Non Communicable Diseases Outsmart Infectious Diseases

Non-communicable Diseases (NCDs) - cancer, cardiovascular disease, chronic respiratory disease and diabetes - are no longer diseases of the wealthy. They are responsible for 8 million deaths in the world’s poorest billion, largely composed of children and young adults. These were among some of the key messages from the speakers at a conference co -organized by the NCD Alliance and Partners in Health , in the first week of March in Boston. This conference was an important step in breaking the myths that surround NCDs, and demonstrates that the growing NCD epidemic should clearly be a top priority for developing country governments and development agencies.


The event, aptly called, "The Long Tail of Global Health Equity: Tackling the Endemic Non-Communicable Diseases of the Bottom Billion," directed attention toward non-communicable diseases among the world’s billion poorest people in advance of a United Nations high-level meeting on NCDs in September 2011, with a view to developing an agenda for addressing NCDs among the world’s poorest. Many of the billion poorest people have little or no access to NCD prevention, diagnosis and treatment. These diseases are resulting in premature death, intense suffering and catastrophic expenditure that pitch entire families into destitution.


"These four diseases are the leading causes of death in the world, yet receive less than 3 per cent of global health funding to low- and middle-income countries. The United Nations must assume a prominent leadership role to engage governments, civil society, the private sector, the health care community and the media to prevent millions of avoidable deaths" said Dr Bertie Squire, President of the International Union Against Tuberculosis and Lung Disease (The Union).

Gene Bukhman, Physician, Partners in Health (PIH), remarked on a noticeable increase in NCDs in low income countries: "In communities where PIH has been providing community-based care for many years, we no longer see large numbers of patients coming to the hospital suffering from HIV, tuberculosis, and other infectious diseases. Instead, our wards are increasingly filled with patients requiring treatment for NCDs."

Practical, achievable actions to turn the tide of a global epidemic of non-communicable diseases have been published in the form of a document listing 34 recommendations by the NCD Alliance, with the overall aim of reducing deaths by NCDs by two per cent a year. The Document recommends wide-ranging action on NCDs, and ambitious goals and targets to measure progress.

The four shared risk factors of tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol have been identified by the WHO as the major stumbling blocks in the fight against NCDs. The NCD Alliance aims at prevention of the foursome diseases by accelerating effective implementation of Framework Convention on Tobacco Control; eliminating all forms of marketing for foods high in saturated fats, transfats, salt and sugars by 2016; achieving substantial reductions in levels of saturated fats, trans-fats, salt and refined sugars in processed foods, as well as reduce intake of salt to less than 5gm/day by 2025—all with a view to decrease childhood obesity; encourage walking, cycling and other physical activities; decrease harmful use of alcohol, especially amongst the youth.

The NCD Alliance also calls upon all nations to:- Ensure universal access to affordable high-quality essential NCD medicines and medical technologies including, but not limited to diagnostic technologies, radiotherapy and cancer medicines, affordable asthma inhalers, and improved access to high quality palliative care
- Encourage, increase and accelerate research on NCD causes and cures, for prevention, treatment and management of NCDs.
- Strengthen national and community-based health systems to ensure continuity of care and support through to effective referral by 2020.
- Develop and implement strategies to strengthen human resources for health, including public health and community health workers, to ensure equitable access to NCD prevention, early detection, treatment and care.
- Accelerate approaches to address the social determinants of NCDs, including malnutrition, and reduce the vulnerability of women, children, indigenous peoples and populations at particularly high risk and eventually implement NCD screening into maternal and child health programmes.
- Implement legislation, policies and public awareness campaigns to reduce stigma and discrimination associated with NCDs.
- Include NCDs in the global development goals that succeed the Millennium Development Goals in 2015.

Calling for international support for the world's poorest people, Jean Claude Mbanya, President of the International Diabetes Federation (IDF) has appealed, "This is the time to send a loud and simple message to the Heads of State and Governments who will attend the UN Summit on NCDs. We have solutions; every country can and must do something now to alleviate the burden of premature death and suffering. The UN NCD Summit must be a global game changer. It must change the lives of real people on the ground and reverse the trajectory of the NCD epidemic which threatens the future of mankind."


Shobha Shukla - CNS
(The author is the Editor of Citizen News Service (CNS) and also serves as the Director of CNS Diabetes Media Initiative (CNS-DMI).She is a J2J Fellow of National Press Foundation (NPF) USA. She has worked earlier with State Planning Institute, UP. Email: shobha@citizen-news.org, website: www.citizen-news.org) 


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