Noncommunicable Diseases
NCD
• Noncommunicable diseases (NCDs) kill more
than 36 million people each year.
• Nearly 80% of NCD deaths - 29 million - occur
in low- and middle-income countries.
• More than nine million of all deaths attributed
to NCDs occur before the age of 60;
– 90% of these "premature" deaths occurred in lowand middle-income countries.
Annual Mortality Burden NCD
1.
2.
3.
4.
Cardiovascular diseases deaths (17.3 million)
Cancers (7.6 million)
Respiratory diseases (4.2 million)
Diabetes (1.3 million1).
• Cardiovascular diseases, cancers, respiratory
diseases, and diabetes account for ~80% of all
NCD deaths.
• Four shared modifiable risk factors:
– tobacco use
– physical inactivity
– harmful use of alcohol
– unhealthy diets.
• Risk factors of tobacco use, physical inactivity,
harmful use of alcohol, unhealthy diets lead to
metabolic/physiological changes that increase
the risk of NCDs:
1.
2.
3.
4.
raised blood pressure
Weight gain  overweight/obesity
hyperglycemia (high blood glucose levels)
hyperlipidemia (high levels of fat in the blood).
Modifiable Risk Factors
• Tobacco accounts for almost 6 million deaths
every year (including over 600,000 deaths
from exposure to second-hand smoke), and is
projected to increase to 8 million by 2030.
• ~3.2 million deaths annually can be attributed
to insufficient physical activity.
• ~1.7 million deaths attributable to low fruit
and vegetable consumption.
• Half of the 2.3 million annual deaths from
harmful drinking are from NCDs.
Ranking NCD Risk Factors
• 16.5% of global deaths are attributed to
hypertension
• Tobacco use (9% global deaths)
• High blood glucose (6%)
• Physical inactivity (6%)
• Overweight and obesity (5%).
– Low- and middle-income countries are witnessing
the fastest rise in overweight young children.
• The MDGs did not adequately address …
increase in NCDs
• Other significant NCD
– mental and neuropsychiatric disorders
– oral diseases
– injuries
– blindness
WHO Response
• First step – WHO, “2008-2013 Action plan of
the global strategy for the prevention and
control of noncommunicable diseases”
• Includes measures/strategies to lessen the risk
factors associated with NCDs.
• Plan has 6 objectives….
6 Objectives 2008-2013 NCD Plan
1. To raise the priority accorded to NCD in
development work at global and national
levels, and to integrate prevention and
control of such diseases into policies across
all government departments.
2. To establish and strengthen national policies
and plans for the prevention and control of
NCD.
6 Objectives 2008-2013 NCD Plan
3. To promote interventions to reduce the main
shared modifiable risk factors for NCD : tobacco
use, unhealthy diets, physical inactivity and
harmful use of alcohol
4. To promote research for the prevention and
control of NCD.
6 Objectives 2008-2013 NCD Plan
5. To promote partnerships for the prevention
and control of NCD.
• 6. To monitor NCD and their determinants and
evaluate progress at the national, regional and
global levels
NCD Goal Setting
• May 2012 World Health Assembly approved
the goal to reduce premature deaths from
NCDs by 25 percent by 2025.
• Video
• http://www.prb.org/Publications/Datasheets/
2012/world-population-data-sheet/video.aspx
Global NCD Action Plan 2013-2020
• WHO member States set the first-ever
voluntary global targets to prevent and
manage NCDs, 11/12
• WHO approved a comprehensive global
monitoring framework for the prevention and
control of NCDs, including a set of indicators
and a set of voluntary global targets, 5/13.
Global NCD Action Plan 2013-2020.
Global NCD Action Plan 2013-2020.
• Sets 9 voluntary global targets and 25
indicators aimed at monitoring progress in
reducing the burden of NCDs, cutting risk
behaviors, and monitoring multisectoral
action and health systems responses to
prevent and manage NCDs.
Voluntary Global Targets Aim to:
• Cut avoidable premature deaths from the leading
NCDs by 25 percent
• Decrease leading risk behaviors, namely tobacco
use, harmful alcohol use, physical inactivity, and
excess salt/sodium intake
• Stop the rise in diabetes and obesity and reduce
population levels of raised blood pressure
• Encourage access to essential medicines and
technologies for NCDs and promote appropriate
use of drug therapy to reduce heart attacks and
strokes
Selected Benchmarks
(1) A 25% relative reduction in risk of premature
mortality from cardiovascular diseases, cancer,
diabetes, or chronic respiratory diseases
(2) At least 10% relative reduction in the harmful
use of alcohol, as appropriate, within the
national context
(3) A 10% relative reduction in prevalence of
insufficient physical activity
Benchmarks
(4) A 30% relative reduction in mean population
intake of salt/sodium
(5) A 30% relative reduction in prevalence of
current tobacco use in persons aged 15+ years
Benchmarks
(6) A 25% relative reduction in the prevalence of
raised blood pressure or contain the prevalence
of raised blood pressure, according to national
circumstances
(7) Halt the rise in diabetes and obesity
Benchmarks
(8) At least 50% of eligible people receive drug
therapy and counseling (including glycemic
control) to prevent heart attacks and strokes
(9) An 80% availability of the affordable basic
technologies and essential medicines, including
generics, required to treat major NCD in both
public and private facilities
• The Problem
• Cooking and heating with solid fuels indoors
pollutes the air and increases the risk of illness
for nearly 3 billion people worldwide. This type of
indoor air pollution is the leading cause of lung
cancer and chronic lung disease among
nonsmoking women in the world’s poorest
communities. The risk for cardiovascular diseases,
digestive and cervical cancers, and low birth
weight babies may increase when women
breathe this unsafe air every day.