Action plan for the prevention and control of noncommunicable diseases in

South-East Asia, 2013–2020

SEA-NCD-89 Distribution: General

© World Health Organization 2013

All rights reserved.

Requests for publications, or for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – can be obtained from Bookshop, World Health Organization, Regional Office for South-East Asia, Indraprastha Estate, Mahatma Gandhi Marg, New Delhi 110 002, India (fax: +91 11 23370197; e-mail: bookshop@searo.who.int).

The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement.

The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters.

All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use.

This publication does not necessarily represent the decisions or policies of the World Health Organization.

Printed in India

Action plan for the prevention and control of noncommunicable diseases in South-East Asia iii

ContentsSection 1. Situation analysis ......................................................................1

1.1 Regional burden of noncommunicable diseases ................1

1.2 Determinants and risk factors for NCDs ............................2

1.3 Global initiatives ...............................................................5

1.4 Regional initiatives ............................................................6

1.5 Progress and challenges in prevention and control of NCDs in the South-East Asia Region ...................8

Section 2. Action plan for the prevention and control of NCDs in South-East Asia, 2013–2020 ..................................................... 10

2.1 Purpose ..........................................................................10

2.2 Vision .............................................................................11

2.3 Goal ...............................................................................11

2.4 Targets ............................................................................11

2.5 Guiding principles ..........................................................12

2.6 Strategic Priority action areas ..........................................13

References ...............................................................................................46

Action plan for the prevention and control of noncommunicable diseases in South-East Asia 1

Section 1. Situation analysis

1.1 Regional burden of noncommunicable diseasesNoncommunicable diseases (NCDs) are the leading cause of death in the WHO South-East Asia Region. Each year, an estimated 7.9 million lives are lost due to NCDs, accounting for 55% of all deaths1. Furhermore, NCDs claim lives at a younger age in the South-East Asia Region compared to the other WHO regions. In 2008, the proportion of NCD deaths occurring among people under the age of 60 was 34%, compared to 23% in the rest of the world. Cardiovascular diseases are the most frequent cause of NCD deaths, followed by chronic respiratory diseases, cancers, and diabetes (Figure 1).

In addition to the four main NCDs, many other chronic conditions and diseases contribute significantly to the NCD burden in the Region, such as renal, endocrinal, mental, neurological, haematological, gastroenterological, hepatic, musculoskeletal, skin and genetic disorders, as well as oral diseases including dental caries, periodontal diseases and oral cancers. Thalassaemia is also a serious health problem in some Member States, especially in the Maldives where approximately 18% of the population carries the Beta thalassaemia trait.

Besides being an enormous health burden, NCDs have serious socioeconomic implications. They disproportionately affect the poor, leading to loss of household income from unhealthy behaviours, poor physical capacity and loss of wages. Due to long-term treatment costs and high out-of-pocket costs, NCDs can result in catastrophic health expenditures and impoverishment. In India, the share of out-of-pocket expenditure due to NCDs increased from 32% in 1995 to 47% in 2004; of this NCD-related expenditure, 40% was financed by

Action plan for the prevention and control of noncommunicable diseases in South-East Asia2

household borrowing and sale of assets.2 In additional to exacerbating household poverty, NCDs and their risk factors exact a huge toll on national economies. In Thailand, for example, the economic burden of the harmful use of alcohol was estimated to be equivalent to 2% of the gross domestic product in 2006.3

1.2 Determinants and risk factors for NCDsThe increasing burden of NCDs is attributed to determinants such as population ageing, rapid and unplanned urbanization, negative effects of globalization (such as trade and irresponsible marketing of unhealthy products), low literacy, and poverty (Figure 2). From 2000 to 2025, it is projected that the proportion of the population aged above 65 years will increase from 3.6% to 6.6% in Bangladesh, from 4.4% to 7.7% in India and from 6.3% to 12.3% in Sri Lanka. As the prevalence of NCDs increases with age, these progressively aging populations will result in a corresponding increase in NCD cases.

Urbanization in the South-East Asia Region is occurring at a rapid rate and increased from 26% in 1990 to 33% in 2009. It is projected that the percentage of populations residing in urban areas will more than double by 2050 in most Member States. Several studies in the Region show that behavioural,

Figure 1: Estimated proportion of deaths by cause, South-East Asia Region, 2008

Cardiovascular diseases25%

Chronic respiratorydiseases/asthma

10%

Cancers8%

Diabetes2%Other NCDs

10%

Communicable diseases,maternal, perinatal andnutritional conditions

35%

Injuries11%

Source: WHO Global Health Observatory 2011.

Action plan for the prevention and control of noncommunicable diseases in South-East Asia 33

anthropometric and biochemical risk factors for NCDs are more prevalent in urban than rural areas. Unplanned urbanization reduces options for physical activity and increases exposure to air pollution.

Globalization has brought processed foods and diets high in total energy, fats, salt and sugar into millions of homes. Nearly 30% of the Region’s population remains non-literate. Low levels of literacy affect health behaviours and lifestyle choices. Poor levels of awareness can also result in high consumption of salt, as well as saturated fats and trans fats, and thus aggravate development of NCDs. Studies in Bangladesh, India, Indonesia, Sri Lanka and Thailand have revealed that both smoking and smokeless tobacco use are more prevalent among the less educated.

Globalization and underlying social determinants are driving unhealthy lifestyle behaviours. Four modifiable lifestyle-related risk behaviours, namely tobacco use, unhealthy diet, insufficient physical activity and harmful use of alcohol, are responsible for the majority of NCDs. The prevalence of these unhealthy risk behaviours is very high in the Region.

Tobacco use is responsible for at least one million deaths each year. There are nearly 250 million smokers and an equal number of smokeless tobacco

Figure 2: Determinants of NCDs

NCDs

Met

abol

ic/

phys

iolo

gica

lris

kfa

ctor

s

Beha

viou

ral

risk

fact

ors

Under

lying

driv

ers

Raised blood pressureOverweight/obesity

Raised blood glucoseRaised lipids

Tobacco useUnhealthy diet

Physical inactivityHarmful use of alcohol

Socialdeterminants

of health

GlobalizationUrbanization

Population ageing

Action plan for the prevention and control of noncommunicable diseases in South-East Asia4

users, who often use tobacco together with other carcinogenic substances (such as betel nut); 90% of the world’s smokeless tobacco users live in the South-East Asia Region. In some Member States, the prevalence of smoking among males is above 60%, making it the number one public health problem in the Region.

Unhealthy diets are very common. Approximately 80% of the population does not consume the recommended five portions of fruits and vegetables a day. The mean intake of salt per day varies from 8 g to 13 g/day, much higher than the recommended levels of <5 g/day. There is a wide variability in the prevalence of physical inactivity ranging from 3% to 41% in males and 6.6% to 64% in females. Annually, an estimated 800 000 deaths in the Region are attributed to inadequate physical activity.

Harmful use of alcohol claims an estimated 350 000 lives each year in the Region. The prevalence of alcohol consumption varies from 2% to 44% in males and 0.1% to 26% in females. The harm from alcohol use extends far beyond medical conditions to social, psychological and economic problems as well as injuries and violence.

The four behavioural risk factors described above lead to four metabolic risk factors, namely overweight/obesity, high blood pressure, raised blood sugar and raised blood lipids. These four metabolic risk factors are highly prevalent in the Region. The prevalence of overweight varies from 8% to 30% among males and from 8% to 52% among females. Childhood obesity is an emerging issue of increasing relevance, particularly in urban areas. Approximately a third of the adult population has hypertension, the principal risk factor for heart attack and stroke. In 2010, the prevalence of raised blood sugar in adults aged ≥25 years ranged from 6.6% to 12.2%. The prevalence of raised cholesterol in the adult population is as high as 50% in some Member States. Clustering of more than one risk factor is found in a significant proportion of individuals.

Infections and environmental factors also increase the risk of NCDs. Infections may be responsible for a fifth of cancers in developing countries. For example, human papillomavirus is responsible for the leading cause of cancer among women – cancer of the cervix – and for an increasing number of oral cancers in men and women; hepatitis B virus and hepatitis C virus cause hepatocellular carcinoma; and Helicobacter pylori causes cancer of the stomach. Household air pollution due to solid fuel combustion is an important risk factor for chronic respiratory diseases. In the South-East Asia Region, the proportion of households using solid fuel in 2010 was 61% (range 8–92%). Important environmental and occupational risk factors for NCDs include exposure to asbestos, diesel exhaust gases and ionizing and ultraviolet radiation, indiscriminate use of agrochemicals in agriculture and discharge of toxic products from unregulated chemical industries.

Action plan for the prevention and control of noncommunicable diseases in South-East Asia 5

1.3 Global initiativesGlobal initiatives to address NCDs began in the year 2000, with the adoption of the World Health Assembly resolution WHA53.17, endorsing the global strategy for the prevention and control of NCDs, with a particular focus on developing countries. The strategy rests on three pillars: (i) surveillance; (ii) primary prevention, and; (iii) strengthened health care.

Since 2000, the World Health Assembly has adopted several other resolutions in support of specific tools for the global strategy, including the WHO Framework Convention on Tobacco Control (WHO FCTC) in 2003 (WHA56.1), the Global Strategy on Diet, Physical Activity and Health in 2004 (WHA57.17), and the Global Strategy to Reduce the Harmful Use of Alcohol in 2010 (WHA63.13). In 2008, the Health Assembly endorsed the 2008–2013 Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases, with a particular focus on developing countries.

To draw the attention of global leaders to the rising crisis of NCDs, the United Nations (UN) General Assembly convened a High-level Meeting on the Prevention and Control of Non-communicable Diseases in September 2011. It was only the second time in history that the General Assembly met with the participation of Heads of States and governments on a health issue. The main outcome of the meeting was the adoption of the Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases,4 which acknowledges the rapidly growing magnitude of NCDs in developing countries and its increasingly devastating health and socioeconomic impact, and calls for concrete and comprehensive actions by Member States and the international community.

As a follow-up to the Political Declaration of the High-level Meeting, WHO led a consultative process in developing a global action plan for prevention and control of NCDs 2013–2020, including a comprehensive monitoring framework with 25 indicators and 9 voluntary global targets. The Sixty-sixth World Health Assembly in May 2013 endorsed the global action plan, including indicators and voluntary targets, through resolution WHA66.10.5 The resolution urges Member States to implement the global action plan and consider the development of national NCD monitoring frameworks, with targets and indicators based on national situations, taking into account the global monitoring framework; and to establish and strengthen a national surveillance and reporting system to enable reporting against the 25 indicators and 9 voluntary global targets.

Action plan for the prevention and control of noncommunicable diseases in South-East Asia6

1.4 Regional initiativesParallel to the global NCD movement, several important activities have been undertaken at the regional level. The South-East Asia Regional Network for Prevention and Control of Noncommunicable Diseases (SEANET-NCD) was created in November 2005 to strengthen partnerships and regional cooperation among Member States for implementing policies and programmes for NCDs. Five meetings of the SEANET-NCD have taken place, with participation of multiple stakeholders from the government, academia, WHO collaborating centres, and nongovernmental organizations (NGOs). These meetings facilitated exchange of information, sensitized stakeholders about new guidelines and tools, and advocated for acceleration of global policies and strategies such as the WHO FCTC, the Global Strategy for Reducing Harmful Use of Alcohol and the Global Strategy for Diet and Physical Activity for Health.

High-level advocacy has been carried out for prevention and control of NCDs through various forums including the Twenty-ninth Meeting of the Health Ministers, and the Sixtieth, Sixty-third and Sixty-fifth sessions of the Regional Committee for South-East Asia. These high-level meetings resulted in adoption of important decisions and resolutions related to NCDs, which form the basis for continued advocacy as well as a framework for future actions.

To develop culturally appropriate salt reduction strategies, an expert group meeting was convened in New Delhi, India in December 2012. The meeting concluded that reducing population salt intake is a high priority, cost-effective intervention for Member States of the Region in the context of prevention and control of hypertension, cardiovascular disease and other NCDs. It was also reaffirmed that a salt reduction strategy is compatible with efforts to iodize salt and called for increased collaboration between salt reduction programmes and salt iodization programmes to increase efficiency and public health gains. In June 2013, a technical working group (TWG) meeting on the regional action plan and regional targets was organized in Bangkok, Thailand. The TWG recommended 10 regional targets and a set of priority actions for prevention and control of NCDs. To develop capacity for research, a regional workshop was conducted in Kandy, Sri Lanka in August 2012. The workshop resulted in prioritization of a regional research agenda and initiation of research protocols on key priorities.

Recognizing the enormous burden of oral diseases, and considering the common risk factors responsible for NCDs and oral diseases, the integration of oral diseases into the NCD context is an important priority area. A regional oral

Action plan for the prevention and control of noncommunicable diseases in South-East Asia 7

health strategy has been developed that calls attention to five priority areas: (i) integrating oral diseases and NCDs; (ii) addressing oral cancer; (iii) promoting oral health through fluorides; (iv) increasing and diversifying the oral health workforce; (v) and, oral health through school health. Effective implementation of priority actions in the regional oral health strategy should also contribute to reducing other NCDs.

Technical support is being provided to Member States in three main areas of work.

(i) In the area of surveillance, regional capacity was built through a training workshop on the WHO STEPwise approach to Surveillance (STEPS) in June 2012 in New Delhi, India. National implementation of STEPS surveys has been supported in several countries, particularly for developing protocols, training, data analyses and report writing. During 2007–2009, WHO supported seven Member States to conduct school-based student health surveys to collect data on NCD risk factors from adolescents.

(ii) Technical assistance is being provided to Member States for developing national multisectoral policies, strategies and action plans. The national action plans should serve as a blueprint for Member States to focus on key priorities and actions related to NCD prevention and control. The national action plans should also help in assessing resource needs and mobilizing the necessary resources from domestic and international sources.

(iii) Technical and financial support has been provided to several Member States to introduce the WHO Package of Essential Noncommunicable Disease Interventions (WHO PEN) into the primary health care system. Five countries are at various stages of PEN implementation, namely Bhutan, Indonesia, the Democratic People’s Republic of Korea, Myanmar and Sri Lanka. In Bhutan, WHO provided technical support for assessing the impact of the PEN pilot project in two districts. This evaluation indicates that implementation of PEN resulted in a reduction of cardiovascular risk among patients attending health clinics in the pilot project areas.

The future thrust of WHO’s regional work will be:

• to support Member States in developing or strengthening national multisectoral action plans;

• scaling-up of cost-effective interventions for NCD prevention and control;

Action plan for the prevention and control of noncommunicable diseases in South-East Asia8

• documenting best practices in the Region;

• facilitating information exchange;

• assisting in resource mobilization.

1.5 Progress and challenges in prevention and control of NCDs in the South-East Asia Region NCDs have been recognized as a public health priority in all Member States of the South-East Asia Region. There is high commitment for prevention and control of NCDs. The Government of Sri Lanka, for example, declared 2013 as the “Year for Prevention and Control of Noncommunicable Diseases”. Increased domestic budget allocations for NCDs have been announced in some countries. The health ministries are taking a leadership role in coordinating prevention and control activities. All 11 Member States have a designated unit for prevention and control of NCDs at the central level. In most countries, the central NCD unit is staffed by at least one full-time staff to manage the programme. Eight Member States report having a national policy or strategy for prevention and control of NCDs; however, operational multisectoral mechanisms to coordinate actions are available in less than half of these countries. Guidelines for management of NCDs or risk factors are available in all Member States. The WHO FCTC has been ratified by all except one Member State. Exemplary legislative actions in the Region towards tobacco control include pictorial warnings to cover 85% of the front and back of the cigarette packets in Thailand and Sri Lanka. Innovative financing through “excise tax” on tobacco and alcohol has yielded funds and at the same time promoted public health.

Continued progress is being made towards strengthening NCD surveillance and monitoring systems. At least one national or subnational survey (WHO STEPS or equivalent) has been completed in 10 of the 11 Member States to assess prevalence of behavioural and metabolic risk factors. Global Adult Tobacco Surveys (GATS) have been conducted in 4 countries and Global Youth Tobacco Surveys (GYTS) have been conducted in 10 countries. One round of school-based multi-risk factor surveys have been conducted in seven countries. Thus, data on NCD risk factors are available in almost all Member States. NCD morbidity data are collected through the routine health information system. In addition, disease-specific registries have been established, most commonly for cancers (although not all cancer types are necessarily recorded), followed by diabetes and stroke. However, most mortality/morbidity data and disease-specific registries are hospital-based.

Action plan for the prevention and control of noncommunicable diseases in South-East Asia 9

All Member States are providing one or more NCD-related services at the primary care level in public health facilities. This includes primary prevention and health promotion (11 Member States), early diagnosis of NCD risk factors (9 Member States), and risk factor and disease management (10 Member States). However, programmes for self-care and home-based care are missing in most countries. All Member States have an essential drugs list and many of the NCD-related drugs are included. Essential drugs to treat metabolic risk factors of NCDs are generally available in the public health systems, but not always at the primary health care level.

Despite this significant progress, important challenges need to be overcome to further scale-up and sustain an effective response to the NCD epidemic.

• Partnerships among different development sectors need to be fully operationalized and sustained.

• Data on overall mortality and disease-specific mortality is generally based on estimates, due to incomplete registration of deaths and limitations in reporting of cause of death. There is a need to invest in strengthening vital statistics systems and cause of death ascertainment (including through verbal autopsy).

• NCD risk factor surveillance systems should be institutionalized and better integrated into the national health information systems.

• Greater resource allocation is required for primary prevention and for strengthening the capacity of primary health care systems to address NCDs.

• Health workers, particularly at the primary care level, need orientation and training in addressing NCDs and their risk factors.

• Overall funding levels for NCD programmes are disproportionately lower than is required to scale-up programmes to result in the necessary health impacts. Innovative financing mechanisms, such as those used in Thailand, should be explored in other Member States for generating funds for NCD prevention and control.

• Reducing the NCD burden will require moving beyond pilot projects to nationwide scaling-up of cost-effective interventions, with emphasis on population-based interventions. Focus should be put on reducing exposure to risk factors and early detection and treatment of “high-risk” groups through a strengthened primary health care system.

Action plan for the prevention and control of noncommunicable diseases in South-East Asia10

Section 2. Action plan for the prevention and control of NCDs in South-East Asia, 2013–2020

2.1 PurposeThe regional NCDs action plan is intended to provide a roadmap for regional and national actions for developing and implementing policies and programmes to reduce the burden of NCDs within the regional socioeconomic, cultural, political and health system contexts. The regional NCD action plan is consistent with the draft global action plan 2013–20206 and consolidates follow-up actions of the Political Declaration of the High-level Meeting on NCDs. While taking specific regional issues into account, it is coherent with the major global strategies for prevention and control of NCDs. Moreover, it provides a framework to support and strengthen the implementation of existing regional resolutions, strategies and plans as well as recommendations of the various regional consultations with Member States.

The regional action plan also aims to inform relevant national and regional stakeholders, as well as international development partners and donors, about regional priorities for the prevention and control of NCDs. This should facilitate the provision of technical and financial support to Member States by partner agencies through alignment along common goals and targets.

Successful implementation of the regional action plan requires high-level political commitment, sustainable resources and the concerted involvement of governments, communities and other stakeholders in society. Implementation

Action plan for the prevention and control of noncommunicable diseases in South-East Asia 11

of the plan will be monitored through a set of indicators which are consistent with the global monitoring framework. Reports on progress in implementing the action plan and achieving regional targets will be submitted to the Regional Committee sessions in 2016, 2018 and 2021.

2.2 VisionFor all people of the South-East Asia Region to enjoy the highest attainable status of health, well-being and quality of life at every age, free of preventable NCDs, avoidable disability and premature death.

2.3 GoalTo reduce preventable morbidity, avoidable disability and premature mortality due to NCDs in the South-East Asia Region.

2.4 TargetsIt is aimed to achieve the following 10 targets in the Region by 2025.

(i) A 25% relative reduction in overall mortality from cardiovascular diseases, cancers, diabetes, or chronic respiratory diseases

(ii) A 10% relative reduction in the harmful use of alcohol

(iii) A 30% relative reduction in prevalence of current tobacco use in persons aged over 15 years

(iv) A 10% relative reduction in prevalence of insufficient physical activity

(v) A 30% relative reduction in mean population intake of salt/sodium

(vi) A 25% relative reduction in prevalence of raised blood pressure

(vii) A Halt the rise in obesity and diabetes

(viii) A 50% relative reduction in the proportion of households using solid fuels (wood, crop residue, dried dung, coal and charcoal) as the primary source of cooking

(ix) A 50% of eligible people receive drug therapy and counselling (including glycaemic control) to prevent heart attacks and strokes

(x) An 80% availability of affordable basic technologies and essential medicines, including generics, required to treat major NCDs in both public and private facilities

Action plan for the prevention and control of noncommunicable diseases in South-East Asia12

2.5 Guiding principlesThe regional action plan relies on the following overarching principles and approaches.

Focus on equity: Policies and programmes should aim to reduce inequalities in NCD burden due to social determinants such as education, gender, socioeconomic status, ethnicity and migrant status.

Multisectoral actions and multistakeholder involvement: To address NCDs and their underlying social determinants and risk factors, functioning alliances are needed within the health sector and with other sectors (such as agriculture, education, finance, information, sports, urban planning, trade, transport) involving multiple stakeholders including governments, civil society, academia, the private sector and international organizations.

Life-course approach: A life-course approach is key to prevention and control of NCDs, starting with maternal health, including preconception, antenatal and postnatal care, and maternal nutrition; and continuing through proper infant feeding practices, including promotion of breastfeeding and health promotion for children, adolescents and youth; followed by promotion of a healthy working life, healthy ageing and care for people with NCDs in later life.

Balance between population-based and individual approaches. A comprehensive prevention and control strategy needs to balance an approach aimed at reducing risk factor levels in the population as a whole with one directed at high-risk individuals.

Empowerment of people and communities: People and communities should be empowered to promote their own health and be active partners in managing disease.

Health systems strengthening: Revitalization and reorientation of health care services are required for health promotion, disease prevention, early detection and integrated care, particularly at the primary care level.

Universal health coverage: All people, particularly the poor and vulnerable, should have access, without discrimination, to nationally determined sets of the needed promotive, preventive, curative, rehabilitative and palliative basic health services, as well as essential, safe, affordable, effective and quality medicines and diagnostics without exposing the users to financial hardship.

Action plan for the prevention and control of noncommunicable diseases in South-East Asia 13

Evidence-based strategies: Policies and programmes should be developed based on scientific evidence and/or best practice, cost-effectiveness, affordability, and public health principles.

Management of real, perceived or potential conflicts of interest: Public health policies for the prevention and control of NCDs should be protected from undue influence by any form of vested interest. Real, perceived or potential conflicts of interest must be acknowledged and managed.

2.6 Strategic Priority action areasTo achieve the 10 regional targets, the priority activities for WHO and Member States are structured around four strategic action areas (Figure 3). Implementation of these strategic actions will lead to a reduction in overall mortality from the four main NCDs.

All actions should be implemented, as far as possible, through close collaboration with other health programmes such as infectious diseases control, maternal and child health, immunization, school health and occupational health services.

Strategic action area 1: Advocacy, partnerships and leadership. Actions under this area aim to increase advocacy, promote multisectoral partnerships and strengthen capacity for effective leadership to accelerate and scale-up the national response to the NCD epidemic. Effective implementation of these actions should result in increased political commitment and availability of sustainable resources, and in setting functional mechanisms for multisectoral actions and effective coordination by ministries of health.

Strategic action area 2: Health promotion and risk reduction. Actions under this area aim to promote the development of population-wide interventions to reduce exposure to key risk factors. Effective implementation of these actions should lead to reduction in tobacco use; increased intake of fruits and vegetables; reduced consumption of saturated fat, salt and sugar; reduction in harmful use of alcohol; increase in physical activity; and reduction in household air pollution.

Action plan for the prevention and control of noncommunicable diseases in South-East Asia14

Strategic action area 3: Health systems strengthening for early detection and management of NCDs and their risk factors. Actions under this area aim to strengthen health systems, particularly the primary health care system. Full implementation of actions in this area should lead to improved access to health-care services, increased competence of primary health care workers to address NCDs, and empowerment of communities and individuals for self-care.

Strategic action area 4: Surveillance, monitoring and evaluation, and research. This area includes key actions for strengthening surveillance, monitoring and research. The desired outcome is to improve availability and use of data for evidence-based policy and programme development

Figure 3: Strategic action areas for the prevention and control of NCDs

Action area 2

Health

promotion and

risk reduction

Action area 3

Health systems

strengthening

for early detection

and management

of NCDsAction area 1

Advocacy,

partnerships,

and leadership

Action area 4

Surveillance,

monitoring and

evaluation and

research

Action plan for the prevention and control of noncommunicable diseases in South-East Asia 15

The following tables list priority actions for Member States and WHO in each of the four strategic action areas. Partners needed for implementing these priority actions are listed. Key indicators to track progress in implementation of the action plan are also provided.

Member States are encouraged to adapt this framework according to national priorities and create a detailed national action plan with specific activities and budget. The national plans can serve as blueprints for action and also facilitate resource assessment and resource mobilization.

Action plan for the prevention and control of noncommunicable diseases in South-East Asia16

Stra

tegi

c ac

tion

area

1: A

dvoc

acy,

par

tner

ship

s, a

nd le

ader

ship

1.1

Advo

cacy

Part

ners

: pa

rliam

enta

rians

, go

vern

men

t ag

enci

es i

nclu

ding

min

istrie

s of

hea

lth,

finan

ce,

trade

, ed

ucat

ion,

jus

tice,

ag

ricul

ture

, spo

rts, y

outh

affa

irs, i

nfor

mat

ion,

and

loca

l gov

ernm

ent;

UN

age

ncie

s, d

evel

opm

ent p

artn

ers,

civ

il so

ciet

y,

NG

Os,

med

ia, p

rivat

e se

ctor

Des

ired

ou

tcom

eIn

dica

tors

Ac

tions

for

WH

OPr

opos

ed a

ctio

ns fo

r M

embe

r St

ates

NC

Ds

prio

ritiz

ed

in th

e na

tiona

l he

alth

and

de

velo

pmen

t ag

enda

• N

CD

s in

clud

ed in

th

e na

tiona

l hea

lth

plan

or n

atio

nal

deve

lopm

ent

agen

da, o

r bot

h

• C

ontin

ue to

stre

ngth

en

advo

cacy

to H

eads

of S

tate

, pa

rliam

enta

rians

and

pol

icy-

mak

ers

to g

ive

a hi

gh p

riorit

y to

N

CD

s

• Pr

ovid

e te

chni

cal s

uppo

rt to

in

tegr

ate

NC

Ds

into

nat

iona

l he

alth

pla

nnin

g pr

oces

ses,

de

velo

pmen

t age

ndas

and

po

verty

-alle

viat

ion

stra

tegi

es

• Su

ppor

t Mem

ber S

tate

s in

re

sour

ce m

obili

zatio

n an

d fa

cilit

ate

inte

rcou

ntry

exc

hang

e of

info

rmat

ion

on in

nova

tive

finan

cing

• In

tegr

ate

NC

Ds

into

hea

lth p

lann

ing

proc

esse

s an

d de

velo

pmen

t pla

ns w

ith

spec

ial a

ttent

ion

to s

ocia

l det

erm

inan

ts

of h

ealth

• G

ener

ate

and

diss

emin

ate

evid

ence

on

the

rela

tions

hip

betw

een

NC

Ds

and

othe

r de

velo

pmen

t iss

ues

such

as

pov

erty

alle

viat

ion,

eco

nom

ic

deve

lopm

ent,

food

secu

rity

and

gend

er

equa

lity

• Ra

ise p

ublic

and

pol

itica

l aw

aren

ess/

un

ders

tand

ing

abou

t NC

Ds t

hrou

gh

soci

al m

arke

ting,

mas

s med

ia a

nd

resp

onsib

le m

edia

repo

rting

• Pr

ovid

e ad

equa

te a

nd s

usta

ined

re

sour

ces

for N

CD

s by

incr

ease

d do

mes

tic b

udge

tary

allo

catio

ns,

inno

vativ

e fin

anci

ng a

nd o

ther

mea

ns

Action plan for the prevention and control of noncommunicable diseases in South-East Asia 17

Des

ired

ou

tcom

eIn

dica

tors

Ac

tions

for

WH

OPr

opos

ed a

ctio

ns fo

r M

embe

r St

ates

• Li

aise

with

UN

Cou

ntry

Tea

ms

to in

tegr

ate

NC

Ds

into

the

Uni

ted

Nat

ions

Dev

elop

men

t As

sista

nce

Fram

ewor

k (U

ND

AF)

proc

esse

s

• Ex

plor

e re

sour

ces

for N

CD

pre

vent

ion

and

cont

rol f

rom

exi

stin

g in

itiat

ives

suc

h as

GAV

I Alli

ance

, the

Glo

bal F

und

to

Figh

t AID

S, T

uber

culo

sis a

nd M

alar

ia

(GFA

TM) a

nd th

e Bi

ll an

d M

elin

da

Gat

es F

ound

atio

n

• M

obili

ze th

e U

N C

ount

ry T

eam

s and

lin

k N

CD

s int

o th

e U

ND

AF

proc

esse

s

Action plan for the prevention and control of noncommunicable diseases in South-East Asia18

1.2

Part

ners

hips

Part

ners

: pa

rliam

enta

rians

, go

vern

men

t ag

enci

es i

nclu

ding

min

istrie

s of

hea

lth,

finan

ce,

trade

, ed

ucat

ion,

jus

tice,

ag

ricul

ture

, spo

rts, y

outh

affa

irs, i

nfor

mat

ion,

and

loca

l gov

ernm

ent;

UN

age

ncie

s, d

evel

opm

ent p

artn

ers,

civ

il so

ciet

y,

NG

Os,

med

ia, p

rivat

e se

ctor

Des

ired

out

com

eIn

dica

tors

Ac

tions

for

WH

O

Prop

osed

act

ions

for

M

embe

r St

ates

Nat

iona

l and

su

bnat

iona

l m

echa

nism

/s

for m

ultis

ecto

ral

actio

ns e

stab

lishe

d an

d fu

nctio

ning

• M

ultis

ecto

ral n

atio

nal

NC

D p

olic

y, s

trate

gy

or a

ctio

n pl

an, w

hich

in

tegr

ates

sev

eral

N

CD

s an

d sh

ared

risk

fa

ctor

s, d

evel

oped

and

op

erat

iona

l

• Pr

ovid

e gu

idan

ce to

Mem

ber

Stat

es fo

r dev

elop

ing

effe

ctiv

e pa

rtner

ship

s fo

r m

ultis

ecto

ral a

ctio

ns

• Pr

ovid

e te

chni

cal s

uppo

rt to

Mem

ber S

tate

s fo

r hea

lth

impa

ct a

sses

smen

t of p

ublic

po

licie

s fo

r max

imiz

ing

inte

rsec

tora

l syn

ergi

es

• C

oord

inat

e ac

tiviti

es

rela

ted

to N

CD

s of

var

ious

U

N a

genc

ies,

fund

s, a

nd

prog

ram

mes

• C

olla

te a

nd p

ublis

h re

gion

al

best

pra

ctic

es fo

r effe

ctiv

e pu

blic

pol

icy

deve

lopm

ent

and

impl

emen

tatio

n in

the

Regi

on

• Se

t up

an e

ffect

ive

natio

nal

mul

tisec

tora

l mec

hani

sm

(com

miss

ion,

age

ncy

or ta

sk fo

rce)

re

porti

ng to

the

Hea

d of

Sta

te (o

r de

lega

te) t

o pl

an, g

uide

, mon

itor

and

eval

uate

the

enac

tmen

t of

mul

tisec

tora

l nat

iona

l NC

D p

olic

ies

and

plan

s an

d to

sec

ure

the

nece

ssar

y bu

dget

• Es

tabl

ish n

ew, o

r stre

ngth

en e

xist

ing,

na

tiona

l mul

tisec

tora

l NC

D p

olic

ies

and

plan

s th

roug

h m

ultis

take

hold

er

enga

gem

ent,

and

with

ade

quat

e bu

dget

, tak

ing

into

acc

ount

glo

bal

and

regi

onal

act

ion

plan

s as

wel

l as

natio

nal p

riorit

ies

• As

sess

the

heal

th im

pact

of p

olic

ies

in n

on-h

ealth

sec

tors

e.g

. agr

icul

ture

, ed

ucat

ion,

trad

e, e

nviro

nmen

t, en

ergy

, lab

our,

spor

ts, t

rans

port,

ur

ban

plan

ning

Action plan for the prevention and control of noncommunicable diseases in South-East Asia 19

Des

ired

out

com

eIn

dica

tors

Ac

tions

for

WH

O

Prop

osed

act

ions

for

M

embe

r St

ates

• Fa

cilit

ate

inte

rcou

ntry

co

llabo

ratio

n fo

r exc

hang

e of

bes

t pra

ctic

es in

the

area

s of

“he

alth

in a

ll po

licie

s”,

“who

le o

f gov

ernm

ent”

an

d “w

hole

of s

ocie

ty”

appr

oach

es

• M

obili

ze a

soc

ial m

ovem

ent

enga

ging

and

em

pow

erin

g a

broa

d ra

nge

of a

ctor

s, in

clud

ing

wom

en

as c

hang

e ag

ents

, to

cata

lyse

a

syst

emat

ic s

ocie

ty-w

ide

natio

nal

resp

onse

to a

ddre

ss N

CD

s an

d th

e un

derly

ing

soci

al, e

nviro

nmen

tal a

nd

econ

omic

det

erm

inan

ts o

f hea

lth

Action plan for the prevention and control of noncommunicable diseases in South-East Asia20

1.3

Lead

ersh

ip

Part

ners

: pa

rliam

enta

rians

, go

vern

men

t ag

enci

es i

nclu

ding

min

istrie

s of

hea

lth,

finan

ce,

trade

, ed

ucat

ion,

jus

tice,

ag

ricul

ture

, spo

rts, y

outh

affa

irs, i

nfor

mat

ion,

and

loca

l gov

ernm

ent;

UN

age

ncie

s, d

evel

opm

ent p

artn

ers,

civ

il so

ciet

y,

NG

Os,

med

ia, p

rivat

e se

ctor

Des

ired

ou

tcom

eIn

dica

tors

Ac

tions

for

WH

O

Prop

osed

act

ions

for

M

embe

r St

ates

Hea

lth m

inist

ry

effe

ctiv

ely

lead

ing

and

coor

dina

ting

the

natio

nal

NC

D p

reve

ntio

n an

d co

ntro

l pr

ogra

mm

e

• O

pera

tiona

l NC

D

unit/

depa

rtmen

t in

the

heal

th m

inist

ry

with

ade

quat

e st

aff

and

fund

s fo

r maj

or

NC

D a

ctiv

ities

in

clud

ing

prim

ary

prev

entio

n an

d he

alth

pro

mot

ion;

ea

rly d

etec

tion

and

treat

men

t; an

d,

surv

eilla

nce

and

mon

itorin

g of

NC

Ds

• Ex

amin

e th

e ca

paci

ty o

f M

embe

r Sta

tes

thro

ugh

capa

city

ass

essm

ent

surv

eys

to id

entif

y ne

eds

and

tailo

r the

pro

visio

n of

tech

nica

l sup

port

• D

evel

op a

ppro

pria

te

train

ing

prog

ram

mes

to

stre

ngth

en s

kills

of

natio

nal p

rogr

amm

e m

anag

ers

in d

ealin

g w

ith th

e co

mpl

ex

issue

s in

volv

ed in

im

plem

enta

tion

of N

CD

pr

ogra

mm

es

• Se

t up

and/

or s

treng

then

a n

atio

nal u

nit f

or

NC

Ds

in th

e he

alth

min

istry

with

sui

tabl

e ex

perti

se a

nd re

sour

ces

for n

eeds

ass

essm

ent,

stra

tegi

c pl

anni

ng, p

olic

y de

velo

pmen

t, m

ultis

ecto

ral c

oord

inat

ion,

pro

gram

me

impl

emen

tatio

n, a

nd e

valu

atio

n

• Im

plem

ent n

atio

nal m

ultis

ecto

ral p

olic

ies

and

the

actio

n pl

an th

roug

h co

llabo

rativ

e pa

rtner

ship

s w

ith m

ultip

le s

take

hold

ers,

in

clud

ing

gove

rnm

ent a

genc

ies,

NG

Os,

civ

il so

ciet

y , a

cade

mia

, and

the

priv

ate

sect

or

• St

reng

then

ski

lls a

nd c

apac

ity o

f wor

kfor

ce

for i

mpl

emen

ting

the

natio

nal a

ctio

n pl

an a

nd

to d

eal w

ith th

e co

mpl

exity

of i

ssue

s re

latin

g to

NC

Ds

incl

udin

g m

ultis

ecto

ral a

ctio

n,

adve

rtisin

g, b

ehav

iour

al c

hang

e, h

ealth

ec

onom

ics,

food

and

agr

icul

tura

l sys

tem

s,

law

, bus

ines

s m

anag

emen

t, tra

de, c

omm

erci

al

influ

ence

and

urb

an p

lann

ing,

and

edu

catio

n,

amon

g ot

hers

Action plan for the prevention and control of noncommunicable diseases in South-East Asia 21

Stra

tegi

c ac

tion

area

2: H

ealth

pro

mot

ion

and

risk

red

uctio

n

2.1

Redu

ce to

bacc

o us

e

Part

ners

: pa

rliam

enta

rians

, go

vern

men

t ag

enci

es i

nclu

ding

min

istrie

s of

hea

lth,

finan

ce,

trade

, ed

ucat

ion,

jus

tice,

ag

ricul

ture

, spo

rts, y

outh

affa

irs, i

nfor

mat

ion,

and

loca

l gov

ernm

ent;

UN

age

ncie

s, d

evel

opm

ent p

artn

ers,

civ

il so

ciet

y,

NG

Os,

med

ia, p

rivat

e se

ctor

Des

ired

ou

tcom

eIn

dica

tors

Ac

tions

for

WH

O

Prop

osed

act

ions

for

M

embe

r St

ates

Toba

cco

use

redu

ced

• Ad

optio

n of

co

mpr

ehen

sive

natio

nal p

olic

ies

and

legi

slatio

ns to

redu

ce

toba

cco

use

• Ag

e-st

anda

rdiz

ed

prev

alen

ce o

f cur

rent

to

bacc

o us

e am

ong

pers

ons

aged

18

year

s an

d ol

der

• Pr

eval

ence

of c

urre

nt

toba

cco

use

amon

g ad

oles

cent

s

• Pr

ovid

e te

chni

cal s

uppo

rt to

M

embe

r Sta

tes

in d

rafti

ng

toba

cco

cont

rol l

egisl

atio

ns/

regu

latio

ns/d

irect

ives

and

su

ppor

t the

ir en

forc

emen

t

• D

evel

op a

nd d

issem

inat

e st

anda

rd g

uide

lines

for

toba

cco

cess

atio

n se

rvic

es fo

r us

e by

hea

lth p

rofe

ssio

nals

(e.g

. phy

sicia

ns, d

entis

ts,

nurs

es, p

harm

acist

s) a

nd a

llied

pr

ofes

sions

, and

trai

n th

em.

• Pr

ovid

e te

chni

cal s

uppo

rt in

tra

inin

g he

alth

pro

fess

iona

ls on

toba

cco

cess

atio

n

• St

reng

then

nat

iona

l cap

acity

in

est

ablis

hing

com

mun

ity-

base

d to

bacc

o ce

ssat

ion

serv

ices

• Ac

cele

rate

full

impl

emen

tatio

n of

the

WH

O F

CTC

; Mem

bers

Sta

tes

that

ha

ve n

ot y

et b

ecom

e pa

rty to

the

WH

O F

CTC

to c

onsid

er a

ctio

n to

ratif

y,

acce

pt, a

ppro

ve, f

orm

ally

con

firm

or

acce

de to

, at t

he e

arlie

st o

ppor

tuni

ty

• St

reng

then

toba

cco

surv

eilla

nce

syst

em

to m

onito

r tob

acco

use

and

pre

vent

ion

polic

ies

• As

sess

the

prev

alen

ce o

f hab

itual

use

of

car

cino

geni

c su

bsta

nces

(bet

el n

ut

chew

ing,

pan

mas

ala,

gut

ka, e

tc.)

and

deve

lop

effe

ctiv

e re

gula

tions

for i

ts

prev

entio

n an

d co

ntro

l

• Ra

ise ta

xes

and

infla

tion-

adju

sted

pric

es

on to

bacc

o pr

oduc

ts (i

n lin

e w

ith W

HO

FC

TC A

rticl

e 6)

Action plan for the prevention and control of noncommunicable diseases in South-East Asia22

Des

ired

ou

tcom

eIn

dica

tors

Ac

tions

for

WH

O

Prop

osed

act

ions

for

M

embe

r St

ates

• Pr

ovid

e te

chni

cal s

uppo

rt to

M

embe

r Sta

tes

to c

ondu

ct

surv

eilla

nce

to m

onito

r to

bacc

o us

e

• M

aint

ain

a da

taba

se o

f pi

ctor

ial w

arni

ngs

to fa

cilit

ate

shar

ing

of b

est p

ract

ices

am

ong

Mem

ber S

tate

s

• Pr

omot

e an

d su

ppor

t pr

iorit

y re

sear

ch in

clud

ing

effe

ctiv

enes

s of

taxa

tion

polic

ies

to re

duce

toba

cco

use

• Le

gisla

te fo

r 100

% to

bacc

o-fre

e en

viro

nmen

ts in

all

indo

or w

orkp

lace

s,

publ

ic tr

ansp

ort,

indo

or p

ublic

pla

ces

and,

as

appr

opria

te, o

ther

pub

lic p

lace

s (in

line

with

WH

O F

CTC

Arti

cle

8)

• W

arn

peop

le a

bout

the

dang

ers

of

toba

cco,

incl

udin

g th

roug

h ha

rd-h

ittin

g m

ass-

med

ia c

ampa

igns

and

larg

e, c

lear

, vi

sible

and

legi

ble

text

and

pic

toria

l he

alth

war

ning

s (in

line

with

WH

O

FCTC

Arti

cles

11,

12)

• Im

plem

ent c

ompr

ehen

sive

bans

on

toba

cco

adve

rtisin

g, p

rom

otio

n an

d sp

onso

rshi

p (in

line

with

WH

O F

CTC

Ar

ticle

s 13

)

• O

ffer h

elp

to p

eopl

e w

ho w

ant t

o st

op

usin

g to

bacc

o (in

line

with

WH

O F

CTC

Ar

ticle

14)

• Pr

otec

t tob

acco

con

trol p

olic

ies

from

co

mm

erci

al a

nd o

ther

ves

ted

inte

rest

s of

the

toba

cco

indu

stry

in a

ccor

danc

e w

ith n

atio

nal l

aw (i

n lin

e w

ith W

HO

FC

TC A

rticl

e 5.

3)

Action plan for the prevention and control of noncommunicable diseases in South-East Asia 23

Des

ired

ou

tcom

eIn

dica

tors

Ac

tions

for

WH

O

Prop

osed

act

ions

for

M

embe

r St

ates

• Re

gula

te th

e co

nten

ts a

nd e

miss

ions

of

toba

cco

prod

ucts

, tob

acco

pro

duct

di

sclo

sure

s an

d th

e m

etho

ds b

y w

hich

th

ey a

re te

sted

and

mea

sure

d (in

line

w

ith W

HO

FC

TC A

rticl

e 9

and

10)

• Ta

ke m

easu

res

to e

limin

ate

the

illic

it tra

de o

f tob

acco

pro

duct

s, in

clud

ing

smug

glin

g, il

licit

man

ufac

turin

g an

d co

unte

rfeiti

ng (i

n lin

e w

ith W

HO

FC

TC

Artic

le 1

5)

• Pr

ohib

it sa

le o

f tob

acco

pro

duct

s to

, an

d by

, min

ors

(in li

ne w

ith W

HO

FC

TC

Artic

le 1

6)

• C

onsid

er ta

king

legi

slativ

e ac

tion

to d

eal

with

crim

inal

and

civ

il lia

bilit

y, in

clud

ing

com

pens

atio

n w

here

app

ropr

iate

, an

d to

offe

r one

ano

ther

rela

ted

lega

l as

sista

nce

(in li

ne w

ith W

HO

FC

TC

Artic

le 1

9)

Action plan for the prevention and control of noncommunicable diseases in South-East Asia24

2.2

Redu

ce h

arm

ful u

se o

f alc

ohol

Part

ners

: pa

rliam

enta

rians

, go

vern

men

t ag

enci

es i

nclu

ding

min

istrie

s of

hea

lth,

finan

ce,

trade

, ed

ucat

ion,

jus

tice,

ag

ricul

ture

, spo

rts, y

outh

affa

irs, i

nfor

mat

ion,

and

loca

l gov

ernm

ent;

UN

age

ncie

s, d

evel

opm

ent p

artn

ers,

civ

il so

ciet

y,

NG

Os,

med

ia, p

rivat

e se

ctor

Des

ired

out

com

eIn

dica

tors

Ac

tions

for

WH

O

Prop

osed

act

ions

for

M

embe

r St

ates

Har

mfu

l use

of

alco

hol r

educ

ed

• Ad

optio

n of

co

mpr

ehen

sive

natio

nal

polic

ies

and

legi

slatio

ns

to re

duce

har

mfu

l use

of

alco

hol

• To

tal (

reco

rded

and

un

reco

rded

) alc

ohol

pe

r cap

ita (1

5 ye

ars

and

olde

r) co

nsum

ptio

n w

ithin

a c

alen

dar y

ear i

n lit

res

of p

ure

alco

hol,

as

appr

opria

te, w

ithin

the

natio

nal c

onte

xt

• Ag

e-st

anda

rdiz

ed

prev

alen

ce o

f hea

vy

episo

dic

drin

king

am

ong

adol

esce

nts

and

adul

ts,

as a

ppro

pria

te, w

ithin

th

e na

tiona

l con

text

• St

reng

then

adv

ocac

y to

all

stak

ehol

ders

for r

educ

ing

the

harm

ful u

se o

f alc

ohol

• C

omm

unic

ate

and

prom

ote

the

com

mon

und

erst

andi

ng

of th

e te

rmin

olog

y “h

arm

ful

use

of a

lcoh

ol”

agre

ed a

t gl

obal

leve

l, an

d its

pol

icy

impl

icat

ion

in th

e Re

gion

• Pr

ovid

e te

chni

cal

assis

tanc

e to

sup

port

the

impl

emen

tatio

n of

the

glob

al

stra

tegy

to re

duce

har

mfu

l us

e of

alc

ohol

• Fa

cilit

ate

oper

atio

nal

rese

arch

to s

cale

-up

effe

ctiv

e in

terv

entio

ns fo

r re

duci

ng h

arm

ful u

se o

f al

coho

l and

diss

emin

ate

data

to in

form

pol

icy

and

prog

ram

me

deve

lopm

ent

• St

reng

then

lead

ersh

ip a

nd p

oliti

cal

com

mitm

ent t

o re

duce

har

mfu

l use

of

alc

ohol

• Ac

cele

rate

impl

emen

tatio

n of

the

Glo

bal S

trate

gy to

Red

uce

the

Har

mfu

l Use

of A

lcoh

ol

• Re

gula

te th

e co

mm

erci

al o

r pub

lic

avai

labi

lity

of a

lcoh

ol th

roug

h la

ws,

po

licie

s an

d pr

ogra

mm

es

• Re

stric

t or b

an a

lcoh

ol a

dver

tisin

g an

d pr

omot

ions

• In

trodu

ce a

nd a

djus

t pric

ing

polic

ies,

suc

h as

exc

ise ta

xes

on

alco

holic

bev

erag

es to

redu

ce

alco

hol-r

elat

ed h

arm

• Im

plem

ent e

ffect

ive

drin

k-dr

ivin

g po

licie

s an

d co

unte

rmea

sure

s

Action plan for the prevention and control of noncommunicable diseases in South-East Asia 25

Des

ired

out

com

eIn

dica

tors

Ac

tions

for

WH

O

Prop

osed

act

ions

for

M

embe

r St

ates

• Pr

omot

e ne

twor

king

and

ex

chan

ge o

f exp

erie

nces

an

d be

st p

ract

ices

am

ong

Mem

ber S

tate

s

• Re

duce

the

publ

ic h

ealth

impa

ct

of il

licit

alco

hol a

nd in

form

ally

pr

oduc

ed a

lcoh

ol th

roug

h id

entif

ied

mea

sure

s

• Re

duce

the

nega

tive

cons

eque

nces

of

drin

king

and

alc

ohol

into

xica

tion

and

prov

idin

g co

nsum

er

info

rmat

ion

• St

reng

then

hea

lth s

ervi

ces

to

prov

ide

prev

entio

n an

d tre

atm

ent

inte

rven

tion

to in

divi

dual

s an

d fa

mili

es a

t risk

of ,

or a

ffect

ed

by, a

lcoh

ol-u

se d

isord

ers

and

asso

ciat

ed c

ondi

tions

• Su

ppor

t and

em

pow

er c

omm

uniti

es

to u

se th

eir l

ocal

kno

wle

dge

and

expe

rtise

in a

dopt

ing

effe

ctiv

e ap

proa

ches

to p

reve

nt a

nd re

duce

ha

rmfu

l use

of a

lcoh

ol

• D

evel

op a

nd st

reng

then

surv

eilla

nce

syst

ems

to m

onito

r the

mag

nitu

de

and

trend

s of

alc

ohol

rela

ted

harm

, to

stre

ngth

en a

dvoc

acy,

to

form

ulat

e po

licie

s an

d to

ass

ess

impa

ct o

f int

erve

ntio

ns

Action plan for the prevention and control of noncommunicable diseases in South-East Asia26

2.3

Prom

ote

heal

thy

diet

hig

h in

frui

ts a

nd v

eget

able

s an

d lo

w in

sat

urat

ed fa

ts/tr

ans

fats

, fre

e su

gars

and

sal

t

Part

ners

: pa

rliam

enta

rians

, go

vern

men

t ag

enci

es i

nclu

ding

min

istrie

s of

hea

lth,

finan

ce,

trade

, ed

ucat

ion,

jus

tice,

ag

ricul

ture

, sp

orts

, yo

uth

affa

irs,

info

rmat

ion,

and

loc

al g

over

nmen

t Pr

ivat

e, f

ood

man

ufac

ture

rs,

food

pro

cess

ors,

re

taile

rs; m

edia

, civ

il so

ciet

y, N

GO

s, c

onsu

mer

s

Des

ired

out

com

eIn

dica

tors

Ac

tions

for

WH

O

Prop

osed

act

ions

for

M

embe

r St

ates

• In

crea

sed

inta

ke

of fr

uits

and

ve

geta

bles

• Re

duce

d co

nsum

ptio

n of

sa

tura

ted

fats

/tra

ns fa

ts, s

ugar

an

d sa

lt

• Re

duce

d ca

rdio

met

abol

ic

risk

• Ad

optio

n of

na

tiona

l pol

icie

s to

re

duce

the

impa

ct

on c

hild

ren

of

mar

ketin

g of

food

s an

d no

n-al

coho

lic

beve

rage

s hi

gh in

sa

tura

ted

fats

, tra

ns-

fatty

aci

ds, f

ree

suga

rs o

r sal

t

• Ad

optio

n of

nat

iona

l po

licie

s th

at li

mit

satu

rate

d fa

tty

acid

s an

d vi

rtual

ly

elim

inat

e pa

rtial

ly

hydr

ogen

ated

ve

geta

ble

oils

in th

e fo

od s

uppl

y

• Pr

ovid

e te

chni

cal

supp

ort t

o M

embe

r St

ates

to d

evel

op a

nd

impl

emen

t nat

iona

l po

licie

s an

d re

gula

tions

• Pr

ovid

e te

chni

cal

supp

ort t

o M

embe

r St

ates

for d

evel

opm

ent

and/

or u

pdat

ing

of

the

food

com

posit

ion

data

base

tabl

es

• Pr

ovid

e te

chni

cal

supp

ort t

o M

embe

r St

ates

to d

evel

op

natio

nal s

odiu

m

redu

ctio

n st

rate

gies

• St

reng

then

cou

ntry

ca

paci

ty to

con

duct

su

rvey

s on

pop

ulat

ion

sodi

um c

onsu

mpt

ion

• Ac

cele

rate

impl

emen

tatio

n of

the

Glo

bal

Stra

tegy

on

Die

t, Ph

ysic

al A

ctiv

ity a

nd

Hea

lth

• Im

plem

ent W

HO

’s s

et o

f re

com

men

datio

ns o

n th

e m

arke

ting

of fo

ods

and

non-

alco

holic

bev

erag

es

to c

hild

ren,

incl

udin

g m

echa

nism

s fo

r m

onito

ring

• D

evel

op p

olic

y m

easu

res

and

guid

elin

es

in c

olla

bora

tion

with

var

ious

sta

keho

lder

s su

ch a

s fo

od p

rodu

cers

, pro

cess

ors,

re

taile

rs a

nd c

onsu

mer

s to

pro

mot

e af

ford

abili

ty, a

vaila

bilit

y an

d ac

cept

abili

ty

of h

ealth

ier f

ood

prod

ucts

• Es

tabl

ish re

gula

tions

and

fisc

al p

olic

ies

incl

udin

g ta

xes

and

subs

idie

s to

pro

mot

e co

nsum

ptio

n of

frui

ts a

nd v

eget

able

s an

d di

scou

rage

con

sum

ptio

n of

unh

ealth

y fo

od

optio

ns h

igh

in s

atur

ated

fat,

suga

r and

sal

t

Action plan for the prevention and control of noncommunicable diseases in South-East Asia 27

Des

ired

out

com

eIn

dica

tors

Ac

tions

for

WH

O

Prop

osed

act

ions

for

M

embe

r St

ates

• Pr

eval

ence

of

pers

ons

aged

18

year

s an

d ol

der

cons

umin

g le

ss th

an

five

tota

l ser

ving

s (4

00 g

) of f

ruit

and

vege

tabl

es p

er d

ay

• Ag

e -st

anda

rdiz

ed

mea

n pr

opor

tion

of

tota

l ene

rgy

inta

ke

from

sat

urat

ed fa

tty

acid

s in

per

sons

ag

ed 1

8 ye

ars

and

olde

r

• M

ean

popu

latio

n in

take

of s

alt

(sod

ium

chl

orid

e)

per p

erso

n pe

r day

• Pr

eval

ence

of r

aise

d to

tal c

hole

ster

ol

amon

g pe

rson

s ag

ed

18 y

ears

and

old

er,

and

mea

n to

tal

chol

este

rol

• D

ialo

gue

with

the

priv

ate

sect

or a

nd b

uild

pr

essu

re to

redu

ce

sodi

um c

onte

nt o

f pr

oces

sed

food

• Pr

ovid

e te

chni

cal

supp

ort t

o M

embe

r St

ates

to d

evel

op

natio

nal p

olic

ies

and

regu

latio

ns to

redu

ce

satu

rate

d fa

ts a

nd

elim

inat

e tra

ns fa

ts in

th

e fo

od s

uppl

y ch

ain

• C

arry

out

pub

lic c

ampa

igns

thro

ugh

mas

s m

edia

and

soc

ial m

edia

to in

form

co

nsum

ers

abou

t a h

ealth

y di

et h

igh

in

fruits

and

veg

etab

les

and

low

in s

atur

ated

fa

t, su

gar a

nd s

alt

• Pr

omot

e an

d su

ppor

t exc

lusiv

e br

east

feed

ing

for t

he fi

rst s

ix m

onth

s of

life

, co

ntin

ued

brea

st fe

edin

g un

til tw

o ye

ars

and

beyo

nd a

nd ti

mel

y co

mpl

emen

tary

fe

edin

g

• Pr

omot

e nu

tritio

n la

belli

ng, a

ccor

ding

but

no

t lim

ited

to, i

nter

natio

nal s

tand

ards

, in

parti

cula

r the

Cod

ex A

limen

tariu

s, fo

r all

pre-

pack

aged

food

s in

clud

ing

thos

e fo

r w

hich

nut

ritio

n or

hea

lth c

laim

s ar

e m

ade

• St

reng

then

cap

acity

of n

atio

nal i

ntui

tions

fo

r tes

ting

and

mon

itorin

g th

e co

nten

t of

satu

rate

d fa

t, sa

lt an

d su

gar i

n pr

oces

sed

food

• D

evel

op a

nd im

plem

ent n

atio

nal s

alt

redu

ctio

n st

rate

gies

in li

ne w

ith W

HO

re

com

men

datio

ns

Action plan for the prevention and control of noncommunicable diseases in South-East Asia28

Des

ired

out

com

eIn

dica

tors

Ac

tions

for

WH

O

Prop

osed

act

ions

for

M

embe

r St

ates

• Ag

e-st

anda

rdiz

ed

prev

alen

ce o

f rai

sed

bloo

d gl

ucos

e co

ncen

tratio

ns/

diab

etes

am

ong

pers

ons

aged

18

year

s an

d ol

der

(def

ined

as

fast

ing

plas

ma

gluc

ose

conc

entra

tion

≥7.

0 m

mol

/L (1

26 m

g/dL

) or

on

med

icat

ion

for

raise

d bl

ood

gluc

ose

conc

entra

tion,

re

spec

tivel

y)

• Ra

ised

bloo

d pr

essu

re a

mon

g pe

rson

s ag

ed 1

8 ye

ars

and

olde

r, an

d m

ean

syst

olic

blo

od

pres

sure

• In

crea

se c

olla

bora

tion

betw

een

salt/

sodi

um

redu

ctio

n pr

ogra

mm

es a

nd s

alt i

odiz

atio

n pr

ogra

mm

es fo

r inc

reas

ed p

ublic

hea

lth

gain

s an

d hi

gher

pro

gram

me

effic

ienc

y

• Re

gula

te p

rivat

e in

dust

ry to

vol

unta

rily

redu

ce s

alt i

n pa

ckag

ed fo

od a

nd m

onito

r co

mpl

ianc

e.

• U

nder

take

repr

esen

tativ

e su

rvey

s to

m

easu

re p

opul

atio

n sa

lt/so

dium

inta

ke

• Es

tabl

ish p

olic

ies

and

regu

latio

ns to

el

imin

ate

parti

ally

hyd

roge

nate

d ve

geta

ble

oils

(PH

VO) i

n th

e fo

od s

uppl

y an

d lim

it sa

tura

ted

fatty

aci

ds a

nd m

onito

r co

mpl

ianc

e of

priv

ate

sect

or w

ith th

e re

gula

tions

• Re

plac

e sa

tura

ted

fat a

nd tr

ans-

fat w

ith

unsa

tura

ted

fat

Action plan for the prevention and control of noncommunicable diseases in South-East Asia 29

2.4

Prom

ote

phys

ical

act

ivity

Part

ners

: M

inist

ries

of h

ealth

, fin

ance

, tra

de,

educ

atio

n, s

ports

, yo

uth

affa

irs,

just

ice,

info

rmat

ion,

loca

l gov

ernm

ent,

infra

stru

ctur

e/tra

nspo

rt, p

lann

ing

and

urba

n de

velo

pmen

t; m

edia

, civ

il so

ciet

y, N

GO

s

Des

ired

out

com

eIn

dica

tors

Ac

tions

for

WH

O

Prop

osed

act

ions

for

M

embe

r St

ates

Phys

ical

inac

tivity

re

duce

d•

Prev

alen

ce o

f ins

uffic

ient

ly

activ

e pe

rson

s ag

ed 1

8 ye

ars

and

olde

r

• Pr

eval

ence

of i

nsuf

ficie

ntly

ac

tive

adol

esce

nts

(def

ined

as

less

than

60

min

utes

of

mod

erat

e to

vig

orou

s in

tens

ity

activ

ity d

aily

)

• Ag

e-st

anda

rdiz

ed p

reva

lenc

e of

ove

rwei

ght a

nd o

besit

y in

ado

lesc

ents

(def

ined

ac

cord

ing

to th

e W

HO

gro

wth

re

fere

nce

as: o

verw

eigh

t –

one

stan

dard

dev

iatio

n bo

dy

mas

s in

dex

for a

ge a

nd s

ex;

and

obes

e –

two

stan

dard

de

viat

ions

bod

y m

ass

inde

x fo

r age

and

sex

)

• D

evel

op a

nd d

issem

inat

e m

odel

legi

slatio

n fo

r su

ppor

tive

envi

ronm

ents

fo

r phy

sical

act

ivity

• Pr

ovid

e su

ppor

t for

es

tabl

ishin

g co

llabo

ratio

n w

ith a

rchi

tect

s an

d to

wn

plan

ners

in c

ount

ries

to

advo

cate

urb

an p

lann

ing

to in

crea

se p

ublic

spa

ces

supp

ortiv

e of

phy

sical

ac

tivity

• D

issem

inat

e gu

idel

ines

for

phys

ical

act

ivity

• Fa

cilit

ate

shar

ing

of b

est

prac

tices

and

less

ons

lear

ned

amon

g co

untri

es

• Ad

opt a

nd im

plem

ent n

atio

nal

guid

elin

es o

n ph

ysic

al a

ctiv

ity

for h

ealth

• D

evel

op p

olic

y m

easu

res

and

guid

elin

es in

con

junc

tion

with

re

leva

nt s

ecto

rs a

nd s

take

hold

ers

to p

rom

ote

phys

ical

act

ivity

th

roug

h ac

tiviti

es o

f dai

ly li

ving

in

clud

ing

thro

ugh

“act

ive

trans

port”

, rec

reat

ion,

leisu

re

and

spor

ts.

• Ad

voca

te to

tow

n pl

anne

rs

for d

esig

ning

incr

ease

d pu

blic

sp

aces

sup

porti

ve o

f phy

sical

ac

tivity

• Es

tabl

ish le

gisla

tion

to e

nsur

e ne

w h

ousin

g de

velo

pmen

ts

incl

ude

safe

spa

ces

for w

alki

ng

and

cycl

ing

Action plan for the prevention and control of noncommunicable diseases in South-East Asia30

Des

ired

out

com

eIn

dica

tors

Ac

tions

for

WH

O

Prop

osed

act

ions

for

M

embe

r St

ates

• Ag

e-st

anda

rdiz

ed p

reva

lenc

e of

ove

rwei

ght a

nd o

besit

y in

pe

rson

s ag

ed 1

8 ye

ars

and

olde

r (de

fined

as

body

mas

s in

dex

grea

ter t

han

25 k

g/m

² fo

r ove

rwei

ght a

nd 3

0 kg

/m²

for o

besit

y).

• C

arry

out

mas

s-m

edia

ca

mpa

igns

and

soc

ial m

arke

ting

to ra

ise a

war

enes

s on

ben

efits

of

phys

ical

act

ivity

thro

ugho

ut th

e lif

e cy

cle

• Ev

alua

te in

terv

entio

ns a

imed

at

incr

easin

g ph

ysic

al a

ctiv

ity

thro

ugho

ut th

e lif

e -co

urse

and

us

e da

ta to

info

rm p

olic

y an

d pr

ogra

mm

e de

velo

pmen

t

Action plan for the prevention and control of noncommunicable diseases in South-East Asia 31

2.5

Prom

ote

heal

thy

beha

viou

rs a

nd r

educ

e N

CD

s in

key

set

tings

Part

ners

: M

inist

ries

of h

ealth

, ed

ucat

ion,

tra

de,

spor

ts,

yout

h af

fairs

, in

form

atio

n, l

ocal

gov

ernm

ent,

infra

stru

ctur

e/tra

nspo

rt, p

lann

ing/

urba

n de

velo

pmen

t; co

rpor

ate

sect

or, m

edia

, civ

il so

ciet

y, N

GO

s

Des

ired

out

com

eIn

dica

tors

Ac

tions

for

WH

O

Prop

osed

act

ions

for

M

embe

r St

ates

Redu

ced

risk

of

NC

Ds

amon

g sc

hool

chi

ldre

n/st

uden

ts a

t ed

ucat

iona

l in

stitu

tes,

and

w

orkf

orce

• N

atio

nal g

uide

lines

fo

r hea

lth p

rom

otin

g sc

hool

s/st

uden

ts a

t ed

ucat

iona

l ins

titut

es

deve

lope

d an

d ad

opte

d

• N

atio

nal g

uide

lines

fo

r wor

kpla

ce

wel

lnes

s pr

ogra

mm

es

deve

lope

d an

d ad

opte

d

• Pr

omot

e an

d fa

cilit

ate

inte

rsec

tora

l act

ion

thro

ugh

the

deve

lopm

ent a

nd

diss

emin

atio

n of

mod

el

heal

thy

scho

ols/

wor

kpla

ce

polic

ies

and

prog

ram

mes

• D

evel

op a

nd d

issem

inat

e m

odel

com

preh

ensiv

e w

orkp

lace

wel

lnes

s po

licie

s an

d pr

ogra

mm

es to

redu

ce

the

risk

of N

CD

s

• Pr

ovid

e te

chni

cal s

uppo

rt to

cou

ntrie

s in

dev

elop

ing

and

impl

emen

ting

scho

ol,

wor

kpla

ce, p

olic

ies

and

prog

ram

mes

• D

evel

op c

urric

ula

mod

ules

fo

r pre

vent

ion

and

cont

rol o

f N

CD

s, in

clud

ing

coun

selli

ng

tech

niqu

es fo

r in

tegr

atio

n in

te

ache

r tra

inin

g

• En

able

and

faci

litat

e in

ters

ecto

ral

actio

n in

sch

ools

and

wor

kpla

ces

thro

ugh

esta

blish

men

t of

inte

rsec

tora

l wor

king

gro

ups,

task

te

ams

or fo

cal p

erso

ns in

cha

rge

of

deve

lopi

ng a

nd c

oord

inat

ing

heal

th

prom

otin

g ac

tiviti

es

• Ap

poin

t and

trai

n fo

cal p

erso

ns

or o

ther

app

ropr

iate

coo

rdin

atio

n m

echa

nism

s be

twee

n M

inist

ry o

f H

ealth

and

Min

istry

of E

duca

tion

to

prom

ote

effe

ctiv

e in

terv

entio

ns in

sc

hool

s an

d pr

e-sc

hool

s

• Es

tabl

ish h

ealth

pro

mot

ing

scho

ols

with

gui

delin

es fo

r im

plem

enta

tion

and

mec

hani

sms

for m

onito

ring

and

eval

uatio

n

• C

ondu

ct a

dvoc

acy

and

train

ing

wor

ksho

ps to

pro

mot

e he

alth

y be

havi

ours

in s

choo

ls an

d w

orkp

lace

s

Action plan for the prevention and control of noncommunicable diseases in South-East Asia32

Des

ired

out

com

eIn

dica

tors

Ac

tions

for

WH

O

Prop

osed

act

ions

for

M

embe

r St

ates

• Fa

cilit

ate

shar

ing

of

expe

rienc

es a

nd b

est

prac

tices

am

ong

Mem

ber

Stat

es

• Es

tabl

ish e

vide

nce

and

best

-pra

ctic

es fo

r effe

ctiv

e in

terv

entio

ns in

sch

ool a

nd

wor

kpla

ce s

ettin

gs

• Es

tabl

ish h

ealth

pro

mot

ing

wor

kpla

ces

with

gui

delin

es fo

r im

plem

enta

tion

and

mec

hani

sms

for

mon

itorin

g an

d ev

alua

tion

• Ba

n fo

ods

high

in s

atur

ated

fat,

suga

r an

d sa

lt fro

m s

choo

l pre

mise

s an

d w

orkp

lace

cat

erin

g fa

cilit

ies

Action plan for the prevention and control of noncommunicable diseases in South-East Asia 33

2.6

Redu

ce h

ouse

hold

air

pol

lutio

n

Part

ners

: Min

istrie

s of h

ealth

, fin

ance

, tra

de, e

duca

tion,

lega

l, ag

ricul

ture

, urb

an d

evel

opm

ent a

nd h

ousin

g, e

nviro

nmen

t, pe

trole

um, e

nerg

y, in

dust

ries,

info

rmat

ion;

med

ia, c

ivil

soci

ety,

NG

Os,

com

mun

ity

Des

ired

out

com

eIn

dica

tors

Ac

tions

for

WH

O

Prop

osed

act

ions

for

M

embe

r St

ates

Hou

seho

ld a

ir po

llutio

n du

e to

sol

id fu

el u

se

for c

ooki

ng a

nd

pass

ive

smok

ing

redu

ced

• 50

% re

duct

ion

in p

ropo

rtion

of

hous

ehol

ds w

ith

solid

fuel

use

as

prim

ary

sour

ce o

f co

okin

g

• St

reng

then

adv

ocac

y to

all

stak

ehol

ders

for r

educ

ing

harm

fro

m h

ouse

hold

air

pollu

tion

• Pr

ovid

e te

chni

cal s

uppo

rt fo

r de

velo

ping

new

and

revi

sed

indo

or a

ir qu

ality

gui

delin

es

• Su

ppor

t res

earc

h fo

r eva

luat

ing

inte

rven

tions

aim

ed a

t red

ucin

g ho

useh

old

air p

ollu

tion

• St

reng

then

Glo

bal H

ouse

hold

En

ergy

Dat

abas

e

• Fa

cilit

ate

shar

ing

of e

xper

ienc

es

and

best

pra

ctic

es a

mon

g M

embe

r Sta

tes

• St

reng

then

adv

ocac

y in

sup

port

of

trans

ition

to c

lean

er te

chno

logi

es

and

fuel

s (L

PG, b

io-g

as, s

olar

co

oker

s, e

lect

ricity

, oth

er lo

w-fu

me

fuel

s su

ch a

s m

etha

nol,

etha

nol)

• D

evel

op a

nd m

aint

ain

natio

nal

data

base

s on

key

var

iabl

es to

su

ppor

t dec

ision

-mak

ing

for

trans

ition

to c

lean

sus

tain

able

ho

useh

old

ener

gy

• D

evel

op a

nd im

plem

ent

prog

ram

mes

aim

ed a

t enc

oura

ging

th

e us

e of

impr

oved

coo

k-st

oves

, go

od c

ooki

ng p

ract

ices

, red

ucin

g ex

posu

re to

fum

es, a

nd im

prov

ing

vent

ilatio

n in

hou

seho

lds

• C

reat

e aw

aren

ess

and

deve

lop

appr

opria

te s

trate

gies

to re

duce

ex

posu

re to

sec

ond-

hand

toba

cco

smok

e in

hou

seho

lds

Action plan for the prevention and control of noncommunicable diseases in South-East Asia34

Stra

tegi

c ac

tion

area

3: H

ealth

sys

tem

str

engt

heni

ng fo

r ea

rly

dete

ctio

n an

d m

anag

emen

t of N

CD

s an

d th

eir

risk

fact

ors

3.1

Acce

ss to

hea

lth s

ervi

ces

Part

ners

: M

inist

ries

of h

ealth

, oth

er r

elev

ant m

inist

ries,

loca

l gov

ernm

ent a

utho

ritie

s; r

egul

ator

y co

unci

ls, c

ivil

soci

ety,

m

edic

al a

ssoc

iatio

ns, p

rivat

e he

alth

pro

vide

rs, N

GO

s, p

harm

aceu

tical

age

ncie

s, m

edia

Des

ired

ou

tcom

eIn

dica

tors

Ac

tions

for

WH

OPr

opos

ed a

ctio

ns fo

r

Mem

ber

Stat

es

Uni

vers

al h

ealth

co

vera

ge a

nd

equi

tabl

e ac

cess

to

pre

vent

ion,

ea

rly d

etec

tion

and

treat

men

t of

NC

Ds

• Av

aila

bilit

y an

d af

ford

abili

ty o

f qua

lity,

sa

fe a

nd e

ffica

ciou

s es

sent

ial N

CD

m

edic

ines

, inc

ludi

ng

gene

rics,

and

bas

ic

tech

nolo

gies

in b

oth

publ

ic a

nd p

rivat

e fa

cilit

ies

• Ac

cess

to p

allia

tive

care

ass

esse

d by

m

orph

ine-

equi

vale

nt

cons

umpt

ion

of s

trong

op

ioid

ana

lges

ics

(exc

ludi

ng m

etha

done

) pe

r dea

th fr

om c

ance

r

• Pr

ovid

e su

ppor

t to

Mem

ber

Stat

es in

inte

grat

ing

cost

-ef

fect

ive

inte

rven

tions

fo

r NC

Ds

and

thei

r risk

fa

ctor

s in

to h

ealth

sys

tem

s,

incl

udin

g es

sent

ial p

rimar

y he

alth

car

e pa

ckag

es

• D

eplo

y an

inte

rage

ncy

emer

genc

y he

alth

kit

for

treat

men

t of N

CD

s in

hu

man

itaria

n di

sast

ers

and

emer

genc

ies

• D

evel

op a

nd d

issem

inat

e st

anda

rd g

uide

lines

, too

ls an

d tra

inin

g m

ater

ials

for

early

det

ectio

n, tr

eatm

ent

and

palli

ativ

e ca

re to

add

ress

N

CD

s in

clud

ing

oral

can

cers

at

prim

ary

heal

th c

are

cent

res

• In

tegr

ate

and

scal

e-up

cos

t-ef

fect

ive

NC

D in

terv

entio

ns, b

ased

on

natio

nal

polic

ies

and

prio

ritie

s, in

to th

e ba

sic

prim

ary

heal

th c

are

pack

age

with

re

ferr

al s

yste

m to

all

leve

ls of

car

e in

or

der t

o ad

vanc

e th

e un

iver

sal h

ealth

co

vera

ge a

gend

a

• Es

tabl

ish q

ualit

y as

sura

nce

and

qual

ity

impr

ovem

ent s

yste

ms

with

em

phas

is on

pr

imar

y he

alth

car

e

• St

reng

then

refe

rral

sys

tem

s fo

r m

anag

emen

t of N

CD

s

• D

evel

op p

olic

ies

for s

usta

inab

le a

nd

equi

tabl

e he

alth

fina

ncin

g (in

clud

ing

insu

ranc

e, ta

x fu

ndin

g, h

ealth

sav

ings

ac

coun

t) to

cov

er c

osts

of p

reve

ntio

n,

treat

men

t, re

habi

litat

ion

and

palli

ativ

e ca

re

Action plan for the prevention and control of noncommunicable diseases in South-East Asia 35

Des

ired

ou

tcom

eIn

dica

tors

Ac

tions

for

WH

OPr

opos

ed a

ctio

ns fo

r

Mem

ber

Stat

es

• Av

aila

bilit

y, a

s ap

prop

riate

(if

cost

-effe

ctiv

e an

d af

ford

able

), of

HPV

va

ccin

es a

ccor

ding

to

natio

nal p

rogr

amm

es

and

polic

ies

• Pr

opor

tion

of e

ligib

le

pers

ons

rece

ivin

g dr

ug th

erap

y an

d co

unse

lling

to p

reve

nt

hear

t atta

cks,

stro

kes

and

chro

nic

resp

irato

ry

dise

ases

• Pr

opor

tion

of w

omen

ag

ed 3

0–49

yea

rs

scre

ened

for c

ervi

cal

canc

er a

t lea

st o

nce,

or

mor

e of

ten

• Pr

opor

tion

of “

at ri

sk”

popu

latio

n sc

reen

ed

for o

ral c

ance

r at l

east

on

ce o

r at r

egul

ar

inte

rval

s

• Pr

ovid

e su

ppor

t to

coun

tries

in

inte

grat

ing

cost

-effe

ctiv

e in

terv

entio

ns fo

r red

ucin

g ris

k fa

ctor

s fo

r ora

l can

cer

into

hea

lth s

yste

ms,

es

peci

ally

at p

rimar

y he

alth

ca

re le

vel

• N

egot

iate

with

ph

arm

aceu

tical

pro

duce

rs

and

who

lesa

lers

to re

duce

co

st o

f ess

entia

l dru

gs

• F a

cilit

ate

tech

nolo

gy

trans

fer f

or m

anuf

actu

re

of m

edic

ines

, vac

cine

s,

med

ical

tech

nolo

gies

, and

in

form

atio

n te

chno

logi

es fo

r pr

even

tion

and

cont

rol o

f N

CD

s

• Fa

cilit

ate

deve

lopm

ent,

adap

tatio

n an

d us

e of

rapi

d sc

reen

ing/

diag

nost

ic te

sts

and

kits

at c

omm

unity

leve

l fo

r ear

ly d

etec

tion

of N

CD

s an

d th

eir r

isk fa

ctor

s.

• In

clud

e es

sent

ial m

edic

ines

and

te

chno

logi

es s

peci

fical

ly fo

r NC

Ds,

in

nat

iona

l ess

entia

l med

icin

es a

nd

med

ical

tech

nolo

gies

list

s

• Im

prov

e ef

ficie

ncy

in th

e pr

ocur

emen

t, su

pply

man

agem

ent a

nd a

cces

s to

ess

entia

l NC

D m

edic

ines

and

te

chno

logi

es in

clud

ing

thro

ugh

the

full

use

of tr

ade-

rela

ted

aspe

cts

of

inte

llect

ual p

rope

rty ri

ghts

(TRI

PS)

flexi

bilit

ies

• Pr

omot

e pr

ocur

emen

t and

use

of

gene

ric m

edic

ines

for p

reve

ntio

n an

d co

ntro

l of N

CD

s by

qua

lity

assu

ranc

e of

gen

eric

pro

duct

s, p

refe

rent

ial

regi

stra

tion

proc

edur

es, g

ener

ic

subs

titut

ion,

fina

ncia

l inc

entiv

es a

nd

educ

atio

n of

pre

scrib

ers

and

cons

umer

s

• En

sure

the

avai

labi

lity

of li

fe-s

avin

g te

chno

logi

es a

nd e

ssen

tial m

edic

ines

for

man

agin

g N

CD

s in

the

initi

al p

hase

of

emer

genc

y re

spon

se

• D

evel

op a

nd im

plem

ent a

pal

liativ

e ca

re

polic

y us

ing

cost

-effe

ctiv

e tre

atm

ent

mod

aliti

es, i

nclu

ding

opi

oid

anal

gesic

s fo

r pai

n re

lief

Action plan for the prevention and control of noncommunicable diseases in South-East Asia36

Des

ired

ou

tcom

eIn

dica

tors

Ac

tions

for

WH

OPr

opos

ed a

ctio

ns fo

r

Mem

ber

Stat

es

• Va

ccin

atio

n co

vera

ge

agai

nst h

epat

itis

B vi

rus

mon

itore

d by

nu

mbe

r of t

hird

dos

es

of h

epat

itis

B va

ccin

e (H

epB3

) adm

inist

ered

to

infa

nts

• Fa

cilit

ate

shar

ing

of

expe

rienc

es, b

est p

ract

ices

an

d le

sson

s am

ong

Mem

ber

Stat

es

• Im

prov

e co

vera

ge o

f hep

atiti

s B

vacc

inat

ion

• St

reng

then

edu

catio

n an

d aw

aren

ess

on e

arly

det

ectio

n of

com

mon

can

cers

in

clud

ing

brea

st c

ance

r, ce

rvic

al c

ance

r an

d or

al c

ance

r

• St

reng

then

bas

ic fa

cilit

ies

of p

rimar

y he

alth

car

e fa

cilit

ies

for p

reve

ntio

n an

d ea

rly d

iagn

osis

of c

ervi

cal c

ance

r and

or

al c

ance

r

• Re

view

exi

stin

g pr

ogra

mm

es, s

uch

as n

utrit

ion,

HIV

, tub

ercu

losis

and

re

prod

uctiv

e he

alth

, for

opp

ortu

nitie

s to

in

tegr

ate

serv

ice

deliv

ery

for p

reve

ntio

n an

d co

ntro

l of N

CD

s

• In

crea

se c

apac

ity o

f hea

lth-c

are

serv

ices

to

del

iver

pre

vent

ion

and

treat

men

t in

terv

entio

ns fo

r haz

ardo

us d

rinki

ng a

nd

alco

hol u

se d

isord

ers

at p

rimar

y ca

re

and

othe

r set

tings

.

• Fa

cilit

ate

acce

ss to

pre

vent

ive

mea

sure

s,

treat

men

t and

voc

atio

nal r

ehab

ilita

tion,

as

wel

l as

finan

cial

com

pens

atio

n of

oc

cupa

tiona

l NC

Ds,

suc

h as

can

cer a

nd

chro

nic

resp

irato

ry d

iseas

e, c

onsis

tent

w

ith in

tern

atio

nal a

nd n

atio

nal l

aws

and

regu

latio

ns o

n oc

cupa

tiona

l dise

ases

Action plan for the prevention and control of noncommunicable diseases in South-East Asia 37

3.2

Hea

lth w

orkf

orce

Part

ners

: M

inist

ries

of h

ealth

, oth

er r

elev

ant m

inist

ries,

loca

l gov

ernm

ent a

utho

ritie

s; r

egul

ator

y co

unci

ls, c

ivil

soci

ety,

m

edic

al a

ssoc

iatio

ns, p

rivat

e he

alth

pro

vide

rs, N

GO

s, p

harm

aceu

tical

age

ncie

s, m

edia

Des

ired

out

com

eIn

dica

tors

Ac

tions

for

WH

O

Prop

osed

act

ions

for

M

embe

r St

ates

Impr

oved

co

mpe

tenc

e of

he

alth

wor

kfor

ce

for p

reve

ntio

n,

early

dia

gnos

is an

d m

anag

emen

t of

NC

Ds

• P e

rcen

tage

of p

rimar

y he

alth

car

e w

orke

rs

train

ed in

inte

grat

ed

NC

D p

reve

ntio

n an

d co

ntro

l

• Pr

ovid

e te

chni

cal

supp

ort t

o de

velo

p co

mpe

tenc

y-ba

sed

curr

icul

um fo

r tra

inin

g of

hea

lth w

orkf

orce

in

NC

D p

reve

ntio

n an

d co

ntro

l, w

ith a

n em

phas

is on

prim

ary

care

• Tr

ain

heal

th w

orke

rs in

us

e of

ava

ilabl

e W

HO

N

CD

tool

s, s

uch

as

WH

O P

EN

• En

cour

age

inno

vativ

e he

alth

wor

kfor

ce

mod

els,

incl

udin

g ta

sk

shift

ing

and

capa

city

bu

ildin

g fo

r low

- and

m

id-le

vel p

rovi

ders

in

prim

ary

heal

th c

are

setti

ngs

• M

anag

e he

alth

wor

kfor

ce to

ade

quat

ely

addr

ess

curr

ent N

CD

bur

den

as w

ell

as p

lann

ing

for f

utur

e ne

eds

in li

ght o

f po

pula

tion

agei

ng

• Id

entif

y co

mpe

tenc

ies

requ

ired

and

inve

st

in im

prov

ing

the

know

ledg

e, s

kills

and

m

otiv

atio

n of

the

curr

ent h

ealth

wor

kfor

ce

to a

ddre

ss N

CD

s, in

clud

ing

com

mon

co -

mor

bidi

ty c

ondi

tions

• In

corp

orat

e pr

even

tion

and

cont

rol o

f NC

Ds

in th

e pr

e-se

rvic

e an

d in

-ser

vice

trai

ning

of

all h

ealth

wor

kers

, pro

fess

iona

l and

non

-pr

ofes

siona

l (te

chni

cal,

voca

tiona

l), w

ith a

n em

phas

is on

prim

ary

care

• Pr

ovid

e ad

equa

te m

echa

nism

s (c

ompe

nsat

ion)

and

ince

ntiv

es fo

r hea

lth

wor

kers

, pay

ing

due

atte

ntio

n to

attr

actin

g an

d re

tain

ing

them

in u

nder

serv

iced

are

as

Action plan for the prevention and control of noncommunicable diseases in South-East Asia38

Des

ired

out

com

eIn

dica

tors

Ac

tions

for

WH

O

Prop

osed

act

ions

for

M

embe

r St

ates

• D

evel

op c

aree

r tra

cks

for h

ealth

wor

kers

th

roug

h st

reng

then

ing

post

grad

uate

tra

inin

g, w

ith a

spe

cial

focu

s on

NC

Ds,

in

vario

us p

rofe

ssio

nal d

iscip

lines

and

car

eer

adva

ncem

ent f

or n

on-p

rofe

ssio

nal s

taff

• Ex

plor

e an

d pr

omot

e in

nova

tive

heal

th

wor

kfor

ce m

odel

s, in

clud

ing

task

shi

fting

, an

d ca

paci

ty b

uild

ing

for l

ow- a

nd m

id-

leve

l pro

vide

rs in

the

cont

ext o

f pre

vent

ion

and

cont

rol o

f NC

Ds

in p

rimar

y he

alth

car

e se

tting

s

Action plan for the prevention and control of noncommunicable diseases in South-East Asia 39

3.3

Com

mun

ity-b

ased

app

roac

hes

Part

ners

: M

inist

ries

of h

ealth

, oth

er r

elev

ant m

inist

ries,

loca

l gov

ernm

ent a

utho

ritie

s; r

egul

ator

y co

unci

ls, c

ivil

soci

ety,

m

edic

al a

ssoc

iatio

ns, p

rivat

e he

alth

pro

vide

rs, N

GO

s, p

harm

aceu

tical

age

ncie

s, m

edia

Des

ired

out

com

eIn

dica

tors

Ac

tions

for

WH

O

Prop

osed

act

ions

for

M

embe

r St

ates

Com

mun

ities

/pa

tient

s em

pow

ered

for

self-

care

• N

atio

nal

guid

elin

es o

n se

lf-ca

re fo

r pr

even

tion

and

man

agem

ent

of N

CD

s de

velo

ped

and

adop

ted

• D

evel

op in

nova

tive

tool

s fo

r sel

f-ca

re,

for e

xam

ple

thro

ugh

info

rmat

ion

tech

nolo

gy

• D

evel

op a

nd

diss

emin

ate

guid

elin

es

for m

onito

ring

and

eval

uatio

n of

co

mm

unity

-bas

ed

initi

ativ

es fo

r NC

D

prev

entio

n an

d co

ntro

l

• Fa

cilit

ate

best

pra

ctic

es

on c

omm

unity

-bas

ed

care

for p

reve

ntio

n an

d co

ntro

l of N

CD

s

• U

se p

artic

ipat

ory

com

mun

ity-b

ased

app

roac

hes

in d

esig

ning

, im

plem

entin

g, m

onito

ring

and

eval

uatin

g N

CD

pro

gram

mes

acr

oss

the

life-

cour

se a

nd c

ontin

uum

of c

are

• C

reat

e aw

aren

ess

to e

mpo

wer

peo

ple

to s

eek

care

and

det

ectio

n fo

r bet

ter m

anag

emen

t of

thei

r con

ditio

ns

• D

evel

op p

atie

nt e

duca

tion/

self-

care

gui

delin

es fo

r pr

even

tion

and

cont

rol o

f NC

Ds

in c

onsu

ltatio

n w

ith a

wid

e va

riety

of s

take

hold

ers

• En

cour

age

the

form

atio

n of

com

mun

ity c

oalit

ions

an

d pa

tient

gro

ups,

and

bui

ld th

eir c

apac

ity

• M

eet t

he n

eeds

for l

ong-

term

car

e of

peo

ple

with

N

CD

s, re

late

d di

sabi

litie

s an

d co

-mor

bidi

ties

thro

ugh

inno

vativ

e an

d ef

fect

ive

mod

els

of c

are

(con

nect

ing

occu

patio

nal h

ealth

ser

vice

s an

d co

mm

unity

hea

lth re

sour

ces

with

prim

ary

care

an

d th

e re

st o

f the

hea

lth-c

are

deliv

ery

syst

em

• M

onito

r and

eva

luat

e co

mm

unity

-bas

ed

initi

ativ

es fo

r pre

vent

ion

and

cont

rol o

f NC

Ds

Action plan for the prevention and control of noncommunicable diseases in South-East Asia40

Stra

tegi

c ac

tion

area

4: S

urve

illan

ce, m

onito

ring

and

eva

luat

ion

and

rese

arch

4.1

Stre

ngth

en s

urve

illan

ce

Part

ners

: M

inist

ries

of h

ealth

, ot

her

rele

vant

min

istrie

s/go

vern

men

t ag

enci

es;

prof

essio

nal b

odie

s, N

GO

s, a

cade

mia

, N

atio

nal R

esea

rch

Cou

ncil/

othe

r res

earc

h in

stitu

tions

, UN

age

ncie

s/bi

late

ral a

nd m

ultil

ater

al d

evel

opm

ent p

artn

ers

Des

ired

out

com

eIn

dica

tors

Ac

tions

for

WH

O (R

egio

nal

Off

ice

and

coun

try

offic

es)

Prop

osed

act

ions

for

M

embe

r St

ates

Impr

oved

av

aila

bilit

y an

d us

e of

info

rmat

ion

on N

CD

mor

talit

y,

mor

bidi

ty, r

isk

fact

ors

and

heal

th

syst

em re

spon

se

• N

atio

nal r

isk fa

ctor

su

rvey

s usin

g st

anda

rd

met

hods

con

duct

ed

ever

y th

ree

to fi

ve

year

s

• D

issem

inat

e st

anda

rd to

ols

and

guid

elin

es fo

r NC

D

surv

eilla

nce/

su

rvey

s

• Bu

ild c

apac

ity o

f Mem

ber

Stat

es in

stre

ngth

enin

g na

tiona

l su

rvei

llanc

e an

d m

onito

ring

syst

ems

(incl

udin

g vi

tal

regi

stra

tion,

risk

fact

or s

urve

ys

and

heal

th fa

cilit

y su

rvey

s) a

nd

supp

ort i

mpl

emen

tatio

n

• Pr

ocur

e a

regi

onal

poo

l of d

ata

colle

ctio

n to

ols

(e.g

. PD

As,

bloo

d pr

essu

re in

stru

men

t) an

d ot

her m

ater

ials

for f

acili

tatin

g su

rvei

llanc

e in

Mem

ber S

tate

s

• Ad

apt a

nd im

plem

ent W

HO

su

rvei

llanc

e fra

mew

ork

that

mon

itors

ex

posu

re (r

isk fa

ctor

s), o

utco

me

(mor

bidi

ty a

nd m

orta

lity)

, and

hea

lth

syst

em re

spon

se

• Al

loca

te a

dequ

ate

fund

s fo

r NC

D

surv

eilla

nce

• Ex

plor

e re

sour

ces

from

exi

stin

g in

itiat

ives

suc

h as

GAV

I Alli

ance

, th

e G

FATM

for s

treng

then

ing

NC

D s

urve

illan

ce a

nd m

onito

ring,

in

clud

ing

vita

l reg

istra

tion,

risk

fact

or

surv

eilla

nce

(incl

udin

g sa

lt su

rvey

s)

and

heal

th s

yste

m re

spon

se.

• In

stitu

tiona

lize

NC

D s

urve

illan

ce

thro

ugh

an a

ppro

pria

te g

over

ning

m

echa

nism

to e

nhan

ce o

wne

rshi

p,

sust

aina

bilit

y an

d co

ordi

natio

n at

co

untry

leve

l.

Action plan for the prevention and control of noncommunicable diseases in South-East Asia 41

Des

ired

out

com

eIn

dica

tors

Ac

tions

for

WH

O (R

egio

nal

Off

ice

and

coun

try

offic

es)

Prop

osed

act

ions

for

M

embe

r St

ates

• St

reng

then

tech

nica

l ca

paci

ty in

Mem

ber S

tate

s in

con

duct

ing

surv

eilla

nce,

w

ith a

focu

s on

bui

ldin

g ca

paci

ty fo

r dat

a m

anag

emen

t, da

ta a

naly

sis a

nd d

ata

use

for a

dvoc

acy,

as

wel

l as

for

plan

ning

and

mon

itorin

g

• Bu

ild n

atio

nal c

apac

ity fo

r dat

a m

anag

emen

t, da

ta a

naly

sis a

nd

data

use

for a

dvoc

acy,

as

wel

l as

for

prog

ram

me

plan

ning

and

mon

itorin

g pr

ogre

ss in

pre

vent

ion

and

cont

rol

of N

CD

s.

• St

reng

then

vita

l reg

istra

tion

and

civi

l re

gist

ratio

n sy

stem

s an

d im

prov

e m

edic

al c

ause

of d

eath

repo

rting

by

pro

activ

ely

enga

ging

rele

vant

st

akeh

olde

rs/s

ecto

rs

• St

reng

then

nat

iona

l can

cer

regi

stra

tion

incl

udin

g po

pula

tion-

base

d re

gist

ries

• St

reng

then

nat

iona

l can

cer

regi

stra

tion

incl

udin

g co

rrec

t di

agno

sis, e

ncod

ing

and

reco

rdin

g of

or

al c

ance

r

• In

tegr

ate

surv

eilla

nce

for N

CD

s in

to

othe

r nat

iona

l hea

lth s

urve

ys

• C

arry

out

STE

PS s

urve

y (in

clud

ing

St

ep 3

) or e

quiv

alen

t sur

veys

, eve

ry

five

year

s. A

ll M

embe

r Sta

tes

are

enco

urag

ed to

use

eST

EPS

Action plan for the prevention and control of noncommunicable diseases in South-East Asia42

Des

ired

out

com

eIn

dica

tors

Ac

tions

for

WH

O (R

egio

nal

Off

ice

and

coun

try

offic

es)

Prop

osed

act

ions

for

M

embe

r St

ates

• C

arry

out

nat

iona

l sch

ool h

ealth

su

rvey

s (a

ge 1

3–17

yea

rs) u

sing

the

glob

al s

choo

l-bas

ed s

tude

nt h

ealth

su

rvey

(GSH

S) e

very

five

yea

rs to

co

llect

dat

a on

mul

tiple

risk

fact

ors

(e.g

. phy

sical

act

ivity

, tob

acco

, ov

erw

eigh

t and

obe

sity,

alc

ohol

)

• U

nder

take

sec

onda

ry d

ata

anal

yses

• U

se s

urve

illan

ce in

form

atio

n fo

r po

licy

and

prog

ram

me

deve

lopm

ent

• D

issem

inat

e re

sults

of s

urve

illan

ce

wid

ely

to a

ll st

akeh

olde

rs

Action plan for the prevention and control of noncommunicable diseases in South-East Asia 43

4.2

Impr

ove

mon

itori

ng a

nd e

valu

atio

n

Part

ners

: M

inist

ries

of h

ealth

, ot

her

rele

vant

min

istrie

s/go

vern

men

t ag

enci

es;

prof

essio

nal b

odie

s, N

GO

s, a

cade

mia

, N

atio

nal R

esea

rch

Cou

ncil/

othe

r res

earc

h in

stitu

tions

, UN

age

ncie

s/bi

late

ral a

nd m

ultil

ater

al d

evel

opm

ent p

artn

ers

Des

ired

out

com

eIn

dica

tors

Ac

tions

for

WH

O (R

egio

nal O

ffic

e an

d co

untr

y of

fices

)Re

com

men

datio

ns fo

r ac

tions

by

Mem

ber

Stat

es

Tim

ely

repo

rting

an

d us

e of

in

form

atio

n to

im

prov

e N

CD

pr

ogra

mm

e

• N

atio

nal p

rogr

ess

repo

rt on

key

nat

iona

l, re

gion

al a

nd g

loba

l in

dica

tors

and

targ

ets

publ

ished

per

iodi

cally

• As

sess

nat

iona

l cap

acity

for

prev

entio

n an

d co

ntro

l of N

CD

s at

regu

lar i

nter

vals

and

use

this

info

rmat

ion

to p

lug

gaps

in

capa

city

• Pr

ovid

e te

chni

cal s

uppo

rt to

M

embe

r Sta

tes

to d

evel

op

a na

tiona

l NC

D m

onito

ring

fram

ewor

k in

clud

ing

indi

cato

rs a

nd n

atio

nal t

arge

ts;

mec

hani

sms

for d

ata

colle

ctio

n;

frequ

ency

of d

ata

colle

ctio

n;

and

use

of d

ata

• Se

t up

a re

gion

al m

echa

nism

to

trac

k ac

hiev

emen

ts o

f M

embe

r Sta

tes

agai

nst k

ey

targ

ets

and

faci

litat

e ex

chan

ge o

f in

form

atio

n

• D

evel

op n

atio

nal t

arge

ts a

nd

indi

cato

rs b

ased

on

the

glob

al

and

regi

onal

mon

itorin

g fra

mew

ork

and

linke

d to

a

natio

nal m

ultis

ecto

ral p

olic

y an

d ac

tion

plan

• In

tegr

ate

NC

D m

onito

ring

syst

em in

to n

atio

nal h

ealth

and

m

anag

emen

t inf

orm

atio

n sy

stem

s

• D

esig

n an

d co

nduc

t eva

luat

ion

of

NC

D in

terv

entio

ns p

erio

dica

lly

• Pu

blish

per

iodi

c re

ports

on

prog

ress

mad

e in

NC

D p

reve

ntio

n an

d co

ntro

l inc

ludi

ng re

porti

ng o

n ke

y na

tiona

l, re

gion

al a

nd g

loba

l in

dica

tors

and

targ

ets

Action plan for the prevention and control of noncommunicable diseases in South-East Asia44

4.3

Stre

ngth

en r

esea

rch

Part

ners

: M

inist

ries

of h

ealth

, ot

her

rele

vant

min

istrie

s/go

vern

men

t ag

enci

es;

prof

essio

nal b

odie

s, N

GO

s, a

cade

mia

, N

atio

nal R

esea

rch

Cou

ncil/

othe

r res

earc

h in

stitu

tions

, UN

age

ncie

s/bi

late

ral a

nd m

ultil

ater

al d

evel

opm

ent p

artn

ers

Des

ired

out

com

eIn

dica

tors

Ac

tions

for

WH

O (R

egio

nal

Off

ice

and

coun

try

offic

es)

Prop

osed

act

ions

for

M

embe

r St

ates

Rele

vant

evi

denc

e ge

nera

ted

and

used

for

natio

nal p

olic

y an

d pr

ogra

mm

e de

velo

pmen

t

• A v

aila

bilit

y of

a

natio

nal r

esea

rch

agen

da a

nd a

pr

iorit

ized

rese

arch

pl

an fo

r pre

vent

ion

and

cont

rol o

f NC

Ds

• Pr

ovid

e te

chni

cal s

uppo

rt to

dev

elop

nat

iona

l NC

D

rese

arch

age

nda

and

assis

t in

reso

urce

mob

iliza

tion

to

carr

y ou

t prio

rity

rese

arch

• St

reng

then

cap

acity

of

natio

nal i

nstit

utio

ns a

nd s

taff

in d

evel

opm

ent o

f res

earc

h pr

otoc

ols,

ana

lyse

s of

dat

a an

d pr

epar

atio

n of

sci

entif

ic

peer

-rev

iew

ed m

anus

crip

ts

• Fo

ster

par

tner

ship

s an

d lin

kage

s be

twee

n ac

adem

ia,

rese

arch

inst

itutio

ns a

nd

heal

th s

ervi

ce a

genc

ies

to

trans

late

rese

arch

into

pol

icy

and

actio

n

• Al

loca

te a

dequ

ate

fund

s fo

r NC

D

rese

arch

• D

evel

op, i

mpl

emen

t and

mon

itor

a pr

iorit

y na

tiona

l res

earc

h ag

enda

fo

r pre

vent

ion

and

cont

rol o

f N

CD

s, b

ased

on

cons

ulta

tion

with

uni

vers

ities

, WH

O a

nd o

ther

st

akeh

olde

rs

• St

reng

then

nat

iona

l cap

acity

for

rese

arch

and

dev

elop

men

t, in

clud

ing

rese

arch

infra

stru

ctur

e, e

quip

men

t an

d su

pplie

s in

rese

arch

inst

itutio

ns,

and

the

com

pete

nce

of re

sear

cher

s to

co

nduc

t goo

d-qu

ality

rese

arch

• En

hanc

e co

oper

atio

n be

twee

n un

iver

sitie

s, re

sear

ch in

stitu

tes

and

heal

th s

ervi

ces

to e

nsur

e sp

eedy

ut

iliza

tion

of re

sear

ch fi

ndin

gs a

nd

scie

ntifi

c ba

sis fo

r dec

ision

-mak

ing

for

NC

D p

olic

y/pr

ogra

mm

e de

velo

pmen

t

Action plan for the prevention and control of noncommunicable diseases in South-East Asia 45

Des

ired

out

com

eIn

dica

tors

Ac

tions

for

WH

O (R

egio

nal

Off

ice

and

coun

try

offic

es)

Prop

osed

act

ions

for

M

embe

r St

ates

• O

rgan

ize

inte

rcou

ntry

m

eetin

gs a

nd c

onfe

renc

es

to fa

cilit

ate

shar

ing

of n

ew

rese

arch

find

ings

am

ong

Mem

ber S

tate

s

• En

cour

age

mul

ti-co

untry

da

ta c

olle

ctio

n an

d an

alys

is to

det

erm

ine

diag

nost

ic c

ut-

off f

or o

verw

eigh

t/ ob

esity

am

ong

Sout

h-Ea

st

Asia

n ad

ults

• Pr

omot

e sh

arin

g of

dat

a an

d re

sear

ch d

atab

ases

am

ong

Mem

ber S

tate

s

• St

reng

then

col

labo

ratio

n be

twee

n na

tiona

l, re

gion

al a

nd in

tern

atio

nal

rese

arch

cen

tres

• Bu

ild fo

rmal

link

ages

bet

wee

n re

sear

ch a

nd p

olic

y/pr

ogra

mm

e

Action plan for the prevention and control of noncommunicable diseases in South-East Asia46

References

(1) World Health Organization Regional Office for South-East Asia. Regional Health Observatory. http://apps.who.int/searo-rho/ - accessed 13 November 2013.

(2) Mahal A, Karan A, Engelgau M. The Economic Implications of Non-communicable Diseases for India. HNP discussion paper. New York: World Bank, 2010.

(3) Thavorncharoensap M, et al. The economic costs of alcohol consumption in Thailand, 2006. BMC Public Health, 2010, 10:323.

(4) United Nations General Assembly resolution. Doc no. A/RES/66/2. New York. http://www.who.int/nmh/events/un_ncd_summit2011/political_declaration_en.pdf - accessed 13 November 2013.

(5) World Health Organization. Follow-up to the Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases. Doc no. WHA66.10. Geneva: WHO 2013. http://apps.who.int/gb/ebwha/pdf_files/WHA66/A66_R10-en.pdf - accessed 13 November 2013.

(6) World Health Organization. Global action plan for the prevention and control of noncommunicable diseases 2013–2020. Geneva: WHO. http://apps.who.int/gb/ebwha/pdf_files/WHA66/A66_R10-en.pdf - accessed 13 November 2013.