Global Noncommunicable Diseases Action Plan Research Articles

A tool to identify NCD interventions to achieve the SDG target

A tool to identify NCD interventions to achieve the SDG target

The impact of obesity on cardiovascular disease risk factor

Obesity has emerged as the most potential cardiovascular risk factor and has raised concern among public and their health related issues not only in developed but also in developing countries. The Worldwide obesity occurrence has almost has gone three times since 1975. Research suggests there are about 775 million obese people in the World including adult, children, and adolescents. Nearly 50% of the children who are obese and overweight in Asia in are below 5 years. There is a steep incline of childhood obesity when compared to 1971 which is not only in developed countries but also in developing countries. A considerable amount of weight gain occurs during the transition phase from adolescence to young adulthood. It is also suggested that those adultswho were obese in childhood also remained obese in their adulthood with a higher metabolic risk than those who became obese in their adulthood. In India, the urban Indian female in the age group of 30-45 years have emerged as an 〝at risk population” for cardiovascular diseases. To understand how obesity can influence cardiovascular function, it becomes immense important to understand the changes which can take place in adipose tissue due to obesity. There are two proposed concepts explaining the inflammatory status of macrophage. The predominant cause of insulin resistance is obesity. Epidemiological and research studies have indicated that the pathogenesis of obesity-related metabolic dysfunction involves the development of a systemic, low-grade inflammatory state. It is becoming clear that targeting the pro-inflammatory pathwaymay provide a novel therapeutic approach to prevent insulin resistance, particularly in obesity inducedinsulin resistance. Some cost effective interventions that are feasible by all and can be implemented even in low-resource settings includes - population-wide and individual, which are recommended to be used in combination to reduce the greatest cardiovascular disease burden. The sixth target in the Global NCD action plan is to reduce the prevalence of hypertension by 25%. Reducing the incidence of hypertension by implementing population-wide policies to educe behavioral risk factors. Reducing cigarette smoking, body weight, blood pressure, blood cholesterol, and blood glucose all have a beneficial impact on major biological cardiovascular risk factors. A variety of lifestyle modifications have been shown, in clinical trials, to lower bloodpressure, includes weight loss, physical activity, moderation of alcohol intake, increased fresh fruit and vegetables and reduced saturated fat in the diet, reduction of dietary sodium intake, andincreased potassium intake. Also, trials of reduction of saturated fat and its partial replacement by unsaturated fats have improved dyslipidaemia and lowered risk of cardiovascular events. This initiative driven by the Ministry of Health and Family Welfare, State Governments, Indian Council of Medical Research and the World Health Organization are remarkable. The Government of India has adopted a national action plan for the prevention and control of non-communicable diseases (NCDs) with specific targets to be achieved by 2025, including a 25% reduction inoverall mortality from cardiovascular diseases, a 25% relative reduction in the prevalence of raised blood pressure and a 30% reduction in salt/sodium intake. In a nutshell increased BMI values can predict the nature of obesity and its aftermaths in terms inflammation and other disease associated with obesity. It’s high time; we must realize it and keep an eye on health status in order to live long and healthy life.

Non-communicable disease prevention policy process in five African countries authors

BackgroundThe increasing burden of non-communicable diseases (NCDs) in sub-Saharan Africa is causing further burden to the health care systems that are least equipped to deal with the challenge. Countries are developing policies to address major NCD risk factors including tobacco use, unhealthy diets, harmful alcohol consumption and physical inactivity. This paper describes NCD prevention policy development process in five African countries (Kenya, South Africa, Cameroon, Nigeria, Malawi), including the extent to which WHO “best buy” interventions for NCD prevention have been implemented.MethodsThe study applied a multiple case study design, with each country as a separate case study. Data were collected through document reviews and key informant interviews with national-level decision-makers in various sectors. Data were coded and analyzed thematically, guided by Walt and Gilson policy analysis framework that examines the context, content, processes and actors in policy development.ResultsCountry-level policy process has been relatively slow and uneven. Policy process for tobacco has moved faster, especially in South Africa but was delayed in others. Alcohol policy process has been slow in Nigeria and Malawi. Existing tobacco and alcohol policies address the WHO “best buy” interventions to some extent. Food-security and nutrition policies exist in almost all the countries, but the “best buy” interventions for unhealthy diet have not received adequate attention in all countries except South Africa. Physical activity policies are not well developed in any study countries. All have recently developed NCD strategic plans consistent with WHO global NCD Action Plan but these policies have not been adequately implemented due to inadequate political commitment, inadequate resources and technical capacity as well as industry influence.ConclusionNCD prevention policy process in many African countries has been influenced both by global and local factors. Countries have the will to develop NCD prevention policies but they face implementation gaps and need enhanced country-level commitment to support policy NCD prevention policy development for all risk factors and establish mechanisms to attain better policy outcomes while considering other local contextual factors that may influence policy implementation such as political support, resource allocation and availability of local data for monitoring impacts.

Strengthening non-communicable disease policy with lessons from Bhutan: linking gross national happiness and health policy action.

There is growing global interest in Gross National Happiness (GNH) as a metric to capture population well-being and economic development. Empirical evidence suggests that health is necessary for achievement of happiness. The growing epidemic of non-communicable diseases (NCDs) threatens to undermine the achievement of GNH. We analyze synergies between current policy priorities and the institutional mechanism for GNH and the Global NCD Action Plan 2013-2020 that has informed Bhutan's approach to NCDs. We identify strategic policy opportunities to strengthen outcomes for both policy areas. Lessons from Bhutan also suggest strategic opportunities to address NCDs in other countries where happiness is on the national agenda, or where action on NCDs could be improved through engagement between health and other sectors, especially where ways to promote and measure GNH (population well-being) already exist.

Alcohol and Noncommunicable Disease Risk

Alcohol use is a major risk factor for noncommunicable diseases (NCDs), annually causing more than 1.8 million deaths, and approximately 52 million disability-adjusted life years lost globally. This review examines the relationship between alcohol use and NCDs in the context of current United Nations (UN) and World Health Organization (WHO) initiatives to reduce the burden of NCDs as well as the resulting policy implications. The importance of alcohol as a major risk factor for NCDs is evidenced by its inclusion as one of only four behavioral risk factors (tobacco use, unhealthy diet, physical inactivity, and harmful use of alcohol) into the World Health Organization’s Global Action Plan for the Prevention and Control of NCDs. Alcohol use also plays a major role in other strategic initiatives of the UN and WHO. While these inclusions help enable policy measures to reduce harmful alcohol use, the Global NCD Action Plan in general disregards many diseases and injuries caused by alcohol, most notably liver cirrhosis and all mental disorders. Furthermore, the Global NCD Action Plan also fails to highlight interactions between risk factors; however, there is strong epidemiological evidence of the differential harms caused by alcohol use between poverty/socioeconomic strata. Thus, future policy plans should explicitly include consideration of health inequalities.

GARD, a new way to battle with chronic respiratory diseases, from disease oriented programmes to global partnership.

Initiated by World Health Organization (WHO) Global Chronic Respiratory Disease (CRD)-oriented programmes, Global Initiative on Asthma (GINA), GOLD-Global Initiative for Chronic Obstructive Pulmonary Disease (COPD), Allergic Rhinitis and its Impact on Asthma (ARIA), and Practical Approach to Lung Health (PAL) have catalyzed creation of the Global Alliance Against CRD (GARD). Forty-five countries sharing GARD's goal to reduce the burden of CRD joint GARD. In 20 countries with reliable death estimates, CRD mortality has been analyzed in 2000, 2005, 2010 and 2015. Dramatic decline in CRD mortality is seen in Kyrgyzstan, Netherlands, Italy and Republic of Korea (69%, 55%, 48%, and 48%). Positive trend in COPD mortality is seen for Lithuania (36% decline) and Spain (21%). In France, Japan, Mexico, Romania and Costa Rica, positive trend for asthma mortality is obvious from 2000 to 2015 from about 40% in France and Romania, 50% and Mexico and Czech Republic, 65% in Japan and 69% in Belgium. In Costa Rica zero asthma mortality was registered in 2015. In Czechia and Belgium decline is seen from 2000 to 2005, which then stabilized in Czech Republic and went further down in Belgium. In Finland initially, low asthma mortality remains practically unchanged with slight decline in 2015. In other countries analyzed, we did not see any positive trend in CRD mortality. In all countries with positive CRD dynamic WHO introduced activities remained active, they have been taken into local guidelines and practice and supported national authorities in implementing these evidence-based guidelines. Before GARD launch WHO initiated activities produced a good basis for further GARD movement and by 2010 we see a visible positive trend in CRD mortality in success countries. By 2015 when WHO noncommunicable disease (NCD) Global Action Plan 2013-2020 rollouts globally dramatic decline in total CRD mortality and particularly in Asthma and COPD mortality became obvious. Global disease oriented programmes, national and international partnerships combined with the Global NCD Action Plan most probable produce a positive synergistic effect on the mortality from CRD.

Translating the WHO 25×25 goals into a UK context: the PROMISE modelling study

ObjectiveModel the impact of targets for obesity, diabetes, raised blood pressure, tobacco use, salt intake, physical inactivity and harmful alcohol use, as outlined in the Global Non-Communicable Disease Action Plan...

A developmental approach to the prevention of hypertension and kidney disease: a report from the Low Birth Weight and Nephron Number Working Group

In 2008, the World Health Assembly endorsed the Global Noncommunicable Disease (NCD) Action Plan based on the realization that NCDs caused more deaths than communicable diseases worldwide. 1 This plan strongly advocates prevention as the most effective strategy to curb NCDs. The “Life Course Approach”, also recently highlighted in the Minsk Declaration, reflects the increasing recognition that early development impacts later-life health and disease. 1,2 Optimization of early development offers the opportunity for true primary prevention of NCDs. Developmental programming in the kidney has been recognized for over 2 decades but its contribution to the global burden of kidney diseases remains underappreciated by policy makers. 3 Given the many factors known to impact fetal kidney development, including maternal health and nutrition, exposure to stress, poverty, pollutants, drugs and infections during gestation, 3 a holistic strategy to prevent such programming effects is consistent with the “Life-Course” approach and aligns with the United Nations Sustainable Development Goals (SDG) to foster health. 2,4 Chronic kidney disease (CKD) is an important contributor to the NCD burden that has been relatively neglected in the Global NCD Action Plan, despite CKD being a major cause of hypertension, and a major risk multiplier of cardiovascular disease 1,5 While the prevalence of CKD in many lower-income countries remains unknown, CKD is more prevalent among disadvantaged populations within industrialized nations, e.g. African Americans and Aboriginal Australians. 6 People receiving dialysis or transplantation are projected to double from 2.6 million in 2010 to 5.4 million in 2030. 7 Between 2.3 and 7.1 million adult people died from lack of access to dialysis and transplantation in lower-income countries in 2010. 7 Given the clinical consequences and often prohibitively high costs of treatment, prevention and early detection are the only sustainable solutions to address this growing global burden. To address the neglected issue of developmental programming of kidney disease and hypertension, a multidisciplinary workgroup, including international expert obstetricians, neonatologists and nephrologists (see Appendix), was convened. We argue that the Global NCD Action Plan does not adequately address the impact of developmental origins of NCDs which is globally but is particularly important in low- and middle-income countries (LMICs) where developmental risk is highest and the burden of NCDs is growing fastest. 8 The working group identified the need to raise awareness of the role of developmental programming in renal disease, and suggests locally adapted preventive strategies that could have long-term benefits on health and heath cost savings worldwide, integrating obstetrical, neonatal and nephrology perspectives.

International cancer control leadership forum program

43 A National Cancer Control Plan (NCCP) comprises an important part of a country’s non-communicable disease (NCD) plan and can help countries meet NCD targets outlined in the WHO Global NCD Action Plan. A comprehensive cancer control plan is based on data such as a country’s cancer burden and cancer risk factors, available resources, and local context of culture and health care. The plan provides a systematic framework for implementation of evidence-based and cost-effective strategies for cancer prevention and control. The InternationalCancerControl LeadershipForum isa2-3day regionalworkshopwith thematic seminar modules on cancer control planning and implementation, aswell as interactive action planning sessions. The goal is to increase the capacity of participating countries to initiate or enhance cancer control planning and implementation through a multisectoral approach. The country teams are composed of high-level leaders who represent government agencies, civil society, oncology professionals, and academia. The program approach engages country teams over a year and a half. Approximately 3-6months prior to the forum, teams conduct a situational analysis of the cancer burden and cancer control planning efforts in their country. During the Forum, teams are introduced to evidence-based approaches and exchange best-practices with colleagues to develop a 12-month action plan to move their cancer control planning and implementation efforts forward. In the year after the Forum, country teams and Forum faculty meet for 3-4 follow-upphone calls to address technical assistanceneeds as countries begin to implement their actionplan.Thus far, Forumshavebeenheld inAfrica,SoutheastAsia, thePacific, theCaribbean,Middle East-North Africa, Latin America, and Central Asia regions. The country teams report that the Forum provides an important opportunity to plan with diverse stakeholders. Participants also report increased awareness and knowledge on developing and implementing a national cancer control plan, and learn best-practices from their colleagues in neighboring countries. In some Forums, countries have shown interest to work collaboratively towards regional initiatives. AUTHORS’ DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: No COIs from the authors. Tulika Singh,BrendaKostelecky, and Lisa Stevens, Center forGlobalHealth,National Cancer Institute (NCI),National Institutes of Health, US Department of Health and Human Services Corresponding author: Brenda Kostelecky, Center for Global Health, National Cancer Institute (NCI), National Institutes of Health, US Department of Health and Human Services, 9609 Medical Center Dr, Rockville, MD 20852; 240-276-5585; kosteleckybd@mail.nih.gov DOI: 10.1200/JGO.2016.004853 Tulika Singh Brenda Kostelecky

World Health Organization.

World Health Organization.

International Cancer Control Leadership Forum Program

Abstract 43 A National Cancer Control Plan (NCCP) comprises an important part of a country's non-communicable disease (NCD) plan and can help countries meet NCD targets outlined in the WHO Global NCD Action Plan. A comprehensive cancer control plan is based on data such as a country's cancer burden and cancer risk factors, available resources, and local context of culture and health care. The plan provides a systematic framework for implementation of evidence-based and cost-effective strategies for cancer prevention and control. The International Cancer Control Leadership Forum is a 2-3 day regional workshop with thematic seminar modules on cancer control planning and implementation, as well as interactive action planning sessions. The goal is to increase the capacity of participating countries to initiate or enhance cancer control planning and implementation through a multisectoral approach. The country teams are composed of high-level leaders who represent government agencies, civil society, oncology professionals, and academia. The program approach engages country teams over a year and a half. Approximately 3-6 months prior to the forum, teams conduct a situational analysis of the cancer burden and cancer control planning efforts in their country. During the Forum, teams are introduced to evidence-based approaches and exchange best-practices with colleagues to develop a 12-month action plan to move their cancer control planning and implementation efforts forward. In the year after the Forum, country teams and Forum faculty meet for 3-4 follow-up phone calls to address technical assistance needs as countries begin to implement their action plan. Thus far, Forums have been held in Africa, Southeast Asia, the Pacific, the Caribbean, Middle East-North Africa, Latin America, and Central Asia regions. The country teams report that the Forum provides an important opportunity to plan with diverse stakeholders. Participants also report increased awareness and knowledge on developing and implementing a national cancer control plan, and learn best-practices from their colleagues in neighboring countries. In some Forums, countries have shown interest to work collaboratively towards regional initiatives. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: No COIs from the authors.

Disability, noncommunicable disease and health information.

Noncommunicable diseases (NCDs) are a major cause of preventable disability worldwide.1 While actions to monitor NCDs have gained significant momentum in the global health agenda, similar developments to monitor and manage the growing burden of NCD-related disability have been relatively slow. The global NCD action plan was developed to support country efforts in addressing the devastating social, economic and public health impacts of NCDs.2 The NCD action plan includes nine voluntary targets and a monitoring framework. However, the monitoring framework has been criticized for its focus on mortality while neglecting adequate measures of morbidity and disability.3 This has resulted from focusing on existing data within health information systems, rather than on identifying appropriate data for measuring disease burden. Indeed, the issue of the chronicity of NCDs seems absent in most monitoring and evaluation frameworks, with an implicit assumption that the only outcome of interest for countries is premature mortality.

Translating global commitments on NCDs into national action: the role of civil society

The inclusion of non-communicable diseases (NCDs) in the UN Agenda 2030 for Sustainable Development, 1 UN General Assembly resolutionTransforming our world: the 2030 Agenda for Sustainable Development, Sept. A/69/L.85. United Nations, 2015 Google Scholar adopted in September, 2015, firmly establishes NCDs as an urgent global health and development priority. With the global prioritisation of NCDs and associated commitments, such as the WHO Global NCD Action Plan 2013–20, 2 WHOGlobal NCD Action Plan 2013–2020. World Health Organization, Geneva2013 Google Scholar in place, the responsibility for action has shifted to the national and regional level. However, progress at the national level has been insufficient and highly uneven, 3 UN Secretary General Progress Report on NCDs, December, 2A/68/650. World Health Organization, Geneva2013http://ncdalliance.org/sites/default/files/rfiles/SG%20progress%20report_January%202014.pdf Google Scholar to use the words of the UN Secretary-General Ban Ki-moon. According to the recent WHO NCD Progress Monitor, 4 WHONoncommunicable Diseases Progress Monitor 2015. World Health Organization, Geneva2015 Google Scholar only 33% of countries have a national NCD action plan or strategy, and only 31% have national NCD targets and indicators. The situation is even bleaker when it comes to resources for NCDs. 5 Dain K Sustainable financing: the Achilles heel of the non-communicable diseases response. Lancet Diabetes Endocrinol. 2015; (published online Oct 22.)http://dx.doi.org/10.1016/S2213-8587(15)00393-9 Google Scholar With only 10 years to achieve the global 25 by 25 NCD mortality reduction goal, what is missing to ensure significant progress over the coming years? The ageing of AfricaDemographically speaking, Africa is the world's youngest continent—as recently as 2011, an estimated 70% of the population was younger than 30 years. But Africa is now ageing faster than the global average, with the number of Africans aged 55 years or older predicted to increase from 64·5 million to 103 million by 2030, and to 212 million by 2050. And with an increasing aged population comes an increased burden of diabetes and other non-communicable diseases (NCDs). Full-Text PDF

Organizational update: the world health organization global status report on noncommunicable diseases 2014; one more landmark step in the combat against stroke and vascular disease.

Most countries are likely to fail to meet global targets on tackling noncommunicable diseases (NCDs), according to the second Global Status Report on Noncommunicable Diseases 2014 released by the World Health Organization on January 19, 2015. ‘Attaining the nine global NCD targets; a shared responsibility’ is the theme of this global report. The report aims to inform Ministries of Health and all stakeholders of the progress made on targets set in 2013, 2 years after world leaders agreed to tackle this global health problem at a United Nations high-level meeting. In May 2013, the World Health Assembly adopted a global NCD action plan monitoring framework with 25 indicators and 9 voluntary global targets set for 2025. According to the latest statistics in the report, NCDs continue to be the leading cause of deaths worldwide and were responsible for 38 million of the world’s 56 million deaths in 2012. An estimated 17.5 million NCD deaths were caused by cardiovascular disease, including 6.7 million from strokes. Some 16 million of NCD deaths occurred in people …

Global Response to the Burden of Cancer: The WHO Approach

As the burden of many cancer types of major public health relevance worldwide are in part determined by behavioral risks, much of the success of cancer control depends on the up take of prevention strategies at the population level. Over the last decade, the World Health Organization (WHO) has developed global prevention strategies of major relevance for cancer prevention and the prevention of other non-communicable diseases (NCDs), such as the 2003 WHO Framework Convention on Tobacco Control and others. The implementation of these core strategies gained momentum in 2011, when heads of states at the United Nation's (UN) High Level Meeting (HLM) on NCDs declared that NCDs are a global health threat that menaces social and economic development globally and requires urgent action. They asked for a paradigm change of the global health agenda by including NCD prevention and control into the group of priorities set by the Millennium Development Goals. WHO's translation of this call for action by the UN into practice has been consolidated into one clearly defined the WHO Global NCD Action Plan 2013-2020, including the pre-existing prevention strategies. Although cancer risk reduction will profit from the WHO Global NCD Action Plan, comprehensive cancer prevention and control will require other supplementary strategies not included in the plan because they are not shared with other NCDs. Causality of the over 200 cancer types is complex. A myriad of non-behavioral factors such as environmental and infectious risks, require specific attention when planning comprehensive cancer prevention. In reducing the cancer burden globally much will depend on how prevention strategies are implemented and how progress in cancer treatment can be translated into the reality of health systems in less affluent countries.

Rallying United Nations organizations in the fight against noncommunicable diseases

Rallying United Nations organizations in the fight against noncommunicable diseases

The contribution of chronic kidney disease to the global burden of major noncommunicable diseases

Noncommunicable diseases (NCDs) are the most common causes of premature death and morbidity and have a major impact on health-care costs, productivity, and growth. Cardiovascular disease, cancer, diabetes, and chronic respiratory disease have been prioritized in the Global NCD Action Plan endorsed by the World Health Assembly, because they share behavioral risk factors amenable to public-health action and represent a major portion of the global NCD burden. Chronic kidney disease (CKD) is a key determinant of the poor health outcomes of major NCDs. CKD is associated with an eight- to tenfold increase in cardiovascular mortality and is a risk multiplier in patients with diabetes and hypertension. Milder CKD (often due to diabetes and hypertension) affects 5-7% of the world population and is more common in developing countries and disadvantaged and minority populations. Early detection and treatment of CKD using readily available, inexpensive therapies can slow or prevent progression to end-stage renal disease (ESRD). Interventions targeting CKD, particularly to reduce urine protein excretion, are efficacious, cost-effective methods of improving cardiovascular and renal outcomes, especially when applied to high-risk groups. Integration of these approaches within NCD programs could minimize the need for renal replacement therapy. Early detection and treatment of CKD can be implemented at minimal cost and will reduce the burden of ESRD, improve outcomes of diabetes and cardiovascular disease (including hypertension), and substantially reduce morbidity and mortality from NCDs. Prevention of CKD should be considered in planning and implementation of national NCD policy in the developed and developing world.