APCNA Non Communicable Disease (NCD) Prevention Project in Pakistan
These are a set of diseases that include Cardiovascular, Cerebrovascular, Type II Diabetes, Chronic Respiratory Disease, and Certain Cancers. Common to all these diseases are three risk factors such as improper diet, lack of exercise and smoking.
NCD has over taken infectious diseases as a major cause of morbidity and mortality in the world (47% of global disease burden). This epidemic, which was considered to be common in the affluent countries, is impacting the developing countries far more. This is explained by a lack of infrastructure, man power and resources to tackle end of the disease complications such heart attacks and strokes. In addition, poor governmental polices in tobacco control, lack of healthy environments for exercise and poor dietary controls has lead to an epidemic of obesity (16%), hypertension (23%), diabetes (12%) and tobacco addiction (41%) of our adult population in Pakistan. Socio-economic consequences of NCD’s are even more devastating. The loss of income in 2005 was 1.2 billion dollars and estimated losses by 2015 will be 6.8 billion dollars. Annual income loss per year from disability is 3.5 billion dollars. Projected economic gains by 2% reduction in NCD is between 3.5 billion dollars.
Such savings may be achieved by strategically approaching the problem. A major shift in thinking has to happen with the policy makers of our country. Approaching medical care through prevention rather than treatment has to happen such that trainees would be spending 60% of there time learning preventative measures and 40% of the time learning about diagnosing and treating diseases
With the participation of Federal Government, International Organizations (WHO, CDC, Harvard Partners International), local organizations and experts, APCNA has been able to forge alliances to set up the first NCD commission in Pakistan. The legal work for the commission is in the process of being debated in cabinet. The model of prevention will be based on well known principals of research, evidence, sustainability, culturally viable, cost effective, and quality driven.
APCNA understands that this will take a considerable time to develop. Program development, implementation, resources generation, research base development, training, human resource development for NCD prevention are some of the challenges that need to be scaled. Working with several government ministries (inter-sectoral), provincial government, health ministries will be required. Fortunately, several international organization, such as WHO is already working with the government to guide with the process.
We are hoping that we will be able to meet the deadline set by WHO for a comprehensive country plan for Pakistan for NCD prevention by 2015.
Nadeem Afridi, MD FACC
Chairman; APCNA- NCD Project.