India carries more than 43% of Asia’s chronic respiratory disease–related disability, the highest proportion in the region, according to a new analysis published in The Lancet Respiratory Medicine. The study identifies air pollution as a key driver of India’s persistently high lung disease burden.
Asia’s Global Impact—and India’s Dominant Share
Using estimates from the Global Burden of Disease (GBD) 2023, researchers found that Asia accounted for nearly 67% of global disability-adjusted life years (DALYs) due to chronic respiratory diseases in 2023. Notably, India alone contributed 43.3% of Asia’s DALYs, while China accounted for 27.8%. Together, the two countries made up over 70% of the regional burden, largely due to large populations and sustained exposure to risk factors.
High DALY Rates Reflect Ongoing Disability and Premature Deaths
In 2023, India’s age-standardised DALY rate from chronic respiratory diseases remained above 2,040 per 100,000 population, among the highest in Asia. Although the rate has declined gradually since 1990, it still signals a substantial burden of disability and premature mortality linked to respiratory conditions.
Clinical Reality: Rising Caseloads and Delayed Diagnosis
Explaining what these numbers mean in practice, Dr G.C. Khilnani, Pulmonologist and Chairman, PSRI Institute of Pulmonary, Critical Care and Sleep Medicine, said clinicians now commonly see pneumonia, asthma, and COPD in daily practice. Importantly, children and older adults remain especially vulnerable. Moreover, delayed diagnosis often worsens outcomes. He added that air pollution has emerged as a major driver, accounting for nearly half of COPD cases and a growing proportion of lung cancers, including among non-smokers.
COPD Prevalence Peaks in South Asia
Meanwhile, South Asia—driven largely by India—recorded the highest age-standardised prevalence of COPD in Asia, at 3,044 cases per 100,000 population. Although COPD prevalence across Asian regions appeared broadly similar, the analysis showed that disability and mortality were significantly higher in lower-income regions, pointing to poorer outcomes rather than higher disease occurrence.
Pollution and Late Detection Worsen Outcomes
Echoing these concerns, Dr Ujjwal Parakh, Senior Consultant in Chest Medicine at Sir Ganga Ram Hospital, noted that chronic respiratory diseases, especially COPD, are steadily increasing in India. However, low awareness and limited access to spirometry often delay diagnosis. As air pollution damages lungs in ways similar to tobacco smoke, he emphasised that pollution control and early detection are critical to reversing current trends.
Household and Ambient Air Pollution Drive Disease Burden
As reported by TOI, the study identified ambient particulate matter pollution and household air pollution from solid fuels as major contributors to India’s respiratory disease burden. In South Asia, household air pollution alone was associated with an age-standardised DALY rate of 658 per 100,000 population, placing it among the highest globally.
Outlook: Progress at Risk Without Sustained Action
Finally, researchers cautioned that although age-standardised DALY rates have declined across Asia over the past three decades, progress remains uneven. Persistent pollution exposure and gaps in access to quality respiratory care threaten to slow—or even reverse—these gains. Without sustained improvements in air quality, cleaner household energy, and equitable respiratory healthcare, India’s lung disease burden is likely to remain high.