Key Details
The Report on Medical Certification of Cause of Death 2024, published by the Office of the Registrar General of India, analyses 20,66,117 medically certified deaths recorded through the Medical Certification of Cause of Death system.
These deaths represented 23.1% of the 89,38,301 deaths registered in India during 2024. The findings therefore describe the distribution of causes among medically certified deaths and should not be interpreted as a complete estimate of mortality across the entire population.
Cause group | Deaths | Share of medically certified deaths |
|---|---|---|
Diseases of the circulatory system | 8,01,619 | 38.8% |
Diseases of the respiratory system | 2,27,496 | 11.0% |
Infectious and parasitic diseases | 1,71,381 | 8.3% |
Neoplasms | 1,02,520 | 5.0% |
Diseases of the genitourinary system | 90,301 | 4.4% |
Diseases of the digestive system | 88,072 | 4.3% |
Injury, poisoning and related consequences | 83,814 | 4.1% |
Endocrine, nutritional and metabolic diseases | 81,612 | 4.0% |
Together, the nine leading cause groups accounted for 90.4% of all medically certified deaths in 2024.
Chronic Diseases Now Shape the Mortality Profile
Diseases of the circulatory and respiratory systems together accounted for 49.8% of all medically certified deaths, placing heart and lung conditions at the centre of India’s recorded mortality burden.
Within circulatory diseases, pulmonary circulation and other forms of heart disease accounted for 53.3% of deaths in the group, while ischaemic heart disease accounted for another 22.5%. Together, these two categories represented 29.4% of all medically certified deaths.
Respiratory diseases were the second-largest cause group at 11.0%. Pneumonia accounted for 15.8% of respiratory deaths, while asthma contributed 7.6%.
The findings point to a health system increasingly required to prevent, diagnose and manage chronic illness over long periods rather than respond primarily through episodic treatment.
Infectious Diseases Have Not Disappeared
India’s epidemiological transition is not a straightforward replacement of communicable diseases by chronic conditions.
Infectious and parasitic diseases remained the third-largest cause group, accounting for 8.3% of medically certified deaths. Within this category:
Septicemia accounted for 57.2%
Tuberculosis accounted for 19.5%
Septicemia alone represented 4.7% of all medically certified deaths, making it a substantial mortality burden in its own right.
This coexistence of chronic and infectious disease means that public health systems must expand NCD prevention and long-term care without weakening infection control, tuberculosis programmes or hospital capacity to prevent and manage severe infections.
Renal Failure, Liver Disease and Diabetes Add to the Burden
Several smaller cause groups were heavily concentrated around particular conditions:
Renal failure accounted for 78.1% of deaths from genitourinary diseases and 3.4% of all medically certified deaths.
Liver diseases accounted for 69.7% of deaths from digestive-system diseases and 3.0% of the total.
Diabetes mellitus accounted for 75.9% of endocrine, nutritional and metabolic deaths and 3.0% of all medically certified deaths.
Neoplasms accounted for 5.0% of the total, with malignant neoplasms of the digestive organs forming the largest cancer subgroup at 25.4% of neoplasm deaths.
These patterns show that the mortality burden extends beyond the broad category of cardiovascular disease to conditions requiring sustained screening, early diagnosis, risk-factor management and specialised care.
COVID-19 Mortality Fell Sharply
Deaths classified under the special-purpose COVID-19 codes declined from 2,040 in 2023 to 497 in 2024.
The fall indicates that COVID-19 had become a very small component of medically certified mortality by 2024, even as the wider chronic and infectious disease burden remained substantial.
A Layered Epidemiological Transition
The report presents a mortality profile in which chronic diseases have become dominant without older public health challenges receding entirely.
Cardiovascular and respiratory diseases account for almost half of medically certified deaths. At the same time, septicemia, tuberculosis, pneumonia, renal failure, liver disease and diabetes remain significant contributors.
The policy challenge is therefore not to shift resources from communicable diseases to NCDs, but to build a health system capable of managing both simultaneously.
Policy Relevance
Primary healthcare must move upstream. Cardiovascular disease, diabetes and chronic respiratory illness require stronger risk assessment, screening and early treatment before complications become fatal.
Chronic care capacity must expand. The concentration of deaths around heart disease, renal failure, liver disease and diabetes reinforces the need for continuity of care, reliable referral systems and long-term disease management.
Infectious disease control remains indispensable. The continued importance of septicemia, tuberculosis and pneumonia shows that the epidemiological transition has added chronic disease pressures without eliminating communicable disease risks.
Hospital quality and infection management matter. Septicemia’s large share within infectious deaths warrants attention to early diagnosis, antimicrobial stewardship, infection prevention and the management of severe infections.
Cause-of-death data must be interpreted cautiously. Because medically certified deaths accounted for only 23.1% of registered deaths and coverage differs sharply across states, the findings are highly valuable but not fully representative of all mortality in India.
Follow the Full Report Here: Report on Medical Certification of Cause of Death 2024, Office of the Registrar General of India.