The Double Burden of Disease in an Ageing Sri Lanka

Abstract

This working paper revisits a 2015 Master's dissertation on Sri Lanka's "double burden" of disease the overlap of a rapidly ageing population with a shift from infectious to non-communicable disease using current 2024–2026 data and accounting for the 2022 economic crisis, which the original analysis could not anticipate. It finds that non-communicable diseases now account for 83% of deaths in Sri Lanka (Ministry of Health, 2025), up sharply from the rough global proxy the original dissertation relied on, and that population ageing continues on a trajectory that will make Sri Lanka one of the fastest-ageing societies in Asia. The paper also addresses a gap in the original study: social protection coverage for the elderly, which remains structurally thin, with state pensions covering fewer than 10% of the working-age population and elderly poverty higher than any other age group. The paper argues that the 2022 crisis did not create this double burden it arrived on top of it, compressing the fiscal space the underlying demographic and epidemiological problem requires, and closes with policy directions grounded in current evidence.