Global burden and future projections of non-communicable diseases (2000–2050): Progress toward SDG 3.4 and disparities across regions and risk factors

Abstract

Background: Non-communicable diseases (NCDs), such as cardiovascular diseases (CVDs), neoplasms, chronic respiratory diseases (CRDs), and diabetes mellitus (DM), are the leading cause of death globally and a major health challenge, threatening Sustainable Development Goal (SDG) 3.4 to reduce premature mortality by one-third by 2030. The study aimed to quantify the current and projected burden of these NCDs, assess disparities, and identify prevention opportunities. Methods: Using data from the Global Burden of Disease Study (GBD) 2021 by the Institute for Health Metrics and Evaluation, the study analysed incidence, mortality, and disability-adjusted life years (DALYs) for CVDs, neoplasms, CRDs, and DM from 2000 to 2021, with projections to 2050. Trends were stratified by time, WHO region, Socio-Demographic Index (SDI), gender, and country, alongside risk factor contributions (metabolic, behavioural, environmental). Age-standardized rates and average annual percent changes (AAPC) were calculated to assess trajectories. Results: In 2021, NCDs accounted for 12·4 billion incident cases (rate: 156,680·64 per 100,000), 43·8 million deaths (64·5% of total, rate: 554·63 per 100,000), and 1·73 billion DALYs (59·9%, rate: 21,887·11 per 100,000). CVDs led with 19·4 million deaths (28·6%), followed by neoplasms (9·9 million, 14·6%), CRDs (4·4 million, 6·5%), and DM (1·7 million, 2·4%). From 2000–2021, DM incidence rose sharply (AAPC: 2·41%), while CVD mortality increased slightly (AAPC: 0·21%). High SDI regions showed peak DM incidence (461·41 per 100,000), Europe led CVD mortality (419·62), and males had higher CVD deaths (258·55 vs 233·41). Projections estimate 75·5 million deaths and 2·44 billion DALYs by 2050, driven by CVDs (86·1% of deaths). Metabolic risks like hypertension dominated CVD burdens. Conclusions: The NCD burden’s rapid rise, marked disparities, and projected escalation demand urgent, equity-focused prevention. Tailored strategies, targeting metabolic risks, gender gaps, and regional inequities, are critical to achieve SDG 3.4 and mitigate this global crisis by 2050.

Keywords: Non-communicable Diseases (NCDs), Cardiovascular Diseases (CVDs), Disparities, Risk Factors