NCD still a ma­jor pub­lic health chal­lenge

Bhutan Times - - Editorial -

The Bhutanese peo­ple are in­creas­ingly af­fected by the ris­ing bur­den on NCDs which in­clude: heart dis­ease, di­a­betes, chronic res­pi­ra­tory dis­eases and can­cers, and men­tal dis­or­ders.

These dis­eases are largely pre­ventable through pub­lic poli­cies that tackle the main risk fac­tors of al­co­hol, tobacco, un­healthy diet and phys­i­cal in­ac­tiv­ity. Yet, too many pre­ventable deaths and dis­abil­i­ties oc­cur de­spite the ex­is­tence of cost ef­fec­tive so­lu­tions and pol­icy op­tions to ad­dress NCDs and men­tal dis­or­ders.

NCDs and men­tal dis­or­ders pose sig­nif­i­cant chal­lenges on health, the econ­omy and to so­ci­ety in Bhutan. NCDs af­fect peo­ple of prime age who are the eco­nomic back­bone of the na­tion, as well as the el­derly pop­u­la­tion with longevity in­creas­ing among the Bhutanese.

Con­cerned with the NCD epi­demic, Bhutan joined the global ef­forts and pledged to com­bat NCDs in the coun­try through the 2011, 2014, 2018 United Na­tion (UN) High-Level com­mit­ments, World Health As­sem­bly and re­gional com­mit­ment res­o­lu­tions. Bhutan has deeply re­solved to im­ple­ment these com­mit­ments that will se­cure the health, hap­pi­ness and so­cial cap­i­tal of the coun­try.

While, progress have been made in the king­dom in ad­dress­ing NCDs and men­tal dis­or­ders through multi-sec­toral ap­proach, re­sponse needs to be fur­ther ac­cel­er­ated and scaled up through whole-of-gov­ern­ment, whole-of so­ci­ety and cross-sec­toral ap­proaches to re­duce deaths by 2025 and the 2030 Sus­tain­able De­vel­op­ment Goal (SDG) health tar­gets.

Lo­cal gov­ern­ment ad­min­is­tra­tions must take greater steps in cre­at­ing and en­abling en­vi­ron­ment to pro­mote healthy life­style and for the im­ple­men­ta­tion of risk fac­tor pre­ven­tion ac­tiv­i­ties for tobacco and al­co­hol con­trol in their an­nual de­vel­op­men­tal work plans.

Holis­tic healthy life­style in­ter­ven­tions in schools and in­sti­tu­tions, pub­lic and pri­vate work­places and the com­mu­nity must be pri­or­i­tized and healthy work­place stan­dards must be adopted and im­ple­mented in these set­tings.

En­force­ment of the ex­ist­ing laws and reg­u­la­tory mea­sures must be strength­ened to pro­tect pub­lic health through ef­fec­tive con­trol of tobacco and al­co­hol, pro­mo­tion of healthy diet and phys­i­cal ac­tiv­ity and con­trol of other risk fac­tors and men­tal dis­or­ders.

Healthy life­style pro­mo­tion and es­sen­tial NCD ser­vice tar­get­ing hard-to-reach and un­reached pop­u­la­tions such as ur­ban poor, those liv­ing in ge­o­graph­i­cally dif­fi­cult ter­rains, and dif­fer­ently abled peo­ple, in­di­vid­u­als with men­tal ill­ness, and among chil­dren and older peo­ple should be im­proved among oth­ers.

As per the WHO es­ti­mates, in Bhutan NCDs are re­spon­si­ble for 69 per­cent of all deaths mak­ing it the lead­ing cause of all pre­ventable deaths. Among them, 53 per­cent died be­fore 70 years of age.

Health sys­tem in Bhutan de­vel­oped over five decades ago when in­fec­tious dis­eases and vac­cine pre­ventable dis­eases were the lead­ing cause of ill­ness and deaths, now need ma­jor re­view and over­haul to be able to tackle the NCDs, added the di­rec­tor.

Ma­jor­ity of com­mu­ni­ca­ble dis­eases that can be pre­vented and treated by pri­mary pre­ven­tion like im­mu­niza­tion, good hy­giene prac­tices at low cost and ef­fec­tive an­tibi­otics for spec­i­fied du­ra­tion, how­ever, for NCDs, many de­ter­mi­nants of be­hav­ioral risk fac­tors lie out­side the health do­main and have strong root so­cial causes such as poverty and il­lit­er­acy that also im­pact health in gen­eral.

The bur­den and treat of NCDs con­sti­tutes a ma­jor pub­lic health chal­lenge that un­der­mines so­cial and eco­nomic de­vel­op­ment through­out the world, and among oth­ers, has the ef­fect of in­creas­ing in­equal­i­ties be­tween coun­tries and within pop­u­la­tion.

We want strong lead­er­ship and ur­gent ac­tion at the global, re­gional and na­tional lev­els to mit­i­gate the in­equal­ity.

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