Non-communicable diseases David Redfern

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Non-communicable diseasesDavid Redfern
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The global situation (1)

• Global mortality from non-communicable diseases
  (NCDs) remains unacceptably high and is
  increasing. 38 million people die each year from
  NCDs, mainly from cardiovascular diseases,
  cancers, chronic respiratory diseases and
  diabetes.
• Over 14 million deaths from NCDs occur between
  the ages of 30 and 70 each year, of which 85 are
  in developing countries.

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The global situation (2)

• The number of NCD deaths has increased worldwide
  and in every World Health Organization (WHO)
  region since 2000.
• Over 80 of NCD deaths 29 million occur in
  low- and middle-income countries.
• Cardiovascular diseases account for most NCD
  deaths, 17.3 million people annually, followed by
  cancers (7.6 million), respiratory diseases (4.2
  million), and diabetes (1.3 million).
• These four groups of diseases account for around
  80 of all NCD deaths.

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Source WHO (2014)
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Behavioural risk factors

• Tobacco use, physical inactivity, unhealthy diet
  and the harmful use of alcohol increase the risk
  of, or cause, most NCDs.
• Tobacco use accounts for almost 6 million deaths
  every year (including over 600,000 deaths from
  exposure to second-hand smoke), and is projected
  to increase to 8 million by 2030.
• About 3.2 million deaths annually can be
  attributed to insufficient physical activity.
• Approximately 1.7 million deaths are attributable
  to low fruit and vegetable consumption.
• Half of the 2.3 million annual deaths
  attributable to harmful drinking are from NCDs.

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National scale selected countries and indicators
Country Indicator Afghanistan Low income group India Lower middle income group Iran Upper middle income group UK High income group
Proportion of deaths from cardiovascular diseases () 19 26 46 31
Proportion of deaths from cancers () 6 7 13 29
Proportion of deaths from chronic respiratory diseases () 3 13 4 8
Proportion of deaths from diabetes () 1 2 2 1
Probability of dying between ages 30 and 70 from the four main NCDs () 31 26 17 12
Male Female Total Male Female Total Male Female Total Male Female Total
tobacco smoking daily (2011) N/A 25 4 15 26 0.5 14 22 22 22
Total alcohol consumption per capita (litres per year) (2010) 1.2 0.1 0.7 8.0 0.5 4.3 1.7 0.3 1 16.9 6.9 11.6
raised blood pressure (2008) 23 22 23 21 21 21 26 22 24 31 25 28
obese (2008) 1.4 3.0 2.2 1.3 2.4 1.9 12.4 26.5 19.4 26 28 27
Source WHO (2014)
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Obesity

• The number of people in the world who are obese
  or overweight has topped 2.1 billion, up from 875
  million in 1980.
• More than half of the world's 670 million obese
  people live in ten countries, ranked in order
  USA, China, India, Russia, Brazil, Mexico, Egypt,
  Germany, Pakistan, Indonesia.
• The UK has the third highest rates in western
  Europe, with 67 of men and 57 of women
  overweight or obese.
• Source The Lancet (May 2014)

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The WHO Global NCD Action Plan 20132020 (1)

• This has six global objectives
• Make prevention and control of NCDs a priority
• Strengthen national capabilities and leadership
• Reduce modifiable risk factors
• Strengthen health systems
• Promote high-quality research
• Monitor trends of disease
• Without taking action WHO estimates a 7 trillion
  loss of productivity.
• WHO states that the annual cost of the action
  plan is 11 billion.

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The WHO Global NCD Action Plan 20132020 (2)

• WHO has set a global target of a 25 reduction in
  premature mortality from NCDs by 2025.
• This is to be achieved by nine targets
• Establish 80 availability of affordable
  technology and medicine to treat NCDs
• Ensure that 50 of people receive preventive
  therapy for heart attacks and strokes
• Half the rise in diabetes and obesity
• 30 reduction in salt intake

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The WHO Global NCD Action Plan 20132020 (3)

• 10 reduction in the harmful use of alcohol
• 25 reduction in premature death of people aged
  30 to 70 from cardiovascular diseases, cancers,
  diabetes or chronic respiratory diseases
• 10 reduction in prevalence of insufficient
  physical activity
• 30 reduction in tobacco use
• 25 reduction in prevalence of high blood
  pressure

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Useful weblinks

• Some of the weblinks used for this presentation
  are
• http//www.who.int/nmh/en/
• http//www.who.int/mediacentre/factsheets/noncommu
  nicable-diseases/en/
• http//gamapserver.who.int/mapLibrary/
• An interesting perspective on the issues of
  obesity and diabetes in India can be found at
• http//www.cseindia.org/userfiles/presentation_cse
  .pdf