global burden of ncds

8/13/2019 Global Burden of NCDs

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Burden of NoncommunicableDiseases: Global and National

Why Address NCDs?

Office of the WHO Representative in the Philippines


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Noncommunicable Diseases NCDs)Heart diseasesand strokes

Cancers

Diabetes

Chronicrespiratory

diseases


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NCDs are a threat to everyone

NCDs are the number one killer in the world

They claim over two-thirds of all deaths

That's 36 million people per year


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25 % of all NCD deaths are premature

(below 60 years) and could be prevented


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14.2 million people die every year from NCDs between the ages 30 and 69:

Most of these premature deaths could have been prevented


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More than 85% of people who die from NCDs between the ages of 30 and 69

live in a developing country


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NCDs contribute to poverty and poverty

increases the risk of developing NCDs


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It's economic effects are devastating.

The World Economic Forum ranks NCDs as

one of the major global threats to economic

development

It's costing hundreds of billions of dollarsevery year in lost productivity

For every 10% rise in NCDs, annual

economic growth falls 0.5%


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US$ 170Bis the overall cost for all

developing countries to

up action by implement

set of "best buy"

interventions between 2and 2025, identified as

priority actions by WHO

US$ 7Tis the cumulative lost

output in developing

countries associated with

NCDs between 2011-2025

The cost of inaction in developing countries over the next 15 years is enormous (compared

the cost of action)

Reports are available at www.who.int/ncd


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It has impact on attainment of MDGs

MDG1: Negative impact on productivity and family

income

MDG 2: Costs for NCDs health care, medicines,

tobacco and alcohol consumption displace househo

resources for education

MDGs 4 & 5:

Rising prevalence of high BP and gestational diabetes

Mothers who smoke are likely to breastfeed for shorter

periods of time and have lower quantities of milk and milk

that is less nutritious

MDG 6: Diabetes associated with 10% of TB cases MDG 8: Affordable essential drugs in developing

countries


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Four types of NCDs account for most deaths in

most low-and middle-income countries


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Causation pathway for NCD


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Modifiable causative risk factors

Tobacco use Unhealthy diets Physical inactivityHarmful use of

alcohol

N

oncommunicablediseases

Heart disease and stroke

Diabetes

Cancer

Chronic lung disease

There are Four Major Groups of NCDs

Four major lifestyles related risk factors

Changing times


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Changing timesNeed social engineering


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Mortality Trend, Philippines, 1953-2005


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Cause Total Rate

1. Diseases of the heart 70, 861 84.8

2. Diseases of the vascular system 51,680 61.8

3. Malignant Neoplasms 40,524 48.9

4. Accidents 34,483 41.3

5. Pneumonia 32,098 38.46. Tuberculosis 26,770 31.0

7. Unclassified 21,278 25.5

8. Chronic lower respiratory diseases 18,975 22.7

9. Diabetes mellitus 16,552 19.8

10. Conditions originating from the

perinatal period

13,180 15.8

Phili ine Statistical Yearbook 2

Top Ten Cause of Mortality


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Prevalence of hypertension,

hyperglycemia, dyslipidemia & overweight

1998, 2003 and 2008

Risk factors1998 2003 2008 Basis

Hypertension 21.0 22.5 25.3 SBP 140, DBP 90

Hyperglycemia 3.9 3.4 4.8 FBS > 126 mg/dL

Total cholesterol 4.0 8.5 10.2 240 mg/dL

LDL-c 8.1 11.7 11.8 160 mg/dL

HDL-c 76.6 54.2 64.1 < 40 mg/dL

Triglycerides 8.7 9.4 14.6 200 mg/dL

BMI (Overweight) 20.2 24.0 26.6 BMI 25.0

Source: Phili ine NNS FNRI


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Total Male Fema

Philippines 23.7 23.8 23.6

20-29 20.4 20.3 20.630-39 26.5 27.4 24.840-49 23.2 22.7 24.150-59 26.1 26.0 26.360-60 22.6 22.1 23.470-up 17.5 19.9 13.6

Percent of the population with adequate

PA, 2008


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Smoking

Total Male Female

Philippines 31 53.2 12.5

20-29 31.1 57.7 8.630-39 30.2 53.2 10.840-49 33 55.5 12.150-59 32.6 54.6 15.360-60 28.2 45 14.870-up 27.1 32.9 23.2

Prevalence of current smokers, 2008


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Alcohol

Total Male Female

Philippines 26.9 47.5 9.8

20-29 26.5 47.2 9.030-39 30.3 54.2 10.440-49 30.7 52.8 10.250-59 27.0 47.6 10.860-60 19.8 32.8 9.570-up 14.0 23.3 7.8

Prevalence of alcohol drinkers, 2008


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Advocacy

Research, Surveillance, Evaluation

Whole of society responseCommunity leadership

Intersectoral partnerships

Community mobilization

Health Systems Response(Health Systems Strengthening)Health workforce development

Health services organization/deliveryFinancingPeople-centred systems of care

Focus on prevention

Health Sector ResponseHealth sector governance

Health sector leadershipIntegration of NCD prevention and controlinto national health strategyWhole of government response

Political will

Political leadershipHealthy public policies and laws

Regional Framework for Action

76

54

1 32

WHO' l b l d t t d


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2000

2003

2004

2008

Global Strategy for the Prevention and Control

of Noncommunicable Diseases

Global Strategy on Diet,

Physical Activity and Health

Action Plan on the Global Strategy for the

Prevention and Control of NCDs

2010

2009

2011

Global Strategy to

Reduce the Harmful Use

of Alcohol

WHO Global Status

Report on NCDs

Political Declaration on NCDs

WHO's global road map to prevent andcontrol NCDs

2012+ Realizing the commitments made in the Political Declaration


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The Political Declaration on NCDs


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The Political Declaration on NCDs

WHO Director-Gen

Heads of State and Government and representatives committed to:

Establish/strengthen, by 2013,national multisectoral policies and plans for NCDs, taking into accounthe Global Strategy for NCDs and its Action Plan

Integrate NCDs policies and programmes into health-planning processesand the nationaldevelopment agendaof each Member State

Develop national targets and indicators based on guidance provided by WHO and give greater prioto surveillance

Accelerate implementationof the WHO FCTC, the Global Strategy on Diet, Physical Activity andHealth, and the Global Strategy to Reduce the Harmful Use of Alcohol.

Strengthen health systemsthat support primary care, prioritize early detection and treatment, andimprove access to affordable essential medicines for NCDs

Rio+20:


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We understand the goals

of sustainable development can only

be achieved in the absence of a highprevalence of debilitating

communicable and NCDs, and where

populations can reach a state of

physical, mental and social well-being.

(paragraph 138)

We acknowledge that the global

burden and threat of NCDsconstitutes

one of the major challenges for

sustainable development in the twenty-

first century.(paragraph 141)

Rio+20:

"NCDs constitute one of the major challenges for sustainable development"

UN System Task Team on the post-2015 UN development agenda:


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The MDGs did not adequately address

increase in NCDs.(paragraph 19)

Priorities for social development and

investments in people would include:

NCDs.Access to sufficient nutritious

food and promotion of healthy life

styles with universal access to

preventive health services will be

essential to reduce the high incidence

of NCDsdiseases in both developed and

developing countries(paragraph 67)

UN System Task Team on the post 2015 UN development agenda:

NCDs is a priority for social development and investments in people


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Set of 9 voluntary global targets

Raised bloodpressure

25% reduction

Salt/

sodium intake

30% reduction

Tobacco use

30% reduction

Physical inactivity

10% reduction

Harmful use ofalcohol

10% reduction

Drug therapy and

counseling

50%

Premature

mortality from

NCDs

25% reduction

Diabetes/

obesity

0% change

Essential NCD

medicines andtechnologies

80%

Mortality and morbidity

Risk factors for NCDs

National systems response


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Comprehensive Global Monitoring Framework

Mortality &Morbidity

Cancer incidence by type ofcancer per 100 000 population

Unconditional probability ofdying between ages 30 and 70

years from cardiovasculardiseases, cancer, diabetes orchronic respiratory diseases

Salt

Fruits and Vegetables

Saturated Fat

Overweight and Obesity (2)

Physical Inactivity (2)

Blood glucose/diabetes

Blood Pressure

Total Cholesterol

Harmful use of Alcohol (3)

Risk Factors

Tobacco use (2)

Access to palliative care

National Systems

Response

Policies to limit SFA and virtualelimination of PHVO

Essential NCD Medicines

HPV Vaccine

Marketing to children

Drug therapy and counseling

Cervical cancer Screening

Hepatitis B Vaccine

NCD B t B


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NCD Best Buys

National Policy on Strengthening Prevention


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National Policy on Strengthening Prevention

and Control of NCDs (2011)

Emphasized the need for strengthening healthsystems and whole-of-government, whole-of-

society response to address the growing NCD

problem in the Philippines.

Universal Health Care


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Universal Health Care

Financial RiskProtection

Improvingaccess to

quality healthfacilities

AchievingMDG max

Better health outcomes Responsive health system Equitable health financing

Health

Financing

Service

Delivery

Policy, standards

and regulation

Health

Human

Resource

Health

Information

Governa

for Hea


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Community health teams

T b t l l i l ti (2003)


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Tobacco control legislation (2003)

The Tobacco Regulatory Act (RA 9211) of 2003 provided for the

implementation of population-based tobacco control measures all over thecountry.


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Sin tax legislation

.

Access to NCD medicines


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Access to NCD medicines

The DOH Complete TreatmentPack (COMPACK) ensure access

to essential drugs and medicines

for the marginalized sector

Includes medicines forhypertension, diabetes,

hyperlipidemia, and asthma

Total Number of PhilHealth Claims for Hypertension, Diabete


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0

50,000

100,000

150,000

200,000

250,000

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Hypertension Diabetes Cancers Heart Disease

Cancer and Heart Disease from 2002-2012

Total Amount Paid for PhilHealth Claims for Hypertension,


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Total Amount Paid for PhilHealth Claims for Hypertension,

Diabetes, Cancer and Heart Disease from 2002-2012

0.00

500,000,000.00

1,000,000,000.00

1,500,000,000.00

2,000,000,000.00

2,500,000,000.00

3,000,000,000.00

3,500,000,000.00

4,000,000,000.00

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Hypertension Diabetes Cancers Heart Disease

Expansion of Social Health Insurance


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Expansion of Social Health Insurance

Benefits for NCDs

Adoption of WHO Package of Essential NCD (PEN


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p g (

Interventions


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WHO-PEN implementation

Training Implementation Monitoring


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Training, Implementation, Monitoring


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A nationwide healthy lifestyle movement that uses social mediaand aims to inform and encourage Filipinos from all walks of life

to practice a healthy lifestyle by making a personal commitment tophysical activity, proper nutrition, and the prevention or cessationof smoking and alcohol consumption.


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CHALLENGES

Varying implementation of intervention across

local government units

Inadequate health financing for NCDs

Inadequate allocation of funds for health

promotion

Inadequate multisectoral actions


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Next steps

Continue and Monitor implementationPEN/NCD services at primary health care

Sin Tax and Tobacco Control legislations

Expand Philhealth benefits Intensify public health education campaigns

Development of national multisectoral action plan for

NCDs

Implementing low-cost workable solutions in developing countries

could prevent most premature deaths from NCDs


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could prevent most premature deaths from NCDs

2/3 + 1/3Implementing cost-effective interventions that reduceexposure of populations to risk factors for NCDs will contribute

up to two-thirds of the reduction in premature mortality.In addition, health systems that respond more effectively and

equitably to the health-care needs of people with NCDs can

reduce premature mortality by another one-third up to one-half.


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Mobilizing governments to include NCDs in health-planning processes an

development initiatives needs to be one of your priorities


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Thank you

global burden of ncds

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