Heart disease, stroke, diabetes, chronic lung disease, and cancer — these are all chronic diseases, also known as non-communicable diseases (NCDs) and have unhealthy lifestyle habits as their biggest contributing factor. The World Health Organisation reveals that these NCDs are collectively responsible for 70 percent of all deaths worldwide, especially in low- and middle-income countries.
Because NCDs are recognised as a major global healthcare challenge, world leaders, organisations under the United Nations and their partners signed up for the Sustainable Development Goal (SDG) 3.4 in 2015. The target was to achieve a one-third reduction in global deaths among those aged between 30 and 70 due to the four major NCDs: cancer, cardiovascular disease, chronic respiratory disease and diabetes. But, according to The Lancet’s NCD Countdown 2030 report , published on 3 September, many member countries are falling short of their goals, and the impact of the COVID-19 pandemic is likely to pose immense obstacles in achieving the set target.
The NCD Countdown 2030 report
Led by experts from the Imperial College London, WHO and the NCD Alliance, the report states that “although premature mortality from NCDs is declining in most countries, for most the pace of change is too slow to achieve SDG target 3.4".
The report says that it’s simply impossible for most countries to achieve the SDG target for 2030 by focusing on a single disease. Instead, there has to be a concerted effort to tackle all the major NCDs simultaneously.
The report states that among high-income countries, only Denmark, Luxembourg, New Zealand, Norway, Singapore and South Korea are on track to meet the 2030 target for both men and women if they maintain or surpass their 2010-2016 average rates of NCD decline.
This report also mentions that though NCDs get plenty of political attention globally, action against them has been clearly inadequate in most countries.
The report further explains that apart from focusing on tobacco and alcohol control, the following health-system interventions may help reduce NCD-related mortality:
- Hypertension and diabetes treatment
- Primary and secondary cardiovascular prevention in high-risk individuals
- Low-dose inhaled corticosteroids and bronchodilators for asthma and chronic obstructive pulmonary disease (COPD)
- Treatment of acute cardiovascular diseases, diabetes complications and exacerbations of asthma and COPD
- Effective cancer screening and treatment
NCDs and the impact of COVID-19
In an editorial published alongside the report, The Lancet explains that “COVID-19 and NCDs form a dangerous relationship, experienced as a syndemic that is exacerbating social and economic inequalities". It mentions a modelling study published in The Lancet Global Health in June 2020 which suggested that one in five people worldwide are at an increased risk of severe COVID-19 should they become infected, primarily due to underlying NCDs.
According to the WHO’s rapid assessment survey released in May 2020, 75 percent of its member countries reported interruptions to regular NCD services and care, public health campaigns and disease surveillance efforts. Data reportedly released by the Indian National Health Mission reveals that child immunisations, in particular, declined at alarming rates after the pandemic hit, especially affecting the administration of polio, meningitis and tuberculosis vaccines.
The editorial mentioned above states that COVID-19 could not only provide “new insights into interactions between immune systems and NCDs, and potentially change the way we understand and treat these diseases”, but also generate new long-term disabilities that can add to the global NCD burden.
Evidently, the impact of COVID-19 pandemic calls for more vigorous campaigns to reduce the high burden that NCDs place on global health systems, including the one in India.
Better disease surveillance, a strong public health system, clear communication with a robust civil society and improved access to resilient healthcare systems are the only ways to reduce the burden of NCDs in the aftermath of COVID-19.
For more information, read our article on COVID-19 prevention tips for older people with chronic diseases .
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