By Dr Than Lwin Tun
Non-Communicable diseases (NCDs), also known as chronic diseases, tend to be of long duration and are the result of a combination of genetic, physiological, environmental and behavioural factors. The main types of NCDs are cardiovascular diseases (such as heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma) and diabetes. NCDs disproportionately affect people in low- and middle-income countries, where nearly three-quarters of global NCD deaths occur.
Prevention and control of non-communicable diseases (NCDs) are important because these diseases are now one of the biggest causes of death and disability worldwide. NCDs include conditions such as Heart Disease, Stroke, Type 2 Diabetes, Cancer, and chronic respiratory diseases like Chronic Obstructive Pulmonary Disease.
People at risk
People of all age groups, regions and countries are affected by NCDs. These conditions are often associated with older age groups, but about 18 million NCD deaths occur before the age of 70 years. NCDs cause more deaths in this age group than all other causes of death combined. Of these premature deaths, 82 per cent are estimated to occur in low- and middle-income countries. Children, adults and the elderly are all vulnerable to the risk factors contributing to NCDs, whether from unhealthy diets, physical inactivity, exposure to tobacco smoke, or the harmful use of alcohol or air pollution.
Unhealthy diets and a lack of physical activity may show up in people as raised blood pressure, increased blood glucose, elevated blood lipids and obesity. These are called metabolic risk factors and can lead to cardiovascular disease, the leading NCD in terms of premature deaths.
Risk factors
Behavioural risk factors
Behavioural risk factors increase the risk of NCDS, including:
v tobacco use (including the effects of exposure to second-hand smoke);
v unhealthy diets, including excess salt, sugar, and fats;
v harmful use of alcohol; and
v Insufficient physical activity.
The social, commercial, and physical environments are key drivers of these behaviours.
Metabolic risk factors
Behavioural risk factors contribute to four key metabolic changes that increase the risk of NCDs:
v raised blood pressure (including hypertension);
v overweight/obesity;
v high blood glucose levels (including diabetes); and
v Abnormal blood lipids (including high cholesterol).
Environmental risk factors
Several environmental risk factors contribute to NCDs. Air pollution – indoor and outdoor – is the largest of these, accounting for 6.7 million deaths globally, of which about 5.6 million are due to NCDs, including stroke, ischemic heart disease, chronic obstructive pulmonary disease, and lung cancer.
Prevention and control
An important way to control NCDs is to focus on reducing the risk factors associated with these diseases. Low-cost solutions exist for governments and other stakeholders to reduce the common modifiable risk factors. Monitoring progress and trends of NCDs and their risk is important for guiding policy and priorities.
To lessen the impact of NCDs on individuals and society, a comprehensive approach is needed, requiring all sectors, including health, finance, transport, education, agriculture, planning and others, to collaborate to reduce the risks associated with NCDs and to promote interventions to prevent and control them.
One of the most important ways of reducing deaths from non-communicable diseases (NCDs) is to control the risk factors that lead to their development. These include reducing the use of tobacco and the harmful use of alcohol, maintaining an active lifestyle and consuming a healthy diet, and improving air quality. Actions towards these goals are cost-effective ways for countries to reduce the number of NCD deaths. Tackling these risk factors can not only save lives, but also provide a huge economic boost for countries.
Beyond prevention, management of NCDs is critical. This includes detection, screening and treatment of the diseases, as well as palliative care for those in need. The vast majority of premature deaths from NCDs occur in low- and middle-income countries, where universal health coverage or access to health care services is often limited. The development and promotion of universal health coverage is therefore essential in tackling NCDs and working to reduce the number of preventable global deaths.
Surveillance of NCDs is another vital action for providing the information needed for policy and program development for NCD prevention and control. Tracking and reporting on NCD-related global targets and indicators to understand progress in NCD prevention and control are key activities. Accurate data from countries are vital to reverse the global rise in death and disability from NCDs, to support evidence-based decision making, and to help monitor and evaluate the progress being made.
Investing in better management of NCDs is critical. Management of NCDs includes detecting, screening and treating these diseases, and providing access to palliative care for people in need. High-impact essential NCD interventions can be delivered through a primary health care approach to strengthen early detection and timely treatment. Evidence shows such interventions are excellent economic investments because, if provided early to patients, they can reduce the need for more expensive treatment. Countries with inadequate health care coverage are unlikely to provide universal access to essential NCD interventions. NCD management interventions are essential for achieving the SDG target on NCDs.
World Health Organization (WHO) Response
The 2030 Agenda for Sustainable Development recognizes NCDs as a major challenge for sustainable development. As part of the agenda, heads of state and government committed to developing ambitious national responses by 2030 to reduce by one-third premature mortality from NCDs through prevention and treatment (SDG target 3.4). WHO plays a key leadership role in the coordination and promotion of the global fight against NCDs and the achievement of the Sustainable Development Goals target 3.4.
In 2019, the World Health Assembly extended the WHO Global Action Plan for the Prevention and Control of NCDs 2013-2020 to 2030 and called for the development of an Implementation Roadmap 2023 to 2030 to accelerate progress on preventing and controlling NCDs. The roadmap supports actions to achieve a set of nine global targets with the greatest impact towards the prevention and management of NCDs.
Briefly, the prevention and control of non-communicable diseases (NCDs) are essential for improving public health and reducing premature deaths. Diseases such as diabetes, cardiovascular diseases, cancer, and chronic respiratory illnesses can largely be prevented through healthy lifestyles, early detection, regular medical check-ups, and effective health policies. Governments, healthcare workers, communities, and individuals all have important roles in promoting healthy behaviours, reducing risk factors, and ensuring access to quality healthcare services. By strengthening awareness, prevention programs, and treatment strategies, societies can reduce the burden of NCDs and improve the quality of life for future generations.
References
https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases
https://www.who.int/health-topics/noncommunicable-diseases
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