Are actions out-of-step to control the 'tsunami' of NCDs?

Author:

Shobha Shukla

Shobha Shukla, CNS (Citizen News Service)

· Photograph of Amy Israel is online at: http://bit.ly/2Ck6Itb

The city of Sharjah is about to get an air-conditioned walkway to promote walking all the year round- during the 5 months of searing summer heat of United Arab Emirates (UAE), informed the Ruler of Sharjah at the Second Global NCD Alliance Forum 2017: "Stepping up the pace on NCDs: Making 2018 count". In 2015 Sharjah, was officially recognised as a WHO Healthy City, by meeting 88% of WHO Healthy City programme criteria. It abounds in public spaces for sports and physical activities too.

CAR-FREE DAY EVERY MONTH IN KIGALI

The City Council of Kigali, the capital of Rwanda, has been organising a 'car free day' on the first Sunday of every month since May 2016, as part of its NCDs awareness campaign. From 7am to 10am on that day the city’s main roads are closed to cars and are instead used for physical activities like walking, running, cycling etc. Participants are also checked for blood sugar, blood pressure, and Glaucoma (glaucoma can cause blindness if left untreated). Its resounding success has led to its replication in two other cities. It is important to mention that our governments have committed to eliminate avoidable blindness by 2020, one of the causes of which is Glaucoma.

MEXICO RESOLUTE TO PREVENT CHILDHOOD OBESITY

After getting the dubious distinction of having the maximum number of obese children, who often develop diabetes later in life, Mexico is all set to prevent childhood obesity by providing safe play areas in schools. Mexican Ministries of Health and Education are working in partnership to prevent children from getting diabetes at a young age.

'NO EMPTY SHELVES'

The 'no empty shelves' project of the Coalition for Access to NCD Medicines and Products led by PATH is dedicated to increasing access to essential medicines and health products to reduce the impact of noncommunicable diseases (NCDs) such as diabetes, hypertension and cardiovascular diseases (CVDs). Their 'no empty shelves' project builds global evidence around availability of affordable essential medicines and technologies for diabetes in low-resource settings.

These are some of the initiatives that are being taken to combat the tidal wave of noncommunicable diseases (NCDs) that is sweeping across nations even though they are not transmitted from person to person. Driven largely by four main modifiable risk factors – tobacco use, unhealthy diet, physical inactivity, and harmful use of alcohol, NCDs like CVDs (the world’s leading killer causing nearly 50% of all NCD deaths), cancer, chronic respiratory diseases (such as asthma), diabetes and mental and neurological disorders - are the most common cause of death and disability worldwide - killing 39.5 million people every year (70% of all deaths globally). They are severely impacting low and middle income countries (LMICs) with four out of five people with an NCD living in a LMIC.

STRONGER HEALTH SYSTEMS AND INTEGRATED RESPONSES ARE VITAL

In an interview given to Shobha Shukla, Managing Editor of CNS (Citizen News Service), on the sidelines of the Global NCD Alliance Forum, AMY ISRAEL, Policy Director at Lilly Global Health, stressed upon the need to build strong and integrated health systems that can respond to and address multiple health conditions, instead of approaching NCDs in silos.

"Most countries currently have vertical programmes with people going to different clinics at different locations for different diseases. Having all the clinics located in different rooms of the same building will increase chances of people staying on their treatment path. We need to develop solutions that look at person-centric care rather than disease centric care. We have tested mechanisms in TB, like mobile technology, that are less human resource intensive to ensure that people complete their treatment and are helped along the cascade of care. These can be applied to diabetes and CVDs too. Also, there are huge opportunities to screen patients, for at least diabetes and hypertension, when they first come to any clinic, including a primary healthcare centre, for any health condition, and then immediately link to care for confirmatory diagnosis. This can be a great entry way for diagnosing and starting treatment early on. These interventions have shown success in many countries like Mexico and South Africa where we succeeded in detecting a lot more cases of diabetes through this. One of the barriers in South Africa was that people did not want to go very far from their house to a district hospital to get their insulin, as it could entail loss of wages, problems of childcare, etc. So if insulin is offered at primary healthcare level, just like HIV and TB medicines, it would make a difference", she said.

As diabetes type-2 and hypertension are getting younger victims with every passing day, Amy Israel advised that, instead of resorting to emergency responses, people should be diagnosed and put on treatment and care without wasting precious time. Many countries have put in their guidelines that people should be screened at 30-35 years onwards. But those who have higher risk factors, should be screened earlier. Schools are great entry ways to test some of the behaviour changes that can be made to prevent the onset of some of these NCDs. So a combination of school and community based education is the need of the hour. Having children and adults exercise everyday is very crucial, she said.

A sustainable development that (i) reduces air pollution; (ii) provides safe public transport, footpaths for walking and affordable play / sports areas for kids, (iii) reins in the march of sugary beverages and unhealthy processed foods; and (iv) results in smart investments for strengthening health systems (especially primary healthcare); can help us achieve the SDG goal of reducing premature mortality from NCDs by one-third by 2030.

We have to communicate, educate, agitate (but not violate) to ensure that political will results in concrete action at the ground level, because as Dr Tom Frieden, former head of CDC and current head of Resolve initiative, said at the Forum: "Healthy people = healthy economies = a safer and more secure world for all."

Shobha Shukla, CNS (Citizen News Service)

(Shobha Shukla is the Managing Editor of CNS (Citizen News Service) and has written consistently on health and gender justice for several years. Follow her on Twitter @Shobha1Shukla or visit www.citizen-news.org)

- Shared under Creative Commons (CC) Attribution License.