The World Health Organisation (WHO) has raised significant attention towards non-communicable diseases (NCDs). Recently, Africa adopted a new strategy known as PEN-PLUS to aid in the diagnosis, treatment, and care of severe NCDs. This move has sparked global interest, prompting a closer look at NCDs and their impact, particularly in countries like India.
The PEN-PLUS Strategy Explained
The PEN-PLUS Strategy is a regional approach aimed at addressing severe non-communicable diseases at first-level referral health facilities. The primary goal of this strategy is to bridge the gap in treatment and care for patients with chronic and severe NCDs. It urges countries to establish standardised programmes for tackling chronic and severe non-communicable diseases by ensuring the availability and accessibility of essential medicines, technologies, and diagnostics in district hospitals.
Understanding Non-Communicable Diseases
Non-communicable diseases (NCDs) are chronic medical conditions of long duration, typically progressing slowly. They result from a combination of genetic, physiological, environmental and behavioural factors. These diseases include heart diseases, cancers, diabetes, asthma, among others.
Globally, NCDs account for 71% of global mortality, according to WHO. In the African Region, the proportion of mortality due to NCDs ranges from 27-88%. These diseases lead to high rates of disability and death among children, adolescents, and young adults if left undiagnosed or untreated.
The Status of Non-Communicable Diseases in India
In India, the impact of NCDs is increasingly alarming. As per a 2015 WHO report, nearly 5.8 million people die annually from NCDs. This implies that 1 in 4 Indians risks dying from an NCD before reaching 70. There’s been an upward trend in the contribution of NCDs to the total disease burden, going from 30% in 1990 to 55% in 2016. The number of deaths due to NCDs also rose from 37% in 1990 to 61% in 2016.
Causes of Non-Communicable Diseases
The main behavioural risk factors for NCDs include physical inactivity, unhealthy diets, tobacco use, and harmful use of alcohol. These contribute to raised blood pressure (hypertension), raised blood sugar (diabetes), and raised and abnormal blood lipids (dyslipidaemia). Air pollution, both outdoor and household, resulting mainly from burning solid fuels, is another leading risk factor for NCDs.
Initiatives Against Non-Communicable Diseases
To combat NCDs, India launched the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular disease and Stroke (NPCDCS). Its objective is to raise awareness, establish infrastructure and carry out opportunistic screening at primary health care levels. India was the first country to adopt a National Action Plan with specific national targets, aiming to reduce global premature deaths from NCDs by 25% by 2025.
Integration of NPCDCS with the National Health Mission (NHM) led to improved infrastructure and human resources, particularly frontline workers like the ANM and the Accredited Social Health Activist (ASHA). Prevention and management of chronic obstructive pulmonary disease (COPD) and chronic Kidney disease (CKD) are also integrated into the programme. Other steps include the integration of Ayurveda, Yoga, Unani, Siddha and Homeopathy (AYUSH) with NPCDCS and promotion of healthy lifestyle changes using social media and mobile technology applications such as mDiabetes and mCessation.