Global Burden of NCDs
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Transcript of Global Burden of NCDs
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Burden of NoncommunicableDiseases: Global and National
Why Address NCDs?
Office of the WHO Representative in the Philippines
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Office of the WHO Representative in the Philippines
Noncommunicable Diseases NCDs)Heart diseasesand strokes
Cancers
Diabetes
Chronicrespiratory
diseases
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Office of the WHO Representative in the Philippines
NCDs are a threat to everyone
NCDs are the number one killer in the world
They claim over two-thirds of all deaths
That's 36 million people per year
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Office of the WHO Representative in the Philippines
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25 % of all NCD deaths are premature
(below 60 years) and could be prevented
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14.2 million people die every year from NCDs between the ages 30 and 69:
Most of these premature deaths could have been prevented
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Office of the WHO Representative in the Philippines
More than 85% of people who die from NCDs between the ages of 30 and 69
live in a developing country
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Office of the WHO Representative in the Philippines
NCDs contribute to poverty and poverty
increases the risk of developing NCDs
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Office of the WHO Representative in the Philippines
It's economic effects are devastating.
The World Economic Forum ranks NCDs as
one of the major global threats to economic
development
It's costing hundreds of billions of dollarsevery year in lost productivity
For every 10% rise in NCDs, annual
economic growth falls 0.5%
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Office of the WHO Representative in the Philippines
US$ 170Bis the overall cost for all
developing countries to
up action by implement
set of "best buy"
interventions between 2and 2025, identified as
priority actions by WHO
US$ 7Tis the cumulative lost
output in developing
countries associated with
NCDs between 2011-2025
The cost of inaction in developing countries over the next 15 years is enormous (compared
the cost of action)
Reports are available at www.who.int/ncd
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Office of the WHO Representative in the Philippines
It has impact on attainment of MDGs
MDG1: Negative impact on productivity and family
income
MDG 2: Costs for NCDs health care, medicines,
tobacco and alcohol consumption displace househo
resources for education
MDGs 4 & 5:
Rising prevalence of high BP and gestational diabetes
Mothers who smoke are likely to breastfeed for shorter
periods of time and have lower quantities of milk and milk
that is less nutritious
MDG 6: Diabetes associated with 10% of TB cases MDG 8: Affordable essential drugs in developing
countries
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Office of the WHO Representative in the Philippines
Four types of NCDs account for most deaths in
most low-and middle-income countries
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Office of the WHO Representative in the Philippines
Causation pathway for NCD
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Office of the WHO Representative in the Philippines
Modifiable causative risk factors
Tobacco use Unhealthy diets Physical inactivityHarmful use of
alcohol
N
oncommunicablediseases
Heart disease and stroke
Diabetes
Cancer
Chronic lung disease
There are Four Major Groups of NCDs
Four major lifestyles related risk factors
Changing times
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Office of the WHO Representative in the Philippines
Changing timesNeed social engineering
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Mortality Trend, Philippines, 1953-2005
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Cause Total Rate
1. Diseases of the heart 70, 861 84.8
2. Diseases of the vascular system 51,680 61.8
3. Malignant Neoplasms 40,524 48.9
4. Accidents 34,483 41.3
5. Pneumonia 32,098 38.46. Tuberculosis 26,770 31.0
7. Unclassified 21,278 25.5
8. Chronic lower respiratory diseases 18,975 22.7
9. Diabetes mellitus 16,552 19.8
10. Conditions originating from the
perinatal period
13,180 15.8
Phili ine Statistical Yearbook 2
Top Ten Cause of Mortality
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Prevalence of hypertension,
hyperglycemia, dyslipidemia & overweight
1998, 2003 and 2008
Risk factors1998 2003 2008 Basis
Hypertension 21.0 22.5 25.3 SBP 140, DBP 90
Hyperglycemia 3.9 3.4 4.8 FBS > 126 mg/dL
Total cholesterol 4.0 8.5 10.2 240 mg/dL
LDL-c 8.1 11.7 11.8 160 mg/dL
HDL-c 76.6 54.2 64.1 < 40 mg/dL
Triglycerides 8.7 9.4 14.6 200 mg/dL
BMI (Overweight) 20.2 24.0 26.6 BMI 25.0
Source: Phili ine NNS FNRI
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Total Male Fema
Philippines 23.7 23.8 23.6
20-29 20.4 20.3 20.630-39 26.5 27.4 24.840-49 23.2 22.7 24.150-59 26.1 26.0 26.360-60 22.6 22.1 23.470-up 17.5 19.9 13.6
Percent of the population with adequate
PA, 2008
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Smoking
Total Male Female
Philippines 31 53.2 12.5
20-29 31.1 57.7 8.630-39 30.2 53.2 10.840-49 33 55.5 12.150-59 32.6 54.6 15.360-60 28.2 45 14.870-up 27.1 32.9 23.2
Prevalence of current smokers, 2008
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Alcohol
Total Male Female
Philippines 26.9 47.5 9.8
20-29 26.5 47.2 9.030-39 30.3 54.2 10.440-49 30.7 52.8 10.250-59 27.0 47.6 10.860-60 19.8 32.8 9.570-up 14.0 23.3 7.8
Prevalence of alcohol drinkers, 2008
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Office of the WHO Representative in the Philippines
Advocacy
Research, Surveillance, Evaluation
Whole of society responseCommunity leadership
Intersectoral partnerships
Community mobilization
Health Systems Response(Health Systems Strengthening)Health workforce development
Health services organization/deliveryFinancingPeople-centred systems of care
Focus on prevention
Health Sector ResponseHealth sector governance
Health sector leadershipIntegration of NCD prevention and controlinto national health strategyWhole of government response
Political will
Political leadershipHealthy public policies and laws
Regional Framework for Action
76
54
1 32
WHO' l b l d t t d
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Office of the WHO Representative in the Philippines
2000
2003
2004
2008
Global Strategy for the Prevention and Control
of Noncommunicable Diseases
Global Strategy on Diet,
Physical Activity and Health
Action Plan on the Global Strategy for the
Prevention and Control of NCDs
2010
2009
2011
Global Strategy to
Reduce the Harmful Use
of Alcohol
WHO Global Status
Report on NCDs
Political Declaration on NCDs
WHO's global road map to prevent andcontrol NCDs
2012+ Realizing the commitments made in the Political Declaration
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Office of the WHO Representative in the Philippines
The Political Declaration on NCDs
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The Political Declaration on NCDs
WHO Director-Gen
Heads of State and Government and representatives committed to:
Establish/strengthen, by 2013,national multisectoral policies and plans for NCDs, taking into accounthe Global Strategy for NCDs and its Action Plan
Integrate NCDs policies and programmes into health-planning processesand the nationaldevelopment agendaof each Member State
Develop national targets and indicators based on guidance provided by WHO and give greater prioto surveillance
Accelerate implementationof the WHO FCTC, the Global Strategy on Diet, Physical Activity andHealth, and the Global Strategy to Reduce the Harmful Use of Alcohol.
Strengthen health systemsthat support primary care, prioritize early detection and treatment, andimprove access to affordable essential medicines for NCDs
Rio+20:
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We understand the goals
of sustainable development can only
be achieved in the absence of a highprevalence of debilitating
communicable and NCDs, and where
populations can reach a state of
physical, mental and social well-being.
(paragraph 138)
We acknowledge that the global
burden and threat of NCDsconstitutes
one of the major challenges for
sustainable development in the twenty-
first century.(paragraph 141)
Rio+20:
"NCDs constitute one of the major challenges for sustainable development"
UN System Task Team on the post-2015 UN development agenda:
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The MDGs did not adequately address
increase in NCDs.(paragraph 19)
Priorities for social development and
investments in people would include:
NCDs.Access to sufficient nutritious
food and promotion of healthy life
styles with universal access to
preventive health services will be
essential to reduce the high incidence
of NCDsdiseases in both developed and
developing countries(paragraph 67)
UN System Task Team on the post 2015 UN development agenda:
NCDs is a priority for social development and investments in people
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Set of 9 voluntary global targets
Raised bloodpressure
25% reduction
Salt/
sodium intake
30% reduction
Tobacco use
30% reduction
Physical inactivity
10% reduction
Harmful use ofalcohol
10% reduction
Drug therapy and
counseling
50%
Premature
mortality from
NCDs
25% reduction
Diabetes/
obesity
0% change
Essential NCD
medicines andtechnologies
80%
Mortality and morbidity
Risk factors for NCDs
National systems response
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Comprehensive Global Monitoring Framework
Mortality &Morbidity
Cancer incidence by type ofcancer per 100 000 population
Unconditional probability ofdying between ages 30 and 70
years from cardiovasculardiseases, cancer, diabetes orchronic respiratory diseases
Salt
Fruits and Vegetables
Saturated Fat
Overweight and Obesity (2)
Physical Inactivity (2)
Blood glucose/diabetes
Blood Pressure
Total Cholesterol
Harmful use of Alcohol (3)
Risk Factors
Tobacco use (2)
Access to palliative care
National Systems
Response
Policies to limit SFA and virtualelimination of PHVO
Essential NCD Medicines
HPV Vaccine
Marketing to children
Drug therapy and counseling
Cervical cancer Screening
Hepatitis B Vaccine
NCD B t B
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NCD Best Buys
National Policy on Strengthening Prevention
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National Policy on Strengthening Prevention
and Control of NCDs (2011)
Emphasized the need for strengthening healthsystems and whole-of-government, whole-of-
society response to address the growing NCD
problem in the Philippines.
Universal Health Care
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Universal Health Care
Financial RiskProtection
Improvingaccess to
quality healthfacilities
AchievingMDG max
Better health outcomes Responsive health system Equitable health financing
Health
Financing
Service
Delivery
Policy, standards
and regulation
Health
Human
Resource
Health
Information
Governa
for Hea
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Community health teams
T b t l l i l ti (2003)
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Tobacco control legislation (2003)
The Tobacco Regulatory Act (RA 9211) of 2003 provided for the
implementation of population-based tobacco control measures all over thecountry.
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Sin tax legislation
.
Access to NCD medicines
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Access to NCD medicines
The DOH Complete TreatmentPack (COMPACK) ensure access
to essential drugs and medicines
for the marginalized sector
Includes medicines forhypertension, diabetes,
hyperlipidemia, and asthma
Total Number of PhilHealth Claims for Hypertension, Diabete
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0
50,000
100,000
150,000
200,000
250,000
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Hypertension Diabetes Cancers Heart Disease
Cancer and Heart Disease from 2002-2012
Total Amount Paid for PhilHealth Claims for Hypertension,
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Total Amount Paid for PhilHealth Claims for Hypertension,
Diabetes, Cancer and Heart Disease from 2002-2012
0.00
500,000,000.00
1,000,000,000.00
1,500,000,000.00
2,000,000,000.00
2,500,000,000.00
3,000,000,000.00
3,500,000,000.00
4,000,000,000.00
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Hypertension Diabetes Cancers Heart Disease
Expansion of Social Health Insurance
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Expansion of Social Health Insurance
Benefits for NCDs
Adoption of WHO Package of Essential NCD (PEN
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p g (
Interventions
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WHO-PEN implementation
Training Implementation Monitoring
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Training, Implementation, Monitoring
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A nationwide healthy lifestyle movement that uses social mediaand aims to inform and encourage Filipinos from all walks of life
to practice a healthy lifestyle by making a personal commitment tophysical activity, proper nutrition, and the prevention or cessationof smoking and alcohol consumption.
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CHALLENGES
Varying implementation of intervention across
local government units
Inadequate health financing for NCDs
Inadequate allocation of funds for health
promotion
Inadequate multisectoral actions
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Next steps
Continue and Monitor implementationPEN/NCD services at primary health care
Sin Tax and Tobacco Control legislations
Expand Philhealth benefits Intensify public health education campaigns
Development of national multisectoral action plan for
NCDs
Implementing low-cost workable solutions in developing countries
could prevent most premature deaths from NCDs
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Office of the WHO Representative in the Philippines
could prevent most premature deaths from NCDs
2/3 + 1/3Implementing cost-effective interventions that reduceexposure of populations to risk factors for NCDs will contribute
up to two-thirds of the reduction in premature mortality.In addition, health systems that respond more effectively and
equitably to the health-care needs of people with NCDs can
reduce premature mortality by another one-third up to one-half.
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Office of the WHO Representative in the Philippines
Mobilizing governments to include NCDs in health-planning processes an
development initiatives needs to be one of your priorities
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Office of the WHO Representative in the Philippines
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Office of the WHO Representative in the Philippines
Thank you