic disease registries can further strengthen India’s response to this growing challenge. Experts also stress the importance of ensuring equitable access to diagnosis and treatment across rural and urban areas.

India’s health success story — marked by declining deaths from infections and improved life expectancy — is now at a crossroads. The rise of non-communicable diseases highlights the urgent need for a national strategy focused on prevention, early detection, and long-term management.

Without decisive action, the very progress that lifted millions out of infectious disease risk could be overshadowed by the growing epidemic of lifestyle-related illnesses.