Non-communicable diseases: As threat of contagious diseases declines, NCDs rise in Pakistan

All levels of healthcare delivery should be provided, WHO adviser says

The burden of diseases affecting Reproductive Maternal Newborn and Child Health (RMNCH) and communicable diseases is gradually declining in the country, but the situation of Non-Communicable Diseases (NCDs) is worrisome as the overall risk of NCDs including injuries is on the rise at around 56% of the total disease burden in Pakistan.

NCDs are contributing to 60.3% of total deaths in Pakistan with the largest share of cardio-vascular diseases, cancers and diabetes. There is a challenge of around 51 million hypertension and 29 million diabetic cases in the country – which is not acceptable and emergency measures need to be taken to control the rising numbers.  There are 2.3 million ischemic heart disease cases, 1.3 million stroke cases, 840,000 cases of cancers, 33 million cases of cirrhosis and chronic liver diseases and 23 million cases of mental disorders.

These were the facts discussed at the concluding session of a two-day national consultative workshop on Non-Communicable Diseases (NCDs) held in Islamabad. The workshop was organised to start formal deliberations on the NCD challenges in Pakistan. The workshop was attended by WHO Regional Advisor Dr Slim Slama on NCDs, representatives of provincial departments of health, academicians, clinicians, researchers and other stakeholders. While, Parliamentary Secretary Dr Nausheen Hamid and Ministry of National Health Services, Regulations and Coordination (NHSRC) Secretary Capt (R) Zahid Saeed addressed the session.

Addressing the workshop, the parliamentary secretary, said, ‘Prime Minister of Pakistan is very supportive of the efforts to tackle the NCD burden in the country in a more comprehensive way, specially to alleviate the suffering of the most underserved segments of the society.’

NHSRC Secretary Zahid Saeed informed, ‘The Ministry has initiated the work of developing a National Action Plan on NCDs and this workshop is the start of this process. In addition, on the direction of NHSRC Minister a National Essential Package of Health Services (EPHS) is also being developed which will adopt the global and national best practices including those for NCDs.’

On the occasion Dr Slim Slama emphasised that there is a need not only to develop a comprehensive EPHS to be implemented at all levels of healthcare delivery system but also to develop and implement inter-sectoral policies. He appreciated the efforts of the ministry to introduce the ‘Health Tax’ on cigarettes and fizzy drinks.

Discussions were held on different NCD interventions being tested in Pakistan and expert opinion from the specialist clinicians and academicians working in the area of NCDs was sought. To tackle the challenges, there was a consensus to adopt an integrated approach for NCDs and prioritizing primary and preventive health care services.

Consultations were held to review the NCDs and Inter-sectoral policies based on Disease Control Priorities-3. In the group work current situation of the health services based on NCDs was reviewed and recommendations made on which DCP3 interventions should be adopted in the EPHS for Pakistan. Recommended NCD interventions will be merged with the recommendations for RMNCH and communicable diseases related interventions during deliberation in the coming days. Provincial/Area DOH made comments on the current situation of NCDs in their respective provinces/ areas. It was observed that there is a need for a more comprehensive and integrated response in the country to make progress on universal health coverage and SDGs in Pakistan.

Published in The Express Tribune, December 15^th, 2018.