WHO calls for urgent action to prevent 16m premature deaths per year

Islamabad
Of the 38 million lives lost to non-communicable diseases (NCDs) in 2012, 16 million or 42% were premature and avoidable — up from 14.6 million in 2000, informs the World Health Organisation’s ‘Global Status Report on Non-Communicable Diseases 2014.’
The report, which was released globally on January 19, provides current estimates on NCD mortality (2012) and risk factors in 194 countries and moves on to establish that most premature NCD deaths are preventable.
Based on the findings of the study, WHO has urged governments to take urgent action to meet the global targets to reduce the burden of NCDs, and prevent the annual toll of 16 million people dying prematurely — before the age of 70 — from heart and lung diseases, stroke, cancer and diabetes.
The report points out that from 2011-2025, cumulative economic losses due to NCDs under a “business as usual” scenario in low- and middle-income countries is estimated at US $7 trillion. WHO estimates the cost of reducing the global NCD burden is US$ 11.2 billion a year: an annual investment of US $1-3 per capita.
Premature NCD deaths can be significantly reduced through government policies reducing tobacco use, harmful use of alcohol, unhealthy diets and physical inactivity, and delivering universal health care. “For example, in Brazil, the NCD mortality rate is dropping 1.8% per year due in part to the expansion of primary health care,” the report mentions.
But the publication calls for more action to be taken to curb the epidemic, particularly in low- and middle-income countries, where deaths due to NCDs are overtaking those from infectious diseases. Almost three quarters of all NCD deaths (28 million), and 82% of the 16 million premature deaths, occur in low- and middle-income countries.
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 9 voluntary global targets that address key NCD risk factors including tobacco use, salt intake, physical inactivity, high blood pressure and harmful use of alcohol.
The report provides ‘best buy’ or cost-effective, high-impact interventions recommended by WHO, including banning all forms of tobacco advertising, replacing trans fats with polyunsaturated fats, restricting or banning alcohol advertising, preventing heart attacks and strokes, promoting breastfeeding, implementing public awareness programmes on diet and physical activity, and preventing cervical cancer through screening.
Many countries have already had success in implementing these interventions to meet global targets. Pakistan, unfortunately, is not among them. Even in areas such as tobacco control, where significant groundwork has been done in the past to build upon, the government is yet to enforce a complete ban on tobacco advertising. Moreover, it has neither rotated the health warning on cigarette packs, nor even increased the size of the pictorial warning or replaced it with a new one.
In providing examples of regional and country ‘best buy’ successes, the report mentions Turkey as being the first country to implement all the ‘best-buy’ measures for tobacco reduction. In 2012, the country increased the size of health-warning labels to cover 65% of the total surface area of each tobacco product. Tobacco taxes now make up 80% of the total retail price, and there is currently a total ban on tobacco advertising, promotion and sponsorship nationwide. As a result, the country saw a 13.4% relative decline in smoking rates from 2008 to 2012.
Similarly, Hungary passed a law to tax food and drink components with a high risk for health, such as sugar, salt and caffeine. A year later, 40% of manufacturers changed their product formula to reduce the taxable ingredients, sales decreased 27% and people consumed 25-35% fewer products.
Argentina, Brazil, Chile, Canada, Mexico and the USA have promoted salt reduction in packaged foods and bread. Argentina has already achieved a 25% reduction in the salt content of bread.
Though some countries are making progress towards the global NCD targets, the majority are off course to meet the 2025 targets. While 167 countries have operational NCD units in the ministry of health, progress on other indicators has been slow, especially in low- and middle-income countries.
As of December 2013, only 70 countries had at least one operational national NCD plan in line with the Global NCD action plan; 56 countries had a plan to reduce physical inactivity; 60 countries had national plans to reduce unhealthy diets; 69 countries had a plan to reduce the burden of tobacco use; 66 countries had a plan to reduce the harmful use of alcohol; and 42 countries had monitoring systems to report on the nine global targets.
“NCDs impede efforts to alleviate poverty and threaten the achievement of international development goals. When people fall sick and die in the prime of their lives, productivity suffers. And the cost of treating diseases can be devastating — both to the individual and to the country’s health system,” the report states.
High rates of death and disease, particularly in low- and middle-income countries, are a reflection of inadequate investment in cost-effective NCD interventions. WHO recommends all countries move from commitment to action, by setting national targets and implementing the ‘best buy’ interventions starting in 2015.