The prevalence of non-communicable diseases (NCD) such as cardiovascular disease, diabetes, chronic obstructive pulmonary disease, and cancers is increasing by the day in the country. Today high blood pressure is a leading risk factor for cardiovascular disease. In 2008, 24 per cent of all deaths in India were from cardiovascular diseases, Dr Nata Menabde, World health Organisation (WHO) Country Head told The Pioneer.
High blood pressure affects one in three adults worldwide and leads to more than nine million deaths globally every year. Many people do not even know that they are suffering from it. Prevention and control of this silent killer requires action by the whole society. It is essential that NCDs (including high blood pressure) are addressed in health system strengthening efforts for universal health coverage.
In many countries, including India, the out-of-pocket expenditures incurred for NCDs are high, contributing to the impoverishment of households and hitting the poor the worst. Medicines for these chronic diseases account for a large portion of expenditures, added Menabde.
The genetic combinations of Indians make them more susceptible to hypertension and diabetes. The genetic vulnerability of South Asians to diabetes is such that, in the United Kingdom, being of Indian descent is viewed as a risk factor in itself.
According to various studies conducted by Indian council of Medical Research (ICMR) on NCDs, it was noted that non-communicable disease like cancer and cardiovascular diseases have replaced communicable disease as the biggest killer in India. According to a 2010 University of Toronto study, the leading cause of death in middle-aged men is heart disease, even in poorer States such as Uttar Pradesh and Bihar.
Dr Menabde says, it is important to create an environment conducive to healthy lifestyles, in which it is easier for all people to make choices that promote better health.
Such an environment reduces exposure to the risk factors for NCDs, including food containing too much salt, sugar and fat, inadequate intake of fruits and vegetables, harmful use of alcohol, consumption of tobacco and insufficient physical activity.
Beside the policies, programmes, and necessary accessibility to medicines, controlling and maintaining a healthy blood pressure can start with having less salt at home.
Eating a balanced diet, reducing salt, regular exercise, avoiding tobacco, reducing alcohol intake, and monitoring your blood pressure regularly are also important, adds the country head.
According to the report published by WHO, India ranks very high among nations struck by rising wave of ‘premature deaths’ caused by NCDs, mainly heart and blood ailments.
Talking about country specific strategy to control this menace Dr Nata Menabde said WHO has increasingly been providing normative guidance to Member States since 2000 to address non-communicable diseases. Global efforts to tackle the challenge of non-communicable diseases have gained momentum since the 2011 United Nations Political Declaration on the prevention and control of non-communicable diseases.
Building on its previous strategies, WHO is developing a Global Plan of Action for NCDs for 2013-2020 to provide a roadmap for country-led action for prevention and control of non-communicable diseases. WHO’s Member States are also reaching consensus on a global monitoring framework to track progress in preventing and controlling these diseases and their key risk factors, she added.
In the eleven countries of the WHO South-East Asia Region, work is also underway towards a Regional Action Plan for NCDs.
WHO has produced normative guidance and tools useful in reducing hypertension. These include but are not limited to guidelines on hypertension and assessment and management of cardiovascular risk, the Package of Essential NCD Interventions (WHO PEN) for primary care in low-resource settings, and the WHO/International Society of Hypertension (WHO/ISH) cardiovascular risk prediction charts.
The WHO/ISH risk prediction charts indicate 10-year risk of a fatal or nonfatal major cardiovascular event (myocardial infarction or stroke), according to age, sex, blood pressure, smoking status, total blood cholesterol and presence or absence of diabetes mellitus.
The draft Global action plan for the prevention and control of NCDs 2013-2020 includes a specific objective on building national capacity for high quality research and development, areas that relate to the health system stewardship function.
Specifically, the action plan calls on Member States to increase investment in research in NCDs, develop a national research policy and plan on NCDs, strengthen national capacity for research through initiatives to support skills, infrastructure, equipment and supplies.