Background The country is experiencing a rapid health transition with a rising burden of Non-Communicable Diseases (NCDs) which are emerging as the leading cause of death in India accounting for over 60% of all deaths with considerable loss in potentially productive years (aged 35-64 years) of life. Non Communicable Diseases (NCDs) are chronic diseases that are not transmissible from one person to another. Taking this definition into account, NCDs may thus include wide spectrum of medical disorders both acute and chronic like Cancers, Diabetes, Hypertension, Cardiovascular Diseases and Stroke, Chronic Kidney Diseases (CKDs), Chronic Obstructive Pulmonary Diseases (COPDs) and Asthma, Non-Alcoholic Fatty Liver Disease (NAFLD), and a gamut of other diseases. These diseases have public health importance globally and in India. NCDs cause significant morbidity and mortality, both in urban and rural population and across all socio-economic strata, with considerable loss in potentially productive years of life. NCDs are also responsible for the maximum out-of-pocket expenditure on health. The economic output lost due to NCDs excluding mental conditions is estimated to be $ 3.55 trillion for India for the period of2012-2030. Taking cognizance of these facts, Sustainable Development Goal 3 (Target 3.4) aims to reduce premature mortality from NCDs by one-third by 2030 in the world. SDG-3 also stresses on prevention and control of tobacco and alcohol use. Burden of Non Communicable diseases As per the WHO – NCD India profile - 2018, NCDs are estimated to account for 63% of all deaths in country of which the cardiovascular diseases lead with 27% overall mortality cause followed by chronic respiratory diseases (11%), cancers (9%), diabetes (3%) and others (13%). Four common NCDs (Cardiovascular Diseases, Cancers, Chronic Respiratory Diseases and Diabetes) account for 23 percent of the total premature mortality in 30-70 years age group. As per the report of National Cancer Registry Program (2020), the incidence of cancer in India is 13.92 lakhs. Among males, cancers of lung, mouth, oesophagus and stomach are the leading sites across most of the registries. Among females, breast cancer is the commonest cancer followed by cervical cancer. NAFLD, the abnormal accumulation of fat in the liver in the absence of secondary causes of fatty liver, such as harmful alcohol use, viral hepatitis, or medications is a serious health concern as it encompasses a spectrum of liver abnormalities, from a simple non-alcoholic fatty liver (NAFL, simple fatty liver disease) to more advanced ones like non-alcoholic steatohepatitis (NASH), cirrhosis and even liver cancer. Over the last two decades global burden of NASH has more than doubled. NAFLD is emerging as an important cause of liver disease in India. Epidemiological studies suggest the prevalence of NAFLD is around 9% to 32% of the general population in India with a higher prevalence in those with overweight or obesity and those with diabetes or prediabetes. Researchers have found NAFLD in 40% to 80 % of people who have type 2 diabetes and in 30% to 90 % of people who are obese. Studies also suggest that people with NAFLD have a greater chance of developing cardiovascular disease. Cardiovascular disease is the most common cause of death in NAFLD. Once the disease develops, there is no specific cure available, and health promotion and prevention aspects targeting weight reduction, healthy lifestyle, and control of aforementioned risk factors are the mainstays to disease progression and prevent the mortality and morbidity due to NAFLD. NAFLD is an independent predictor of future risk of cardiovascular diseases, type 2 diabetes and other metabolic syndromes like hypertension, abdominal obesity, dyslipidaemia, glucose intolerance. Major risk factors for these NCDs are raised blood pressure, cholesterol, tobacco use, unhealthy diet, physical inactivity, alcohol consumption, and obesity which are modifiable. The other non-modifiable risk factors such as age, sex and heredity are also associated with the occurrence of NCDs. Hence a majority of cancers and CVDs can be prevented and treated if diagnosed at an early stage. About NP-NCD Considering the rising burden of NCDs and common risk factors to major Chronic Non –Communicable Diseases, Government of India initiated an integrated National Programme for Prevention and Control of Cancers, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) under the National Health Mission. The focus of the Programme is on health promotion and prevention, strengthening of infrastructure including human resources, early diagnosis and management and integration with the primary health care system through NCD cells at different levels for optimal operational synergies. During the period 2010 - 2012, the programme was implemented in 100 districts across 21 States. The programme at present covers the entire country. During February 2021, Ministry of Health and Family Welfare launched the operational guidelines for Integration of NAFLD (Non-Alcoholic Fatty Liver Disease) with NPCDCS. Realizing the growing burden of NCDs, associated morbidities and mortalities, Government of India has identified other priority NCD conditions beyond common NCDs and widened the ambit of the programme by including Chronic Obstructive Pulmonary Disease (COPD) and Asthma, Chronic Kidney Disease (CKD), Non-Alcoholic Fatty Liver Disease (NAFLD), Pradhan Mantri National Dialysis Programme (PMNDP). Hence, the NPCDCS is now renamed as National Programme for Prevention & Control of Non-Communicable Diseases (NP-NCD). Objectives Health promotion through behaviour change with involvement of community, civil society, community-based organizations, media and development partners. Screening, early diagnosis, management, referral and follow-up at each level of healthcare delivery to ensure continuum of care. Build capacity of health care providers at various levels for prevention, early diagnosis, treatment, follow-up, rehabilitation, IEC/BCC, monitoring and evaluation, and research. Strengthen supply chain management for drugs, equipment and logistics for diagnosis and management at all health care levels Monitoring, supervision and evaluation of programme through proper implementation of uniform ICT application across India. To coordinate and collaborate with other programmes, departments/ministries, civil societies. Strategy Health promotion for prevention of NCDs and reduction of risk factors. Screening, early diagnosis, management, referral and follow up of common NCDs. Capacity building of health care providers. Evidence based standard treatment protocols. Uninterrupted drug and logistics supply. Task sharing and people-centered care. Information system for data entry, longitudinal patient records. Monitoring, supervision, evaluation and surveillance including technology enabled interventions. Multi-sectoral coordination and linkages with other National Programmes. Implementation research and generation of evidences. To access the complete guidelines, click here. Source : Ministry of Health and Family Welfare. Related resources Guidelines for Prevention and Management of Stroke