India is the diabetes capital of the world with some 215 million people who live with the condition, and 136 million who are pre-diabetic. In metros, up to 3 out of 4 adults are diabetic or pre-diabetic. The recent Apollo Hospitals' 'Health of the Nation 2025' report, based on health screenings from over 2.5 million individuals, revealed some alarming trends: 61% are obese in India with another 18% being overweight, 65% have fatty liver and 46% i.e. 1 in 2 have silent heart issues.

Non-communicable diseases are often associated with the older generation. But Indians get diabetes some 10 to 20 years earlier than people in the West – at age 30, at the peak of their productive years. India’s very future as an economic powerhouse on the world stage is in jeopardy unless we address NCDs. What must be appreciated is that the development of NCDs begins early in life, during adolescence, when lifestyle habits are usually acquired, and these lifestyle habits have long-lasting impact on long-term health.

For instance, in India, according to the Global Youth Tobacco Survey (GYTS-2019) 8.5% of students aged 13-15 years use tobacco in one form or another. And this habit leads to heart disease, cancer and so many other serious diseases later in life. India’s growing obesity problem especially among children was highlighted in the Economic Survey Report 2023-24. According to the report, while the adult obesity rate in India has more than tripled; the annual rise in children’s obesity is the steepest in the world for India, according to the World Obesity Federation. The recent Apollo report also showed that obesity among students is rising rapidly – that 8% of primary school students were already overweight or obese, and that increases significantly to reach 28% among college students. According to the WHO / Lancet 2019--3 out of 4 teens in India get “insufficient physical activity” and the CNNS National Nutrition Survey -2016-2018 showed that >10% of school-going children (5-9 years) and adolescents (10-19 years) were estimated to be pre-diabetic in India. Another study showed that 35% of India’s 10-year-olds have high blood pressure. These alarming findings have informed India’s ambitious child nutrition programmes and policy recommendations that address the triple burden of malnutrition and start programmes in the early years to instill healthy lifelong eating habits.

There are 280 million adolescents in India and preserving their health and setting them up for a lifetime of health is critical to India’s future. School-based public health interventions that use compelling, age-appropriate games and activities, and teach 11- and 12-year-olds how to choose healthy foods, avoid fried food and junk food, and simply go out to play during Games period instead of sitting and talking to friends, are an important strategy to combat diabetes and related NCDs. This strategy is in fact a key pillar of India’s national Ayushman Bharat school health curriculum.

India cannot treat its way out of the NCD crisis – the problem is simply too big. But we know from WHO and compelling clinical studies that 80% of type 2 diabetes, and 80% of heart disease can be prevented with 3 lifestyle changes – one must eat right, increase physical activity and avoid tobacco. Prevention through lifestyle change is smart. The key to control NCDs is early detection and prevention.

India has a huge focus on screening for diabetes and hypertension. But a multi-faceted and integrated approach where prevention and behaviour change efforts are also part of the government health systems, is key. Furthermore, these public health interventions must be delivered outside the doctor’s office because overworked healthcare providers simply do not have time to give any lifestyle change advice to their patients. Schools and workplaces, the kitchen table, social media channels, chefs, street food vendors, influencers, all become crucibles for change. Adopting models that help take prevention to the doorsteps of people’s homes, is important. Today mobile phones have made it easier to reach people in remote areas as well. Something as simple as a text message can empower people to get off the couch and move.

Addressing NCDs requires collective action—no single sector can tackle the challenge alone. Meaningful collaboration among governments, private enterprises, civil society, academia, is essential to drive lasting impact.

Leadership from the government is key but NGOs must be included as important stakeholders as they make terrific implementers including at the last mile. Community engagement is vital for cultural relevance and for effectiveness, in the designing, implementing, and evaluation of programs. It is also important that NGOs collaborate among themselves – that education NGOs partner with health NGOs to improve reading and literacy and health all at the same time.

We applaud the government of India for being the first country to step up and have an action plan for NCDs, for its emphasis on health and wellness centers, and screening for hypertension and diabetes, for covering the costs of hospitalizations for the very poor etc. All these are efforts to strengthen India’s healthcare system and much needed.

But more emphasis on preventative measures is also needed, including on workplace health, and leveraging AI for improving the effective use of mobile technology. If India doesn’t tackle diabetes and NCDs, it will have a weaker workforce as millions more get diabetes. And our country will lose its potential to be a global economic powerhouse. If India doesn’t tackle diabetes and NCDs head on, right now, the world won’t meet SDG#3. The stakes are that high. Inaction is not an option.

This article is authored by Dr Nalini Saligram, founder & CEO, Arogya World.