ECOSOC/UNESCWA/WHO Western Asia Ministerial
Meeting “Addressing non communicable diseases and
injuries: major challenges to sustainable development in the
21st century
NCD Burden
The Regional Responses
Dr. Ibtihal Fadhil
Regional Adviser Non communicable diseases,
World Health Organization, Regional Office for EMR
10-11 May 2009
Doha, Qatar
lesson learned
• The ADG and prominent panelists presented the
detailed insight to the growing NCD burden globally
and in EMR
• Non communicable diseases constituted around 55%
of the mortality in EMR in 2005. It is estimated that it
will increase to more than 60% by 2020 if the current
trends continue
• The Risk Factors are identifiable in EMR and therefore
can be prevented. Increasing trend of smoking
overweight and obesity among different age groups.
Cost-effective interventions are available to prevent up to
80% of cardiovascular disease and diabetes and 40% of
cancer,
Effective interventions exist for primary prevention: Examples..
- Raising tobacco taxes and prices
- Salt reduction
- Improving availability and affordability of healthy food
- Improving transportation policies and environmental designs
- Raising alcohol taxes and prices
Cost-effective interventions exist for secondary and tertiary prevention:
- Cardiovascular disease can be prevented by targeting high risk people
- 75% of recurrent heart attacks and strokes can be prevented by 4 medicines
- Treating diabetes
- Early detection of cancer
WHO Responses
Global strategy for NCD prevention & control
NCD Action plan for the global strategy
Framework convention on tobacco control
Strategy on diet physical activity and health
 Regional Framework on DPAS
The Regional strategy on cancer control
Successful interventions
• Heart file in Pakistan,
• The Isfahan healthy heart project in the
Islamic Republic of Iran,
• Nizwa Healthy City in Oman and
• Dar Al Fatwa in Lebanon
• Araina in Tunisia
community-based intervention
Isfahan - Iran
Isfahan healthy Heart community Program
“North Karelia of the Middle East”
A 6-year program Launched in 1999 an
integrated, community-based
intervention aimed at fostering
healthy diet,
• The program is quasi experimental: a
reference population exists
The Isfahan Healthy Heart
Program (IHHP)
•
IHHP interventions in two cities of Isfahan
and Najaf Abad have involved more than
150 government and non-government
organizations.
•
Interventions: community-based
approach reduced tobacco smoking,
increased physical activity and stress
reduction among 2 m people in central
Iran. to tackle NCDs risk factors using a.
IHHP strategies to control CVD
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increasing fibre and decreasing salt content in
bread
convincing snack producers to market for children
new snacks with less trans fats and sugars
serving healthy foods and increasing exercise
times in schools and workplaces
setting standards for restaurants
stopping television advertising of sausage and
soft drinks
incorporating messages into TV programs
simplifying food labelling.
Results: increased intake of liquid oil, decreased smoking,
increased physical activity, increased awareness of health personnel.
IHHP initiatives
A bicycle path in Isfahan
Promotion of vegetarian
pizza served with salad
community-based Interventions
Nizwa - Oman
Nizwa healthy lifestyle project in Oman
• Community–based approach to tackle risk
factors
• Interventions were undertaken in 2004.
• Evaluation in 2009
• The project promotes healthy lifestyle through
three subcommittees;
(1) Tobacco control & accident prevention;
(2) Promotion of physical activity and
(3) Promotion of healthy nutrition.
Targeted outcome
Physical Activity:
• Increase of percentage of physical activity among
men from 52% to 67%.
• Increase of percentage of physical activity among
women from 27% to 42%.
• Reduce the current prevalence of overweight among
men from 31.9% to 25% and among women from
25.3% to 19%.
• Reduce the current prevalence of obesity among men
from 8.6% to 5.6% and among women from 17% to
11%.
Targeted outcome
Dietary styles:
• Reduce the percentage of usage the animal’s fat from
83.9% to 68.9% and increase the percentage of usage
the vegetarian oils from 74.9% to 89.9%.
• Reduce the prevalence of hypercholesterolemia from
34.6% to 28.6% among men and among women from
36% to 30%.
• Increase the knowledge (know-how) about healthy
dietary habits from 32% to 67%.
Targeted Outcome
Tobacco use, RTA, and domestic accidents
• Reduce the percentage of the regular smokers
and irregular smokers from 9.2% to 4.5% .
• Establishment of counseling service to assist
quitting smoking.
• Reduce the deaths and diseases related to
tobacco.
• Increase public awareness about prevention of
road traffic, home (domestic) accidents, work
injuries, and poisonings.
• Reduce the percentage of road traffic
accidents, injuries and poisonings
subsequently reduce the death related to them
Interventions
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NHLP Friendly Schools
Alharaka Baraka (Move for Health)
Lifestyle Clinic
Health professionals education and
involvement
• Obesity screening and management at
PHC
• Tobacco intervention, Health education
in schools and tobacco cessation clinic
WHO Global Strategy on Diet, Physical Activity and Health &
Regional Framework
The Regional Framework is a response to
the growing burden of NCDs in the EM
Region.
 Addresses two of the main risk factors
for non-communicable diseases, namely
diet and physical activity
Develop multicultural approach for the
prevention and control of NCD's
 Specificity in EM Region ( physical
activities, diet and food consumption
patterns
Policy to promote physical
activities
100
80
60
Leisure
40
Work
20
0
No/light
Moderate
Vegorous
• Under The Patronage of his highness the
Crown Prince of Kuwait.
• Multiple sectors involved as members (
Health professionals, exercise specialists,
Nutritionists, Media, Politicians etc.
Outcome
Be an active Citizen
Inter-sectoral collaboration
Support Physical Activities In Bahrain
School based interventions
Health Promoting Schools in EMR
• The health-promoting
schools initiative is
being implemented in all
countries
• Healthy choices made
easy and enjoyable to
all school children,
school staff and parents
Health promoting schools
• In United Arab Emirates &
Bahrain is a collaborative effort
between the Ministry of Health
and Ministry of Education
(through the Joint Committee),
with other relevant partners
including the Gulf Cooperation
Council (GCC) School Health
Committee and WHO.
• The 8 components of the health
promotion are implemented in all
schools .
AKey
Waychallenges
Forward
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Leaders
Supportive environment
Funding
Community awareness
Clear Problem, Indeed we have the
ability to make clear Actions