- Noncommunicable diseases (NCDs) impose a major and growing burden on health and development in the Western Pacific Region.
- NCDs are the leading causes of death and disability in the Region, responsible for 80% of all deaths.
- Of particular concern is premature mortality from NCDs. In most of the Region's low- and middle-income countries, half of all deaths from NCDs occur before age 70.
- Globally, NCD deaths are projected to increase from 36 million in 2010 to 44 million in 2020. In the Western Pacific Region, the projected increase is from 10.2 million to 12.3 million.
- The economic consequences of NCDs are staggering.
- NCDs are largely preventable by means of effective interventions that tackle shared risk factors, namely: tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol.
- People with and at risk of NCDs need a proactive, patient-centered, community-based and sustainable long-term care delivered equitably through health systems based on primary health care.
- A whole-of-society approach with a whole-of-government response is needed for prevention and control of NCDs.
What are noncommunicable diseases?
Noncommunicable – or chronic – diseases are diseases of long duration and generally slow progression. The four main types of noncommunicable diseases are cardiovascular diseases (like heart attacks and stroke), cancer, chronic respiratory diseases (such as chronic obstructed pulmonary disease and asthma) and diabetes.
Cumulative economic losses to low- and middle-income countries (LMICs) from the four diseases are estimated to surpass US$ 7 trillion over the period 2011-2025 (an average of nearly US$ 500 billion per year).
On a per-person basis, the annual losses amount to an average of US $25 in low-income countries, US$ 50 in lower middle-income countries and US$ 139 in upper middle-income countries.
What can we do about NCDs?
- NCDs are both preventable and treatable. The risk of developing NCDs can be reduced by healthier lifestyles and enabling environments.
- Raising awareness and advocacy for policies and actions are important for prevention and control of NCDs.
- If the major risk factors for NCDs were eliminated, around three-quarters of heart disease, stroke and type 2 diabetes, and 40% of cancer would be prevented.
- NCD prevention and control is being addressed using WHO strategies and frameworks such as:
- MPOWER measures to reduce tobacco use
- Global status report on alcohol and health
- Set of recommendations on the marketing of foods and non-alcoholic beverages to children
- Global recommendations on physical activity for health
- • A set of evidence-based and cost-effective interventions are available (the 'best buys') for prevention and control of NCDs.
- Population-based interventions addressing NCD risk factors
- Tobacco use: Reduce affordability of tobacco products by increasing tobacco excise taxes; create by law completely smoke-free environments in all indoor workplaces, public places and public transport; warn people of the dangers of tobacco and tobacco smoke through effective health warnings and mass-media campaigns; and ban all forms of tobacco advertising, promotion and sponsorship
- Harmful alcohol use: Excise tax increases on alcoholic beverages; comprehensive restrictions and bans on alcohol advertising and promotion; and restrictions on the availability of retailed alcohol
- Unhealthy diet and physical inactivity: Salt reduction through mass-media campaigns/reduced salt content in processed foods; replacement of trans-fats with polyunsaturated fats; and public awareness programme about diet and physical activity
- Individual-based interventions addressing NCDs in primary care
- Cardiovascular diseases and Diabetes Mellitus: Multidrug therapy (including glycaemic control for diabetes mellitus) to individuals who have had a heart attack or stroke, and to persons with a high risk (> 30%) of a CVD event in the next 10 years; and providing aspirin to people having an acute heart attack
- Cancer: Prevention of liver cancer through hepatitis B immunization; and prevention of cervical cancer through screening (visual inspection with acetic acid and treatment of pre-cancerous lesions
- A Package of Essential Noncommunicable Disease Interventions (PEN) for primary care is available and can be used for NCD management as per the national context.
- PEN is a prioritized set of cost-effective interventions that can be delivered to an acceptable quality of care, even in resource-poor settings.
- It includes methods for early detection of NCDs and their diagnoses using inexpensive technologies, non-pharmacological and pharmacological approaches for modification of NCD risk factors and affordable medications for prevention and treatment of heart attacks and strokes, diabetes, cancer and asthma.
How can progress in NCD prevention and control be monitored?
A comprehensive global monitoring framework, including indicators, and a set of nine voluntary global targets are available for the prevention and control of NCDs. The NCD surveillance framework is applicable across regional and country settings to monitor trends and to assess progress made in the implementation of national strategies and plans on NCDs.
The nine voluntary global targets for 2025 are:
- Mortality and morbidity
- A 25% relative reduction in overall mortality from cardiovascular diseases, cancer, diabetes, or chronic respiratory diseases.
- Risk factors
- At least a 10% relative reduction in the harmful use of alcohol, as appropriate, within the national context.
- A 10% relative reduction in prevalence of insufficient physical activity.
- A 30% relative reduction in mean population intake of salt/sodium intake.
- A 30% relative reduction in prevalence of current tobacco use in persons aged 15 and older.
- A 25% relative reduction in the prevalence of raised blood pressure or contain the prevalence of raised blood pressure according to national circumstances.
- Halt the rise in diabetes and obesity.
- National systems response
- At least 50% of eligible people receive drug therapy and counseling (including glycaemic control) to prevent heart attacks and strokes.
- An 80% availability of the affordable basic technologies and essential medicines, including generics, required to treat major noncommunicable diseases in both public and private facilities.
Beyond health sector
The environments where we live, study, play and work have a huge influence on our behavior.
To succeed, a strong collaboration among health and relevant non-health sectors and civil society is needed.