The landmark Global Burden of Disease (GBD) Study 2023, published this week in The Lancet and Journal of the American College of Cardiology (JACC), shows that while people worldwide are living longer, health inequalities and chronic lifestyle-related diseases are on the rise.
The GBD 2023, presented at the World Health Summit in Berlin, reveals that deaths from infectious diseases like tuberculosis, diarrhoea, and malaria have dropped sharply since 1990.
However, deaths due to non-communicable diseases (NCDs) such as heart disease, stroke, diabetes, cancer, and mental health disorders now dominate, accounting for nearly two-thirds of global mortality.
“The rapid growth in the world’s ageing population and evolving risk factors have ushered in a new era of global health challenges,” said Dr. Christopher Murray, Director of the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.
In fact, the evidence presented in the Global Burden of Disease study is a wake-up call, urging government and health leaders to respond swiftly to the disturbing trends reshaping public health.
India Mirrors the Global Shift
India reflects the same paradox. While life expectancy in the country has improved dramatically — reaching over 70 years on average — the healthy years of life, free from disease or disability, remain far fewer.
The GBD 2023 data show that India has achieved a massive decline in infant and maternal mortality, but now faces rising threats from hypertension, obesity, diabetes, and air pollution.
India is experiencing what is called a ‘double burden of disease’. It is also an issue of concern that infectious diseases still persist in some regions, but lifestyle disorders have exploded, especially in urban centres.
Air pollution, unhealthy diets, and mental stress are now among the most pressing health threats in India.
According to the report, nearly half of all death and disability worldwide could be prevented by addressing key modifiable risks — including high blood sugar, high body mass index (BMI), high blood pressure, smoking, and exposure to particulate air pollution.
Between 2010 and 2023, the rate of death and disability due to infectious and nutritional diseases fell globally by about 26 percent.
However, NCD-related disability-adjusted life years (DALYs) — the total years of healthy life lost — have surged. Ischaemic heart disease, stroke, and diabetes now top the list of causes of premature death and disability.
The GBD 2023 analysis of 375 diseases and 88 risk factors across 204 countries and 660 sub-national regions found that while the world’s population has grown and aged, the pattern of disease has changed dramatically.
Communicable diseases such as HIV/AIDS and tuberculosis declined sharply, while conditions linked to modern lifestyles — such as metabolic syndrome, anxiety, depression, and cancer — have grown rapidly.
The challenge is not just to treat disease, but to prevent it through environmental and behavioural change. And, India’s future health will depend on how effectively we address pollution, food systems, and mental well-being.
The JACC paper, Global, Regional, and National Burden of Cardiovascular Diseases and Risk Factors, 1990–2023, paints a particularly alarming picture for India.
Cardiovascular diseases remain the leading cause of death globally — responsible for 19.2 million deaths in 2023 — with India contributing a significant share. Cases of ischemic heart disease and stroke have doubled since 1990, and hypertension is now one of the country’s most prevalent chronic conditions.
The study estimates 437 million cardiovascular DALYs worldwide, up from 320 million in 1990. Nearly 80 percent of this burden is linked to modifiable factors such as high blood pressure, poor diet, high LDL cholesterol, and air pollution.
The researchers warn that India’s youthful population is not immune. Urbanisation, sedentary work culture, high stress, and dietary transitions are leading to early-onset heart disease — sometimes striking people in their 30s and 40s.
At the same time, under-diagnosis and inadequate follow-up care in rural regions make the challenge even more complex.
The GBD 2023 data also highlight a global mental health emergency. Anxiety disorders have risen by 63 percent and depression by 26 percent since 2010. Mental illness now ranks among the top 10 causes of health loss worldwide — particularly among young adults.
In India, suicide remains a leading cause of death among those aged 15–29 years. Yet, mental health receives less than 1% of the national health budget, and stigma often prevents people from seeking help.
Mental health must be treated as a mainstream health issue as it affects productivity, education, and social stability. Investing in mental well-being is an investment in national development.
India’s demographic shift has brought new gender and age-related challenges. Women now live longer than men — averaging 73 years — but face disproportionate rates of anaemia, diabetes, and osteoporosis, compounded by poor healthcare access in rural areas.
Elderly Indians, meanwhile, face multiple chronic diseases without adequate geriatric support.
Globally, women’s mortality from cardiovascular disease has risen closer to men’s, but female heart disease remains underdiagnosed.
In South Asia, the “invisible patient” problem persists — many women delay seeking care until advanced stages of illness.
Among all environmental risks, air pollution stands out as India’s most urgent public-health crisis. The GBD 2023 study ranks particulate matter pollution as the second leading environmental cause of global disease burden, with the highest DALY rates observed in South Asia.
Exposure to PM2.5 particles increases the risk of heart disease, stroke, lung cancer, and even neurological disorders.
India’s fast-growing cities are among the most polluted on Earth, with pollution levels often exceeding WHO safety limits by tenfold.
At the same time, climate-related factors such as heat stress, drought, and displacement are exacerbating health risks in vulnerable populations.
Everyone should understand that the environment is not separate from health, so clean air, safe food, and green infrastructure is as vital to health as hospitals and medicines.
It is unfortunate that India’s healthcare spending remains at around 2 percent of GDP, among the lowest in the G20.
Public hospitals face overcrowding, and primary healthcare in rural areas is under-resourced. While initiatives like Ayushman Bharat and the NPCDCS are improving access, gaps remain in prevention, mental-health coverage, and air-quality regulation.
The GBD 2023 findings also call for an integrated national response — linking environment, economy, and health.
Policy experts recommend expanding early screening, investing in clean energy, promoting healthy lifestyles, strengthening mental health services, and using digital health data for better monitoring.
As India’s youth are both a demographic strength and a responsibility, the policy makers must act now — through prevention, education, and environmental stewardship — to ensure a healthier, more resilient generation.
The Global Burden of Disease 2023 findings are both a triumph and a warning. They celebrate human progress in extending life but expose the vulnerabilities of modern living.
India’s success in controlling infectious diseases is undeniable, yet its rising tide of chronic illness demands urgent, coordinated action. The message from global scientists is clear: without sustained investment in prevention, environmental protection, and equitable healthcare, the gains of the past decades could unravel.
As people live in times of great opportunity, they should always remember the great risk. And, the future of health will depend on how decisively the people act today.
