NON - COMMUNICABLE

DISEASES
 Definition
Causative agent, Prevention, care and
control of,
1. Cancer
2. Diabetes
3. Blindness
4. Cardiovascular diseases
 Definition

 a diseases,
 Caused due to
 Multiple causes
 are not passed or transmitted
 Directly or indirectly
 from person to another
By any agency.
E .g: Cancer etc
 Definition
“Non-communicable diseases is a diseases,
caused due to multiple causes and are not
passed or transmitted directly or indirectly
from person to another by any agency”.
E .g: Cancer etc

“Non-communicable diseases (NCDs), is a diseases

which are not passed from person to another”.
E .g: Cancer etc
 M o re than nine
million of all deaths
attributed to
noncommunicable
diseases (NCDs) occur
before the age of 60.

• Around the world,

NCDs affect women and
men almost equally.
Risk factors
1. Smoking
2. Consumption of alcohol
3. Bad Life style pattern
(E.g.: Diet, Physical activity etc)
4. Insufficient health services
5. Environmental factors
(E.g.: air & water pollution, etc)
6. Stress conditions
Cancer
Cardiovascular
disease
s Cardiovascular disease is caused by disorders of the
heart and blood vessels, and includes coronary heart
disease (heart attacks), cerebrovascular disease (stroke),
raised blood pressure (hypertension), peripheral artery
disease, rheumatic heart disease, congenital heart
disease and heart failure.
 Although heart attacks and strokes are major killers in
all parts of the world, 80% of premature deaths from
these causes could be avoided by controlling the main
risk factors: tobacco, unhealthy diet and physical
inactivity.
Cardiovascular
disease
s:
Facts and figures

–  Cardiovascular disease (CVD) causes more

than half ofall deaths across the European
Region.
–  8 0 % of premature heart disease
and stroke ispreventable.
Cardiovascular diseases:
Contributing factors

 A person’s genetic make-up

 T h e foundations of adult health are laid in earlylife
 Socioeconomic group
 Mental health
Diet
 Overweight and obesity
 Inactivity
 Tobacco
 Alcohol
 Diabetes
 Globalization and urbanization
Cardiovascular diseases:
Prevention

–  Focusing on a combination of risk

factors forcardiovascular disease
–  Implementing medical screening for
individuals atrisk
–  Providing effective and affordable
treatment tothose who require it
Cardiovascular diseases:

Prevention
 It has been predicted that mortality from coronary heart disease
(CHD) in the United Kingdom could be halved by small changes in
cardiovascular risk factors: a 1% decrease in cholesterol in the
population could lead to a 2–4% CHD mortality reduction; a 1%
reduction in smoking prevalence could lead to 2000 fewer CHD
deaths per year; and a 1% reduction in population diastolic blood
pressure could prevent around 1500 CHD deaths each year.

 80% of the reduction in CHD mortality in Finland during the

period of 1972–1992 has been explained by a decline in the major
risk factors. Similarly, in Ireland, almost half (48.1%) of the
reduction in CHD mortality rates during 1985–2000 among those
aged 25–84 years has been attributed to favorable trends in
population risk factors. In both countries, the greatest benefits
appear to have come from reductions in mean cholesterol
concentrations, smoking prevalence and blood pressure levels.
Cardiovascular diseases:

Treatment
 Effective measures are available for people at high
risk. For example, combination drug therapy (such
as aspirin, beta blocker, diuretic and statin) can
lead to a 75% reduction in myocardial infarction
(heart attack) among those at high risk of having
one.
 B u t many such interventions are not being
implemented, and about half of coronary patients
in the world still require more intensive blood
pressure management.
Cancer

 Cancer is the uncontrolled growth and

spread of cells that arises from a change in
one single cell. The change may be started by
external agents and inherited genetic factors
and can affect almost any part of the body.
The transformation from a normal cell into a
tumour cell is a multistage process where
growths often invade surrounding tissue and
can metastasize to distant sites.
Cancer: I nteraction
between a
person’s genetic factors andany of
three
categories of external agents

 physical carcinogens, such as ultraviolet and ionizing

radiation or asbestos;
 chemical carcinogens, such as vinyl chloride, or
betnapthylamine (both rated by the International
Agency for Research into Cancer as carcinogenic),
components of tobacco smoke, aflatoxin (a food
contaminant) and arsenic (a drinking-water
contaminant); and
 biological carcinogens, such as infections from certain
viruses, bacteria or parasites.
Most chemicals to which people are exposed in everyday life have not been
tested for their long-term impact on human health.
 Cancer:
the majority of cancer
deaths

 Lung , breast, colorectal, stomach and liver cancers

 I n high-income countries, the leading causes of
cancer deaths are lung cancer among men and
breast cancer among women.
 I n low- and middle-income countries cancer levels
vary according to the prevailing underlying risks.
In sub-Saharan Africa, for example, cervical cancer
is the leading cause of cancer death among women.
 Cancer:

risk factors for cancer

 tobacco use
 unhealthy diet
 insufficient physical activity
 t h e harmful use ofalcohol
 Infections (hepatitis B, hepatitis C (liver cancer), human
papillomavirus (HPV; cervical cancer), Helicobacter pylori
(stomach cancer)
 Radiation
 variety of environmental and occupational exposures of
varying importance
Cancer:

policy

WHO’s approach to cancer has four pillars:

 prevention,
 early detection,
 screening,
 treatment
 palliative care.
 Cancer:
policy

 A t least one third of the 10 million new cases of cancer

each year are preventable through reducing tobacco
and alcohol use, moderating diet and immunizing
against viral hepatitis B.
 Early detection and prompt treatment where
resources allow can reduce incidence by a further one
third.
 Effective techniques are sufficiently well established to
permit comprehensive palliative care for the remaining
more advanced cases.
Cancer:
National cancer control programme
 W H O has consolidated tools for countries in a
framework known as the national cancer control
programme, which focuses government attention and
services on all facets of the fight.
 A national cancer control programme is a public health
programme designed to reduce cancer incidence and
mortality and improve cancer patients’ quality of life,
through the systematic and equitable implementation of
evidence-based strategies for prevention, early
detection, diagnosis, treatment and palliation, making
the best use of available resources.
 Chronic respiratory
diseases:

Quick facts and figures

 According to the WHO Global Status Report on NCDs
2010, smoking is estimated to cause about 71% of all lung
cancer deaths and 42% of chronic respiratory disease
worldwide. Of the six WHO regions, the highest overall
prevalence for smoking in 2008 was estimated to be the
in the European Region, at nearly 29%.
 Chronic
respiratory
diseases:
Quick facts and figures
 Sur vey data from 2002–2007 indicate that over half of all
children aged 13–15 years in many countries in the
European Region are exposed to second-hand tobacco
smoke at home. Second-hand smoke causes severe
respiratory health problems in children, such as asthma
and reduced lung function; and asthma is now the most
common chronic disease among children.

23
 Chronic
respiratory
diseases:
Quick facts and figures
 According to the latest available data for 1997–2006,
over 12% of infant deaths in the world are due to
respiratory diseases.
 Indoor air pollution from biological agents related to
damp and mould increases the risk of respiratory
disease in children and adults. Children are particularly
susceptible to the health effects of damp, which include
respiratory disorders such as irritation of the
respiratory tract, allergies and exacerbation of asthma.
Damp is often associated with poor housing and social
conditions, poor indoor air quality and inadequate
 Chronic
respiratory
diseases:
Quick facts and figures
 Increasing evidence suggests that allergic sensitization,
which is the most common precursor to the
development of asthma, can already occur antenatally.
Emphasis on the health, nutrition and environment of
the pregnant woman and the unborn child are therefore
essential.
 Ozon e pollution causes breathing difficulties, triggers
asthma symptoms, causes lung and heart diseases, and is
associated with about 21 000 premature deaths per year
in 25 countries in the WHO European Region.
 Chronic
respiratory
diseases:
Quick facts and figures
 M o s t countries in the world and the European Region
have introduced a wide range of comprehensive policies
to reduce and eliminate tobacco smoke. For example,
the advertising of cigarettes and the sale of tobacco
products to minors have been banned in more than 80%
of the countries in the Region. Smoking in restaurants
and bars continues to be regulated less strictly, however.
Ireland, Turkey and the United Kingdom are the first
countries to make public places 100% smoke free.
Diabetes

–  Diabetes is a chronic disease that occurs

when the pancreas does not produce
enough insulin (a hormone that regulates
blood sugar) or alternatively, when the
body cannot effectively use the insulin it
produces. The overall risk of dying among
people with diabetes is at least double the
risk of their peers without diabetes.
Diabetes: Quick facts
and figures

 Ab out 347 million

people worldwide
have diabetes.

 T h er e is an emerging
global epidemic of
diabetes that can be
traced back to rapid
increases in overweight,
obesity and physical
inactivity.
Diabetes: Quick facts and
figures
 Diabetes is predicted
to become the seventh
leading cause of death
in the world by the
year 2030.

 Total deaths from

diabetes are projected
to rise by more than 50%
in the next 10 years.
Diabetes: Quick facts
and figures

 8 0 % of diabetesdeaths
occur in low- and
middle-income
countries.
 I n developed countries
most people with
diabetes are above the
age of retirement,
whereas in developing
countries those most
frequently affected are
aged between 35 and 64.
Diabetes: Health implications

Elevated blood sugar is a common effect of uncontrolled

diabetes, and over time can damage the heart, blood
vessels, eyes, kidneys, and nerves.
Some health complications from diabetes include:
 Diabetic retinopathy
 Diabetic neuropathy
 Diabetes is among the leading causes of kidney failure;
10-20% of people with diabetes die of kidney failure.
 Diabetes increases the risk of heart disease and stroke;
50% of people with diabetes die of cardiovascular
disease (primarily heart disease and stroke).
 Diabetes: Prevention

Without urgent action, diabetes-related deaths will increase

by more than 50% in the next 10 years. To help prevent type 2
diabetes and its complications, people should:
 Achieve and maintain healthy body weight.
 B e physically active - at least 30 minutes of regular,
moderate-intensity activity on most days.
 Ear ly diagnosis can be accomplished through relatively
inexpensive blood testing.
 Treatment of diabetes involves lowering blood sugar and
the levels of other known risk factors that damage blood
vessels.
 Tobacco cessation is also important to avoid complications.
Diabetes: Control
–  People with type 1 diabetes require insulin; people with
– type 2 diabetes can be treated with oral medication, but may
also require insulin.
–  Bl ood pressure control
–  Fo o t care
– Other cost saving interventions include:
–  Screening and treatment for retinopathy (which
causes blindness);
–  Bl ood lipid control (to regulate cholesterollevels);
–  Screening for early signs of diabetes-related kidney
disease and treatment.
– These measures should be supported by a healthy diet, regular
physical activity, maintaining a normal body weight and avoiding
tobacco use.
Obesity
 Obesity is one of the greatest public health challenges of
the 21st century. Its prevalence has tripled in many
countries of the WHO European Region since the 1980s,
and the numbers of those affected continue to rise at an
alarming rate, particularly among children.
 I n addition to causing various physical disabilities and
psychological problems, excess weight drastically
increases a person’s risk of developing a number of
noncommunicable diseases (NCDs), including
cardiovascular disease, cancer and diabetes.
 T h e risk of developing more than one of thesediseases
(co-morbidity) also increases with increasing body
weight.
 Obesity

 Overweight and obesity are

defined as "abnormal or
excessive fat accumulation
that may impair health“

 Body mass index (BMI) – the

weight in kilograms divided by the
square of the height in meters
(kg/m2) – is a commonly used
index to classify overweight and
obesity in adults. WHO defines
overweight as a BMI equal to or
more than 25, and obesity as a BMI
equal to or more than 30.
Obesity: Quick facts
and figures

 More than 1.4 billion adults

were overweight in 2008, and
more than half a billion
obese

 In 2008, more than 1.4 billion

adults were overweight and
more than half a billion were
obese. At least 2.8 million
people each year die as a result
of being overweight or obese.
The prevalence of obesity has
nearly doubled between 1980
and 2008. Once associated with
high-income countries, obesity
is now also prevalent in low-
and middle-income countries.
Obesity: Quick facts
and figures

 Globally, over 40 million

preschool children were
overweight in 2008

 Childhood obesity is one of the most

serious public health challenges of
the 21st century. Overweight
children are likely to become obese
adults. They are more likely than
non- overweight children to develop
diabetes and cardiovascular diseases
at a younger age, which in turn are
associated with a higher chance of
premature death and disability.
Obesity: Quick facts and
figures

 Overweight and obesity are

linked to more deaths
worldwide than underweight

 65% of the world's population

live in a country where
overweight and obesity kills
more people than underweight.
This includes all high-income
and middle-income countries.
Globally, 44% of diabetes, 23%
of ischaemic heart disease and
7–41% of certain cancers are
attributable to overweight and
obesity.
 Obesity: Quick facts
and figures

 Supportive environments and

communities are fundamental
in shaping people’s choices and
preventing obesity

 Individual responsibility can

only have its full effect where
people have access to a healthy
lifestyle, and are supported to
make healthy choices.
 WHO mobilizes the range of
stakeholders who have vital
roles to play in shaping healthy
environments and making
healthier diet options
affordable and easily accessible.
 Obesity: Quick facts
and figures

 The global obesity epidemic

requires a population-based
multisectoral, multi-
disciplinary, and culturally
relevant approach

 WHO's Action Plan for the

Global Strategy for the
Prevention and Control of
Noncommunicable Diseases
provides a roadmap to establish
and strengthen initiatives for
the surveillance, prevention
and management of
noncommunicable diseases,
including obesity.
Noncommunicable diseases:

countr y income
 About 30% of people dying from NCDs in low- and
middle-income countries are aged under 60 years
and are in their most productive period of life.
 T h e prevalence of NCDs is rising rapidly and is
projected to cause almost three-quarters as many
deaths as communicable, maternal, perinatal, and
nutritional diseases by 2020, and to exceed them as
the most common causes of death by 2030.
 I n most middle- and high-income countries NCDs
were responsible for more deaths than all other
causes of death combined, with almost all high-
income countries reporting the proportion of
NCD deaths to total deaths to be more than 70%.
Noncommunicable diseases:
Current status and trends in risk
factors
 Common, preventable risk factors underlie most NCDs.
These risk factors are a leading cause of the death and
disability burden in nearly all countries, regardless of
economic development.
 T h e leading risk factor globally for mortalityis:
1. raised blood pressure (responsible for 13% of deaths
globally),
2. followed by tobacco use (9%),
3. raised blood glucose (6%),
4. physical inactivity (6%),
5. overweight and obesity (5%).
Noncommunicable diseases:
Current status and trends in risk
factors
 The prevalence of these risk factors varied between country
income groups, with the pattern of variation differing
between risk factors and with gender. High-, middle- and low-
income countries had differing risk profiles.
 Several risk factors have the highest prevalence in high-
income countries. These include:
1. physical inactivity among women,
2. total fat consumption,
3. raised total cholesterol.
 Some risk factors have become more common in middle-
income countries. These include:
1. tobacco use among men,
2. overweight and obesity.
 Noncommunicable diseases:

parameters for estimation of behavioural

and metabolic risk factors
 cur rent daily tobacco smoking: the percentage of the
population aged 15 or older who smoke tobacco on a daily
basis.
 physical inactivity: the percentage of the population aged
15 or older engaging in less than 30 minutes of moderate
activity per week or less than 20 minutes of vigorous
activity three times per week, or the equivalent.
 raised blood pressure: the percentage of the population
aged 25 or older having systolic blood pressure ≥ 140 mmHg
and/or diastolic blood pressure ≥90 mmHg or on
medication to lower blood pressure.
Noncommunicable diseases:
parameters for estimationof
behavioural and metabolic risk
factors
 raised blood glucose: the percentage of the population aged
25 or older having a fasting plasma glucose value ≥ 7.0
mmol/L (126 mg/dl) or on medication for raised blood
glucose.
 overweight: the percentage of the population aged 20 or
older having a body mass index (BMI) ≥ 25 kg/m2.
 obesity: the percentage of the population aged 20 or older
having a body mass index (BMI) ≥30 kg/m2.
 raised cholesterol: the percentage of the population aged 25
or older having a total cholesterol value ≥ 5.0 mmol/L (190
mg/dl).
Noncommunicable diseases:
Prevention and Control of NCDs
 Millions of deaths can be prevented by stronger
implementation of measures that exist today.
 T h es e include policies that promote government-wide
action against NCDs:
1. stronger anti-tobacco controls
2. promoting healthier diets,
3. physical activity,
4. reducing harmful use of alcohol;
5. along with improving people's access to essential health
care.
Noncommunicable diseases:
Prevention and Control of
Noncommunicable Diseases
 T h er e is the 2008-2013 Action Plan for the
implementation of the WHO Global Strategy on the
Prevention and Control of Noncommunicable Diseases.
This Action Plan was endorsed by the 2008 World Health
Assembly.
 I t provides countries a roadmap for taking action
against NCDs, including raising the priority of NCD
control, improving disease surveillance, enabling
governments to take comprehensive action against the
diseases, and protecting countries, particularly
developing, from the burden of the epidemic.
Noncommunicable diseases:
The six objectives of the 2008-2013 Action
Plan are:
 T o raise the priority accorded to noncommunicable
disease in development work at global and national
levels, and to integrate prevention and control of such
diseases into policies across all government departments
 T o establish and strengthen national policies and plans
for the revention and control of noncommunicable
diseases
 T o promote interventions to reduce the main shared
modifiable risk factors for noncommunicable diseases :
tobacco use, unhealthy diets, physical inactivity and
harmful use of alcohol
Noncommunicable diseases:

The six objectives of the 2008-2013 Action

Plan are:
 T o promote research for the prevention and control of
noncommunicable diseases
 T o promote partnerships for the prevention and control
of noncommunicable diseases
 T o monitor noncommunicable diseases and their
determinants
 Evaluate progress at the national, regional and global
levels
First global ministerial conference on healthy
lifestyles and noncommunicable disease control
28-29 April 2011, Moscow, the Russian Federation
The aim of the conference was to support Member States
develop and strengthen policies and programmes on healthy
lifestyles and NCD prevention.
The conference had three main goals:
 to highlight the magnitude and socio-economic impact of NCDs;
 to review international experience on NCD prevention and control;
 to provide evidence on the pressing need to strengthen global and
national initiatives to prevent NCDs as part of national health plans
and sustainable development frameworks
UNGeneralAssembly’s
commitment to fight
noncommunicable diseases

– UN General Assembly adopt of the political

declaration on the prevention and control of
noncommunicable diseases. For the first time,
global leaders have reached consensus in the
General Assembly on concrete actions to
tackle these diseases.
–  Governments agreed on the need for global
targets to monitor these diseases and their risk
factors like tobacco use, unhealthy diet,
physical inactivity and the harmful use of
alcohol.
 UNGeneralAssembly’s
commitment to fight
noncommunicable diseases
 Global leaders committed to greater efforts to prevent
and treat noncommunicable diseases and improve
health care including better access to vital medicines.
 Success will depend on the engagement of non-health
sectors such as finance, agriculture, transportation,
urban development, and trade.
 Governments will integrate policies to reduce
noncommunicable diseases into health planning
processes and national development agendas.
 T h e declaration is a clear signal that global leaders
acknowledge the devastating impact of
noncommunicable diseases worldwide and that they are
committed to reducing it. The next step is to act on
those commitments.
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about the updates on WHO or interventions on Non-
Communicable Diseases.