NCD Burden in the South-East Asia Region Regional Action Plan and Targets Dr. Renu Garg Regional Advisor NCD
1.8 Billion People 25% of world s population
Outline of presentation Burden of NCDs Regional action plan and targets
NCDs are # 1 killers in the South-East Asia Region 55% of all deaths in the Region are due to NCDs An estimated 7.9 million people die due to NCDs each year in the Region One-third of NCD deaths in the Region are <60 years Premature mortality due to NCDs causes immense social and economic loss
Usman Ahmed, 48 year old Tea vendor (India) Earns Rupees 200 or US$ 4 per day. Sole breadwinner A father of three school-going children Suffered a heart attack in 2009 and had to be hospitalized. Because of hospitalization and follow-up care, he had to stop work for 6 months. He is now on oral medicines and has quit smoking. But he worries for his family, if something was to happen to him
Estimated proportion of deaths by cause, South-East Asia Region, 2008 Injuries 10.7% (1.5 million) Communicable diseases 34.7% (n=5.0 million) Noncommunicable diseases 54.6% (n=7.9 million) Total number of annual deaths in SEAR=14.5 million NCDs cause more deaths than all other causes put together Source: WHO global Health observatory 2011 http://apps.who.int/ghodata/
Age standardized mortality rates per 100,000 population, 2008 800 700 701 SEAR Global High-income countries rate per 100 000 population 600 500 400 300 200 100 363 275 32 612 408 131 93 -Mortality in SEAR higher than global average and much higher than mortality in high-income countries -NCD mortality higher than all other causes in SEAR and elsewhere 43 0 Communicable diseases Noncommunicable diseases Injuries Dhillon et, al, Int J Epidemiol. 2012; 41:847-60.
Estimated proportion of deaths by cause, South-East Asia Region, 2008 Injuries 11% Cardiovascular diseases 25% Cardiovascular disease, diabetes, cancers and chronic respiratory diseases most common Communicable diseases, maternal & perinatal conditions, nutritional deficiencies 35% Chronic respiratory diseases/asthma 10% Cancers 8% Other NCDs 10% Diabetes 2% Total number of deaths in the Region=14.5 million Source: WHO global Health observatory 2011 http://apps.who.int/ghodata/
Estimated age-standardized incidence and mortality rates, South-East Asia, 2012 Males Females 1.8 million new cases and 1.2 million deaths each year
Tobacco use the biggest public health emergency in the Region Tobacco Kills 1.2 million people annually in SEAR Smoking Prevalence in males above 60% in some countries Smoking among youth on an upward trend 250 million smokers in the Region Smokeless tobacco use 90% of global smokeless tobacco users in SEAR Common in men and women in several countries Increasing trend in women and youth
Population intake of salt in Member Countries of South-East Asia Number of attributable deaths (000's) 15 10 5 11 12 9 12 8.3 Salt consumption is significantly higher than recommended level of <5 gms 10.8 recommended level 0 Dhaka, 2012 Ladakh, 1988 Delhi, 1988 Nepal, 1993 Sri Lanka, 2012 Thailand, 2009 Source: Global Health Risks, 2009, WHO
Large proportion of individuals have metabolic risk factors for NCDs and they go often undetected or untreated One out of three adults have high blood pressure One out of ten adults have diabetes 13% adults are overweight upward trend in childhood obesity, particularly in urban settings 30-50% adults have abnormal lipid profile Clustering of multiple risk factors in individuals
Household air pollution due to solid fuel use % of households using solid fuel for cooking 100 80 60 40 20 0 1990 2000 2010 AFR SEAR WPR EMR Europe Americas High income countries Bonjour et, al, Environ Health Perspectives. 2013
High priority to NCDs in the Region 2007 60 th RC endorses regional framework on Prevention and Control of NCDs 2009 31st session of SEA-ACHR discussed research priorities in NCDs 2010 63 rd RC discussed progress in the prevention and control of NCDs 2010 NCDs discussed at the 29 th Health Minister s Meeting 2012 NCDs discussed at 65 th Regional Committee 2013 NCDs discussed at 33 rd ACHR, 31 st HMM, 66 th Regional Committees Outcomes: Jakarta call for Action Health Minisiter s decision (2011), declaration (2013) RC resolutions (RC 60, RC 65, RC66)
Regional NCD priorities Diabetes Cardiovascular Disease Cancer Chronic Respiratory Diseases Physical inactivity Harmful use of alcohol tobacco use Household air pollution Unhealthy diets + thalassemia, chronic kidney disease in some countries
Regional Targets for NCD Harmful use of alcohol 10% reduction Household air pollution 50% reduction in SFU for cooking Essential NCD medicines and technologies 80% coverage Physical inactivity 10% reduction 25% reduction in NCD mortality by 2025 Drug therapy & counseling 50% coverage Salt/sodium intake 30% reduction Diabetes/obesity 0% increase Tobacco use 30% reduction Raised blood pressure 25% reduction
Regional Action plan and ten targets endorsed by RC 66
Guiding Principles for Action Plan Focus on equity Multisectoral partnerships Life course approach Balance of population based and individual approaches Empowerment of people and communities Health systems strengthening and integrated services Universal health coverage Evidence-based cost-effective approaches Management of conflict of interest
Four strategic areas of Regional Action Plan 2013-2020 Action area 2 Health promotion and risk reduction Action area 1 Advocacy, partnerships, and leadership Action area 4 Surveillance, monitoring & evaluation and research Action area 3 Health systems strengthening for early detection and management of NCDs
Action area 1 Advocacy, partnerships, and leadership Develop/strengthen national multisectoral policies and action plans Advocacy for integration of NCDs into health planning and development plans
Action area 2 Health promotion and risk reduction Tobacco use Harmful use of alcohol Unhealthy diet Physical inactivity Household air pollution Settings approach Schools Workplace community
Action area 3 Health systems strengthening for early detection and management of NCDs Increasing access to NCD interventions through strengthened health care systems particularly primary health care system
Action area 4 Surveillance, monitoring & evaluation and research Surveillance Monitoring and evaluation Research
The way forward Translating commitments to Action Global and regional momentum built for NCDs It is now important for countries to translate commitments to actions Countries should set national targets and develop/strengthen national multisectoral policies and action plans for prevention and control of NCDs and cost thems
Thank You