NCD’s is the leading global cause of death

Noncommunicable diseases (NCDs), such as cardiovascular diseases, cancer, diabetes and chronic respiratory diseases, is an important public health challenge in all countries, including low- and middle-income countries like Namibia. Three quarters of NCD occur in these countries.

It is the leading global cause of death and are responsible for just over 70% of deaths worldwide.

According to the World Health Organisation (WHO)’s Progress Monitor for noncommunicable diseases for 2020 these NCDs share key modifiable behavioural risk factors like tobacco use, unhealthy diet, lack of physical activity, and the harmful use of alcohol, which in turn lead to overweight and obesity, raised blood pressure, and raised cholesterol, and ultimately disease.

Effectively tackling NCDs and their key risk factors requires a detailed understanding of the current status and progress being made at the country level, warns the report. “Feasible and cost-effective interventions exist to reduce the burden and impact of NCDs now and in the future. Tracking national implementation of a key set of tracer actions linked to these interventions allows for global benchmarking and monitoring of progress being made against NCDs.”

It also serves to highlight challenges and areas requiring further attention. In May 2015 the World Health Organization published a Technical Note (1) on how WHO will report in 2017 to the United Nations General Assembly on the progress achieved in the implementation of national commitments included in the 2011 UN Political Declaration and the 2014 UN Outcome Document on NCDs. The Technical Note was updated in September 2017 to ensure consistency with the revised set of WHO ‘best-buys’ and other recommended interventions for the prevention and control of noncommunicable diseases which were endorsed by the World Health Assembly in May 2017. The Technical Note outlines a set of ten progress monitoring indicators intended to show the progress achieved in countries in the implementation of selected national commitments included in the 2014 Outcome Document. Some of the guidelines include reducing risk factors for NCDs. This include amongst others reducing affordability by increasing excise taxes and prices on tobacco products; eliminating exposure to secondhand tobacco smoke in all indoor workplaces; public places and public transport; implementing plain or standardized packaging andor large graphic health warnings on all tobacco packages; implementing effective mass media campaigns that educate the public about the harms of smoking and tobacco use and second hand smoke as well as enacting and enforcing comprehensive bans on tobacco advertising, promotion and sponsorship. According to the Progress Monitor 8 Member States have implemented at least one recent national public awareness and motivational communication for physical activity, including mass media campaigns for physical activity behavioural change.

The report warns health systems need to be strengthened to address NCDs through peoplecentred primary health care and universal health coverage.

Part of the primary health care approach includes the provision of drug therapy, including glycaemic control, and counselling for eligible persons at high risk to prevent heart attacks and strokes, with emphasis on the primary care level. With regards to the reduction of unhealthy diets as well as the harmful use of alcohol, member states should enforce restrictions on the physical availability of retailed alcohol (via reduced hours of sale); adopt national policies to reduce population salt/sodium consumption; increase excise taxes on alcoholic beverages as well as enact and enforce bans or comprehensive restrictions on exposure to alcohol advertising (across multiple types of media).

The WHO also encourages member states to enforce legislation and regulations fully implementing the International Code of Marketing of Breast-milk Substitutes as well as adopt national policies that limit saturated fatty acids and virtually eliminate industrially produced trans fatty acids in the food supply. The 2019 NCD CCS questionnaire was completed through an online web-based platform by the NCD focal points or designated colleagues within the Ministry of Health (MOH) or a national institute or agency in all WHO Member States (194 countries) between March and June 2019. The questions were developed in a manner intended to obtain objective information about adequacy.

The WHO’s director-general, Tedros Adhanom Ghebreyesus warns NCD’s are the leading cause of premature death globally. Every year, 41 million people die from heart attacks, stroke,

cancer, chronic respiratory diseases, diabetes or a mental disorder.

“That’s more than 70% of all deaths worldwide along with a crippling

economic impact. Taking action against NCDs is therefore not only a

moral imperative, it’s an economic imperative,” Ghebreyesus says.

In 2015, world leaders committed to reduce premature deaths from NCDs by one-third by 2030.

“Data from 194 countries highlights that there are only 2 indicators out

of 10 that half of all countries are fully meeting. This is a grim sign, and

this decade is critical to advance the work on NCDs in all countries.”

According to Ghebreyesus the WHO has developed ‘best buys’ – a set of 16 practical and costeffective interventions that work and can be delivered at the primary

level.

“Critically these put the emphasis on promoting health and preventing disease and include things like increasing tobacco taxes;

restricting alcohol advertising; reformulating food products with less salt, sugar and fat; vaccinating girls against cervical cancer; treating hypertension and diabetes; and more.”

He explains the best buys are a powerful economic tool, with an estimation that every

dollar invested in the best buys will yield a return of at least seven

US dollars.

If implemented globally, they will save 10 million lives by 2025, and prevent 17 million strokes and heart attacks by 2030.”

According to him primary health care, with its emphasis on promoting health and

preventing disease, is the most inclusive, effective and efficient way to reduce premature mortality from NCDs and promote mental health and well-being. In addition to strong primary health care, countries need strong referral systems with other levels of care.

“But we also need to go beyond the health sector to address the root causes of NCDs, in the food we eat, the water we drink, the air we breathe and the conditions in which people live, work and play.

No country can afford to treat its way out of the NCDs epidemic. We have

all the pieces to save lives we just have to put them into place.”

Source: WHO Noncommunicable diseases – Progress Monitor 2020