HEALTHCARE DELIVERY
NCDs: reducing the burden on the NHS
SUZANNE CALLANDER reports on activity in the UK to reduce the NHS burden for treating some of the major noncommunicable diseases (NCDs).
Urgent action is needed to meet global targets to reduce the burden of NCDs, and to prevent 16 million premature deaths every year – before the age of 70 – from heart and lung diseases, stroke, cancer and diabetes, according to a new report from the World Health Organization (WHO). The report found that most premature NCD deaths are preventable. Of the 38 million lives lost to NCDs in 2012, 16 million (42%) were premature and avoidable – up from 14.6 million in 2000. The WHO report states that premature NCD deaths can be significantly reduced through government policies to reduce tobacco use, harmful use of alcohol, unhealthy diets and physical inactivity, and delivering universal healthcare. In Brazil, for example, the NCD mortality rate is dropping 1.8% per year due, in part, to the expansion of primary healthcare, according to the WHO. The report provides the baseline for monitoring implementation of the ‘Global action plan for NCDs 2013-2020’, which has the aim of reducing the number of
Many noncommunicable diseases are directly related to obesity, which increases the likelihood of diabetes, hypertension, coronary heart disease, stroke and certain types of cancer.
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premature deaths from NCDs by 25% by 2025.
Outlined in the action plan are nine voluntary global targets that address key NCD risk factors. These are: Target 1: A 25% relative reduction in risk of premature mortality from CVDs, cancer, diabetes, chronic respiratory diseases. Target 2: At least 10% relative reduction in the harmful use of alcohol, as appropriate, within the national context. Target 3: A 10% relative reduction in prevalence of insufficient physical activity. Target 4: A 30% relative reduction in mean population intake of salt/sodium. Target 5: A 30% relative reduction in prevalence of current tobacco use in persons aged 15+ years. Target 6: A 25% relative reduction in the prevalence of raised blood pressure or contain the prevalence of raised blood pressure, according to national circumstances. Target 7: Halt the rise in diabetes and obesity. Target 8: At least 50% of eligible people receive drug therapy and counselling (including glycaemic control) to prevent heart attacks and strokes. Target 9: An 80% availability of the affordable basic technologies and essential medicines, including generics, required to treat major NCDs in both public and private facilities.
“Our world possesses the knowledge and resources to achieve these targets by 2025,” said Dr Oleg Chestnov, the WHO’s assistant director-general for noncommunicable diseases and mental health. “Falling short of the targets would be unacceptable. If we miss this opportunity to set national targets in 2015 and work towards attaining our promises
in 2025, we will have failed to address one of the major challenges for development in the 21st century.”
Obesity issues
Many noncommunicable diseases are directly related to obesity, which increases the likelihood of diabetes, hypertension, coronary heart disease, stroke and certain types of cancer. According to the WHO the prevalence of obesity has nearly doubled since 1980 worldwide. In 2014, 11% of men and 15% of women aged 18 years and older were obese. More than 42 million children under the age of five years were overweight in 2013. The global prevalence of diabetes in 2014 was estimated to be 9%. Diabetes risk can be reduced by moderate weight loss and moderate daily physical activity in persons at high risk and the WHO has recommended that further research be undertaken to evaluate the effectiveness of interventions to prevent obesity and diabetes. According to a Public Health England report,1 obese adults are five times more
likely to be diagnosed with diabetes than adults of a healthy weight and currently
APRIL 2015
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