How BRICS Nations Are Reducing Mortality from Lifestyle Diseases

Mortality from noncommunicable diseases in the BRICS countries

Noncommunicable diseases (NCDs) such as type 2 diabetes, obesity, cardiovascular conditions (including heart attacks, strokes, and hypertension), liver disease, chronic respiratory issues, certain cancers (notably lung cancer), and lifestyle-related mental disorders account for a substantial portion of premature mortality across the BRICS countries.

The BRICS nations show significant variation in their age-standardised mortality rates from the four major NCD groups—cardiovascular conditions, cancer, diabetes, and chronic respiratory disease—among adults aged 30 to 70. This indicator, which reflects deaths per 100,000 people in this age group adjusted for age structure, facilitates comparisons across nations with varying demographics and ranges from 11.6% to 26%. The BRICS countries can be broadly divided into two groups: those with rates above 20%, including Egypt (26%), India (23.6%), South Africa (22.7%), Russia (22.4%), and Indonesia (21.9%); and those with rates below 20%, comprising the UAE (11.6%), Saudi Arabia (13.6%), Iran (13.9%), Brazil (14.5%), China (15.9%), and Ethiopia (16.8%).

Cardiovascular diseases remain the leading cause of mortality in BRICS countries, despite an overall decline in age-standardized mortality rates. Between 1990 and 2019, China, Brazil, and India experienced a decline in stroke mortality, whereas trends in ischemic heart disease mortality were characterized by a slower decline or stagnation, particularly in Russia and South Africa. Brazil has shown the most notable progress in reducing cardiovascular mortality. In China and India, the decline in age-standardized rates has been accompanied by an increase in the absolute number of deaths due to demographic changes, including population ageing and growth. Overall, BRICS countries exhibit a pattern in which progress in reducing stroke mortality coexists with more stable trends in ischemic heart disease mortality, reflecting the growing influence of metabolic risk factors, primarily obesity. Trends in mortality from chronic respiratory diseases, such as chronic obstructive pulmonary disease and asthma, were mixed between 1990 and 2019 across the group. China and Russia saw the greatest declines, while South Africa, Egypt, and Indonesia experienced increases. Cancer mortality patterns also varied. Deaths from tracheal, bronchial, and lung cancers fell in Russia, Brazil, and South Africa, but rose in China and India between 1990 and 2019. Obesity-related conditions, including type 2 diabetes and non-alcoholic fatty liver disease, have been rising rapidly, particularly in China and India. Mental health disorders like anxiety and depression are also increasing overall, driven by factors including stress, social isolation, and alcohol use.

Despite progress in certain areas of NCD prevention and treatment, the overall burden on healthcare systems remains high and is still growing. This challenge demands proactive national policies and international action to address the underlying social determinants of health and promote healthier lifestyles.

 

Policies for preventing and treating lifestyle diseases

From the 2010s through the 2020s, most BRICS countries have introduced national strategies and programmes aimed at reducing mortality from noncommunicable diseases. Notable examples of comprehensive approaches, aligned with World Health Organization guidelines, include Brazil’s Strategic Action Plan to Combat Non-Communicable Diseases 2011–2022 and the Healthy Brazil (Brasil Saudável) 2024–2030 Programme, China’s Healthy China 2030 Strategy, and Iran’s National Comprehensive Plan for Non-Communicable Diseases Prevention and Control 2015–2025. These initiatives have a strong focus on improving social determinants of health—such as housing conditions, poverty reduction, and raising education levels.

All BRICS nations have also rolled out programmes designed to encourage lifestyle changes that help prevent and manage NCDs. These are either broad in scope or target specific areas like increasing physical activity, improving diet, and reducing alcohol and tobacco use.

In India, the Fit India Movement and Khelo India programmes aim to involve the population—especially children, youth, women, and people with disabilities—in mass sports, while also building digital and physical infrastructure to support this goal. Indonesia’s GERMAS (Healthy Living Community Movement) campaign promotes healthy lifestyles by encouraging physical activity, balanced nutrition, and reduced smoking and alcohol consumption. Key activities include public awareness campaigns, building better infrastructure such as walking paths and green spaces, organising mass sports events, and introducing workplace fitness programmes like group stretching and the SIPGAR digital app to track fitness progress. In Egypt, tailored recommendations have been developed for different age groups on achieving an optimal balance of moderate and vigorous physical activity, balance and flexibility exercises, healthy sleep patterns, and reducing daily sedentary time. China is implementing its National Fitness Plan to raise the share of the population that exercises regularly, alongside the 15-Minute Fitness Circles initiative, which ensures people have access to fitness facilities within a 15-minute walk or bike ride from home.

Iran's comprehensive plan for preventing and controlling non-communicable diseases includes measures to reduce salt, sugar, and saturated fat consumption while promoting healthier eating habits. The UAE's National Nutrition Strategy 2030 focuses on building sustainable food systems and educating the public about healthy foods and balanced nutrition. The country's Federal Law on Public Health includes a Healthy Lifestyles article that regulates the sale of foods high in sugar, salt, and fat, requiring clear labelling standards to inform consumers about nutritional content and calories. South Africa is implementing its National Strategy for the Prevention and Control of Obesity, which employs both preventive and therapeutic measures throughout the healthcare system. The strategy limits advertising and availability of unhealthy foods while encouraging physical activity and better eating habits.

Russia has approved an action plan to implement its Concept for Reducing Alcohol Consumption Through 2030 and Beyond, comprising approximately 29 measures. Key initiatives include improving access to medical care and rehabilitation for alcohol dependence, strengthening prevention and early detection programmes, and regulating the distribution of moonshine stills through retail restrictions, online sales bans, and advertising prohibitions. The plan also restricts when and where strong alcohol can be sold, increases excise taxes and minimum retail prices, bans alcohol discounts, and limits product displays near checkout areas. Ethiopia is exploring legislative measures to regulate tobacco and alcohol use, including prohibitions on alcohol advertising, bans on smoking in public spaces and transport, and restrictions on alcohol and tobacco promotions on radio and billboards. Brazil has introduced selective taxation designed to lower the tax burden on basic, healthy foods while raising taxes on unhealthy products like tobacco, alcohol, and sugary drinks. The country is also enforcing a tobacco control policy, overseen by the National Agency for Sanitary Vigilance (ANVISA), which includes bans on tobacco advertising, mandatory health warnings on packaging, and a prohibition on the use of misleading terms such as "light" and "mild."

These national efforts to combat NCDs are now being mirrored at the BRICS level. At the XV BRICS Health Ministers' Meeting in 2025, members agreed to establish the Partnership for the Elimination of Socially Determined Diseases. The meeting's declaration highlights that diseases whose occurrence, progression, and outcomes are closely tied to social determinants of health reflect structural inequalities, posing a serious challenge that hinders sustainable social and economic development. The partnership aims to coordinate joint action to reduce mortality from lifestyle-related noncommunicable diseases and other socially determined medical conditions.