There is an alarming increase in the incidence of non-communicable diseases in this country. A report appearing in this paper the other day noted that up until 1994, the prevalence of communicable and non-communicable diseases (NCDs) was almost equal at 38.4 percent and 37.7 percent. That has changed now to 59 percent for the latter group and 41% for the former. On the basis of these statistics the World Health Organization (WHO) reckons one-third of this country's population is suffering from NDCs - the cause of over 80 premature deaths in low and middle income countries. A joint research study carried out by the Aga Khan University and the Journal of Pakistan Medical Association shows an estimated 32 million people in the country suffer from a heart condition, 40 million from hypertension, 8 million from diabetes, 18 million from high cholesterol, and about 50 million from mental disorders, while 24 million are obese.
There are a number of factors contributing to a progressive rise in these diseases. The leading causes include uncontrolled air and water pollution, unhealthy diets, and the bane of urbanization: sedentary lifestyles. To make a bad situation worse health planners do not seem to believe that it is better to try and stop something dreadful from happening rather than to deal with it after it has happened. Obesity being one of the key contributors to NDCs, some European governments pay for overweight people to register in physical exercise programmes so they can lose weight, and consequently reduce the risk of developing chronic diseases. The money spent on a preventive measure saves a lot more in terms of hospital expenses. Unfortunately, however, here there is no attempt, even indication of interest, to make prevention and control an integral part of the national health policy. According to the WHO, the country has not devised any evidence-based national standards for the management of major NCDs through primary care approach. It has no population-based cancer registry maintained on a national basis, and no NDCs surveillance and monitoring system in place to enable reporting on the attainment of the global targets by 2025.
There is an urgent need for the policymakers to take a holistic view of the health sector and come up with an action plan to check the spread of chronic diseases. Some of the measures required are all too obvious. Governments both at the centre and in the provinces ought to ensure effective implementation of the cleaner environment laws, and the food quality control authorities must get their act together. Also, public awareness needs to be created about the dangers inherent in physical inactivity as well as unhealthy diets, especially overuse of saturated fats. It is about time a well thought-out operational policy is introduced to push back the prevalence of non-communicable diseases causing premature deaths.