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NCDs in the development agenda

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The Partnership to Fight Chronic Diseases in this paper attempts to sensitise decision makers at all levels towards the growing burden of non-communicable diseases and shape their opinion towards a multi-stakeholder approach

201611ehm24
Dr Kenneth Thorpe

The Partnership to Fight Chronic Disease (PFCD) with technical support from the National Health Systems Resource Centre (NHSRC) recently released an advocacy paper – ‘NCDs in the Development Agenda.’

DIABETES

  • The WHO estimates that 80 per cent of diabetes deaths occur in low and middle-income countries and projects that such deaths will double between 2016 and 2030
  • India is a home to 65.1 million diabetic patients at present, compared to 50.8 million in 2010, and the number expected to increase to 101.2 million by 2030, according to the International Diabetes Federation
  • India’s diabetic population is seen rising by a staggering 79 per cent to 123.5 million by 2040, according to The International Diabetes Federation
  • Indians are diagnosed with diabetes on average 10 years earlier than their Western counterparts

CARDIOVASCULAR DISEASES (CVDs)

  • CVDs have now become the leading cause of mortality in India, with a quarter of all mortality attributable to it
  • Ischemic heart disease and stroke are the predominant causes and are responsible for more than 80 per cent all CVD deaths
  • The Global Burden of Disease study estimate of age-standardized CVD death rate of 272 per 100,000 population in India is higher than the global average of 235 per 100,000 population
  • Premature mortality in terms of years of life lost because of CVD in India increased by 59 per cent, from 23.2 million in 1990 to 37 million in 2010
  • The rate of CVD mortality in India in the 30-59 year age group is double than that in the US
  • The incidences of CVDs have increased significantly for people between the age 25 and 69 to 24.8 per cent, resulting in the loss of more productive people

CANCER

  • Prevalence of cancer in India is estimated to be 3.9 million people with reported incidence of 1.1 million in 2015
  • The National Cancer Registry Program of the India Council of Medical Research (ICMR) shows that new cancer cases or its incidence in India is estimated to grow by 25 per cent by 2020, with around 1.4 million in 2016 to over 1.7 million by 2020
  • Breast and cervical cancers among women, head, neck, lung and gastrointestinal cancers among men represent more than 60 per cent of the incidence burden
  • According to a Tata Memorial Hospital study, more than 20 per cent of the world’s childhood cancer deaths happen in India
  • At least 70,000 kids between the ages of four months and 14 years are diagnosed with one of the 16 forms of childhood cancers annually

CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)

  • India is estimated to have 30 million COPD patients
  • According to the recent Global Burden of Disease Study, COPD has become one of the major causes of death in the country
  • India contributes a significant and growing percentage to global COPD mortality rates, with India projected to be amongst the highest in the world
  • The prevalence rate is likely to average around five per cent in the adult population with higher rates in smokers, males, rural areas, depending on the type of domestic fuel use and socioeconomic status

MENTAL ILLNESS

  • At least five per cent of the population in India lives with a mental illness, which translates to over 50 million people, spread across both urban and rural area
  • According to recent papers published in The Lancet and The Lancet Psychiatry, 38.1 million years of healthy life will be lost due to mental illness in India by 2025, an increase of 23 per cent from 2013
  • Nearly half of those with severe mental disease aren’t treated and of those with less severe versions, nearly nine in 10 go uncared for
  • According to the government’s estimates, about 1 in 5 people in the country need counselling, either psychological or psychiatric
  • Depression, the most prevalent form of mental illness, is estimated to exist in three of every 100 in urban areas, and of this one in three are severely neurotic

National Action Plan and Monitoring Framework for Prevention and Control of NCDs

  • National NCD Monitoring Framework outlines 21 indicators and 10 targets for the prevention and control of NCDs
  • The specified indicators and targets will be used to track progress of actions designed to prevent and control NCDs until 2025, in India
  • Suggested action points by diverse sectors to meet the NCD targets at various levels have been outlined

Screening

Guidelines for the prevention, early detection and control of:
Diabetes

  • Hypertension
  • Common cancer

Awareness

  • M-Diabetes initiative under which information is being provided through mobile telephony network on how to prevent and manage diabetes
  • Digital and broadcast media campaigns to raise public awareness on diet and/ or physical activity

Reduction measures for the harmful use of tobacco

  • Ban on smoking in many public places and work places as well as on public transport
  • Ban on the sale of tobacco products to person below 18 years, and in places within 100 metres radius from educational institutions
  • Advertisement of tobacco products is prohibited. Surrogate advertisement is also not allowed

Draft National Health Policy 2015

  • Inclusion of NCDs for the very first time in the draft National Health Policy
  • It would support an integrated approach where screening for the most prevalent NCDs would be incorporated into the comprehensive primary health care network
  • It would ensure emphasis on medication and access for select chronic illness on a round the year, basis

Unhealthy Diet Reduction Measures

  • Marketing to children restrictions
  • Marketing of breast-milk substitutes restrictions

References:
1. http://www.searo.who.int/india/topics/tobacco/economic_burden_of_tobacco_related_diseases_in_india_executive_summary.pdf
2. http://www3.weforum.org/docs/WEF_EconomicNonCommunicableDiseasesIndia_Report_2014.pdf
3. http://www3.weforum.org/docs/WEF_EconomicNonCommunicableDiseasesIndia_Report_2014.pdf
4. http://apps.searo.who.int/PDS_DOCS/B0361.pdf
5. http://www3.weforum.org/docs/WEF_EconomicNonCommunicableDiseasesIndia_Report_2014.pdf
6. https://www.pharmamedtechbi.com/publications/pharmasia-news/2016/4/20/who-raps-indias-low-level-public-health-care-investment
7. https://www.pharmamedtechbi.com/publications/pharmasia-news/2016/4/20/who-raps-indias-low-level-public-health-care-investment
8. http://thelancet.com/journals/lancet/article/PIIS0140-6736(10)61884-3/fulltext
9. http://dcp-3.org/sites/default/files/resources/Circulation%20article_DP.pdf
10. http://dcp-3.org/sites/default/files/resources/Circulation%20article_DP.pdf
11. http://dcp-3.org/sites/default/files/resources/Circulation%20article_DP.pdf
12. http://www.omicsonline.org/open-access/risk-factors-associated-with-the-increasing-cardiovascular-diseases-prevalence-in-india-a-review-2155-9600-5-331.php?aid=36844
13. http://www.ey.com/Publication/vwLUAssets/EY-Call-for-action-expanding-cancer-care-in-india/$FILE/EY-Call-for-action-expanding-cancer-care-in-india.pdf
14. http://icmr.nic.in/icmrsql/archive/2016/7.pdf
15. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3978965/
16. http://www.who.int/mediacentre/factsheets/fs312/en/
17. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3775194/

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