Prevention, control of noncommunicable diseasesBy Rafael Castillo M.D.
Philippine Daily Inquirer
Health authorities, including world leaders, all over the world are now turning their eyes intently on how to stem the rising tide of noncommunicable diseases (NCDs) before it gets to be a tsunami.
And it’s just rightfully so. NCDs, consisting mainly of cardiovascular diseases, cancers, chronic lung diseases and diabetes, are responsible for 63 percent of all deaths worldwide. The World Health Organization reports that 36 million out of 57 million global deaths in the past year are due to NCDs.
It is for this reason that the United Nations General Assembly is convening a “High-level Meeting on the Prevention and Control of Noncommunicable Diseases (NCDs)” on Sept. 19-20 in New York City.
The UN does not do this often. This is only the second time in the history of the UN that it meets as a general assembly, involving the participation of heads of state and government on a health issue. The first time it did this was to discuss preventive and control measures against HIV/AIDS.
The objective of the meeting is to provide “a unique opportunity for the international community to take action against the NCD epidemic, save millions of lives and enhance development initiatives.”
I’m not sure if President Noynoy Aquino is joining the meeting. I read in the papers that he’s also going to New York sometime this month, but it is for another meeting. It’s good though that we will be well represented in the summit. Again, rightfully so because 80 percent of NCD deaths occur in low- and middle-income countries, and 29 percent of these deaths occur in people under the age of 60 which is the age when one is just about at the peak of one’s career. So the socioeconomic impact of NCDs is really a big blow not only to the individuals affected, but to their families and to the society.
We’re happy to note that Health Secretary Enrique Ona will lead the Philippine delegation to the high-level meeting. Statistics from the Department of Health show that NCDs remain among the top 10 causes of illness and death in the country with cardiovascular diseases being the leading cause of deaths. I’m sure Secretary Ona will pitch in his share of the country’s experiences and challenges in combating NCDs during the roundtable discussions and open forums.
About 10-M deaths yearly
In the Western Pacific region, which includes the Philippines, the WHO reports that 26,500 people die daily due to NCDs. That means close to 10 million deaths yearly attributable to NCDs. A few weeks back (Aug. 18-20), Dr. Shin Young-soo, WHO regional director for the Western Pacific, presided over an intercountry consultation on preventing and controlling NCDs in the region.
I was privileged to be invited to the summit, unfortunately I could not attend it due to some previous commitments abroad. I was told though that it was a very productive meeting and the participants were able to come up with country-specific recommendations on how to further improve access to essential medicines, diagnostics and medical devices in the management of NCDs.
Previously, an expert committee from the WHO Western Pacific endorsed a regional action plan for the prevention and control of NCDs. Practical, cost-effective and evidence-based interventions that countries can adopt to achieve a reduction in NCD risk factors were detailed in the action plan. I guess what we need to do now is to try to implement the plan, rather than come up with additional plans.
Dr. Shin recommends that health authorities all over the region must focus their urgent attention on issues involving the marketing of food to children; limiting salt, sugar and fat in mass-manufactured foods; restricting the availability and promotion of tobacco and alcohol, and urban design that promotes physical activity.
The regional WHO chief stresses that strategies to mobilize support beyond the health sector will be needed to address some of the issues related to NCDs since known risk factors are frequently caused or aggravated by factors outside the health sector.
It is well known that common risk factors for NCDs are tobacco use, unhealthy diets, physical inactivity and the excessive use of alcohol. Health authorities must train their eyes on how to address these risk factors.
From a strategic point, controlling NCD risk factors is clearly definable and seems to be easy but in the real world, we all know it’s easier said than done. A strong government commitment and decisive political will are not that easy to come by.