National Action Plan and Monitoring Framework for Prevention and Control of Noncommunicable Diseases (NCDs) in India

Objectives

The plan provides a national framework for preventing and controlling cardiovascular diseases, cancers, chronic respiratory diseases and diabetes, alongside their major risk factors, through multisectoral action, strengthened health-system capacity and monitoring aligned with the World Health Organization global framework through 2025.[1][2]Its overarching ambition is to reduce premature mortality from non-communicable diseases by 25% and meet agreed national targets.[3]

• Strengthen national capacity, mechanisms and mandates for coordinated multisectoral prevention and control of non-communicable diseases.[1]
• Reduce harmful alcohol use and insufficient physical activity by 10%, and halt the rise in obesity and diabetes prevalence.[3]
• Reduce raised blood pressure prevalence by 25% through the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke, lower salt consumption, increased physical activity, and improved dietary fats.[4]
• Reduce mean population salt or sodium intake by 30% through food-sector policies, public awareness, access to reduced-salt products and comprehensive nutrient labelling.[4]
• Reduce current tobacco use prevalence by 30% through expanded tobacco control, enforcement of the Cigarettes and Other Tobacco Products Act, 2003, implementation of the World Health Organization Framework Convention on Tobacco Control, restrictions on packaged smokeless tobacco, and cessation support.[4]
• Ensure that at least 50% of eligible people receive drug therapy and counselling to prevent heart attacks and strokes.[4]
• Achieve 80% availability of affordable essential non-communicable disease medicines and basic technologies in public and private facilities, including diagnostics and palliative care.[4]
• Reduce household solid-fuel use and associated indoor air pollution by 50% through intersectoral action, guidelines, public campaigns and health-system strengthening.[4]
• Address tobacco use, raised blood pressure, salt intake, indoor air pollution, access to preventive medicines, and the affordability and availability of essential medicines and technologies.[2]

Implementation

Delivery centres on integrating the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke at district level and beyond under the National Health Mission, aiming for equitable universal coverage.[1]The programme is to expand from 100 districts to all districts in phases during the Twelfth Five Year Plan.[1]A consultative process involving national stakeholders and an advisory group supports agreement on a monitoring framework consistent with the global framework.[2]

• Develop healthy-behaviour policies and programmes in educational institutions, workplaces and communities, while strengthening health promotion, early detection and treatment services.[3]
• Engage civil society and the private sector in prevention and control activities.[3]
• Develop national policies and guidelines on alcohol regulation, physical activity, nutrition and food marketing, and conduct public health and awareness campaigns.[3]
• Establish or strengthen alcohol de-addiction services and create environments that enable walking, cycling and other physical activity.[3]
• Engage food producers, processors, commercial operators, retailers, caterers, civil society and consumers to reduce salt in prepared and processed foods and improve access to healthier options.[4]
• Scale up the National Tobacco Control Programme to all districts, enforce tobacco-control legislation, increase tobacco taxation, support alternative livelihoods for tobacco farmers and workers, and provide tobacco cessation services including a national quitline.[4]
• Build health-worker and system capacity to provide cardiovascular risk-reduction medicines, counselling, tobacco cessation, indoor-air-pollution prevention and non-communicable disease follow-up through primary healthcare.[4]
• Develop evidence-based public campaigns, indoor-air-pollution guidelines, palliative-care policy and cost-effective service-delivery modalities.[4]
• Track progress through a National Non-communicable Disease Monitoring Framework with 21 indicators and 10 targets, covering prevention and control actions until 2025.[2]
• Monitor premature mortality, alcohol use, obesity and diabetes, physical inactivity, blood pressure, salt intake, tobacco use, preventive therapy, medicine and technology access, and household indoor air pollution.[2]
• Recognise affordability, generic medicines, tobacco taxation and cost-effective delivery as financing-related considerations; no programme budget, allocation, funding source, resource gap or economic assumption is specified.[4]

Monitoring & Evaluation

Monitoring is organised around a National Non-communicable Disease Monitoring Framework aligned with the World Health Organization global monitoring framework, covering prevention and control actions in India through 2025.[1][2]The framework comprises 21 indicators and 10 national targets.[2]It is intended to support stewardship of non-communicable diseases, their risk factors and comorbidities, building on the India-World Health Organization Call for Action on Non-communicable Diseases.[2]

• Track premature mortality from cardiovascular diseases, cancers, chronic respiratory diseases and diabetes, including the overarching objective of reducing premature non-communicable disease mortality by 25%.[1][3]
• Monitor behavioural and environmental risk factors, including alcohol use, insufficient physical activity, tobacco use, salt intake, obesity, household solid-fuel use and associated indoor air pollution.[2][3][4]
• Measure metabolic risk factors, including raised blood pressure and diabetes prevalence, with targets to reduce raised blood pressure prevalence by 25% and halt the rise in obesity and diabetes.[3][4]
• Assess progress towards a 30% reduction in mean population salt or sodium intake through food-sector policies, public awareness activity, access to reduced-salt foods and comprehensive nutrient labelling.[4]
• Track progress towards a 30% reduction in current tobacco use, alongside expansion of tobacco-control activity, enforcement of the Cigarettes and Other Tobacco Products Act, 2003, implementation of the World Health Organization Framework Convention on Tobacco Control, cessation provision and a national quitline.[4]
• Measure access to preventive services, including the target for at least 50% of eligible people to receive drug therapy and counselling to prevent heart attacks and strokes.[4]
• Assess availability and affordability of essential non-communicable disease medicines and basic technologies in public and private facilities, against the target of 80% availability.[2][4]
• Monitor the target to reduce household use of solid fuel and related indoor air pollution by 50%, supported by intersectoral policies, guidance, public campaigns and health-system capacity building.[4]

A consultative governance process involving national stakeholders and an advisory group is used to agree the monitoring framework in accordance with the global framework.[2]The framework also identifies suggested actions linked to its targets, including health promotion, early detection, treatment, primary healthcare counselling, tobacco cessation and risk-reduction medicines.[2][3][4]

The source does not specify reporting schedules, data-collection or surveillance sources, indicator definitions, evaluation methods, publication arrangements, named accountability bodies or corrective mechanisms for underperformance.[2][4]

Costing & Financing

Financing detail is limited. The source identifies affordability of essential medicines, diagnostic tests, basic technologies and palliative care as implementation considerations, and promotes access to generic medicines and cost-effective service-delivery modalities.[4]It also identifies increased tobacco taxation and alternative livelihoods for tobacco farmers and workers as financing-related policy measures within tobacco control.[4]

• Promote affordable essential non-communicable disease medicines, diagnostic tests, basic technologies and palliative care in public and private facilities.[4]
• Improve access to generic medicines and counselling as part of preventive drug therapy for people eligible to prevent heart attacks and strokes.[4]
• Develop cost-effective modalities for delivering non-communicable disease services.[4]
• Increase tobacco taxation and support alternative livelihoods for tobacco farmers and workers within intersectoral tobacco-control mechanisms.[4]

No programme costs, budget allocations, expenditure estimates, financing sources, resource-mobilisation plan, funding gaps, costed implementation plan or economic assumptions are specified.[1][2][3][4]