Time is running out in the battle against NCDs

Dr Amitava Acharyya, CNS Correspondent, India
Non-communicable diseases (NCDs) are responsible for 68% of global deaths and are projected to cause 75% of global deaths by 2030. Nearly 80% of these NCD related deaths occur in low and middle income countries (LMICs). Also, two thirds of NCD deaths are related to cardiovascular diseases (CVD), cancer, diabetes and chronic respiratory diseases. According to a WHO report, premature NCD mortality rates decreased globally by 15% between 2000 and 2012, mainly due to the decline in CVD deaths.

This was facilitated by improvements in population level blood pressure, decline in tobacco use, and progresses in medical treatment. The decrease, however, has been more in high-income countries than in the LMICs. With a view to improve general healthcare, economy, social structures, and the environment, the United Nations has formulated, for its 193 Member States, 17 Sustainable Development Goals (SDGs) with 169 targets. Goal 3.4 calls for reduction of premature mortality from NCDs by one third by 2030, through prevention and treatment. NCDs are also indirectly related to other SDG targets, such as SDG 3.5-to strengthen the prevention and treatment of substance abuse; SDG 3.8- universal health coverage; and SDG 3.9 –aiming at a substantial reduction in the number of deaths and illnesses from pollution and contamination by 2030.

A study conducted in 23 LMICs revealed that 24 million deaths could have been prevented by actions initiated to prevent and control NCDs (2% yearly reduction in chronic disease death rates over the next 10 years), saving an estimated $8 billion, accounting for around 10% of the anticipated loss in national income during the period from 2006 to 2015. If nothing is done to reduce the risk of chronic diseases, an estimated US$84 billion of economic production will be lost from heart disease, stroke, and diabetes alone in these 23 countries between 2006 and 2015. This shows that the burden of NCDs is grave and will continue to grow unless result oriented actions are initiated to prevent and control them in developing countries.

Cristina Parsons Perez, Capacity Development Director, NCD Alliance, described 5 main challenges of NCDs prevention in a webinar organized by CNS. These challenges are: (i) weak political commitment, (ii) limited progress in engaging non-health sectors, (iii) inadequate funds (globally only 1.7% of the total health budget is allocated for NCD care and control), (iv) weak health systems  and (v) commercial determinants of health.

There should be high level of policy making commitment from central and state governments. This includes budget for community level NCDs screening and awareness programmes, proper training of healthcare personnel, adequate drug supply and other essential equipments for NCD care and control. Missing on any of the above mentioned components can adversely impact the fight against NCDs. India still lacks ideal guidelines for diabetes preventions and treatment. Few months ago, India got first hypertension treatment guideline under Govt of India.  But we need to develop our own updated treatment guidelines for all NCDs which are validated for our country.

The local community and civil society organizations also need to be stakeholders of NCD prevention activities. Major NCDs are lifestyle related disorders and an aware civil society has to educate common people about the benefits of healthy lifestyle, and early screening..

India has to cover a long journey to create a robust healthcare structure. Today’s fruitful efforts for NCD care and control can help us to achieve our SDG targets for 2030.

Dr Amitav Acharyya, Citizen News Service - CNS
July 10, 2017