India has made notable progress in healthcare over the past decade, particularly in combating infectious diseases and expanding immunization programs. However, persistent challenges continue to hinder the country’s efforts to build a stronger public health system. According to the World Health Organization’s (WHO) Annual Report 2024, released this week, systemic gaps threaten to undermine years of progress. Critical areas such as climate change, non-communicable diseases (NCDs), and regional inequalities remain significant concerns.
The Surging Silent Epidemic of NCDs
One of the major concerns highlighted in the WHO report is the growing burden of NCDs, including diabetes, hypertension, cardiovascular diseases, and cancer. These diseases now account for a substantial portion of India’s disease burden, with millions of people requiring long-term care.
According to WHO estimates, over 58.6 million people in India were undergoing treatment for NCDs in 2024, marking a 15% increase from the previous year. The report points to urbanization, poor dietary habits, sedentary lifestyles, and rising pollution levels as primary contributors to this surge. While treatment facilities have improved, prevention strategies remain weak.
Dr. Roderico H. Ofrin, WHO’s Representative to India, emphasized the need for a shift in focus:
“The challenge of NCDs is both a medical and an economic one. While we have scaled up treatment, the focus must shift to prevention—reducing the root causes like poor lifestyle choices and environmental factors.”
To combat this issue, WHO has been working closely with India’s National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS). This initiative has strengthened early detection and screening efforts. However, the rapid lifestyle changes in urban areas continue to drive the rising prevalence of these diseases, underscoring the urgent need for stronger public awareness campaigns and regulatory policies to promote healthier living.
Vector-Borne Disease Challenge
In addition to NCDs, the WHO report raises concerns about the increasing outbreaks of vector-borne diseases, such as dengue, chikungunya, and malaria. While India has made progress in malaria control, dengue cases have surged, particularly in urban centers like Mumbai, Delhi, and Bengaluru.
The report noted that climate change has contributed to an increase in the frequency and intensity of dengue outbreaks, often overwhelming healthcare infrastructure during peak seasons. Poor urban sanitation, stagnant water accumulation, and inadequate disease surveillance have exacerbated the issue.
Dr. Ofrin commented on the crisis:
“These diseases are heavily influenced by changing weather patterns. Urbanization and poor sanitation, combined with inadequate vector control, are making outbreaks harder to manage.”
WHO has been supporting India’s National Vector Borne Disease Control Programme, providing technical assistance and disease surveillance tools. However, stronger public health interventions are required, including improved drainage systems, better mosquito control measures, and public education campaigns on preventing vector-borne diseases.
The Rising Threat of Antimicrobial Resistance (AMR)
Another alarming issue identified in the WHO report is antimicrobial resistance (AMR), a growing global health threat. AMR occurs when bacteria, viruses, fungi, and parasites evolve resistance to medications, making infections harder to treat.
India is among the countries most affected by AMR due to overuse and misuse of antibiotics in both human and veterinary medicine. Self-medication, over-the-counter antibiotic sales, and unnecessary prescriptions have worsened the crisis.
In response, WHO is collaborating with the Indian government on the National Action Plan on Antimicrobial Resistance (NAP-AMR), which focuses on promoting antibiotic stewardship, strengthening infection prevention, and enhancing surveillance. Despite these efforts, the report highlights that unregulated antibiotic use in rural areas and private healthcare settings continues to fuel the AMR crisis. More stringent regulations and awareness programs are required to combat this growing threat.
Health Equity and Infrastructure Gaps
Despite improvements in healthcare access, the WHO report highlights regional inequalities that persist across India. While urban centers benefit from modern healthcare facilities, many rural and remote regions continue to struggle with inadequate infrastructure, a shortage of medical professionals, and limited access to essential medicines.
The report calls for greater investment in primary healthcare to bridge these disparities. The Ayushman Bharat initiative, launched to provide universal health coverage, has improved access to healthcare services for low-income populations. However, challenges remain in implementing these programs effectively in underdeveloped regions.
Dr. Ofrin emphasized the need for a more resilient healthcare system:
“India’s health system must be adaptable. We need to anticipate health emergencies, not just react to them. Building resilience in healthcare infrastructure is essential, particularly in rural areas.”
To address these issues, WHO has been supporting India’s National Digital Health Mission and Integrated Health Information Platform, which aim to improve healthcare accessibility through digital solutions. Telemedicine initiatives have also gained traction, especially in remote areas, but their effectiveness remains limited due to gaps in internet connectivity and healthcare literacy.
Climate Change and Health Risks
The WHO report also draws attention to the impact of climate change on public health. Rising temperatures, extreme weather events, and increasing air pollution levels are exacerbating health challenges across India.
- Heatwaves have led to an increase in heatstroke cases, particularly among outdoor laborers and vulnerable populations.
- Air pollution has been linked to respiratory diseases, including asthma and chronic obstructive pulmonary disease (COPD). The report notes that air pollution remains one of the leading causes of premature deaths in India.
- Waterborne diseases such as cholera and typhoid continue to pose risks, especially in flood-prone areas.
The WHO urges the Indian government to strengthen climate adaptation strategies, including improving early warning systems, increasing green spaces in cities, and enhancing public awareness of climate-related health risks.
The Path Forward: Recommendations and Future Prospects
Despite the challenges highlighted in the WHO report, India’s healthcare system has demonstrated resilience and progress in several areas. The expansion of universal healthcare schemes, advancements in digital health, and improvements in disease surveillance are positive steps.
However, urgent reforms are required to address the systemic gaps that threaten public health progress:
- Strengthening Preventive Healthcare
- Increase awareness campaigns on NCD prevention and promote healthier lifestyles.
- Expand routine screenings and early detection programs for diseases like diabetes, hypertension, and cancer.
- Combating Vector-Borne and Infectious Diseases
- Enhance mosquito control programs and improve urban sanitation.
- Strengthen disease surveillance and outbreak preparedness.
- Tackling Antimicrobial Resistance
- Implement stricter regulations on antibiotic use.
- Expand AMR awareness programs for both healthcare professionals and the general public.
- Bridging Regional Healthcare Disparities
- Invest in healthcare infrastructure in rural and underserved regions.
- Expand telemedicine services to improve access to specialists.
- Addressing Climate Change-Related Health Issues
- Implement climate adaptation strategies in healthcare planning.
- Reduce air pollution levels through stricter environmental policies.
- Enhancing Digital Health Infrastructure
- Improve the implementation of digital health initiatives like the National Digital Health Mission.
- Expand electronic health records and digital consultations.
The WHO Annual Report 2024 provides a crucial roadmap for India’s healthcare system. While the country has made significant advancements in disease control and healthcare access, systemic challenges continue to hinder progress. The rising burden of NCDs, vector-borne diseases, antimicrobial resistance, and regional disparities require urgent attention.
A multi-pronged approach involving government action, public participation, and international collaboration is essential to overcoming these challenges. By prioritizing preventive healthcare, strengthening infrastructure, and addressing climate-related health risks, India can build a resilient and inclusive healthcare system that ensures better health outcomes for all its citizens.
