Abstract

BackgroundThe incidence of noncommunicable diseases (NCDs) is rising dramatically throughout the world. Aspects of researches concerned with the improvement and development of prevention and control of NCDs have been conducted. Furthermore, the influence of most determinants of the major NCDs has showed that a broad and deep response involving stakeholders in different sectors is required in the prevention and control of NCDs. ObjectiveChina has experienced an increase in NCDs in a short period compared with many countries. To address the burden of NCDs in China, it is important to learn about the progress that has been made in prevention and control of NCDs in China and worldwide, informed by opinions of stakeholders in different areas. MethodsIn 2014, GRAND South developed the NCD Scorecard instrument to evaluate progress of NCD prevention and control in 23 countries through a 2-round Delphi process. The scorecard included 51 indicators in 4 domains: governance, surveillance and research, prevention and risk factors, and health system response. Stakeholders were then selected in the areas of government, nongovernmental organizations, private sectors, and academia to join the NCD Scorecard survey. Indicators of progress were scored by stakeholders from 0 (no activity), 1 (present but not adequate), and 2 (adequate) to 3 (highly adequate) and then the percentage of progress in each domain was calculated, representing the current situation in each country. FindingsThere were 14 indicators in the domains of governance and surveillance and research. Of 429 stakeholders worldwide, 41 in China participated in the survey. China scored in the top 5 out of all participating countries in those 2 domains, scoring 67% in governance and 64% in surveillance and research. Indicators on which China scored particularly well included having a well-resourced unit or department responsible for NCDs, having a strong national system for recording the cause of all deaths, and having a system of NCD surveillance. Areas where China had the greatest need for improvement included increasing taxes on tobacco and addressing the needs of the population older than age 70 dying from major NCDs. ConclusionIn China the burden of disease of NCDs and disabilities remains serious, although China has put significant efforts into its governance and surveillance and research. To improve, further action is needed on reducing tobacco consumption, increasing investment in the national health budget, and increasing the focus on system construction.

Highlights

  • Current global mortality from noncommunicable diseases (NCDs) remains unacceptably high and is still increasing.[1]

  • In Phase 2, a pilot study of the NCD Scorecard instrument was conducted in 3 countries (Guatemala, Bangladesh, and South Africa) in 2013, stakeholders were identified, and the scorecard was implemented in participating countries

  • One key finding of this investigation was that high-income countries (HICs) and upper middle–income countries (UMICs) have put efforts in many aspects of NCD prevention and control, whereas lower middle–income countries (LMICs) and lowincome countries (LICs) have only made progress mostly in governance

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Summary

Introduction

Current global mortality from noncommunicable diseases (NCDs) remains unacceptably high and is still increasing.[1] Approximately 70% of global deaths were due to NCDs (38 million out of total 56 million) in 2012.2 The 4 main types of NCDs (cardiovascular diseases [CVDs], cancers, diabetes, and chronic respiratory diseases) and shared 4 behavioral risk factors have greatly influenced aspects of people’s life and health. China is the world’s most populous developing country and has experienced an acceleration of industrialization, urbanization, population aging processes, and rapid changes of national lifestyle.[5] China is poised to address the world’s greatest emerging health threat: NCDs. China has undergone major demographic and epidemiologic transitions.[6] The overall mortality from NCDs was 533 per 100,000 in 2012, accounting for 86.6% of total deaths in China in 2012,7 which was higher than the global average.

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