Urgent action is needed to reduce the increasing burden of noncommunicable diseases (NCDs) and prevent the annual toll of 16 million people dying prematurely – before the age of 70 – from heart and lung disease, stroke, cancer and diabetes, according to a new World Health Organization report. The Western Pacific Region is one of two WHO regions in which deaths due to NCDs have increased the most, from 8.6 million in 2000 to 10.9 million in 2012. It is also the WHO region that accounts for the highest number of lives lost to NCDs.
“Eight out of 10 adults in the Western Pacific Region die because of NCDs. Many of these deaths can be prevented. Governments need to invest in cost-effective policies and interventions to help reduce tobacco use, harmful use of alcohol, unhealthy diets, high blood pressure and insufficient physical activity which are among the leading risk factors for NCDs,” said Dr Shin Young-soo, WHO Regional Director for the Western Pacific.
The burden of noncommunicable diseases in the Western Pacific Region
According to the Global status report on noncommunicable diseases 2014, 82% of the 16 million premature deaths occur in low- and middle-income countries, overtaking deaths from infectious diseases. In the Western Pacific Region, NCD risk factors remain unacceptably high:
- one in five adults over 18 years of age has elevated blood pressure;
- nearly half of all men over 15 years of age smoke tobacco daily; and
- 85% of adolescents do not engage in sufficient physical activity.
The NCD epidemic in the Region is aggravated by the forces of globalization, urbanization and rapid economic growth. Processed foods, often high in salt and sugar, have become more affordable and accessible, replacing traditional diets in parts of the Region.
Pacific island countries have called for a reduction in the trade of unhealthy products. According to the report, the prevalence of NCD risk factors such as overweight, obesity and elevated blood glucose is significantly higher in Pacific island countries than other parts of the Region.
In the Pacific, nearly half of women over 18 years of age are obese. One in five adults has elevated blood glucose. In declaring an NCD crisis, Pacific island leaders have underscored the fundamental role of health in development. As Samoa’s Minister of Health Dr Talalelei Tuitama put it, “With no health, there is no development.”
“NCDs create a huge financial burden for families and society,” explained Dr Shin. NCDs impede efforts to alleviate poverty and threaten the achievement of international development goals. When people of productive age fall sick and die productivity suffers. And the cost of treating diseases can be devastating - both to the individual and to a country’s health system.
Combatting NCDs in the Western Pacific Region
“Most NCDs can be prevented through ”best buy”, or cost-effective high-impact interventions,” said Dr Susan Mercado, Director of NCD and Health through the Life-Course for WHO’s Western Pacific Region. “Everyone has a role to play in the prevention and control of NCDs. Legislators, mayors, teachers, media, civil society and communities can take action to reduce NCD risks, e.g. by banning all forms of tobacco advertising, educating the public about the benefits of a healthy diet and physical activity, or promoting breastfeeding.”
Efforts must also foster a reorientation of health systems to promote better collaboration between primary care facilities and referral centres, better preventive care, early screening for risk factors, better medical records systems and improved access to essential drugs and medicines.
Many countries have already had success in implementing “best buy” interventions to meet global targets to reduce the burden of NCDs. With support from WHO, Western Pacific Member States are taking action to address the NCD burden. In the Republic of Korea, counselling centres have been established to provide community-based preventive care services. The centres provide health education, organize exercise groups and refer residents to health professionals. In Mongolia, industry engagement prompted a major bread manufacturer to reduce the amount of salt in its products. Overconsumption of salt is linked to high blood pressure.
Raising tobacco taxes and prices is one of the most effective ways to prevent NCDs. Eighteen countries in the Region have increased taxes on tobacco products over the past two years.
The WHO report provides the baseline for monitoring implementation of the Global action plan for NCDs 2013-2020, aimed at reducing the number of premature deaths from NCDs by 25% by 2025. Outlined in the action plan are nine voluntary global targets that address key NCD risk factors including tobacco use, salt intake, physical activity, high blood pressure and harmful use of alcohol. “WHO is more committed than ever to work with Member States to address each country’s particular challenges with appropriate “best buy” actions to prevent and control NCDs,” stressed Dr Shin.
Editors notes:
The report provides the most current estimates on NCD mortality (2012) and risk factors in 194 countries. The nine global voluntary targets are outlined in the report.
The first UN General Assembly high-level meeting on NCDs took place in 2011 and resulted in the adoption of a Political Declaration that put the prevention and control of NCDs high on the development agenda. The second high-level meeting took place in 2014 where countries committed to setting national NCD targets in 2015. In 2018, the UN General Assembly will convene a third high-level meeting to take stock of national progress in attaining the voluntary global targets by 2025.
The nine global NCD targets are:
Target 1
A 25% relative reduction in risk of premature mortality from CVDs, cancer, diabetes, chronic respiratory diseases
Target 2
At least 10% relative reduction in the harmful use of alcohol, as appropriate, within the national context
Target 3
A 10% relative reduction in prevalence of insufficient physical activity
Target 4
A 30% relative reduction in mean population intake of salt/sodium
Target 5
A 30% relative reduction in prevalence of current tobacco use in persons aged 15+ years
Target 6
A 25% relative reduction in the prevalence of raised blood pressure or contain the prevalence of raised blood pressure, according to national circumstances
Target 7
Halt the rise in diabetes and obesity
Target 8
At least 50% of eligible people receive drug therapy and counselling (including glycaemic control) to prevent heart attacks and strokes
Target 9
An 80% availability of the affordable basic technologies and essential medicines, including generics, required to treat major NCDs in both public and private facilities