Friday, 21 January, 2022

Silent Epidemic of Non-Communicable Diseases: Multisectoral Initiatives Needed to Reduce Risk

National Professor Brigadier (Retd.) Abdul Malik

Silent Epidemic of Non-Communicable Diseases: Multisectoral Initiatives Needed to Reduce Risk

Our healthcare sector is passing through a difficult time. For the past two years, the health sector has been working tirelessly to control the global epidemic Covid-19. About nine and a half crore doses of vaccine have already been provided to the mass people. As a result, the graph of covid infection has been declining, although it may take longer to fully control the pandemic. Initially, Covid-19 had a relatively high mortality rate due to lack of specific treatment and vaccine. As a result, emergency measures were taken at national and international levels to control and prevent the disease. Gradually we are reaping the benefits.

While we are busy with the Covid pandemic, at the same time, we are not paying much attention to another silent epidemic — non-communicable diseases (NCDs). However, Covid-19 has shown the importance of non-communicable disease control in a larger scale. This is because non-communicable diseases such as cardiovascular disease, cancer, lung disease, hypertension, and diabetes have been linked to more deaths and complications due to Covid. More than 5.2 million people worldwide have died in Covid so far. According to the World Health Organization, non-communicable diseases kill 40 million people worldwide each year, accounting for 71 percent of the world's deaths. More tragically, these non-communicable diseases kill 15 million people each year between the ages of 30 to 69, and 85 percent of these "premature" deaths occur in low- and middle-income countries. Bangladesh is no exception. According to the World Health Organization's NCD Country Profile 2018, more than five lakh people die of non-communicable diseases every year in Bangladesh. Twenty-two percent of these deaths are premature deaths, meaning they die between the ages of 30 to 69.

Non-communicable diseases are not just a threat to public health. Rather, it hurts the economy equally. Due to the high cost of treatment for non-communicable diseases, most of the victims of this disease go below the poverty line to meet the medical expenses. Moreover, if someone gets these diseases, he cannot be cured completely, and his efficiency also decreases. As a result, it becomes a burden on the economy as a whole.

Multiple factors work behind non-communicable diseases. Especially tobacco use; Unhealthy eating habits, such as: eating too much salt, sugar and trans fat; Eating small amounts of fruits and vegetables, air pollution, lack of physical activity etc. are responsible for these diseases. However, we focus on treatment rather than disease prevention by controlling these risks of non-communicable diseases. In our country, most of the allocations for the health sector are spent on medical services. However, non-communicable diseases can be easily prevented by enacting public health friendly policies and laws. For example, if tobacco is strictly controlled in the country, it is possible to keep a large number of people safe from various diseases. Therefore, both production and use of tobacco products must be controlled.

Recently, the Ministry of Health and Family Welfare has taken initiative to amend the Tobacco Control Act. It is important to strengthen some sections of this law to effectively control tobacco. Particularly, there must not be kept any provision for designated smoking areas (DSA) in public places and on public transport under any circumstances. It is often argued that DSAs care for the right of smokers to smoke. However, this undermines the constitutional right of non-smokers to save their own health. We should remember, it is not the responsibility of the state to protect the rights of smokers, because smokers cause harm to themselves and the people around them. Studies have shown that smoke comes out of the smoking area in any way. As a result, the smokers who come there suffer from health damage. Therefore, in order to protect the health rights of non-smokers, the provision of keeping 'smoking area' in public place should be abolished by amending the tobacco control law. Necessary amendments should also be made in the law to ban display of tobacco products in shops, ban CSR of tobacco companies, ban import, production, sale and use of e-cigarettes, increase the size of pictorial health warnings on tobacco products and ban single stick sale of tobacco products.

In addition to tobacco control, it is important to implement the Clean Air Act 2019 and formulate necessary policies to determine the level of salt and trans fat in processed food. Apart from adopting laws and policies to prevent non-communicable diseases, there is also the issue of increasing municipal services in some cases. Especially in large cities like Dhaka, Chittagong, Sylhet, Rajshahi it is important to have sidewalks and bicycle lanes for people to walk along with vehicles. This will encourage people to walk short distances or ride bicycles, which is very important for keeping good health. Policymakers need to pay special attention to these.

Bangladesh is striving to achieve the Sustainable Development Goals (SDGs) by 2030. According to the SDG 3.4 target, the rate of premature death due to non-communicable diseases should be reduced by one third as compared to 2015 by 2030. Therefore, in order to achieve the goals of SDGs and implement the dream of building a better Bangladesh, we need to place great emphasis on non-communicable disease control and prevention.


The writer is the Founder and President, National Heart Foundation of Bangladesh