Let me know if you'd like variations like: “Nepal’s Quiet Health Emergency” “The Growing Threat of Lifestyle Diseases in Nepal” “Nepal’s Silent Killer: Non-Communicable Diseases” “A Slow-Moving Health Crisis in Nepal”

In remote villages of Bajhang and on the busy streets of Kathmandu, a quiet but deadly health crisis is spreading—one that doesn’t pass from person to person, but is claiming more lives than any infectious disease. Non-communicable diseases (NCDs) like heart disease, diabetes, cancer, and chronic respiratory illnesses are now the top cause of death in Nepal.

A Rising Burden

According to the WHO’s 2019 STEPS Survey, NCDs were responsible for 71.1% of all deaths in Nepal—up from 63.7% in 2015. Heart disease caused 24% of deaths, chronic lung diseases 16.3%, and cancer 11.1%.

NCDs also account for 61.2% of total Disability-Adjusted Life Years (DALYs), which measure the years lost due to ill health or early death. The financial toll is just as alarming—NCDs made up nearly 40% of all health spending, and households spent over 40% of their out-of-pocket health expenses on them.

Key reasons behind this growing problem include longer life spans, changes in population and disease patterns, rapid urbanization, and unhealthy lifestyles. Poor diets, lack of exercise, smoking, and alcohol use are major contributors. All of this is leading to lower quality of life, more illness, and high healthcare costs.

Comparing health data from 2008 to 2019, we see troubling increases:

Physical inactivity rose from 3.5% to 6.5%

High blood sugar went up from 3.6% to 8.5%

Obesity increased from 17.1% to 24.3%

A Hidden Danger

Unlike infectious diseases that cause immediate public concern, NCDs develop slowly and often go unnoticed until they become life-threatening. These illnesses are sometimes seen as problems for the elderly, but today, more and more young Nepalis in their 20s and 30s are being diagnosed with high blood pressure, diabetes, and liver disease. Most of these conditions are preventable.

One of the biggest challenges is that NCDs often don’t show symptoms until it’s too late. And in rural areas, the lack of awareness and poor access to diagnosis or treatment makes the problem worse.

The Urban-Rural Divide

As Nepal urbanizes, traditional diets are being replaced by processed foods high in salt, sugar, and unhealthy fats. People are also getting less exercise due to more sedentary work.

While cities show visible signs of this health shift, rural areas are also being affected. Healthcare facilities in remote districts are limited, and people often have to travel long distances to see a doctor.

For example, in a recent health screening across 12 local governments in Bajhang, 8,511 people over age 30 were tested. Out of these, 565 had high blood pressure, 230 had diabetes, 21 had kidney problems, and 348 were obese. Clearly, NCDs are no longer just an urban problem.

A Health System Unprepared

Nepal’s health system is still mostly focused on infectious diseases. While there have been improvements in maternal and child health, services for NCD prevention and treatment are still lacking. Most government hospitals don’t have regular screening programs for common NCDs like high blood pressure or diabetes.

Schools and communities also do not provide enough education about lifestyle-related diseases. Treatment for NCDs can be very expensive—one stroke or heart surgery can wipe out a family’s savings.

Unlike cheap vaccines or antibiotics, managing NCDs requires long-term care—regular medicine, lifestyle changes, and constant monitoring. Many families simply can’t afford this.

Government Response: MSAP II and Key Programs

Recognizing the seriousness of the issue, the Government of Nepal launched the National Multi-sectoral Action Plan II (MSAP II) for 2021–2025. Its main goal is to reduce premature deaths from major NCDs by 25% by 2025, and by one-third by 2030 (2086/87 BS).

MSAP II aims to:

Make NCD prevention a national priority

Improve coordination among sectors

Reduce risk factors (like tobacco use, unhealthy diet)

Provide better, fairer healthcare

Use data to shape policies

Several nationwide programs are also in place:

Nepal PEN Program (basic NCD care)

Hypertension Care Cascade Initiative Nepal (HCCIN)

PEN Plus Program (treatment for severe chronic NCDs in rural areas)

National Cancer Control Strategy (2024–2030)

Behavior Change Communication campaigns targeting unhealthy habits

These initiatives aim to improve early detection, make treatment more accessible, and reduce the financial burden on families.

Time to Act

The positive news is that many NCDs are preventable. Simple changes—like eating less salt, exercising, quitting tobacco, and regular health checkups—can make a big difference.

Local governments and schools can lead by organizing free screening camps, promoting health education, and removing junk food from school menus. National leaders need to realize that NCDs aren’t just about health—they’re about Nepal’s future. A healthy population is key to economic growth.

Investing in primary healthcare, raising public awareness, and including NCD services in existing programs is essential. Strong coordination among all levels of government—federal, provincial, and local—is also crucial. With collaboration and culturally appropriate solutions, we can design better programs and strengthen research for long-term success.

This approach not only saves lives but supports Nepal’s broader goals—like the Sustainable Development Goals (SDGs), universal healthcare, and ensuring no one is left behind.