KARACHI, Jan 6: Chronic non-communicable diseases (CNDs) are increasing to alarming proportions in the developing world, with a particular reference to Pakistan, that still have to struggle with the unfinished agenda of communicable diseases.

The CNDs— cardiovascular ailments, diabetes, obesity, cancers and respiratory disorders— now account for 59 per cent of the 56.5 million deaths that occur annually worldwide and are almost half (45.9pc) of the diseases which remain a burden on the globe.

The epidemiological transition in Pakistan is characterised by a double burden of diseases, where both communicable and non-communicable are prevalent.

Five of the top 10 selected global diseases burden risk factors, identified by the World Health Report 2002, included obesity, high blood pressure, high cholesterol, alcohol and tobacco independently and often in combination, are often the major causes of these diseases.

There is sufficient scientific evidence that a change in dietary habits, physical activity and tobacco control can produce rapid changes in population risk factors for the cited chronic diseases.

The NCDs are registered to frequently involve overlapping risk factors and chronic conditions. Recognising this, the WHO is adopting a broad ranging approach. It has begun to formulate a Global Strategy on Diet, Physical Activity and Health under a May 2002 mandate from the World Health Assembly.

The extensive, population-wide, prevention-based strategy will be developed over the next two years and presented to the assembly in 2004. The WHO will be consulting widely with all stakeholders during this process.

A globally recognised strategy for combating the NCDs is an tobacco-free initiative. The initiate is well advanced in facilitating development of the Framework Convention on Tobacco Control.

Another strategy focuses on the need for a daily moderate physical activity to maintain good health and reduce the risk of cardiovascular diseases. The latter is supported by this year’s World Health Day theme: “Move for Health”.

Intensity of the situation could be gauged from the fact that heart attacks and strokes kill about 12 million people every year (7.2 million due to ischaemic heart diseases and 5.6 million owing to cerebrovascular diseases). In addition, 3.9 million die annually from hypertension and other heart conditions.

About 75 per cent of the cerebrovascular diseases can be attributed to the risks of high cholesterol, high blood pressure, low fruit and vegetable intake, inactive life style and tobacco.

An estimated 177 million people are affected by diabetes, of which two-thirds live in the developing world. The situation needs to trigger an urgent action combining health promotion, disease prevention and control of the main NCDs and their determination through community-based interventions.—APP