NCDs: Disease burden, Risk factors & WHO best buys Interventions !!

NCDs (Non-communicable Diseases) often known as the chronic disease, are the set of the disease that cannot be transferred from one person to another. NCDs do not occur from acute infection rather it results from the lifestyle and other multiple causes.
NCDs does not occur spontaneously as they are resulted by the sum of individual’s behavior and activities till the date of occurrence of disease.
Four main types of NCDs are:
- cardiovascular diseases (like heart attacks and stroke)
- cancers
- chronic respiratory diseases (like chronic obstructive pulmonary disease and asthma) and
- diabetes
Furthermore, it also includes mental illness, musculoskeletal disease, injuries etc.

Table of Contents

Disease burden due to NCDs:

NCDs are the cause for the death of 41 million people (annually) around the globe, which is 71% of the total deaths.
Among the NCDs, cardiovascular diseases (15 million) is responsible for maximum death followed by cancers (9 million), respiratory diseases (3.9 million), and diabetes (1.6 million). These four diseases account for 80% of all premature NCD deaths [2018 WHO].
Among the top 10 causes of death in the year 2016, 8 out of 10 diseases (conditions) are NCDs. Ischemic heart disease ranks the first position followed by stroke, pulmonary disease and others.
NCDs are not only associated with death but with disability as well.

Are NCDs an important issue?

The global burden of the NCDs is increasing yearly. Disease burden shifted from the communicable disease to NCDs. Similar increasing trend of NCDs could lead to pandemic
NCDs causes premature death, disability and has huge economic burden as well.
The treatment of NCDs would lead to catastrophic health expenditure.
NCDs mostly effects the low and middle income countries thereby increasing the burden tenfold times.
NCDs not only effect health of single individual but also acts as the major hindrance for development, progress and is highly associated with poverty.

Risk factors for NCDs:

Risk factors of NCDs can be identified as modifiable and metabolic risk factors. They are

Modifiable risk factors: These are the risk factors which can be modifiable/changed for increasing or decreasing the risk of NCDs.

– Smoking

– Alcohol consumption

– Physical inactivity

– Unhealthy diet

Metabolic risk factors: It includes four key metabolic changes in the body that might increase the risk of NCDs.

– Hypertension/high blood pressure

– Hyperglycemia (high blood glucose)

– Hyperlipidemia (high level of fat in the blood)

– Overweight/obesity

Causation Pathway for chronic NCDs:

Contributory factors to NCDs:

Source: WHO, 2014

Different interventions to address NCDs and its risk:

1. Population wide interventions:

Reduce tobacco use
Promote physical activity
Reduce harmful use of alcohol
Promote healthy diet

2. WHO best buys interventions:

WHO has identified the interventions for NCDs, also known as “best buys”. These interventions are very cost effective, easily adaptable, suitable and effective. They are:

Source: WHO, 2011

3. Life style interventions:

Some major life style interventions could be:

a) Education:

Education is the key to every intervention.
Health education regarding NCDs acts as the motivational factor and also enables person to have control over own health.
Creates awareness

b) Healthy diet:

Diet is also the determining factor for the NCDs
Encouragement and priority to the healthy foods
Avoid packed, junk, canned and take away foods
Inclusion of variety of vegetables and fruits in the diet
Low intake of food containing trans fatty acids

c) Discourage smoking and alcoholism:

Tobacco, its products and alcohol are to be avoided
This can be done through government level by casting more tax on such products.
Banning the advertisement of their use.

d) Healthy living:

Giving up the sedentary lifestyle
Exercise and increase the physical activity
Walk when you can

Note: NCDs demands attention from individual, governmental and global level. Along with lifestyle interventions, medical interventions, disease specific interventions, etc., are necessary to prevent NCDS.

Challenges to address the NCDs:

a) Insufficient resources to meet up with the global outbreak

With the incidence and burden of NCDs increasing each year, resources are insufficient to meet up.
Both financial and human resource are not adequate.
Inequitable distribution of health workers further adds up the problem.

b) Lack of commitment

Lack of Commitment is the serious challenge for addressing the NCDs
Neither the government nor public are committed about the interventions to address NCDs.
Health is usually less prioritized and NCDs even lesser, especially in developing countries
Government barely accept that the risk factors of NCDs are more related to socio-economic status than health factors.
Unlike communicable disease, NCDS requires Behavior Change Communication (BCC) approach. People are less committed to adopt the healthy lifestyle
High level of illiteracy too affects and acts as a barrier.
Multi-sector involvement and global partnership is necessary to solve the problem of NCDs. Such partnership and commitments are hard to maintain practically.

c) Double burden of disease

We are currently facing the double burden of disease
Disease like diarrhea still claims the life of thousands of the people.
With CDs still killing people NCDs are given less priority
NCDs degrades the health as well as economic status further deepening the burden

d) Lack of Researches