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NONCOMMUNICABLE

DISEASE

BRIG DR HEMANT KUMAR

OUTLINE

• Definition • Burden• The Epidemiological Transition• Major risk factors• Infection and non-communicable diseases• Prevention & Control• Summary

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DEFINITION

NCD is a medical condition or disease, which is not infectious which are generally chronic in nature and have relatively slow progression

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Why NCDs Are Important Public

Health Problems?

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GLOBAL BURDEN• Non-communicable diseases (NCDs) kill

38 million people each year.• Almost 80% deaths - 28 million - occur in

low- and middle-income countries.• Sixteen million NCD deaths occur before

the age of 70; 82% of these "premature" deaths occurred in low- and middle-income countries.

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• Cardiovascular diseases account for most (40%) NCD deaths, or 17.5 million people annually, followed by cancers (8.2 million), respiratory diseases (4 million), and diabetes (1.5 million).

• These 4 groups of diseases account for 82% of all NCD deaths.

• Tobacco use, physical inactivity, the harmful use of alcohol and unhealthy diets all increase the risk of dying from an NCD.

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INDIAN SCENARIO

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• Every year, roughly 5.8 million Indians die from heart and lung diseases, stroke, cancer and diabetes.

• In other words, 1 in 4 Indians risks dying from an NCD before they reach the age of 70.

• In 2015, India, like other developed countries, had more deaths due to non-communicable diseases.

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• In males, deaths due to NCDs (3.6 million) were more than double due to communicable diseases (1.5 million)

• In females (2.7 million due to non-communicable diseases and nearly 1.4 million deaths due to communicable diseases).

• CVDs were the leading cause of death in both sexes(1.6 : 1.1 million ),followed by chronic respiratory diseases — 0.68 : 0.5 million .

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WHO IS AT RISK OF SUCH DISEASES?• All age groups and all regions are affected

by NCDs. • NCDs are often associated with older age

groups, but evidence shows that 16 million of all deaths attributed to non-communicable diseases (NCDs) occur before the age of 70.

• Of these "premature" deaths, 82% occurred in low- and middle-income countries.

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• All ages/genders are all vulnerable to the risk factors, whether unhealthy diet, physical inactivity, exposure to tobacco or use of alcohol.

• These diseases are driven by forces that include ageing, rapid unplanned urbanization, and the globalization of unhealthy lifestyles

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RISK FACTORS

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RISK FACTORS..............

Modifiable behavioral risk factors Tobacco use, physical inactivity, unhealthy diet and

the harmful use of alcohol increase the risk of NCDs.

1. Tobacco accounts for around 6 million deaths every year, and is projected to increase to 8 million by 2030.

2. More than half of the 3.3 million annual deaths from harmful drinking are from NCDs .

3. About 3.2 million deaths annually can be attributed to insufficient physical activity.

4. In 2010, 1.7 million deaths from CVS have been attributed to excess salt/sodium intake.

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METABOLIC/PHYSIOLOGICAL RISK FACTORS

• Metabolic/physiological changes that increase the risk of NCDs are raised blood pressure, overweight/obesity, DM and hyperlipidemia (high levels of fat in the blood).

• In terms of attributable deaths, the leading metabolic risk factor globally is HTN (to which 18% of global deaths are attributed) , followed by overweight and obesity and raised blood glucose.

• Low- and middle-income countries are witnessing the fastest rise in overweight young children.

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Public Health Agency of Canada | Agence de la santé publique du Canada 23

• NCDs are a major fiscal and productivity risks for low and middle income countries

• NCDs increase income inequities, deplete household wealth, increase health spending and lower productivity

• Most countries will not be able to address NCD challenge with medical care alone: Prevention is critical

IMPACT

Source: World Bank 2011.

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PREVENTION AND

CONTROL OF NCDs

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• NCDs need a comprehensive approach and it needs---

• MoH,finance,foreign, affairs, education, agriculture, planning and others, to work together to reduce the risks associated with NCDs, as well as promote the interventions to prevent and control them.

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Contd…• An important way to reduce NCDs is to

focus on lessening the risk factors associated with these diseases.

• Low-cost solutions exist to reduce the common modifiable risk factors (mainly tobacco use, unhealthy diet and physical inactivity, and the harmful use of alcohol) .

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WHO RESPONSE.....• In 2011 Under the banner of the WHO

more than 190 countries agreed to reduce the NCD burden including a Global action plan for the prevention and control of NCDs 2013-2020. 

• This plan aims to reduce the number of premature deaths from NCDs by 25% by 2025 through nine voluntary global targets.

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• The targets will focus on addressing main risk factors such as tobacco use, harmful use of alcohol, unhealthy diet and physical inactivity .

• The UN General Assembly will convene a third high-level meeting on NCDs in 2018 to take stock of progress in attaining the global targets by 2025.

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NATIONAL PROGRAMME FOR PREVENTION AND

CONTROL OF CANCER , DIABETES , CARDIOVA SCULAR DISEASES &

STROKE (NPCDCS)

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OBJECTIVES OF NPCDCS1) Prevent and control common NCDs through

behaviour and life style changes, 2) Provide early diagnosis and management of

common NCDs, 3) Build capacity at various levels of health care for

prevention, diagnosis and treatment of common NCDs,

4) Train human resource to cope with the increasing burden of NCDs, and

5) Establish and develop capacity for palliative & rehabilitative care

SUMMARY• Non-communicable diseases are now the most

common cause of death world wide• Increasing rates in low and middle income

countries because of change in lifestyles (urbanisation)

• Key risk factors have very large effects• Interventions are effective and can reduce

burden• The need to combine results and have large

studies

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80% of heart disease, diabetes and respiratory diseases and 40% of cancers are preventable by eliminating four common risk factors

NCDs

Common risk factors

Tobacco use

Unhealthydiets

Physicalinactivity

Harmful useof alcohol

Cardiovasculardiseases

Diabetes

Cancer

Respiratorydiseases

TAKE HOME MESSAGE

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