Premature deaths from cancer, heart diseases, stroke, diabetes and certain lung diseases have jumped to 70 per cent of all global deaths in the last few years, posing a major threat to sustainable development of nations, according to an assessment report on non-communicable diseases (NCDs) by the World Health Organisation (WHO). The report highlights the need to intensify national action to meet the global targets governments have agreed in order to protect their people from cancer, cardiovascular diseases, stroke, diabetes and chronic respiratory diseases – the Sustainable Development Goals (SDGs) agenda includes a target to reduce premature deaths from NCDs by 30% before 2030.
Another study in the ‘Lancet’ said that by 2030, nearly 70 to 80 per cent of all global deaths will be from NCDs. Of these deaths due to NCDs, 80 per cent will be in the less wealthy nations, and approximately 16 million deaths involving people under-70 years of age. The total number of deaths from NCDs are projected to increase by 17 per cent over the next 10 years. The greatest increase will be seen in the African region (27 per cent) and the Eastern Mediterranean region (25 per cent), and the highest absolute number of deaths will occur in the South-East Asia.
In an earlier report, the WHO had particularly expressed concern about diabetes, as the number of people living with the illness has nearly quadrupled in the last 35 years, with most living in developing countries. The report said that diabetes cases have risen to 422 million in 2015 from 108 million in 1980 – 314 million more, and warned that the world is facing an ‘unrelenting march’ of the illness which now affects nearly one in 11 adults.
According to the report, the numbers would continue to increase unless ‘drastic action’ was taken particularly in view of the fact that high blood sugar levels are a major killer – linked to 3.7 million deaths around the world each year. Even in the poorest setting, governments must ensure that people are able to make these healthy choices and that health systems are able to diagnose and treat people with diabetes promptly and efficiently. The report clubs both Type 1 and Type 2 diabetes together, but the surge in cases is predominantly of Type 2 – the form closely linked to unhealthy lifestyle and the consequent overweight and obesity.
India is now in the grip of an obesity epidemic and the trend needs to be immediately arrested, says a study by the Organisation for Economic Co-operation and Development (OECD), which warned that low income countries cannot cope with the health consequences of wide scale obesity. The study that looked at the burden of overweight citizens in six countries – Brazil, China, India, Mexico, Russia and South Africa – has found that India’s overweight rates in the last about a decade increased by 20 per cent. Currently, almost one in 5 men and over one in 6 women are overweight. In some urban areas, the rates are as high as 40 per cent.
Obesity is said to be the root for several non-communicable diseases in India. According to estimates in the study, the annual cost-effectiveness ration of a broad-based prevention strategies tackling obesity and other related health threats, would be very high for India. The country has far fewer healthcare resources to deal with the consequences of obesity, which includes high rates of cardiac disease, stroke, cancer, diabetes and respiratory ailments.
Incidentally, policy makers in India are particularly concerned about the premature deaths due to heart disease, cancer, stroke, diabetes and chronic lung diseases, as these diseases account for 55 per cent of the premature mortality in the country in the age group of 30 to 60 years. To control the incidence and mortality from these diseases, the Union Health Ministry has introduced National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular diseases, strokes and lung diseases in 2008. The programme was initially rolled out in around 100 districts in 2010, and has now been further approved in 500 districts across the country.
Under the programme, over 300 districts have been sanctioned dedicated NCDs clinics, whereas around 85 cardiac clinics have already been started across the country. Besides, the Health Ministry has started retail stores like AMRIT to make cancer and cardiovascular drugs available at a largely discounted price. India is also the first country to develop specific national targets and indicators aimed at reducing the number of premature deaths from NCDs by 25 per cent by 2025. Besides, India has developed a National Multi-sectoral Action Plan outlining actions that can be initiated by various other ministries in addition to Health Ministry in order to reduce the NCD burden, in line with WHO’s global action plan.
According to recent WHO assessment, so far 60 per cent countries have set national time-bound targets for NCDs indicators. Tobacco taxation is the most widespread fiscal intervention with 87 per cent of countries reporting that they have implemented excise and non-excise taxes on tobacco. Alcohol taxation is the second most widespread fiscal intervention with 80 per cent of countries reporting this type of intervention. Experts are of the opinion that up to 80 per cent of heart disease, stroke, respiratory disease and Type 2 Diabetes and over a third of cancers can be prevented by eliminating shared risk factors mainly due to tobacco use, unhealthy diet, physical inactivity and the harmful use of alcohol.
Though WHO has recognised the recent efforts made by India to control mortality from NCDs, it says countries like India and China need to speed up efforts to meet global commitment. The UN agency has stressed on the need for countries to regulate trade and marketing of unhealthy harmful products including sugar sweetened beverages and packaged food items high on sugar, salt and fats.
(The writer is a freelance journalist).
